Last week this paper organized one of its Business Breakfasts at the Hilton. The subject this time was health, specifically how can healthcare be rendered sustainable?

Minister Chris Fearne explained the government thinking on the matter. Condensed to the essentials, the future of healthcare in our country is based on the principle that healthcare must remain free for all Maltese citizens. On this there is agreement across the political spectrum.

Deriving from the over-arching principle, the present government has opened up to possible private sector participation with an eye to refurbishing the Gozo General Hospital, St Luke's Hospital and Karin Grech Hospital - all of which can surely do with capital investment and refurbishing.

There is controversy in the country regarding the company chosen to enter in this PPP, Vitals Global Healthcare, its structure and ultimate owner, as well as regards the mode of this PPP.

While pointing this out, and while the controversy still rages, also because entire pages of the contract have been blacked out, this paper wants to ask why exactly was this route chosen when it is open to so much dangerous pitfalls?

Under the preceding administration, the route that was chosen was to do the required upgrades through the public purse. This is how Mater Dei Hospital was built and beyond the inevitable controversies, it has proved to be a signal improvement in healthcare.

However, even so, the healthcare in Malta still requires further and further investment. When one considers, for instance, primary healthcare, the clinics and health centres around the island are starved of funds and resources.

At the same time, the previous administration itself was forced at one point to seek the PPP model and rope in the help of the private sector. But these were small fry compared to the whole scale PPP this government intends with VGH.

In the intention of the government, the investment that VGH will put in will be recouped by selling beds and care in Malta to private patients from abroad. Malta, and Gozo, can thus become centres of medical excellence. Considering the huge investment VGH will put in, all hopes that it can recoup costs require a large amount of patients.

The basic idea has been, even in the previous administration's time, that maybe people from the Gulf and North Africa will find it easier to come to recuperate in Malta rather than go for instance to London or to the US and face far steeper costs.

That may be true but it is in no way infallible. First of all the countries of the Gulf now have state-of-the-art hospitals staffed by some of the world's best doctors. Secondly, the quality of healthcare offered in Malta is of an excellent quality but still an unknown quantity until the VGH restructuring is complete and we see the final product.

And we have already seen how the granting of medical visas to unfortunate Libyan victims of the civil war ended up mired in allegations of corruption.

In other words, beyond all the controversies regarding VGH, the business model of this venture has not been spelled out in detail and is more a dream and a hope than a real prospect.

Having said that, this paper also believes that the top quality of Maltese surgeons, consultants and doctors as well as the top quality of healthcare in Malta can attract patients from abroad although perhaps not in the quantity envisaged by the government.