These reforms have, until now, only been discussed within the Malta Council for Economic and Social Development, where MAM is not directly represented. It is indeed strange that the government has chosen to exclude from discussions those who hold most expertise on the matter and have a direct interest, MAM said.

The health system is doing very well and surveys have consistently shown high public

satisfaction, MAM said. Any radical changes that are contemplated must therefore be well thought out and discussed extensively with experts as well as the stakeholders.

In the words of Dr Appleyard, president of the World Medical Association, “experience has shown that a radical change to a health care system that is already performing well has an 80 per cent chance of resulting in deterioration of service”.