What is being done in diverse areas of the national healthcare is very strange. Strange and mysterious.

As in specific areas of the national governance, we seem to have learned first of the solution without getting to know what the question was. That is the first thing that hits the eye. In normal countries the government would first enunciate the principles, then carry out a wide consultation, then ask for expression of interest and finally choose that entity with whom the project will be carried out.

But in Malta we first get to know who the preferred partner is, and then work backwards to uncover the whole reasoning behind the project.

But this is so tortuous and piloted, directed at the answer that it brings to mind the escapade at school when we would work backwards from the answer to fill out the workings of the sum, hoping the examiner would not mind.

Time and again these past four years we have asked ourselves if there was not any other more transparent way. Suspicions have become rife, as they inevitably would, that behind this tortuous way there was corruption.

It is as if the authorities worked backwards beginning with the name of the preferred bidder arriving at the general principles only at the end of the exercise.

There has been a huge sandstorm over this exercise but we must simplify the issue and get down to the basic facts.

According to an 11 November press release, “Partners HealthCare International® (PHI) and Vitals Global Healthcare Limited (VGH) of Malta today announced the signing of an agreement aimed at enhancing health care services and clinical education in Malta. This announcement comes following the award of a service concession from the Government of Malta (GoM) to VGH for the management and operation of Karin Grech Rehabilitation Hospital, Gozo General Hospital and St. Luke's Hospital. In collaboration with VGH, PHI will focus on the development of clinical quality and patient safety standards, benchmarks and systems, and the development of structures and systems for post graduate medical education.”

This should have had the whole country up in arms, coming as it did on an unsuspecting public. Assuming that the Gozo Hospital and St Luke’s Hospital needed an upgrade, who is to say this could only be carried out by a foreign company?

When the PN government was about to build Mater Dei Hospital, it went through a long series of consultations and calls for expressions of interest before Skanska was chosen.

And when the Milan San Raffaele Hospital was chosen to serve as a model for Malta’s second hospital, that was done in public without this cloak and dagger approach we have now as regards Partners, Vitals et al.

And when we speak about San Raffaele, we know what we are talking about. That was not a set of Chinese boxes of companies within companies so that the ultimate owner is shrouded in mist.

In this regard Malta has allowed itself to put the future of healthcare in Gozo and at St Luke’s in the hands of a mysterious, shady, company within a company and ad infinitum. Now this can be cutting-edge in financial sectors but rather rare in the medical field and surely a first for Malta.

Having been used all our lives to health being stably in government hands, we have been thrown head-first in this maelstrom by the government without a By your leave.

Basically, the question at the end is: how did we get here? How did we get from the drowsy Gozo Hospital to Vitals? There must have been someone driving this process and what’s in it for him?

To be in government is precisely to avoid falling into this trap: to lead the country towards a common decision rather than impose your solution on the nation as a whole (and to commit it for many many years) and have everyone speculate you must have had some incentive to push things this way rather than that.