In 2024, Mater Dei Hospital (MDH) received 104,886 patient admissions, Parliament has been informed. This meant that for the first time, the total number of admissions into the national hospital surpassed 100,000 in a full calendar year.

This mark was almost reached in 2023, though around 5,000 fewer people were admitted to Mater Dei that year, with the total admissions reaching 99,697.

2022 had recorded 94,610 total admissions, meaning that this total has been increasing by 5,000 per year since the country emerged from the Covid-19 pandemic, equating to an uptick of 10,276 admissions in just two years.

2024 therefore recorded the most annual admissions since MDH was opened in June 2007. As the population of the Maltese Islands continues to grow due to the ongoing influx of foreign workers, annual admissions into Mater Dei Hospital are set to continue increasing over the coming years.

Earlier this March, National Statistics Office Malta (NSO Malta) said that Malta's effective population, including tourists, peaked at over 628,000 people in 2023. The lowest effective population for that year was 562,591 people during that December, when only 9,857 tourists were present.

With the national population on a continuous rise and hospital infrastructure already lagging behind, how concerned must we be about increasing hospital admissions? Can the present infrastructure cope with the ever-rising demand? How much longer must we wait until a serious plan is announced and undertaken to alleviate the country's reliance off Mater Dei Hospital's shoulders?

This newsroom has analysed the rate of admissions into MDH, with the information obtained from the Health Ministry, and compared these figures to yearly population numbers throughout. It is important to note that the data referenced throughout this article is related solely to admissions, which are distinct from figures relating to the MDH emergency department, where the number of people seen by doctors is much higher.

More admissions each passing year

Since 2008, with the exception of 2020 due to the emergence of Covid-19, MDH's annual admissions have continued to climb to new levels with each passing year.

During Mater Dei's first full operational year in 2008, the national hospital recorded a total of 66,742 admissions. This means that in less than 20 years of operation, the annual number of admissions has risen by some 57%. The number of admissions has nearly doubled in the past 20 years; in 2005, when St Luke's Hospital was still in operation, 58,290 admissions were recorded.

According to NSO's Malta population tracking, the Maltese population in 2005 was recorded to be 404,962 people. By 2011, this grew to 417,432 and has since spiked. By 2021, the Maltese population was registered at 519,562 people.

By 2012 - the last year of the Nationalist Party in government - the population of Malta stood at 421,464 and 77,983 admissions into the national hospital were recorded, according to a 2015 Hospital Activity Report that excluded admissions into MDH's renal unit and newborns.

In Mater Dei's first five full years of operations (2008-2012), admissions went up from 66,742 to 77,983 as the population also increased by approximately 11,000 people.

In 2013, the Labour Party won the election and, since then, there has been a steady increase in population as the Labour government preferred an economy which was largely based on the importation of foreign workers.

The first three years of Muscat's PL administration (2013-2015) saw the population of the Maltese islands increase by 21,479 people, to just under 450,000, while MDH admissions exceeded the 90,000-mark for the first time. By this point, MDH admissions had already increased by a third since the hospital's inauguration less than a decade prior.

By the end of the 2010s, population numbers exceeded half a million for the first time in the country's history and MDH admissions had steadily climbed to 97,307 in 2019.

Judging by the way the data was trending, the 100,000-mark was set to be first exceeded in around 2020, though the arrival of the Covid-19 pandemic changed the situation. This new secluded lifestyle, coupled with strict hospital restraints put in place at the time, caused MDH admissions to decrease by approximately 25,000 in 2020 - down to 72,581 admissions that year.

In 2021, with the pandemic still in full swing but with a vaccination campaign combating the spread of the virus, admissions that year rose to 84,476. It continued to rise steadily in subsequent years until it breached the 100,000 mark last year.

Fortunately, as the Maltese islands grew more populous in the 2020s, the ratio between MDH admissions to the population marginally decreased; it has gone down from 19-20% pre-pandemic to under 18%. This is significant since presently, a difference in 1% accounts for some 5,600 admissions, 2% equates to 11,200 admissions, and so on.

Looking towards the future

The rate of admissions has remained pretty stable over the years, mostly hovering between 17-20% over the past decade, With the exception of 2020, when the country nearly went into full lockdown and access to Mater Dei Hospital became more restricted, the admission rate dropped to 14.06% that year.

Since MDH opened until 2023, excluding the two years mostly affected by the Covid-19 pandemic - 2020 and 2021, the average ratio between annual admissions into the hospital and the country's population was 18.5%. If one had to recalculate this ratio to include only the years during which Malta has been under Labour governance - when the population began to rise significantly - it would increase to 19.1%. The difference between these two periods is that between 2008-2012, the Maltese population increased at around half the rate of the years to follow.

Finance Minister Clyde Caruana has stated to the Maltese public that the Maltese population is set to rise to 600,000 before 2030, and to a staggering 800,000 by 2040; the latter would mean a population increase of around a quarter of a million people in 15 years.

Through these very simplistic calculations that do not factor any social circumstances or any potential changes in hospital management or the general health sector, one can forecast the annual admissions for Mater Dei Hospital to reach 152,800 by 2040. Is Mater Dei Hospital equipped to cope with the growing pressure?

While this is far from scientific, these rapidly increasing figures loom severe concerns over the country's struggling hospital infrastructure.

Since MDH's inauguration in 2007, the original facilities have barely been expanded upon for the aim of increasing the national hospital's general capacity.

Aside from the inauguration of the Sir Anthony Mamo Oncology Centre (SAMOC) in December 2014 for oncology-related services, work was done in 2015/16 to add two new wards to join with the Emergency Department and accommodate 68 additional beds. A new 40-patient ward, M10, was also inaugurated in July last year.

Looking into the future, the government's long-term strategy, Vision 2050, does not divulge into much detail on these needed prospects.

The mission to "improve current health infrastructures to enhance services, capacity and quality" is mentioned in the government's long-term strategy, Vision 2050, however, this only presents itself as a one-liner within the entire strategy.

Regarding healthcare, Vision 2050 discusses having a "lifelong and high-quality health system which ensures timely access to advanced medical technologies", enhancing preventative care through smart technologies and AI and "strategic financial empowerment by the private sector to expand service accessibility for all", among other things.

The last thing this country needs is for the capacity of its health infrastructure to lag behind its rapid population growth, especially for the sake of the healthcare workers who were rightly praised and thanked for their contributions during the pandemic just a few years ago.

Again, will Mater Dei Hospital cope?