A shade over two years ago I was entrusted with improving our already robust healthcare systems. My training as a hospitalist could have hardly prepared for me for such a task, and even my brief stint as Minister for Active Ageing represented but a fraction of the broad spectrum. But I thought that it made sense stands to get things right at the start. If we support people early, we spare them, and the system, far greater difficulties later on in life.

Child, Adolescent and Youth Services, or CAYS, grew out of that understanding. The idea developed rapidly through sustained work across services. Pending an ear to the professionals and the parents and families involved formed a vivid picture of the realities that young people face when dealing with fragmented delivery from dated sites that are no longer fit for purpose. It is for this very reason that during my very first detailed discussion with Prime Minister Robert Abela, I determinedly laid down plans for a holistic multidisciplinary approach delivered from modern premises and under one roof. He agreed instantly.

Malta and Gozo are endowed with dedicated clinicians, therapists and support staff working with children and young people. The problem was never a lack of commitment. What was missing was coherence. Services evolved separately, often in response to immediate pressures. Families found themselves moving between appointments, locations and assessments at times when they were already anxious and looking for reassurance. "The need for a move outside the adult psychiatric area of the Gozo General Hospital and the CDAU and CYPS units at St Luke's campus had become a dire necessity".

The CAYS concept set out to change all of that. Not by replacing what already worked, but by bringing it together in a modern and friendly ambience. Children do not experience their challenges in neat categories, and neither should our services. Developmental, emotional, educational and social issues are deeply inter-connected. Care needs to reflect real life, not administrative boundaries.

As a surgeon, I can assure you that nothing works better than having good colleagues. Over the past years our country has worked hard to achieve better outcomes through discussion  and by strengthen the multi-disciplinary approach. Teams are collaborating more closely, pathways are clearer, and care is becoming more continuous rather than episodic. There is a stronger focus on early identification and on ensuring that assessment leads smoothly into support, rather than families feeling left in limbo.

We set out on the pilot-project in Gozo. CAYS is housed in an airy and welcoming building in the heart of Victoria and is close to turning two years of age. It is a pilot-project no more because it proved so successful that it keeps spawning new services. Ensuring that children and families in Gozo have equitable access to services has also been an important part of this work, correcting long-standing disparities in availability. Support should be close to where people live, not something that requires added stress and travel at already difficult moments. Logistics in Malta are rather more complicated but the Ministry proudly opened the new premises in Birkirkara just a few weeks ago.

Why does all this matter? Because early support makes a real difference. When difficulties are recognised and addressed in time, children are more likely to stay engaged in school, families feel less overwhelmed, and long-term outcomes improve. "From a clinician's point of view, prevention and early intervention may not be necessarily gentler but they are kinder, they are the better form of medicine".

There is also a wider message here. When services are accessible, welcoming and part of the community, seeking help becomes normal. It stops being something to hide or delay. That is especially important when it comes to mental health and developmental support.

In Government, we believe strongly in universal public healthcare. Every child and young person deserves access to quality care, regardless of background or circumstance. Strengthening CAYS forms part of a broader commitment to equity, prevention and a health system that supports people when they need it most.

There is still work to do. Demand continues to grow, and the needs of young people are becoming more complex. One of our key challenges now is ensuring continuity, particularly during adolescence and the transition to adulthood. Care should not fall away because of an arbitrary age cut-off.

CAYS is not yet a finished product. It is a determined commitment to change for the better. It is not a destination but a direction of travel. It shows what can be achieved when policy is informed by clinical experience, evidence and a genuine concern for people.

As Minister, and as a doctor who has spent years listening to patients and their families, "I remain committed to improve our health systems. A commitment that supports people at every stage of their life, from the very beginning".

By Jo Etienne Abela, Minister for Health and Active Ageing