For any government, investing in healthcare infrastructure is a necessity, not a luxury. Hospitals age, populations grow, and medical demands evolve. So, on the face of it, the Labour government's announcement of a master plan which includes the upgrading of Mater Dei Hospital, Gozo General Hospital, St Luke's Hospital, Karin Grech Hospital and Boffa Hospital should be welcomed. Malta and Gozo need better healthcare facilities, modernised services and long-term planning. Nobody can seriously argue against that.

But the problem with Labour's latest health-sector pitch is not the projects themselves. It is the political context in which they are being presented.

The government is speaking as though it has just arrived in office after years in opposition, having discovered the shortcomings of the health sector for the very first time. It is speaking of "future needs", "new visions" and "transformation" as though the state of these hospitals is the responsibility of someone else. Yet Labour has been in government for 13 years and counting. If these hospitals need such extensive intervention today, then the obvious question is: what exactly was happening during all this time?

The uncomfortable truth for Labour is that three of the hospitals now being promoted as part of a grand national healthcare vision - Gozo General Hospital, St Luke's Hospital and Karin Grech - were at the centre of one of the biggest political scandals in Malta's recent history. It has also been known long enough that Mater Dei Hospital has grown too small for a population that has increased by 150,000 people in 13 years. As for Boffa Hospital, the situation there has been deteriorating for years.

The three hospitals concession was not a minor policy error. It was a national disgrace. Public hospitals were handed over to the private sector through a deal that the courts later described in devastating terms before rescinding it entirely, a judgment confirmed on appeal. Hundreds of millions of euro were poured into the concession over seven years while very little materialised on the ground. Taxpayers paid the price, while promised investments failed to happen.

The same Labour government that is today promising regeneration and expansion voted for the budgets that financed that disastrous agreement year after year. The same administration defended the concession politically for years before eventually being forced to retreat under the weight of public scrutiny and court rulings.

Let us also remember that a former Prime Minister, Joseph Muscat, together with former Labour ministers and others are facing court proceedings related to the deal.

And beyond the financial waste and political liability lies something even more serious: lost time.

Healthcare projects are not built overnight. All five hospitals Labour is now promising to modernise could have been undergoing transformation years ago. Instead, Malta lost more than a decade trapped in a failed experiment that delayed investment, created uncertainty and left infrastructure stagnating.

Thirteen years is a long time in politics. In healthcare planning, it is an eternity. So much could have been done with these hospitals since 2013, and yet the Labour government chose to enter into a commitment which came undone - and which it had wholeheartedly defended until it was forced to accept by courts of law that all had gone wrong.

That is why the government's sudden urgency raises legitimate questions. Why now? Why did it take an election campaign for Labour to rediscover the need to upgrade hospitals? Why were these ambitious visions absent for so many years while the country was repeatedly told that the concession agreement would deliver state-of-the-art healthcare?

The timing inevitably invites comparison with the Opposition's proposals on health. The Nationalist Party has placed healthcare among the centrepieces of its electoral platform, presenting detailed proposals and repeatedly attacking Labour's record on the subject. It is planning to build hospitals and expand others which, while keeping Mater Dei as a centre point, will aim to relieve pressure and offer a better service.

Labour now appears eager to reclaim the initiative in a sector where its credibility has been badly damaged.

This does not mean the government's proposals should be dismissed outright. Malta still needs investment in healthcare infrastructure irrespective of who is in office. Gozo deserves a modern hospital capable of serving the island's realities. St Luke's has long cried out for a serious vision after years of abandonment, while the nearby Karin Grech hospital has not been given the attention it requires. Boffa Hospital also needs to be modernised to meet with today's needs and demands. Malta's main hospital, Mater Dei, itself needs to be expanded and upgraded.

Patients and healthcare workers deserve better conditions and services. But governments cannot expect applause without accountability.

Many people will remember that this same government spent years defending a concession that delivered little except controversy, court defeats and enormous public expense. Before speaking about "future readiness", Labour must first answer for the opportunities it squandered in the past and how it mocked all those who tried to open its eyes, from the very start, to the fact that the deal would not work.

Healthcare policy requires continuity, competence and trust. Trust, however, is difficult to rebuild once it has been eroded.

That is Labour's real challenge in this election debate. It is not whether the projects sound ambitious. It is whether the public still believes the government when it speaks about healthcare reform after 13 years that produced so little for the very hospitals it is now promising to save.