There was a time when pressure on Malta's hospitals was largely associated with January and February, when the annual influenza season placed an additional burden on an already busy health service. Hospital corridors would become more crowded, wards would come under pressure and healthcare workers would have to cope with a temporary surge in demand.
Today, however, the crisis is no longer seasonal. It is becoming a feature of the health service throughout much of the year.
That should concern everyone.
The latest reports of shortages of space at Mater Dei Hospital, including in infectious diseases and mental health wards, are particularly worrying. Patients who require isolation should not be placed alongside others because there is nowhere else to put them. Likewise, patients requiring acute mental health care should not have to share facilities with patients whose needs are less intensive simply because the hospital does not have sufficient space.
These are not problems that healthcare workers can be expected to solve indefinitely.
The workers at Mater Dei and throughout Malta's health service have repeatedly demonstrated their commitment to their patients. They continue to work under considerable pressure and frequently compensate for shortcomings in the system through their professionalism, dedication and personal sacrifice.
They should not, however, be required to compensate for years of inadequate planning.
Malta's population has increased rapidly over the past 13 years. The number of people requiring healthcare has consequently increased, while the country's principal general hospital has not expanded at anything approaching the same pace. It was entirely foreseeable that existing infrastructure would eventually struggle to cope.
The present situation is therefore not simply an unfortunate consequence of an unusually busy period. It points to a failure to plan for the needs of a changing country.
The Government has also had opportunities to increase capacity. The promises made years ago concerning the redevelopment of St Luke's Hospital, Karin Grech Hospital and Gozo General Hospital have not produced the additional capacity that the country needs. At the same time, enormous sums of public money were committed to the controversial three-hospitals deal, money which could have been directed towards strengthening and expanding the public health service.
The issue is not merely one of buildings and beds. Space is important, but so are the people needed to provide the service. Expanding facilities without ensuring that there are enough doctors, nurses, allied health professionals and other workers to operate them would solve only part of the problem.
The government must therefore act quickly on both fronts.
Malta has long taken pride in the quality and accessibility of its healthcare system. That reputation was built over decades and is largely the result of the dedication of the people working within it. It should not be allowed to deteriorate because the government failed to anticipate the consequences of population growth and changing healthcare needs.
A health service cannot be managed by reacting to crises as they emerge. Nor can hospital staff be expected to improvise their way out of structural problems every time capacity is exhausted.
The government must provide a credible plan for increasing hospital capacity, improving facilities and ensuring that there are sufficient healthcare professionals to meet demand. It must also explain why problems that have been evident for years have not been addressed before reaching this point.
The crisis at Mater Dei should not be dismissed as a summer anomaly, just as previous winter pressures could no longer be treated as isolated events. If the health service is under severe pressure throughout the year, the problem is structural.
And structural problems require structural solutions.
Malta's healthcare workers deserve better. Most importantly, patients deserve better. The government has a responsibility to ensure that the health service is equipped not for the Malta of yesterday, but for the Malta that exists today and will exist tomorrow.