Shadow Health Minister Stephen Spiteri said Malta's healthcare system must be planned to prioritise the needs of Maltese and Gozitan patients amid rapid population growth. He argued that the country needs to better manage the impact of foreign residents on the national health service, while continuing to uphold their right to access healthcare.
Speaking to The Malta Independent on Sunday, Spiteri said that the PN would prioritise reducing pressure on Mater Dei rather than relying solely on expansion, arguing that immediate operational changes are needed alongside long-term infrastructure investment. Spiteri blamed the Labour government for failing to expand health infrastructure over the past 13 years, saying the Vitals and Steward hospitals' deal resulted in both "lost money" and "lost time".
Spiteri proposed a reform of Mater Dei's emergency department, including replacing the nurse-led triage with a junior doctor-led triage, and establishing an Immediate Care Unit staffed by experienced primary care doctors to treat non-urgent patients without admitting them into the emergency department.
Spiteri claimed that more than 60% of people attending the emergency department do not have genuine emergencies and could instead be treated through primary care. He thus called for stronger public education campaigns encouraging people with non-emergency conditions to seek treatment at health centres or family doctors instead of Mater Dei.
Spiteri also suggested shifting outpatient follow-up appointments, particularly the communication of test results, from Mater Dei to health centres or GPs to reduce congestion. Moreover, he called for Mater Dei to become a dedicated acute hospital, with other services gradually relocated to refurbished St Luke's and Karin Grech hospitals once works are completed.
The Shadow Minister also advocated expanding public-private partnerships (PPPs) to tackle long waiting lists for elective and minor surgery, arguing these should be long-term, planned agreements rather than emergency outsourcing. He said the private healthcare sector is willing to invest if the government offers reliable, long-term partnerships.
Spiteri said new healthcare infrastructure must be matched by long-term workforce planning, arguing that new hospitals alone will not solve the healthcare crisis. He reiterated the PN's proposal for a new healthcare hub in northern Malta, complementing Mater Dei, and an expanded southern hub at the Ċensu Moran centre.
According to Spiteri, the government failed to plan for healthcare staffing needs despite Malta's population growth, leading to shortages of nurses, doctors, specialists and paramedics. He thus called for stronger incentives to encourage students into healthcare professions.
Spiteri linked healthcare pressures to population growth, saying the government had not adequately planned services for the increased demand. He said the use of public healthcare by foreigners requires better planning, while stressing he is not suggesting they should be denied access to the national health service. He argued that the goal should be to maintain service quality for Maltese and Gozitan patients, warning against a situation where locals increasingly turn to private healthcare because of long waits.
Spiteri wants healthcare staff retention measures to go beyond pay, with a greater focus on working conditions, quality of life and work-life balance. He called for reduced workloads and more rest periods, saying healthcare professionals are working 10-12 hour breathless shifts and struggling with back-to-back work. He identified burnout as a major threat to the healthcare workforce, saying professionals have told him they are exhausted and "cannot keep up".
Staff wellbeing directly affects patient care, Spiteri said. Happier and less exhausted workers will provide better services to patients. He also said healthcare workers deserve greater dignity in their work, including adequate time for themselves and their families. Spiteri drew on his own experience as a healthcare professional, noting he has worked through weekends and public holidays and continues to do so.
"When you have workers who are happy with their work, they will give a better service," Spiteri said.
Spiteri acknowledged Malta cannot currently function without foreign healthcare workers, saying there is no immediate way to replace them given the existing demand across the health system. He said the long-term goal should be stronger local healthcare workforce, achieved by encouraging more Maltese students to enter healthcare training and professions. Foreign workers would remain part of the system, but Spiteri said recruitment should be more targeted toward qualified workers who add value to the health service. He called for greater "quality assurance" in the recruitment of foreign healthcare workers.
The Shadow Minister proposed attracting Maltese healthcare professionals working abroad back to Malta, particularly experienced surgeons and specialists. He said returning Maltese professionals could strengthen the system at senior levels, bringing experience gained from working overseas. More broadly, he framed healthcare recruitment as a "return on investment", arguing that government investment in workers should translate into benefits for the health system.
Spiteri supports giving community pharmacists a greater role in healthcare, saying this is "the way forward". He called for closer coordination between doctors, consultants and community pharmacists to reduce pressure on the medical profession. He suggested pharmacists could play a larger role in repeat prescriptions, potentially reducing unnecessary GP visits for patients who simply need medication renewed. He also proposed expanding the role of community pharmacies to vaccinations, saying this could further reduce pressure on doctors and other medical professionals. He framed the proposal as part of a broader effort to address healthcare workload, saying the medical profession is struggling to keep up with current demand.
Criticising the government's approach to obesity prevention, Spiteri said he has "doubts" about whether enough is being done. He highlighted Malta's very high childhood obesity rate, with Malta ranking first among European countries for childhood obesity. He called obesity a national health priority, linking it to hypertension, cardiovascular disease, stroke and diabetes.
Spiteri said more investment is needed in both public-health education and medical treatment, particularly among children and young people. He questioned whether schools are receiving enough public-health education and support to prevent obesity, asking whether sufficient investment is being made to change behaviour early. Spiteri argued that obesity should be formally treated as a medical condition, rather than addressed primarily through lifestyle messaging. He described obesity as an "epidemic" and compared it to the growing burden of diabetes in Malta.
Turning to the topic of sexual health, Spiteri also described sexually transmitted infections (STIs) as a "silent epidemic" in Malta, saying cases are on the rise and arguing that sexual health is not receiving sufficient investment. He criticised the state of the GU clinic, saying it is "drowning" and lacks sufficient human resources. He called for faster access to diagnosis and treatment for STIs, warning that delays can leave patients sick for longer and increase anxiety.
"A pillar which is most important in sexual health is prevention," said Spiteri.
Spiteri said sexual health education should begin in schools at an age-appropriate level, including education for children as young as 10-12, followed by more targeted information for adolescents. He proposed tailored sexual-health education for different age groups and settings, including secondary schools, higher secondary institutions, MCAST, university and workplaces. He rejected relying primarily on TV and radio advertising for sexual health education, arguing that public health officials need to engage directly with communities "on the ground". He also said public health campaigns should provide practical information on prevention, testing, and what people should do if they test positive for an STD.
On the topic of mental health, Spiteri called for the gradual phasing out of Mount Carmel Hospital, arguing it is no longer fit for modern mental healthcare because of its ageing infrastructure and environment. He said mental health must be given the same importance as physical health, urging increased investment in infrastructure, staffing and healthcare services. Mater Dei has lacked a dedicated acute psychiatric ward since the Covid-19 pandemic, Spiteri said, resulting in psychiatric patients being treated in general medical wards. Spiteri argued that treating acute psychiatric patients alongside general medical patients is inappropriate, saying it is detrimental to patients, staff and the wider hospital environment. He thus backed plans for a new acute psychiatric unit at Mater Dei.
Moreover, Spiteri supported the creation of a separate mental health centre near Mater Dei for patients requiting longer-term inpatient care after acute treatment. He said that community-based mental healthcare should remain the goal, but acknowledged some patients will continue to require long-term residential treatment. He said that former health minister Chris Fearne had identified a site near Mater Dei for a new mental health hospital, but his successor Jo Etienne Abela later abandoned those plans. Spiteri warned that demand for mental health services is rising both in Malta and internationally, highlighting the need for increased investment in infrastructure, human resources and service capacity.