Over a decade after disgraced former prime minister Joseph Muscat first alluded to a €200 million private investment in three public hospitals, his successor, Robert Abela, has gone full circle, promising to revamp the same three hospitals, which, by now, should form a central part of Malta’s overburdened healthcare system.

During a press conference on Monday, Health Minister Jo Etienne Abela announced that the government intended to embark on a 15-year plan to overhaul St Luke’s Hospital, Karin Grech Rehabilitation Hospital, and Gozo General Hospital, set to cost €1.5 billion. The price tag also covers the refurbishment of Sir Paul Boffa Hospital in Floriana.

Of those €1.5 billion, the government will disburse €300 million over the course of the next legislature to cover the first phase of the new masterplan, which The Shift reported in November 2025.

After the hospitals concession awarded to Vitals Global Healthcare (VGH) and later, Steward Healthcare, was declared fraudulent by the courts in February 2023, the International Chamber of Commerce concluded that the government paid out a whopping €885 million to Steward while inexplicably failing to terminate a concession that the government itself argued was being breached by Steward.

After €885 million was paid out over the course of the concession, the three public hospitals in question remain in poor shape, with the government scrambling to make up for lost time and fill the massive gaps in the country’s healthcare system.

Besides exposing this gap, the government’s new masterplan, billed as “realistic and costed” and certified by specialist firm Italconsulta S.P.A., is a tacit confirmation that the plans originally presented by Vitals Global Healthcare and passed on to Steward Healthcare were not.

In fact, a comparison of the promised investment and timelines presented in the original private concession plans with those in the masterplan presented this week indicates the government is now at pains to overcome its lack of credibility on public health by downplaying expectations around project delivery.

This is perhaps most visible around the plans originally announced for Gozo General Hospital (GGH).

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Had the private concession actually delivered what was promised, GGH would now have “a new state-of-the-art hospital with 200 – 250 acute care beds” connected with the current building, including several clinical support rooms and the latest imaging equipment for patient investigations.

The existing building was also to be redesigned and remodelled to host a combination of a long-term geriatric care and rehabilitation facility, equipped with an additional 150 and 50 beds, respectively.

Now, the government is promising to build a 331-bed hospital in GGH by 2040, with a further promised expansion to 400 beds by 2060.

In the run-up to this week’s master plan announcement, Health Minister Jo Etienne Abela had previously announced an ongoing expansion of services, including the procurement of an MRI scanner, a CT scanner, ultrasound machines, bone densitometry machines, a new cardiorespiratory unit, and an early pregnancy unit.

In simpler terms, the government spent the past two years working on a new masterplan that did not acknowledge Steward’s original plans directly while making incremental announcements that slowly made up for the gaps left by Steward’s failure to deliver.

As far as Gozo is concerned, the only promise that was actually delivered by the concession was the creation of Barts Medical School, a university that is part of Queen Mary University of London.

All other promised investments outlined in the data table above – new operating theatres, lab facilities, day care and outpatient facilities, new consultation and examination rooms, and so on – were not delivered by the concessionaires.

Even basic infrastructure upgrades, such as a new helipad, a larger pharmacy unit, or a new anatomy centre within the existing building, were not delivered. A promised expansion of the hospital’s mortuary did not happen.

Tellingly, the government is now saying it will build a new helipad and modernise the pharmacy unit, alongside more out-of-the-box announcements, such as issuing a tender for the delivery of immunotherapy and chemotherapy via aerial drones.

The promised delivery of a new regional primary care hub, a new regional health information and audit centre, a new health and NGO resources and coordination centre, and a swath of other amenities were nowhere to be seen.

A similarly large gap between what was promised and what was delivered exists when examining the original plans for the supposed revamp of St Luke’s Hospital (SLH) and Karin Grech Rehabilitation Hospital (KGRH).

Click here for a larger version of this chart

Click here for a larger version of this chart

If the hospitals concession actually was “a real deal” and not the biggest case of institutional fraud in Malta’s history, KGRH would now be a redeveloped 300-bed long-term geriatric care facility, with interior renovations targeting common areas, modern food production facilities, an integrated information system, and a leading team of professionals focused on both carrying out research and implementing the latest know-how into their services.

As for SLH, inpatients were supposed to be treated in a new 80-bed rehab centre, complemented by a separate outpatients’ rehab centre offering the latest in physiotherapy, aquatherapy, and prosthetic care.

The SLH site was also supposed to include a dermatology centre, a holistic healthcare centre incorporating oriental medicine, and even a new “nursing university-level institution designed to accommodate a minimum of 100 students”.

Now, the government is promising to develop SLH into a 503-bed facility by 2040, expanding capacity by an additional 90 beds by 2060, while KGRH will be converted into an ambulatory hospital for day surgeries and temporary hospitalisations of up to 72 hours.

While the current outpatients’ block will be turned into a 120-bed unit for physiotherapy and occupational therapy, the building currently known as H-block will become a new outpatients’ hospital with 200 rooms for specialist clinics.

Meanwhile, the government has issued an unprecedented €120 million direct order to a company led by his former business partner, Gilbert Bonnici of Bonnici Brothers, after an award notice for the controversial Mater Dei Hospital extension project was quietly issued last week.