The perception that our public health system is free for all who need it at the point of delivery is increasingly becoming a delusion. Those who can afford private health insurance undoubtedly have a better chance of getting medical care as early as required.

The rest often have to wait a long time, sometimes even for urgent treatment or diagnosis of severe medical conditions.

In the last decade, the public health system has often been in the news for the wrong reasons.

Long waiting lists for medical appointments or surgery, prescribed medicine at times being out of stock and a botched privatisation of medical services due to corruption at the highest level of government are all symptoms of a public health system that has sadly become unfit for purpose.

Health Minister Jo Etienne Abela inherited a poisoned chalice. He cannot be blamed for the systemic failures in the public health system which have been building up for years, possibly decades. Still, he is now responsible for putting things right in the short to long term. This is a tall order, especially in the context of the collapse of public health policymakers’ credibility.

Abela was clinical in his diagnosis of why the country’s health service is struggling when he acknowledged that the general hospital continues to feel the strain of excessive demand and limited resources.

He recently listed several short-term measures that could ease some of the symptoms that affect health services.

Of course, all of these measures are welcome, even if it may be too early to judge whether they will be implemented successfully.

It is an open secret that certain well-paid public health sector workers are exploiting the system knowing there are few administrative controls. Others are simply overworked and underpaid

Devising measures to try to reduce the workload on the emergency department are of course a step in the right direction, but we have heard similar pledges in the past and the situation in that department remained critical.

The minister wants to increase Mater Dei Hospital’s bed space by 600 and increase the number of operating theatres. It is a positive pledge but increasing more beds without dealing with a chronic staff shortage is unlikely to solve anything.

No amount of short-term tactical measures will resolve the long-term challenges of our public health system, especially in the context of a lack of human resources coupled with population growth.

The government needs a total overhaul of the national healthcare  system and not a continuous patchwork approach. This needs good planning, strong leadership and proper execution against clear timeframes.

It is not sustainable for the government to commit to building more facilities and trying to offer everything and more knowing it does not have the necessary resources, competence, long term strategy or financial means.

In fact, the government avoids giving details on how it will strengthen medical services and how it will finance the investment. There are other chronic issues in the system. For example, it is an open secret that certain well-paid public health sector workers are exploiting the system knowing there are few administrative controls. Others are simply overworked and underpaid.

Prime Minister Robert Abela keeps repeating the mantra of lowering taxation in the next budget. How about offering serious subsidies to encourage people to take up private insurance or use private services and be able to claim this expense?

Free healthcare for all must no longer be just a sound bite that political leaders keep repeating. The reality that many people are experiencing is an unfair rationing of public health services. Fixing an outdated and broken system needs to become a priority.