Health Minister Jo Etienne Abela said that Cabinet has approved a new framework for organ transplants, with a public consultation to be launched before Christmas.

Abela was speaking in Parliament on Monday during the Budget Estimates debate for the Ministry for Health and Active Ageing, where he said that a new organ donation model, known as the Donation after Circulatory Death (DCD), could increase the number of organ transplants by 50%.

He said that the framework is aimed at reducing waiting times for kidney transplants and represent a shift in Malta's transplant system, as under the current laws, organ donation is only allowed when a patient is certified as brain dead.

The proposed changes would allow donations from patients who are certified as cardiac dead, or when their hearts have stopped beating, Abela explained.

Abela said that the proposed policy is a "pro-life, humanitarian and revolutionary development," adding that government had worked closely with the Opposition on the matter, with PN MP Ivan Bartolo backing the proposal.

"This is how mature politics is done for the people, through sensible discussions that produce results, and not through insults and arguments," Abela said.

He also said that himself and Bartolo met with Church leaders in Malta and Gozo, who have expressed support and willingness to collaborate with government on public awareness efforts on the DCD model, thanking Archbishop Charles Scicluna and Bishop Anton Teuma for their support.

PN MP Ivan Bartolo described the move as important for taking concrete steps to save lives through organ donation, and said that DCD is "the act of doing something beautiful to help others after you die."

Minister Abela said that the health budget, which has increased, must be spent "carefully, conscientiously and without populism," saying that the Ministry's work spans "from pre-conception to elderly care, to end-of-life and even after."

He said the government's strategy is "solid but not inflexible," and guided by evidence, not "empty or recycled promises."

Abela listed a series of completed or ongoing projects, including the opening of the Censu Moran Centre, described as "a record" for expanding specialised clinics and procedures.

Other accomplishments included the acquisition of new ultrasound machines, a CT scanner at St Vincent de Paul, an equipment capable of handling obese patients, with increased accuracy.

Abela listed the expansion of radiology services and new MRI scanners, as well as IVF clinic renovations using modern technology - with 48 babies already born this year and 122 pregnancies ongoing.

He spoke of the introduction or procurement of new medicines including ADHD, autism, diabetes, cholesterol, chemotherapy and new EpiPens, increased vouchers for gluten-free products, and more dialysis sessions outside normal hours.

Abela said that government has worked on a new palliative care and physical activity strategy, as well as the soon-to-be launch of Malta's first national suicide prevention strategy.

Abela said that a three-year study informing a forthcoming consultation on digital health and artificial intelligence, with an international conference on AI in health is to start tomorrow.

Responding to criticism over outsourcing emergency services, Abela said the PN was contradicting itself.

"They object to outsourcing, and say people should not call be having to call 1400. However, won't they still need to pick up the phone to call 112?" Abela said.

He said the emergency department was built too small, leading to inevitable pressure.

Despite this, "we have never had patients lying in ward corridors," he said, adding that government will begin work to double the space of the emergency department, in addition to outsourcing.

On scoliosis surgery delays, Abela apologised to patients and their families, admitting "failures due to various disagreements" and announcing that by 17 December the necessary equipment will be installed. He said he has directed for double the number of operations to be carried out.

Abela said that taiting lists in paediatrics will be addressed with more staff.

Abela also said major hospital masterplans are under expert evaluation, where in Gozo General Hospital, geological studies were done, and the masterplan is being scrutinised by an Italian expert company, where tenders are expected to be issued next year.

In the meantime, the existing hospital is being upgraded, with "unprecedented" transfers and promotions for Gozitan staff.

He also said that drone transport of samples between Malta and Gozo will be introduced.

For St Luke's and Karin Grech, masterplans are also under review by the same expert company, and tenders for the relocation of Karin Grech's services are at an advanced stage.

Abela mentioned a new 50-bed ward to be added, as well as expansions planned for outpatients and the medical school.

Abela noted that photography is not permitted in hospital wards "just like in Parliament."

He also confirmed that colorectal cancer screening will be expanded, lowering the entry age to 45.

On Mount Carmel Hospital, Abela said renovation works are ongoing, as renovations have to be done block-by-block.

He said the government tried to procure a tender for Mount Carmel, but failed due to the stigma, but the aim is to open a new psychiatric unit at Mater Dei.

"We remain committed to offering the best possible health services," the Minister said.

PN MP Stephen Spiteri said that Malta's health system is "struggling under growing demand, outdated infrastructure and procurement failures."

Spiteri said that while Malta is experiencing a strong economy, this should be reflected in commensurate investment in healthcare.

With admissions continuing to rise, Spiteri said that Mater Dei "cannot keep up with demand," and warned that the hospital's emergency department is suffering from exaggerated waiting times and overcrowding that also affects staff.

He said Malta needs more hospitals, including in Gozo, and criticised the government for "losing years, money and opportunity" after the collapse of the Steward hospitals concession.

"There was no investment in infrastructure to meet rising demand, and now we are paying the price," he said, adding that core public health services should never have been handed to the private sector, especially when there are Maltese professionals capable of running Malta's hospitals.

Spiteri said that over 50% of patients who end up at Mater Dei's emergency could instead be treated in primary care, calling for a serious triage system, enlarged urgent-care units near emergency, more 24/7 clinics, and additional staff to make the new Paola Primary Care Hub work as intended.

He said that retaining and attracting healthcare professionals requires not only financial packages but also humane working conditions and work-life balance.

The PN MP delivered some of his strongest criticism on the health procurement system, saying it has repeatedly led to cancelled operations and the use of poorer-quality materials.

"Consultants tell us that even during orthopaedic operations, lower-quality equipment are being used because of the way tenders are awarded. The cheapest price is not always the best. Procurement failures ultimately hurt patients," he said.

Spiteri called for the system to be reformed to ensure that delays, tender disputes and cost-cutting "do not work to the detriment of care."

Spiteri also pressed for increased access to innovative medicines, improved mental health and sexual health services, and reminded Parliament of Hospice Malta's warning that palliative care must be strengthened "before any discussion on euthanasia takes place."

PN MP Paula Mifsud Bonnici also spoke, saying that by 2050 Malta will have more than 14,000 people living with dementia, yet only €200,000 are allocated in the Budget.

"This level of investment is nowhere near enough," she said, calling for long-term planning and substantial investment in care homes and community care.