The nursing shortage in Malta is not unique and, in fact, it is experienced throughout the developed world. This is due to a combination of an ageing population with greater longevity, leading to increasing healthcare needs, and more opportunities for youngsters apart from the traditional roles, such as nursing. Nursing shortages inevitably lead to the curtailment of health services, including hospital services.

The government is attempting to encourage students to take up nursing through a publicity campaign. The focus on personal development and not only the search for a job, is clearly being emphasised. For many, this is a welcome step, but rather late in that the shortfall of nurses was acknowledged by Social Policy Minister John Dalli in January and even that was tardy in view of the move to the new hospital. Is it possible the authorities did not work out how many nurses and paramedical support staff would be needed at Mater Dei Hospital? Then, Mr Dalli said 140 nurses were needed but the nurses' union insists the real number is closer to 400.

The lack of nursing staff is evident even through a cursory web search, which yields a veritable plethora of sites offering nursing jobs in Malta. But there are few takers and, clearly, this must be due to better conditions being offered in other countries; more money in short. Thus, the government has no option but to consider the financial package on offer. In addition, even if the government may be willing to finally train and employ more nurses, the Institute of Health Care/the University is physically incapable of taking on such a large load in one fell swoop.

Many millions of euros were spent on the hospital but not so in the case of human resources and the consequences are being felt now. Basic planning would not have allowed the situation to reach such a parlous state. For example, a collective agreement negotiated with the nurses' union in 2007 established that, by the end of that year, budgets would be allocated to market the nursing profession but this never happened.

Nurses also face politically-created problems, such as a hospital that has too few beds, where admissions overspill into the system, clogging up essential units such as the Day Care Unit with Day Surgery having to be cancelled, and where no provision for social cases were made. What was supposed to happen to social cases? Were they meant to be banished from the new hospital with no plans whatsoever for their absorption elsewhere? All of this occurs in the setting where the hospital footprint is much larger than the old St Luke's Hospital site and where moving patients or equipment from place to place involves a significantly greater amount of time, thus requiring more staff. Moreover, the government says it wishes to open an oncology hospital, annex Zammit Clapp Hospital, create a new rehabilitation hospital, extend primary healthcare... etc. Good political posturing, surely, but where will the nurses to run such services come from?

Nurses are not without blame for the prevailing situation, with significant numbers opting to man units where trained clerks would readily do the job, such as in outpatients. Nurses have also objected to the introduction of theatre technicians, an internationally-recognised professional who would reduce the workload in operating theatres.

So, attracting more people to the noble profession of nursing is a must but this is likely to serve very little unless, one, adequate funds are allocated and, two, both the nurses and their employer work closely together.