In 2015, a deal was struck in which the management of three of the country's hospitals was handed over to a private company. The concessionaire changed in 2018. In February 2023, a court annulled the concession, citing fraud, in a case filed by a former opposition leader. The Court of Appeal confirmed the decision last October, ruling that there was evidence of collusion between the parties in the concession.

The ruling had an immediate impact on the governing Labour Party's popular support, which dropped sharply.

Meanwhile, a magisterial inquiry into the hospital agreement was completed in April. Soon after, charges including bribery were filed in court against people involved in the hospital deal, including current and past public officials.

Among those facing criminal charges are former Prime Minister Joseph Muscat, who led the country between 2013 and 2020, and Chris Fearne, who resigned as deputy prime minister days after news of the charges emerged. Both have denied any wrongdoing.

The first stage of the criminal proceedings, a pre-trial stage, starts Tuesday for a group of those charged, including the former prime minister. A few hundred Muscat supporters gathered in front of the courthouse ahead of the hearing, chanting slogans backing the former leader, who still is highly popular among some Labour Party voters.

The proceedings for a second set of defendants, including the former deputy prime minister, are scheduled to start Wednesday.

The scandal has dominated politics as the European Parliament election nears. Prime Minister Robert Abela, also a member of the Labour Party, has questioned the timing of the inquiry's outcome, noting that “after four and a half years, it concluded precisely with the opening for the candidacy for the European Parliament elections”.

Abela also raised questions about the inquiry process itself, such as whether those accused were given the chance to be heard by investigators. His comments sparked an outcry, with the opposition describing his statements as attacks on the judiciary.

The Labour Party has dominated elections in the small country since 2013, winning each by a landslide. The last general election was held in 2022, with the Labour Party winning 39,000 more votes than its main rival, the Nationalist Party. There were 355,000 registered voters.

But the events unfolding since last year have seen that lead shrink. Malta holds six seats in the European Parliament. Four are currently occupied by Labour Party members and two by Nationalist Party members. One of the latter seats is held by Roberta Metsola, president of the European Parliament.

The Nationalist Party is hoping to attain a third seat in the election. In the 2014 European Parliament election, it managed to grab three seats despite receiving 33,000 votes less than the Labour Party.