After the 1927 election, Strickland had a majority in the Legislative Assembly and became Head of the Ministry (the fourth Prime Minister of Malta) from August 1927 until 1932. Amongst the most important events of his government were the commencement of building works for St. Luke's Hospital in Gwardamanġia and his clash with the Senate, which led to the issue of Letters Patent which curtailed its powers and his concurrent clash with the ecclesiastical authorities. On 1 May 1930, Sir Mauro Monsignor Caruana, Titular Archbishop of Rhodes and Bishop of Malta, and Mikiel Monsignor Gonzi, Bishop of Gozo, issued a pastoral letter, read in all the churches of Malta and Gozo. In it, Archbishop Caruana and Bishop Gonzi declared that whoever voted for the Constitutional Party and its former coalition partner, the Labour Party, committed a mortal sin. That year he narrowly avoided assassination.