Manx Care

[Apple]

2 hours ago, John Wright said:

August 2018 my haemo-oncology consultant in Liverpool referred me for an urgent neuro consult following nerve damage caused by arsenic trioxide chemo. A fellow patient who was being treated at the same time, same problem, was seen at Walton in 2 weeks. DHSC wouldn’t authorise off Island referral. So I joined the Nobles waiting list.

An urgent situation and they wouldn't authorise off island referral. Why on earth not ?

On the news just now (yes I know it is not local) the Margate child death case was admitted by the Trust in court. They accepted full responsibility. Who and how will anyone then be called to account and what should the charge be. negligence doesn't seem to cut it no more. 

[John Wright]

1 minute ago, Apple said:

An urgent situation and they wouldn't authorise off island referral. Why on earth not ?

On the news just now (yes I know it is not local) the Margate child death case was admitted by the Trust in court. They accepted full responsibility. Who and how will anyone then be called to account and what should the charge be. negligence doesn't seem to cut it no more. 

DHSC have told the consultants in the English trusts there are ( or are not ) contracts for treatment that they won’t pay for onward referrals. So the consultant in England writes to the consultant here, who then refers. 

No real damage done. Except to my pocket. 3 trips on the ferry, weekends away combined with appointments, trip to see my aunt. Plus the annual excess on the policy. 

I didn’t use the policy for the Leukaemia treatment. The only offered Christie and that wasn’t doing the experimental treatment. Still they gave me 77 nights of inpatient benefit payment.

[Apple]

Thanks John,

As we move more and more into Manx Care territory there seems to be more questions than answers at the moment.

Digitisation and data transfer is a concern in that to be able to read either a phone app or printed passport when we travel there may (will) need to be a data storage system in place in the UK for Manx residents and their 'clinical information' (along with personal data) to ensure travel is allowed.

The question for me is how much medical history / data will we each allow to be used for off island travel. Who will check the accuracy of it, and who will set any limits. ?

[John Wright]

4 minutes ago, Apple said:

Thanks John,

As we move more and more into Manx Care territory there seems to be more questions than answers at the moment.

Digitisation and data transfer is a concern in that to be able to read either a phone app or printed passport when we travel there may (will) need to be a data storage system in place in the UK for Manx residents and their 'clinical information' (along with personal data) to ensure travel is allowed.

The question for me is how much medical history / data will we each allow to be used for off island travel. Who will check the accuracy of it, and who will set any limits. ?

It’ll be based on the NHS app on which IOM patient data is stored already.

[Apple]

This, in tomorrows Tynwald, from the Tynwald administrator, gives a reasonable picture of how the DHSC operates:

(e) In my last Report, I referred to a Department of Health and Social Care (‘DHSC’) complaint involving delay by the Independent Review Body (IRB) for Health in investigating a complaint. The Chief Executive of DHSC had agreed that it fell within my remit because DHSC were responsible for funding the IRB and provided and funded the administrative staff who remained their employees.

I investigated on that basis with the full co- operation and assistance of his successor, the then Acting Chief Executive. At the end of last year, I had completed my enquiries and was in a position to report when I received a separate complaint about the IRB for Health. The complaint had initially been made to the Cabinet Office and there was correspondence between the Chief Secretary and the Acting Chief Executive who had agreed that the complainant should be advised to complain to me.

By the time I received the complaint, the Acting Chief Executive was on long- term sick absence and in her place another Acting Chief Executive had been appointed. She responded to my request for information by stating that the IRB for Health was a body entirely independent of the Department and was outside my jurisdiction. I questioned this, pointing out the position taken by the previous Chief Executive and the Acting Chief Executive. I was told that she had received advice to that effect from the Attorney General. She offered to obtain formal advice and, when she had done so, she waived privilege and provided me with a copy. The advice did not address the points I had made and did little more than set out the legislation. It certainly did not explain why an experienced Chief Executive and the previous Acting Chief Executive had accepted that the IRB’s delay in concluding investigations could be attributable to inadequate funding by the Department and therefore fell within my remit.

Nevertheless, being pragmatic, I concluded that I could not investigate without the Department’s co-operation and I had to write to the complainant explaining why, despite the information he had received from Cabinet Office, I could not investigate.
This creates a problem in respect of the case on which I was about to report. Either I have or have not got jurisdiction to investigate the cause of delay by the IRB for Health and, in particular, to ascertain whether it is caused by departmental failure to provide adequate resources. My jurisdiction cannot differ according to individual circumstances or who is the Acting Chief Executive in any particular week. For that reason, I have decided that it is not appropriate to report in respect of the initial complainant but I will lodge a section 14 statement, on the basis that I do not have jurisdiction, setting out my findings without recommendations and leave it to Tynwald to consider whether the situation is satisfactory or whether any amendment to the Tynwald Commissioner for Administration Act 2011 should deal with this.

Edited April 19, 2021 by Apple

[Uhtred]

1 hour ago, Apple said:

This, in tomorrows Tynwald, from the Tynwald administrator, gives a reasonable picture of how the DHSC operates:

(e) In my last Report, I referred to a Department of Health and Social Care (‘DHSC’) complaint involving delay by the Independent Review Body (IRB) for Health in investigating a complaint. The Chief Executive of DHSC had agreed that it fell within my remit because DHSC were responsible for funding the IRB and provided and funded the administrative staff who remained their employees.

I investigated on that basis with the full co- operation and assistance of his successor, the then Acting Chief Executive. At the end of last year, I had completed my enquiries and was in a position to report when I received a separate complaint about the IRB for Health. The complaint had initially been made to the Cabinet Office and there was correspondence between the Chief Secretary and the Acting Chief Executive who had agreed that the complainant should be advised to complain to me.

By the time I received the complaint, the Acting Chief Executive was on long- term sick absence and in her place another Acting Chief Executive had been appointed. She responded to my request for information by stating that the IRB for Health was a body entirely independent of the Department and was outside my jurisdiction. I questioned this, pointing out the position taken by the previous Chief Executive and the Acting Chief Executive. I was told that she had received advice to that effect from the Attorney General. She offered to obtain formal advice and, when she had done so, she waived privilege and provided me with a copy. The advice did not address the points I had made and did little more than set out the legislation. It certainly did not explain why an experienced Chief Executive and the previous Acting Chief Executive had accepted that the IRB’s delay in concluding investigations could be attributable to inadequate funding by the Department and therefore fell within my remit.

Nevertheless, being pragmatic, I concluded that I could not investigate without the Department’s co-operation and I had to write to the complainant explaining why, despite the information he had received from Cabinet Office, I could not investigate.
This creates a problem in respect of the case on which I was about to report. Either I have or have not got jurisdiction to investigate the cause of delay by the IRB for Health and, in particular, to ascertain whether it is caused by departmental failure to provide adequate resources. My jurisdiction cannot differ according to individual circumstances or who is the Acting Chief Executive in any particular week. For that reason, I have decided that it is not appropriate to report in respect of the initial complainant but I will lodge a section 14 statement, on the basis that I do not have jurisdiction, setting out my findings without recommendations and leave it to Tynwald to consider whether the situation is satisfactory or whether any amendment to the Tynwald Commissioner for Administration Act 2011 should deal with this.

‘Shitshow’ comes to mind. Remind me again, who is the the Minister for DHSC?

[Gladys]

14 minutes ago, Uhtred said:

‘Shitshow’ comes to mind. Remind me again, who is the the Minister for DHSC?

I suspect he may be convoluting as we speak. 

[Uhtred]

23 minutes ago, Gladys said:

I suspect he may be convoluting as we speak. 

Without a shred of regret.

[Gladys]

4 minutes ago, Uhtred said:

Without a shred of regret.

Yes, would be awful to be caught conflagrante nabisco!

[Roger Mexico]

2 hours ago, Apple said:

This, in tomorrows Tynwald, from the Tynwald administrator, gives a reasonable picture of how the DHSC operates:

This bit particularly struck me:

I was told that she had received advice to that effect from the Attorney General. She offered to obtain formal advice and, when she had done so, she waived privilege and provided me with a copy. The advice did not address the points I had made and did little more than set out the legislation. It certainly did not explain why an experienced Chief Executive and the previous Acting Chief Executive had accepted that the IRB’s delay in concluding investigations could be attributable to inadequate funding by the Department and therefore fell within my remit.

In other words they just assumed that it said what they wanted it to say without checking or that everyone else would go along with it because they were were not really concerned or couldn't be bothered to stand up to them.

(It also suggests that the AG's Office isn't much good at one of its main functions which is providing advice for government - but that's another topic).

[GD4ELI]

Some unhappy people:

Manx Care to ask for money to tackle 'concerning' waiting lists - Manx Radio

 

[Boo Gay'n]

4 minutes ago, GD4ELI said:

Some unhappy people:

Manx Care to ask for money to tackle 'concerning' waiting lists - Manx Radio

 

It didn't take long, did it?  Five weeks in and out comes the begging bowl.

[Beelzebub3]

Just now, Boo Gay'n said:

It didn't take long, did it?  Five weeks in and out comes the begging bowl.

Here is an idea, get rid of the top 3 layers of management and replace them with staff who actually work to provide care and deliver at the coal face where it's needed, if you think that Manx care is going to change anything, all it will change is the amount of money wasted on more non medical staff.

[Dr. Grumpy]

At £4.5 million squid a year, you'd think 'Manx Care' executive team will have some magic soutions that don't involve asking for additional funds🤔

[Roger Mexico]

4 minutes ago, Beelzebub3 said:

Here is an idea, get rid of the top 3 layers of management and replace them with staff who actually work to provide care and deliver at the coal face where it's needed, if you think that Manx care is going to change anything, all it will change is the amount of money wasted on more non medical staff.

The trouble is that they need a lot of managers who don't do anything else to deal with all the managers at the DHSC who don't do anything except demand information and reports from Manx Care so they can produce more reports on that.  Management bloat is actually built into the system. 

That's why bureaucracies love 'arms-length' organisations and outsourcing because you automatically at least double (usually a lot more) the number of managers.