IOM DHSC & MANX CARE

[code99]

Given that “Manx Care has identified a £40m funding gap between what it is mandated to do, and the cash is available” and further cuts to what is already (IMHO) an unsatisfactory level of health service would probably collapse the IOM public health system completely, an obvious question is: where the money needed for the IOM healthcare is to come from?

Before deciding that the Island’s residents should pay more taxes/ different taxes/ etc., it is worth contemplating as to why we are currently in this pickle.  After all, we have known for years that the IOMG’s financial resources were not infinite... because what was once there has been squandered by innumerable unaccountable incompetent decisions across various sections of government (some of the individuals who left a trail of chaos and shambles in their wake have retired with impunity on the premise that current taxpayers will happily pony up their eye-watering pensions). Although government jobs are perennially being created/ re-cycled, the services that the IOM residents used to take for granted have perceptibly diminished e.g., education/childcare/health and social care are struggling, transport links are flaky, banking facilities are increasingly under peril, etc, etc.

IMHO, the greatest omnipresent existential threat that the Island is facing is to be absorbed into the UK. Many residents, including myself, would not welcome such an unpalatable (irreversible) outcome. The possible solution to help mitigate this risk is the current administration's aspiration to grow the Island’s population by 10,000. This aspiration seems to have little substance - to attract and retain these new denizens, the IOMG will need to provide them with a range of quality services such as quality healthcare. To-date the IOMG have produced consultants’ waffle but as far as I can see few (if any) proper plans as to how to move forward - what would the impact of this ‘growth strategy’ be on infrastructure and indeed on all the already crumbling services? Understandably, the IOM public are not very supportive of the IOMG’s population expansion aspiration.

The Treasury Minister’s financial update in July cannot come soon enough. Squaring the circle of having less resources to spend on healthcare while at the same time having increasing pressures to spend more is something the IOMG needs to urgently address. The IOMG owes IOM residents a duty of care – a duty to spell out what they are doing to improve the Island’s future, and a clear statement about where the Island’s overall finances are currently at and also where they are projected to go.

[Roxanne]

21 minutes ago, code99 said:

Given that “Manx Care has identified a £40m funding gap between what it is mandated to do, and the cash is available” and further cuts to what is already (IMHO) an unsatisfactory level of health service would probably collapse the IOM public health system completely, an obvious question is: where the money needed for the IOM healthcare is to come from?

Excellent post.

This idea of funding for the Island to come from new residents when the services we currently have are crumbling is a nonsense. It might be a plan, but it's not a workable plan.

If we're that desperate for money - and if we're not now then we soon will be - then take a more reliable and lucrative route.

Decriminalise cannabis and get drug tourism going.

It will mean the Island will change immeasurably, but frankly, if we carry on over spending with no income then it's going to change immeasurably anyway - it already is.

Trying to get new residents over with our dwindling reputation is hard.

Turning over our Island to the decriminalisation of cannabis will be hard.

Sometimes we just have to choose our hard.

It's not something I want to see here to be honest, and I can see pitfalls ahead for sure, however, the tourism industry will be boosted, hospitality will be revitalised and the airport will be booming again.

We need the money. Stop fannying around with useless proposals and do something dynamic and put our name back on the map.

Shoot me now. 😁

[BriT]

16 hours ago, finlo said:

More like made up bollocks to try and take the heat off of them.

Not true. When the guy on the Manx Care Board died the other week under the reports of his death and tributes in the paper and on the Manx Radio Facebook pages there were some genuinely vile comments from clearly mental anti vaxxers claiming the sudden death would be all down to the vaccine, deserves all he gets, they’re killing people etc etc. The police want to rein that f**king lunatic Heading and his mental mates in. They’re an absolute disgrace but so many of them have gone totally over the edge now they don’t care who they abuse. 

Edited April 14, 2023 by BriT

[Moddey Dhoo]

40 mill funding gap eh? Time for a clever chap from across to come over and do a review?

[Banker]

13 minutes ago, Moddey Dhoo said:

40 mill funding gap eh? Time for a clever chap from across to come over and do a review?

No just increase NI particularly for higher earners to meet the increasing demands 

[wrighty]

28 minutes ago, Banker said:

No just increase NI particularly for higher earners to meet the increasing demands 

You like the Channel Islands, I seem to recall.  Have you looked at health provision in Jersey and Guernsey and how it's funded there? It puts our "fully comprehensive, free at the point of delivery" ideal into context.

Some highlights:

Jersey - GP appointment about £54, home visit over £100, charges for blood tests, ECG etc separate

Jersey has free secondary care, but if you think you could move there from the UK and demand to get your operation immediately (like patients do here) - forget it.  Unless they really really want you to live there, there seems to be a 5 year qualifying period to be able to access it.

Guernsey - Charges in A&E https://www.gov.gg/CHttpHandler.ashx?id=113643&p=0 from £120 depending on complexity and time of day.  £25 for children

Guernsey hospital care is private, maybe funded by insurance, but a hip replacement will cost you £14k if not.

I'm just pointing this out, not suggesting we adopt their practices here.  But we should be doing something.

[Andy Onchan]

53 minutes ago, Banker said:

No just increase NI particularly for higher earners to meet the increasing demands 

So how much will that reduce the funding gap by? Genuine question as I have no idea.

[Banker]

19 minutes ago, wrighty said:

You like the Channel Islands, I seem to recall.  Have you looked at health provision in Jersey and Guernsey and how it's funded there? It puts our "fully comprehensive, free at the point of delivery" ideal into context.

Some highlights:

Jersey - GP appointment about £54, home visit over £100, charges for blood tests, ECG etc separate

Jersey has free secondary care, but if you think you could move there from the UK and demand to get your operation immediately (like patients do here) - forget it.  Unless they really really want you to live there, there seems to be a 5 year qualifying period to be able to access it.

Guernsey - Charges in A&E https://www.gov.gg/CHttpHandler.ashx?id=113643&p=0 from £120 depending on complexity and time of day.  £25 for children

Guernsey hospital care is private, maybe funded by insurance, but a hip replacement will cost you £14k if not.

I'm just pointing this out, not suggesting we adopt their practices here.  But we should be doing something.

I appreciate that, have a number of friends in CI , they say it’s fairly easy to get doctors appointments due to fees, but still have delays in operations etc unless you’re paying. I don’t propose we follow their model but we need to sort out funding soon & those who earn more should pay more , possibly a health tax on sliding scale eg 1% on earnings over £25k,2% over £40k, 3% over £60k etc 

[BriT]

31 minutes ago, wrighty said:

I'm just pointing this out, not suggesting we adopt their practices here.  But we should be doing something.

I still don’t know why we’re looking at healthcare re jigs to refinance healthcare. We’ve just spent £25M on a prom that’s a total pile of sh*t, we’re about £80M into a totally mis managed Liverpool port project, we’re moving fleets of brand new empty buses about daily and sinking money on running useless horse trams and Victorian scrap railways. Why do we always look at a £40M gap in healthcare and think it’s horrendous when we have incompetents burning money on useless sh*t like the above but that’s ok?

We need priority budgeting that allocates money where it’s needed for front line services not spent on the shite pet projects of buffoons. 

Edited April 14, 2023 by BriT

[wrighty]

10 minutes ago, BriT said:

I still don’t know why we’re looking at healthcare re jigs to refinance healthcare. We’ve just spent £25M on a prom that’s a total pile of sh*t, we’re about £80M into a totally mis managed Liverpool port project, we’re moving fleets of brand new empty buses about daily and sinking money on running useless horse trams and Victorian scrap railways. Why do we always look at a £40M gap in healthcare and think it’s horrendous when we have incompetents burning money on useless sh*t like the above but that’s ok?

We need priority budgeting that allocates money where it’s needed for front line services not spent on the shite pet projects of buffoons. 

Economically they're sunk costs.  If we could recoup the £25m spent on the prom and give it to Manx Care it might be worth mentioning, but we can't.  Your point regarding priority budgeting however is fair.

[BriT]

Just now, wrighty said:

Economically they're sunk costs.  If we could recoup the £25m spent on the prom and give it to Manx Care it might be worth mentioning, but we can't.  Your point regarding priority budgeting however is fair.

I agree they’re sunk costs but honestly I can’t believe we’re now trying to find £40M for healthcare when some moron signed off £25M for the substandard shite project that is Douglas prom. We should have had priority budgeting for years which would have stopped a lot of this waste. If it’s a priority between finding more money for Nobles or running the horse trams for the next 10 years it’s a no brainer. Get the trams cleared and auction the scrap off. 

[2112]

3 minutes ago, BriT said:

I agree they’re sunk costs but honestly I can’t believe we’re now trying to find £40M for healthcare when some moron signed off £25M for the substandard shite project that is Douglas prom. We should have had priority budgeting for years which would have stopped a lot of this waste. If it’s a priority between finding more money for Nobles or running the horse trams for the next 10 years it’s a no brainer. Get the trams cleared and auction the scrap off. 

Some ‘moron’? There is more than one moron in IOMG, and the island is inhabited by them. 
 

I think the charges idea, which was dismissed was mooted, and will be mooted and mooted and dismissed, until there comes a time it becomes inevitable and the GMP are resigned to paying. I think other fresh thinking and alternative ideas won’t get adopted, as in many cases people don’t like change, and many view the NHS as a sacred cow - and untouchable. Remember that the NHS in the UK is a political hot potato and a football when it suits the political agenda. In the IOMs case it’s a mixture of underfunding, incompetence, political interference, too much bureaucracy and layers of management. As well as a shortage of frontline staff where it matters. 
 

Personally they could increase tax or NI, but IOMG wouldn’t spend it on ManxCare, but on Peggy, Choo Choos, TT Galleries, Civil Sevants and Little Empires. They won’t ring fence it, 

[wrighty]

39 minutes ago, Banker said:

I appreciate that, have a number of friends in CI , they say it’s fairly easy to get doctors appointments due to fees, but still have delays in operations etc unless you’re paying. I don’t propose we follow their model but we need to sort out funding soon & those who earn more should pay more , possibly a health tax on sliding scale eg 1% on earnings over £25k,2% over £40k, 3% over £60k etc 

A very rough calculation suggests that a 5% health tax on earnings over £30k might generate about £40m in receipts.

[BriT]

2 minutes ago, 2112 said:

Personally they could increase tax or NI, but IOMG wouldn’t spend it on ManxCare, but on Peggy, Choo Choos, TT Galleries, Civil Sevants and Little Empires. They won’t ring fence it, 

Yes I agree my long term objection to tax and NI increases is just that. Without any priority budgeting or any form of financial management we’ll just blow the money on more useless shite. They can’t help themselves. We should be focussing on how budgets are allocated centrally. 

[Two-lane]

1 hour ago, wrighty said:

Jersey - GP appointment about £54, home visit over £100, charges for blood tests, ECG etc separate

Presumably it is possible to pay for insurance to cover this?

So if everyone pays for insurance for everything health-wise, it is inefficient to have competing insurance companies (some of which occasionally go bust) - the most efficient organisation is a well-run monopoly. Therefore the  best solution is to have one insurance company - let's call it National Insurance.

The simplest way to get people to pay for the insurance is to take from taxes.