IOM DHSC & MANX CARE

[Jarndyce]

2 minutes ago, John Wright said:

So DHSC set waiting list reduction targets, provided the additional funding, and Manx Care, operationally, achieved the reductions within budget. That’s a win for both.

Only if Manx Care don’t meet the targets, or go over budget, is MC to blame, but, DHSC, because it’s not operationally responsible, isn’t.

DHSC - “Trebles all round!”

[joebean]

2 hours ago, Gladys said:

Is that a surprise?

Saw his Tweet (or is it X) on the legal basis for refusing road access to the Roundhouse.  Unsurprisingly arrogant, condescending and dismissive. 

He always comes over that way. To be fair he can’t help it, on account of being an arrogant, condescending and dismissive twat. 

[joebean]

1 hour ago, John Wright said:

But DHSC sets the targets and provides the funds  it costs to meet the budgeted cost of the targets.

So DHSC set waiting list reduction targets, provided the additional funding, and Manx Care, operationally, achieved the reductions within budget. That’s a win for both.

Only if Manx Care don’t meet the targets, or go over budget, is MC to blame, but, DHSC, because it’s not operationally responsible, isn’t.

Win Win for Hooperman.

The only losers with Hooper are the public. Let’s hope the voters of Ramsey put him in the Loser category, next time the votes are counted. 

[swoopy2110]

10 minutes ago, joebean said:

The only losers with Hooper are the public. Let’s hope the voters of Ramsey put him in the Loser category, next time the votes are counted. 

He still wins as he gets a payoff of our money

[Roger Mexico]

2 hours ago, joebean said:

There is a good news story to be told about the Health Service today, in terms of a reduction in waiting times for operations. 

Amazingly, Lawrie Hooper has decided that the Health Minister has something to do with it. When things go wrong or questions are asked, it always seems to be outside of his remit 🤷🏼

How good a news story it is if you examine the details is another matter as cissolt pointed out earlier:

19 hours ago, cissolt said:

The manxcare waiting list figures make for interesting reading.

1.5 million for support services? Who did that go to?

They have failed to hit the targets in the business case but have managed to spend all the money?

The table they quoted comes from a fairly comprehensive report to Tynwald entitled Manx Care Restoration and Recovery - Phase Two Programme Summary and it's worth looking at that table in more detail:

Financially this has the signs of the sort of thing we've seen from DHSC/Manx Care before.  While individual items differ wildly from the figure given in the B[usiness] Case, miraculously the total spend just happens to match up with the estimated total exactly.  Only 0.01% under in this particular case.  No doubt they and the dumber politicians think that this proves how wonderfully efficient they are, but to the rest of us it just looks like they are fiddling the figures.

How they've done this is less certain.  Part of it may be in Support Services which will be supplied from the hospital budget.  If the whole project goes over they just bill less internally.  There's obviously also scope for using the contingency.  And the General Surgery figures are wildly out.  It's also possible they simply stopped treating people once the budget ran out, no matter what the need.

But because Manx Care/DHSC have prioritised making it look like there's a 'good story' over providing honest information, we can't really tell.  The worry is they may not know either or not care.

[littlebushy]

20 minutes ago, Roger Mexico said:

How good a news story it is if you examine the details is another matter as cissolt pointed out earlier:

The table they quoted comes from a fairly comprehensive report to Tynwald entitled Manx Care Restoration and Recovery - Phase Two Programme Summary and it's worth looking at that table in more detail:

Financially this has the signs of the sort of thing we've seen from DHSC/Manx Care before.  While individual items differ wildly from the figure given in the B[usiness] Case, miraculously the total spend just happens to match up with the estimated total exactly.  Only 0.01% under in this particular case.  No doubt they and the dumber politicians think that this proves how wonderfully efficient they are, but to the rest of us it just looks like they are fiddling the figures.

How they've done this is less certain.  Part of it may be in Support Services which will be supplied from the hospital budget.  If the whole project goes over they just bill less internally.  There's obviously also scope for using the contingency.  And the General Surgery figures are wildly out.  It's also possible they simply stopped treating people once the budget ran out, no matter what the need.

But because Manx Care/DHSC have prioritised making it look like there's a 'good story' over providing honest information, we can't really tell.  The worry is they may not know either or not care.

The other thing that isn't mentioned is the price per case. This equates to £5792 per case. 

Now a typical inpatient joint replacement in the UK costs around £13 000 fixed price but at most, this made up 582 of the 3156 cases listed above. The rest such as cataracts would cost an individual around £3000 and a lot of the minor operations, less than this. And of course, in a private hospital in the UK, each patient would be funding their bed, meals, theatre time, implant cost etc. all of this is already provided at Nobles. So the price per case should work out less than the eye watering £6k charged. On top of this, there is the economy of scale and the buying power of In excess of 3000 cases so whoever negotiated these costings in my opinion, should be held to account!

[Andy Onchan]

4 hours ago, Gladys said:

Is that a surprise?

Saw his Tweet (or is it X) on the legal basis for refusing road access to the Roundhouse.  Unsurprisingly arrogant, condescending and dismissive. 

And wrong if the FOI answer is correct.

[Gladys]

43 minutes ago, Andy Onchan said:

And wrong if the FOI answer is correct.

Not sure he was wrong.  It was something like 'when you know property law, come back to me', but it was the way it was phrased. 

[John Wright]

39 minutes ago, Andy Onchan said:

And wrong if the FOI answer is correct.

The FoI answer is correct. But, as explained above, it doesn’t mean DoI as Nobles estate land owner/DHSC as occupier don’t have the power to stop access.

If your next door neighbours decided to access their back garden through your garden ( I know Mrs A wouldn’t object, she’s nice, but you would, you’re a bastard ) you’d stop them. I’d then ask you where was your right to stop them. You’d not be able to point to anything.

The FoI is an example of rubbish in rubbish out, or ask an unanswerable question and get a meaningless answer you can’t rely on principles.

[Gladys]

Just now, John Wright said:

The FoI answer is correct. But, as explained above, it doesn’t mean DoI as Nobles estate land owner/DHSC as occupier don’t have the power to stop access.

If your next door neighbours decided to access their back garden through your garden ( I know Mrs A wouldn’t object, she’s nice, but you would, you’re a bastard ) you’d stop them. I’d then ask you where was your right to stop them. You’d not be able to point to anything.

The FoI is an example of rubbish in rubbish out, or ask an unanswerable question and get a meaningless answer you can’t rely on principles.

Who leased the bit of land to Braddan to build on?  Shouldn't access been sorted in that transaction? 

 

[John Wright]

9 minutes ago, Gladys said:

Who leased the bit of land to Braddan to build on?  Shouldn't access been sorted in that transaction? 

 

See what I mean?

No one leased the land to Braddan.

I could have ended there. That would be like the FoI response. There is no lease and nothing about restricting access in any lease, document or information.

Braddan bought the roundabout corner site. It has road access on two, out of four, sides. Shouldn’t require access over the Nobles estate roadways. But, you’re right, if Braddan had wanted access over Nobles estate roadways it should have negotiated an access easement/right of way when it bought, or when it decided what to build..

Braddan didn’t.

The FoI is addressed to the wrong party and asks the wrong questions.

more profitable to ask might be

1. in the title documentation by which Braddan acquired the Round House site from DoI/DHSC are there any access rights granted or reserved over Nobles estate roadways?

2. Does the Round House site have access from adopted public roads on two of its four sides?

[Gladys]

4 minutes ago, John Wright said:

See what I mean?

No one leased the land to Braddan.

I could have ended there. That would be like the FoI response. There is no lease and nothing about access in any document or information.

Braddan bought the roundabout corner site. It has road access on two, out of four, sides. Shouldn’t require access over the Nobles estate roadways. But, you’re right, if Braddan had wanted access over Nobles estate roadways it should have negotiated an access easement/right of way when it bought, or when it decided what to build..

Braddan didn’t.

I didn't know if it was bought or leased, but either way access should have been considered and formalised then.  Was the vendor DHSC or some estates part of government? 

[John Wright]

Just now, Gladys said:

I didn't know if it was bought or leased, but either way access should have been considered and formalised then.  Was the vendor DHSC or some estates part of government? 

Access is from the public roads. 

[Roger Mexico]

1 hour ago, littlebushy said:

The other thing that isn't mentioned is the price per case. This equates to £5792 per case. 

Now a typical inpatient joint replacement in the UK costs around £13 000 fixed price but at most, this made up 582 of the 3156 cases listed above. The rest such as cataracts would cost an individual around £3000 and a lot of the minor operations, less than this. And of course, in a private hospital in the UK, each patient would be funding their bed, meals, theatre time, implant cost etc. all of this is already provided at Nobles. So the price per case should work out less than the eye watering £6k charged. On top of this, there is the economy of scale and the buying power of In excess of 3000 cases so whoever negotiated these costings in my opinion, should be held to account!

Quite.  That's an example of what I meant by it might not be as good a story as Hooper is proclaiming.  I'd add to your points that as well as all the costs already being covered by Nobles, many of the operations were done by Manx Care surgeons such as wrighty, so the amounts paid out look even more generous.  I'll try to examine the figures in more detail later.

[littlebushy]

12 minutes ago, Roger Mexico said:

Quite.  That's an example of what I meant by it might not be as good a story as Hooper is proclaiming.  I'd add to your points that as well as all the costs already being covered by Nobles, many of the operations were done by Manx Care surgeons such as wrighty, so the amounts paid out look even more generous.  I'll try to examine the figures in more detail later.

Totally agree, it doesn't matter what the costs are, this is all about health care and it has to be a good news story!

I'm not sure that any of these were done by the local surgeons. However, what you have to factor into the equation was how many surgical theatres and lists were taken over by Synaptic and thus preventing our local surgeons from performing joint replacements, cataracts and hernia repairs when their job plans were for them to be operating. It would be interesting to know for example, how many cataracts have been performed by the Nobles Ophthalmologists for example.