IOM DHSC & MANX CARE

[Ghost Ship]

On 9/13/2024 at 11:47 PM, wrighty said:

I've posted this many times before, but here goes again. 
 

NI pays for state pension and certain benefits such as statutory sick pay. It does not fund the health service (although yes, if in surplus, some of it can contribute, but the NHS is funded mainly by general taxation)

Is that the case?

I thought that there wasn't a system of hypothecation - at least there isn't in the UK so far as I'm aware - and all govt income (tax and NI) goes into one big pot and all govt expenditure (NHS and pensions etc) comes out of that one big pot.

Is it different in the IoM?

[Ghost Ship]

On 9/14/2024 at 6:23 PM, Fred the shred said:

I think Manx Care is underfunded, I get a lot of care from Nobles and am grateful and usually meet quite a few people I know who are in a similar age group.    People are living longer and are living more active lives now, so many people I know have had knee or hip operations as well as people being treated for other illnesses that are ongoing.   Years ago old people were mostly looked after by family and if they were ill they just sat in a chair with a couple of sticks until they died now there is more treatment for illnesses and the care is so much better.   Scans didn’t exist now they do and they save lives for young and old but they cost money now doctors use bloods to diagnose many diseases that clinic is always busy, costs money.    A friend went away privately to have a hip operation it cost £14,000 so you can reckon every hip op on the NHS will cost the hospital perhaps £10,000 and over the year that adds up.    I think our expectations are high but willingness to give Manx Care the money to meet these expectations is not there.

Apart from the expected increase in physical ailments and frailties that an ageing population brings, surely a bigger problem with that ageing population is an increase in various types of dementia.

I'm 66 and I'm more concerned about deterioration in my mental health rather than I am my physical health.

The UK has no answer to this ticking time bomb - or the wider issue of funding adequate social care provision to an ageing population - and I suspect the IoM is in no better position, probably worse.

I don't understand how the IoM can possibly publicly fund an appropriate level of health and social care from a population of 85k, a low tax base and no corporation tax.

 

(Am I right about no corporation tax?  Apologies if I'm mistaken)

[Roger Mexico]

1 hour ago, Ghost Ship said:

I thought that there wasn't a system of hypothecation - at least there isn't in the UK so far as I'm aware - and all govt income (tax and NI) goes into one big pot and all govt expenditure (NHS and pensions etc) comes out of that one big pot.

Is it different in the IoM?

There isn't in the UK (I'm not sure there ever was) but there is a National Insurance Fund in the Isle of Man.

[Boo Gay'n]

9 hours ago, Roger Mexico said:

There isn't in the UK (I'm not sure there ever was) but there is a National Insurance Fund in the Isle of Man.

There is a National Insurance Fund in the UK, and always has been.  We have consistently largely copied UK NI legislation, which is we we also have a fund - but we manage ours differently.

For anyone as nerdy as me, this article, although slightly old now, gives the history of hypothecation (or lack of it) in the UK.

[Boo Gay'n]

Tony Benn made a speech in parliament in 1995, and used the analogy of a health service boat race between a Japanese and British team.

"Both sides tried hard to do well, but the Japanese won by a mile. The NHS was very discouraged and set up a consultancy. The consultancy came to the conclusion that the Japanese had eight people rowing and one steering, whereas the NHS had eight people steering and one rowing. The NHS appointed people to look at the problem and decided to reorganise the structure of the team so that there were three steering managers, three assistant steering managers and a director of steering services, and an incentive was offered to the rower to row harder. When the NHS lost a second race, it laid off the rower for poor performance and sold the boat. It gave the money it got from selling the boat to provide higher than average pay awards for the director of steering services."

Whatever the latest reorganisation across or here looks like, we should never forget that the essence of health and social care is the delivery of services to people by a professional, effective, committed and enthusiastic front-line workforce.  The boards, directors, comms people etc. are all secondary to that.

[code99]

3 hours ago, Boo Gay'n said:

Tony Benn made a speech in parliament in 1995, and used the analogy of a health service boat race between a Japanese and British team.

"Both sides tried hard to do well, but the Japanese won by a mile. The NHS was very discouraged and set up a consultancy. The consultancy came to the conclusion that the Japanese had eight people rowing and one steering, whereas the NHS had eight people steering and one rowing. The NHS appointed people to look at the problem and decided to reorganise the structure of the team so that there were three steering managers, three assistant steering managers and a director of steering services, and an incentive was offered to the rower to row harder. When the NHS lost a second race, it laid off the rower for poor performance and sold the boat. It gave the money it got from selling the boat to provide higher than average pay awards for the director of steering services."

Whatever the latest reorganisation across or here looks like, we should never forget that the essence of health and social care is the delivery of services to people by a professional, effective, committed and enthusiastic front-line workforce.  The boards, directors, comms people etc. are all secondary to that.

I wonder what Tony Benn would say about:

https://www.manxradio.com/news/isle-of-man-news/manx-care-says-short-term-savings-plan-could-see-service-cuts/

ETA: in 2012 "Tony Benn was asked for his views on the Island, a crown dependency and low tax jurisdiction"...

https://www.manxradio.com/news/isle-of-man-news/benn-enthralls-manx-audience/

Edited Monday at 12:49 PM by code99

[Luker]

5 minutes ago, code99 said:

I wonder what Tony Benn would say about:

https://www.manxradio.com/news/isle-of-man-news/manx-care-says-short-term-savings-plan-could-see-service-cuts/

 

What she seems to ignore is whether the Michael’s Report said you’re entitled to another £155 million or not the Manx taxpayer can’t just pull this money out of its arse. So tough shit. 

[cissolt]

21 minutes ago, Luker said:

What she seems to ignore is whether the Michael’s Report said you’re entitled to another £155 million or not the Manx taxpayer can’t just pull this money out of its arse. So tough shit. 

I don't understand how the overspend is allowed, they get a set  budget and go over it every month.  Who in government is approving the overspends?

Who else has looked at the Jonathan Michaels figures to confirm they are economically viable and necessary?

[Jarndyce]

12 minutes ago, cissolt said:

Who else has looked at the Jonathan Michaels figures to confirm they are economically viable and necessary?

Shouldn’t Tynwald have done this due diligence, before they let it go through “on the nod”?

[Dave Hedgehog]

So the plan is to cut everything in this financial year and create a bigger, more expensive mess next year. 

 

Nice one. Well done all. 

[Jarndyce]

37 minutes ago, Luker said:

What she seems to ignore is whether the Michael’s Report said you’re entitled to another £155 million or not the Manx taxpayer can’t just pull this money out of its arse

Once more - shouldn’t Tynwald have considered the cost before they approved the changes?  Or maybe they didn’t read the report thoroughly enough.   Or maybe they missed out the hard bits with the numbers.

[code99]

45 minutes ago, Luker said:

What she seems to ignore is whether the Michael’s Report said you’re entitled to another £155 million or not the Manx taxpayer can’t just pull this money out of its arse. So tough shit. 

'She', her executive team, out politicians earn sufficient dosh to go private in the UK, but Joe Public will suffer e,g,, if you need hip/ knee/ back/ teeth/ eyes/ ears, etc treated - "tough shit".

[Boo Gay'n]

1 hour ago, cissolt said:

I don't understand how the overspend is allowed, they get a set  budget and go over it every month.  Who in government is approving the overspends?

Who else has looked at the Jonathan Michaels figures to confirm they are economically viable and necessary?

As an aside, and augmenting what Roger Mexico said in another thread, Jonny Michael was appointed by Alf Cannan when he was Treasury Minister - without a competitive competition and on the basis of an introduction by a government insider who used to work with him.  Michael sold us a diet version of the 2012 Lansley "reforms" from across, and Tynwald (to loud hurrahs) accepted it hook, line and sinker.

Look at what Lord Darzi said in his letter to the government last week when sending his report on the NHS -
"The Health and Social Care Act of 2012 was a calamity without international precedent. It proved disastrous."

Nobody in the current Council of Ministers or Tynwald has a clue what they signed up for.  Is it a surprise that things feel worse than they did five years ago?

Edited Monday at 02:27 PM by Boo Gay'n
typo

[Gladys]

26 minutes ago, Jarndyce said:

Shouldn’t Tynwald have done this due diligence, before they let it go through “on the nod”?

Or Treasury? 

[Jarndyce]

22 minutes ago, Boo Gay'n said:

Michael sold us a diet version of the 2012 Lansley "reforms" from across, and Tynwald, to loud hurrahs), accepted it hook, line and sinker.

Look at what Lord Darzi said in his letter to the government last week when sending his report on the NHS -
"The Health and Social Care Act of 2012 was a calamity without international precedent. It proved disastrous."

Nobody in the current Council of Ministers or Tynwald has a clue what they signed up for.  Is it a surprise that things feel worse than they did five years ago?

This.   Manx Care was set up to fail by Tynwald - on the very day that they voted it into existence.