IOM DHSC & MANX CARE

[2112]

It will be interesting to see how some of these cuts will come into play, especially elective surgery. I can imagine when dear old Doris from Onchan operation gets cancelled and rescheduled for a later date, the complaints will soon come in thick and fast. I’m sure Onchans finest Rob Callister MHK will be lobbying Manx Care and Minister Hooperman on behalf of their constituents. I would imagine that most MHKs will be lobbying Manx Care. 

[code99]

4 hours ago, Jarndyce said:

 

This: assuming that the funding required to match the full mandate will never - ever - be made available.   Without the funding, The DHSC /MC set-up is an experiment which was doomed to failure from its inception.

I agree; seems we are on the same page?

1.  When Manx Care was created it included a substantial administrative infrastructure i.e. Board of Directors, managers and administrators. If, however, patient-facing services are progressively cut back, then Manx Care’s administrative infrastructure will increasingly become disproportionate to the medical side;
2. The demand for healthcare/ Manx Care services will continue to increase (according to Sir Johnathan Michael’s report, by 2.7% annually). To accommodate these increasing health service demands, Manx Care needs to expand its services by about 2.7% annually and, once inflation is taken into account, increase its budget by about 5%. The Treasury is saying that it cannot afford to give Manx Care anything like what they need. This means that the financial road ahead for Manx Care will become increasingly pot-holed and the Island’s residents are in for an increasingly rough ride;           
3. My assumptions are that now that Manx Care has started cutting "front line services" : a) those cuts will be permanent, and b) in future years they will be expanded.
4. Could the DHSC do better by bringing healthcare back ‘in-house’?

[Fred the shred]

Well I doubt they could do worse and it would rid us over a lot of over paid, under principled, so called professionals who are unfit for purpose.    That would be the first cut to be made.

[Auntie Depressant]

5 hours ago, Jarndyce said:

 

This: assuming that the funding required to match the full mandate will never - ever - be made available.   Without the funding, The DHSC /MC set-up is an experiment which was doomed to failure from its inception.

 

28 minutes ago, code99 said:

I agree; seems we are on the same page?

1.  When Manx Care was created it included a substantial administrative infrastructure i.e. Board of Directors, managers and administrators. If, however, patient-facing services are progressively cut back, then Manx Care’s administrative infrastructure will increasingly become disproportionate to the medical side;
2. The demand for healthcare/ Manx Care services will continue to increase (according to Sir Johnathan Michael’s report, by 2.7% annually). To accommodate these increasing health service demands, Manx Care needs to expand its services by about 2.7% annually and, once inflation is taken into account, increase its budget by about 5%. The Treasury is saying that it cannot afford to give Manx Care anything like what they need. This means that the financial road ahead for Manx Care will become increasingly pot-holed and the Island’s residents are in for an increasingly rough ride;           
3. My assumptions are that now that Manx Care has started cutting "front line services" : a) those cuts will be permanent, and b) in future years they will be expanded.
4. Could the DHSC do better by bringing healthcare back ‘in-house’?

Totally agree with all of this but my confusion is around the ‘why’. Why commission the report in the first place? Why create Manx Care without implementing the funding required? Why now, apparently, throwing Manx Care under the bus? 

[Jarndyce]

2 minutes ago, Auntie Depressant said:

Totally agree with all of this but my confusion is around the ‘why’. Why commission the report in the first place? Why create Manx Care without implementing the funding required? Why now, apparently, throwing Manx Care under the bus?

Why indeed?   I suspect very few of our estimable MHKs read (far less understood) the report and the full implications of what they were voting through.   It was an expensive report to commission, so it had to be implemented - who cares what it actually said?   Or what the implications might be for funding?

[Two-lane]

9 hours ago, Moghrey Mie said:

The next Board Meeting of Manx Care is on November 12th and will be open to the public as usual.

Unfortunately I will not be here.

I recall watching part of this video:

https://www.youtube.com/watch?v=Xo7UtaUWm10

Board Meeting 4 April 2023.

From about 8:54 for several minutes Cope reads out a letter from a patient who had had two eye cataract operations. I commented here at the time that it reminded me of an American evangelical meeting in which the lame can walk and the blind can see (which is exactly so in the case of cataracts). I also commented that she did not read out any letters from dissatisfied customers.

She closes that part of the discussion with:

14:20
I gently replied Nobles Hospital the manx care board and all the staff have
14:27
made this possible I have just played a minor role personally the work I did I
14:34
do on the Isle of Man has given me great immense satisfaction

My cynicism has gone off the scale.

In the next meeting is she going to read out thank-you letters from people who are on the wrong end of a long waiting list? Is she going to gently reply that she "just played a minor role personally" in allowing this situation to exist?

Will it be "It's not my fault. The MHKs did not give me enough money"?

Edited to add:

Not forgetting the "great immense satisfaction"

Edited Saturday at 06:00 PM by Two-lane
Extra sarcasm

[Non-Believer]

1 hour ago, Jarndyce said:

Why indeed?   I suspect very few of our estimable MHKs read (far less understood) the report and the full implications of what they were voting through.   It was an expensive report to commission, so it had to be implemented - who cares what it actually said?   Or what the implications might be for funding?

Unanimously voted through on the unspoken grounds that it had cost a lot of money, had been delivered by somebody very important and must therefore have been a very good idea, not to be questioned, scrutinised or examined as to its suitability for the local system. And if possible we'll try and do it on the cheap too.

[Gladys]

6 minutes ago, Non-Believer said:

Unanimously voted through on the unspoken grounds that it had cost a lot of money, had been delivered by somebody very important and must therefore have been a very good idea, not to be questioned, scrutinised or examined as to its suitability for the local system. And if possible we'll try and do it on the cheap too.

And it will get the politicians off the hook.  Unfortunately,what it has achieved is the exact opposite, no matter how they wriggle and argue otherwise. 

[FANDL]

35 minutes ago, Non-Believer said:

Unanimously voted through on the unspoken grounds that it had cost a lot of money, had been delivered by somebody very important and must therefore have been a very good idea, not to be questioned, scrutinised or examined as to its suitability for the local system. And if possible we'll try and do it on the cheap too.

Tuesday could be interesting. But it wouldn’t be the first time Tynwald had set up something to fail either knowing it was doomed from the off. Most people seemed to agree that Manx Care made little sense and would just add to costs and duplicate roles which clearly it has. But there is an underlying lack of understanding from Cope and Manx Care here. The UK can keep printing money and issuing gilts to raise money for the NHS but the fundamental reality here is (regardless of who is right and who is wrong) we are down to £600M in reserves. We are also going into reserves by another £100M this year. We will also probably raid the NI Fund next week too. So where does Manx Care think the extra money is coming from if it’s to be re-negotiated?

The 2% tax increase has been a colossal failure that has just added to the tax burden of the least paid in the Island and has achieved next to nothing to support Manx Care as claimed. There is a proposed NHS levy coming at the next budget too which presumably will have to have an even bigger net effect than the doomed 2% tax increase. So where are these aspirations to be financed from? Lawrie Hooper, Liberal Vannin, and Theresa Cope seem to be living in some sort of alternative reality where they think people will just keep on paying if they threaten to cut back services. But we’ve now gone past that point. Most average workers cant afford to pay anymore as they are already hurting from the high cost of living and other associated costs of living in the IOM so it doesn’t really matter. They ain’t going to get the money. 

[Banker]

18 minutes ago, FANDL said:

Tuesday could be interesting. But it wouldn’t be the first time Tynwald had set up something to fail either knowing it was doomed from the off. Most people seemed to agree that Manx Care made little sense and would just add to costs and duplicate roles which clearly it has. But there is an underlying lack of understanding from Cope and Manx Care here. The UK can keep printing money and issuing gilts to raise money for the NHS but the fundamental reality here is (regardless of who is right and who is wrong) we are down to £600M in reserves. We are also going into reserves by another £100M this year. We will also probably raid the NI Fund next week too. So where does Manx Care think the extra money is coming from if it’s to be re-negotiated?

The 2% tax increase has been a colossal failure that has just added to the tax burden of the least paid in the Island and has achieved next to nothing to support Manx Care as claimed. There is a proposed NHS levy coming at the next budget too which presumably will have to have an even bigger net effect than the doomed 2% tax increase. So where are these aspirations to be financed from? Lawrie Hooper, Liberal Vannin, and Theresa Cope seem to be living in some sort of alternative reality where they think people will just keep on paying if they threaten to cut back services. But we’ve now gone past that point. Most average workers cant afford to pay anymore as they are already hurting from the high cost of living and other associated costs of living in the IOM so it doesn’t really matter. They ain’t going to get the money. 

We need to tax the wealthy and higher earners more, ma6be capital gains taxes for amounts over £5k Pa  to tax all the investment property owners, higher rates on second homes etc. UK budget due this month may help by raising fuel duty which give us more money.

[Non-Believer]

Naturally, the fear is that if this draw on the NI Fund does go through it will set a precedent; for further draws. The PS will breath a huge sigh of relief that further funding is magically available for expansion and payrises and it will be business as normal, can kicked down the road; until the ordinary Joes find out that there's nothing left of what they paid in to pay their pensions with.

But for those who made the decisions, it won't matter, they'll be long gone. And once again, £600M left in reserves equates to only 1 year's worth of PS salaries, if that. No wonder they're getting worried.

[Mercenary]

2 hours ago, Auntie Depressant said:

 

Totally agree with all of this but my confusion is around the ‘why’. Why commission the report in the first place? Why create Manx Care without implementing the funding required? Why now, apparently, throwing Manx Care under the bus? 

Over the medium term there will be continual tension over NHS and what it can actually deliver.

 

The cost of services will keep expanding at a rate higher than inflation, so it's either accept constantly increasing taxation (which is likely to affect IoM competitiveness), reduced services elsewhere (and/or investment, again decreasing IoM competitiveness), or accepting a reduction in scope/increase in charges.

 

Yes there is obviously marginal improvements to be made from efficiencies, management costs etc. , but the fundamentals is ageing population & ever expanding range of services / cost of care.

[Gladys]

2 minutes ago, Non-Believer said:

Naturally, the fear is that if this draw on the NI Fund does go through it will set a precedent; for further draws. The PS will breath a huge sigh of relief that further funding is magically available for expansion and payrises and it will be business as normal, can kicked down the road; until the ordinary Joes find out that there's nothing left of what they paid in to pay their pensions with.

But for those who made the decisions, it won't matter, they'll be long gone. And once again, £600M left in reserves equates to only 1 year's worth of PS salaries, if that. No wonder they're getting worried.

Who is worried?  I suspect just the ordinary Joes, Government doesn't seem too concerned. 

What is needed is a complete re-set of public services, putting the emphasis on service and VFM.  What we will get is some 'clever' words and furrowed brows, and things will continue on the same depressing trajectory.

We used to pride ourselves as being nimble and responsive, but all we seem to respond to now is pressure (real or perceived) from external sources. 

Bin the stuff that doesn't actually benefit Manx residents, stop trying to be a player on a world stage and focus on what is best for the island.   The world actually couldn't give a shit.  Time to stop behaving like an ignored child and start acting like a responsible adult concentrating on the best for your family.  Not at all costs, but face up to the hard decisions which ultimately will serve your family the best. That is what we all individually do anyway. 

Oh, and stop this shite term that MHKs seem to be adopting "our island" as though that pardons everything. 

 

[FANDL]

17 minutes ago, Banker said:

We need to tax the wealthy and higher earners more, ma6be capital gains taxes for amounts over £5k Pa  to tax all the investment property owners, higher rates on second homes etc. UK budget due this month may help by raising fuel duty which give us more money.

We already struggle to get people to stay here after relocating. As a strategy CGT is fundamentally doomed, as is IHT or a high rate of tax just on high earners until Jersey or Guernsey decide to bring any of these aspects in. It will just further empty this place out as they are all one of the few benefits of being here.

A tax on investment property owners - that will just put up rents in an already expensive market as they’ll look to offset as much as they can onto their tenants. 

Unfortunately government has to start living within the financial footprint of what can support its costs. Which makes this Manx Care situation so ridiculous - there isn’t any extra money and even if you got it we’d just run out of reserves sooner. 

[Two-lane]

Take a look at countries that have a better health service.

What does it cost? How do they achieve it?