Department of Health and Manx Care

[joebean]

https://www.manxradio.com/news/isle-of-man-news/manx-care-being-hampered-by-lack-of-clear-service-specifications/

This is an interesting snippet of information, which raises some fundamental questions. Firstly, Manx Care are the service provider but were created without any clear service specifications, something that would be a fundamental first step before appointing any organisation to provide a service. Once again, IoM Government appears to have done something without doing the hard yards first. Secondly, Manx Care has been operating now since April 2021 and still seems no closer to having a clear service specification. I realise that this is a challenging piece of work, but surely the Department should have been working on this over the last three years, with Manx Care and other specialists to complete this? What exactly is the point of the Department and what exactly are their priorities? 

I suppose we should be prepared, after this news, to hear Minister Hooper declare it is nothing to do with him or anybody he is responsible for, but as the service owner, it clearly is. Perhaps if he stopped concentrating on being a pompous know-it-all and applied his mind to his actual responsibilities, things would be different. 
 

[Harry Lamb]

They still don't know which of them is responsible for a number of areas, and this sits firmly with the department and minister who have failed to set out clear specs and requirements. It's now a smaller department so there isn't quite the duplication some imagine, but its purpose is not clear: the minister certainly doesn't know, but then he just sees it as an affirmation of his own importance.

[John Wright]

The problem is at both ends. It’s difficult to set targets and outcomes without detailed information about performance and cost. In setting service levels the Department can’t just say do x operations/procedures of type y - that’d be an open cheque book.

It’s for the Department to balance, demand, need, priority and cost, that’s its political role as a commissioner, then it sets the service level in that area or speciality. The internal market is bureaucratic.

But, whether we have the Manx Care DHSC split or not, the information collecting and processing systems aren’t set up to allow efficient assessment and reporting to anyone, which TC admits.

[Dirty Buggane]

Manx care has a clear and specific role. To hang on to their well paid positions and provide free cash to friends and colleagues. You only have to look at the secondment palaver, who is paying for his services if we are why the fuck is he gallivanting around the UK and is he getting payed by the other trust therefore getting double bubble. Nice work if you can get it, and are our civil servant's scrabbling round trying to stop any details  of the employment floating to the surface, mighty quick to resign and sweep it under the rug.

[Jarndyce]

16 minutes ago, Dirty Buggane said:

Manx care has a clear and specific role. To hang on to their well paid positions and provide free cash to friends and colleagues

Bollocks - try that line on any frontline worker and see how far you get.   Sweeping statements like yours wind up the people who actually do the work every day.

Or are they not part of Manx Care in your thesis?

 

[Boo Gay'n]

As Jonny Michael sold us the Conservatives' 2012 'reforms' lock,stock and barrel, we can look to England for guidance on what we now ought to have in place. Have a look here, which is the government side commitments in a lot of detail and showing political accountablities.  You can find mirror commitments from NHS England on their side of the relationship.

As said earlier in the topic, that we don't have anything remotely like this in place after five years (when the Michael Report was approved by Tynwald, hurrah!) says a lot about the capability of our government.

[Roger Mexico]

4 hours ago, Jarndyce said:

4 hours ago, Dirty Buggane said:

Manx care has a clear and specific role. To hang on to their well paid positions and provide free cash to friends and colleagues

Bollocks - try that line on any frontline worker and see how far you get.   Sweeping statements like yours wind up the people who actually do the work every day.

Or are they not part of Manx Care in your thesis?

In a sense they're not - any more than a check-out op or shelf-stacker is 'part of' Tesco now or Shoprite a year ago.  Branding doesn't normally really affect how people do their jobs or feel about them.  Obviously those working in the health service are normally more qualified and skilled and more committed to the job they do and the public they serve, but the heading on the notepaper doesn't define them.

In fact the vast majority of health and social services workers are the people who suffer the most from the managerial shenanigans that the various changes and favouritisms that successive waves of imports decide to impose.  They have to put up with resources misdirected to pet projects; incompetents promoted or recruited because their main skill is saying what those in charge want to hear;  pointless bureaucracy to give those in charge something to do or produce figures that look good rather than tell you what is happening; endless meetings to flatter those running them; decisions avoided till possible blame can be put elsewhere.

And those in charge will often then misconstrue even the most reasoned and evidenced criticism as an attack on the service as a whole rather than particular policies or decisions.  So we shouldn't really let them escape criticism by hiding behind those doing the work, despite the best efforts of those above to screw things up.

[Cinderella]

All I know is that primary care on the island is in crisis. First GP appt I could get for my 94 year old mother was end July. Because, and in full hearing of everyone in waiting room, the receptionist deemed her not requiring emergency appt. She is 94 FFS.

And Ask most women if they want to discuss many women’s medical issues in front of everyone ….
 

Personally, I think is outrageous that one is required to say what is wrong with you, to an untrained staff member, with no privacy. It is just wrong. 
 

A medical discussion should only be between the patient and the medical professional. 
 

And yes, I know there is a shortage of GPs. But that doesn’t make this right. 

[Jarndyce]

56 minutes ago, Roger Mexico said:

In a sense they're not - any more than a check-out op or shelf-stacker is 'part of' Tesco now or Shoprite a year ago.  Branding doesn't normally really affect how people do their jobs or feel about them.  Obviously those working in the health service are normally more qualified and skilled and more committed to the job they do and the public they serve, but the heading on the notepaper doesn't define them.

In fact the vast majority of health and social services workers are the people who suffer the most from the managerial shenanigans that the various changes and favouritisms that successive waves of imports decide to impose.  They have to put up with resources misdirected to pet projects; incompetents promoted or recruited because their main skill is saying what those in charge want to hear;  pointless bureaucracy to give those in charge something to do or produce figures that look good rather than tell you what is happening; endless meetings to flatter those running them; decisions avoided till possible blame can be put elsewhere.

And those in charge will often then misconstrue even the most reasoned and evidenced criticism as an attack on the service as a whole rather than particular policies or decisions.  So we shouldn't really let them escape criticism by hiding behind those doing the work, despite the best efforts of those above to screw things up.

I agree with you, certainly your second paragraph - the difference is that you have presented a nuanced view.   I think your comparison in paragraph one is a bit off the beam.

Edited Monday at 04:14 PM by Jarndyce
typo

[Roger Mexico]

5 hours ago, John Wright said:

But, whether we have the Manx Care DHSC split or not, the information collecting and processing systems aren’t set up to allow efficient assessment and reporting to anyone, which [Teresa Cope] admits.

It's not just a DHSC/Manx Care issue though - the whole of Manx Government is effectively opposed to such things.  And Treasury, which you would think you be keenest on the best costings and information gathering, seems to be very unwilling to pay more than lip service.  You see this in the more specialist reports from external consultants that get published (on the Airport, Meat Plant, swimming pools and so on).  Those writing them are amazed at the lack of costings or even any attempt to provide them, both internally within Departments and with regard to services provided between them.

[John Wright]

1 minute ago, Roger Mexico said:

It's not just a DHSC/Manx Care issue though - the whole of Manx Government is effectively opposed to such things.  And Treasury, which you would think you be keenest on the best costings and information gathering, seems to be very unwilling to pay more than lip service.  You see this in the more specialist reports from external consultants that get published (on the Airport, Meat Plant, swimming pools and so on).  Those writing them are amazed at the lack of costings or even any attempt to provide them, both internally within Departments and with regard to services provided between them.

And yet, we moved to individual cost centres, for income and budgeting, decades ago.

But the systems are poor.

Ive had a minor run in with Courts today. I lodged some papers on Friday. A fee was payable. For 40+ years I, or the firms I was partner in, or principal of, have had a court account, I’d get billed every month end and pay with one cheque or transfer.

Today I got a phone call. They wanted to take a payment over the phone. I was told I didn’t have a court account, then that it had been closed.

Eventually someone called back. I do have an account. But it seems it’s not indexed under J or W but under A for Advocate. The systems are full of these idiosyncrasies.