Your pension to be used to fund the NHS from 2024?

[Kopek]

The figures are little related to reality though, aren't they.

Inflation, drug price increases, staffing costs, staff wage increases, presume you don't object to those?, more and many cost increases, etc.

Michaels figures are well out of date?

[woolley]

1 hour ago, FANDL said:

So to answer your question in a long way. Even though they should do it even chucking 50 highly paid civil servants under a bus isn’t going to make much of a dent now as realistically they probably need to save around £50M a year not the £10M Alf is talking about finding.

 

40 minutes ago, Kopek said:

Even if they got rid of 50 managers that would only save a few mil. Hardly solve the overspend?

But it should be done. It's a statement of intent. A recognition that things need to change. Even before starting with redundancies, there will be about 200 retirements per year from the public service. At a very conservative average of £40k per year each, that's £8 million a year. There should be a review on each position with a presumption not to replace unless absolutely necessary. If the position is vital, look to redeployment first, and new recruitment only as a last resort. Yes, we still have to pay the pension, but at the moment we're doing that plus expensive replacement. It's just a start, but for God's sake, they need to do something intelligent for a change.

[cissolt]

12 minutes ago, Kopek said:

The figures are little related to reality though, aren't they.

Inflation, drug price increases, staffing costs, staff wage increases, presume you don't object to those?, more and many cost increases, etc.

Michaels figures are well out of date?

I don't know if they were ever accurate to be honest.

I don't object to unforseen increases, it's the little things like why were we paying for our medical director to work somewhere else for 3 years? How much revenue has been lost failing to open the private patients wing? How hard is it to fix an appointment system to avoid DNAs?

We have more directors in Manx care than dentists on the island, which do we need more?

 

[Cambon]

13 minutes ago, Kopek said:

The figures are little related to reality though, aren't they.

Inflation, drug price increases, staffing costs, staff wage increases, presume you don't object to those?, more and many cost increases, etc.

Michaels figures are well out of date?

To put it in perspective, £60 million would be enough per year to pay for around 600 junior doctors! Where the hell is this money going? 

[Alanbellend]

53 minutes ago, cissolt said:

The underfunding in Jonathan Michaels report was based on a projected year on year growth of population by 367.

Since manxcare was formed we have had  a population increase of 461, 600 odd off the projection.  Maybe based on his formula they are getting too much?

You’re right the problem with the Micheal’s formula was that it was based on our idiotic island plan to grow the IOM population which is sensible as Manx Care was going to have to resource to cover the cost of providing services to the growing population. But the population isn’t growing by the 367 new residents the Micheal’s formula factors in each year and in fact is growing nothing like predicted. So they are actually providing services to less people than projected so they don’t need that level of budget. The formula wasn’t approved by Tynwald either so it’s irrelevant. 

[cissolt]

Just now, Alanbellend said:

You’re right the problem with the Micheal’s formula was that it was based on our idiotic island plan to grow the IOM population which is sensible as Manx Care was going to have to resource to cover the cost of providing services to the growing population. But the population isn’t growing by the 367 new residents the Micheal’s formula factors in each year and in fact is growing nothing like predicted. So they are actually providing services to less people than projected so they don’t need that level of budget. The formula wasn’t approved by Tynwald either so it’s irrelevant. 

Correct.  And we have the highest number of residents enrolled in private healthcare than anytime in our history, so even less people using the services.

[Alanbellend]

16 minutes ago, cissolt said:

Correct.  And we have the highest number of residents enrolled in private healthcare than anytime in our history, so even less people using the services.

And some rocket scientist (Ashford) decided to close down any private wards and services at Nobles where they could possibly have made some money out of private patients when he was health minister. All those private patients are now flying away to use Spire Health and similar facilities in the UK.

Edited Wednesday at 06:28 PM by Alanbellend

[Two-lane]

I assume that private patients have wards in buildings separate from NHS wards. It should be easy to calculate the cost of them, and how much to charge the users.

I also assume private patients do not have operating theatres separate from NHS, but have the use of operating theatres that have been constructed with NHS money.

How is the charge-out rate for use of NHS operating theatres and other equipment calculated?

[John Wright]

5 minutes ago, Two-lane said:

I assume that private patients have wards in buildings separate from NHS wards. It should be easy to calculate the cost of them, and how much to charge the users.

I also assume private patients do not have operating theatres separate from NHS, but have the use of operating theatres that have been constructed with NHS money.

How is the charge-out rate for use of NHS operating theatres and other equipment calculated?

The PP unit always ran at a loss, mainly because DHSC were poor at billing for services.

It was closed and refurbished. 

Idea was to get a private operator in to run it. It’s too small to be economically viable, so, surprise, surprise, no takers.

Not been open for 5 years

Perhaps we should forget about private elective inpatient treatments and use it as amenity beds. Private B&B/hotel services.

[woolley]

I've never understood the financial stance taken by successive governments for at least 15 years since the so-called VAT bombshell in 2009, mainly because I just cannot see who it would serve to drive with foot down, headlong over a cliff.

So there's a long term financial plan, but how much thought has been put into what happens if it doesn't work? Or is that simply the unthinkable that can't be acknowledged? In 3 years since the LTFP was issued, immigration appears to be less than half the projected figure. Presumably a good number of those arrived to take up employment in the public service too, and does it also include staff who worked for the King Gaming group companies which is now not happening? While questioning some of the projects funded to date, I support the principle of the seeding fund to stimulate inward investment. What I fail to see is the benefit of perpetually increasing the size of the bureaucracy for no good reason, thus stacking up even greater future liabilities.

It is very clear that there has to be a reckoning, and the longer it takes to act, the worse the reckoning will be. Surely those top civil servants, who we all know drive policy, want their pensions to be there someday? Among their number we have some really intelligent people who appear to be simply kicking the problem down the road and projecting greater draw down of reserves for longer with each yearly update, always projecting things will get better over about 5 years with hot air and glossy brochures, but with seemingly nothing concrete to suggest it will happen. So what's going on?

Maybe they think the Orsted wind farm will be the saviour, or the 15% tax on large corporates, but the way we are going, our deficits are going to dwarf even those projected windfalls. Time to think the unthinkable. Scrap the green transition fund for starters.

I don't believe the Island will go bankrupt because it wouldn't be in the interests of anyone to allow it to happen, not least the UK, but it's plain to see there is going to be privation from the most cursory glance at the balance sheet. How bad do we want it to be?

[A fool and his money.....]

What do reserves stand at now compared to pre 2008?

[Dirty Buggane]

Depleted, Sorry. Very depleted

[Omobono]

3 hours ago, Two-lane said:

I assume that private patients have wards in buildings separate from NHS wards. It should be easy to calculate the cost of them, and how much to charge the users.

I also assume private patients do not have operating theatres separate from NHS, but have the use of operating theatres that have been constructed with NHS money.

How is the charge-out rate for use of NHS operating theatres and other equipment calculated?

was in there this week  for my  latest jab , nothing wrong with the private faciities  in fact better then Spire hospitals   , if they were used we might attract a few more decent doctors to the Island   who could work in both the DHS and Private  areas  ,cant see any other way off attracting fresh blood to the Manx medical service 

[Non-Believer]

9 hours ago, woolley said:

It is very clear that there has to be a reckoning, and the longer it takes to act, the worse the reckoning will be. Surely those top civil servants, who we all know drive policy, want their pensions to be there someday? Among their number we have some really intelligent people who appear to be simply kicking the problem down the road and projecting greater draw down of reserves for longer with each yearly update, always projecting things will get better over about 5 years with hot air and glossy brochures, but with seemingly nothing concrete to suggest it will happen. So what's going on?

The only driver is short-term self interest. Look how long it takes them to address anything, at best it's all last minute.com.

Warnings were given about the pensions situation in 2006, it took them until 2014 to implement GUS and all that did was shift the huge burden onto present and future generations of employee and the taxpayer and consumer.

The only thing that matters is safe-guarding entitlement.

[asitis]

I had an appointment this week with a medical professional ( nothing to do with Nobles) who was here on a part time basis having been flown in and accomodated by their company. This person was asked if they were prepared to move to the IOM, they would be high earners, taxpayers with private pensions etc etc ! They told me in no uncertain terms that whilst the proposition looked attractive, on digging deeper they realised they would become older, and at some stage need health services. They told me not a hope in hell of relocating here, simply because the possibly needed future healthcare was poor to non existent. They went on to explain that although the UK health system was in tatters it was still far better than here, and this was a risk they were not prepared to take !

Looking at the future income and reserve draw down bar graph, published by government, it's difficult to see where income is going to increase , apart from pain for everyone in the form of taxes / stealth taxes, or indeed less expenditure ( rolls on floor laughing ) !

In terms of enticing professional residents, I think this is a snapshot of where we are, and if any of our elected morons don't get the importance of our health services, this is exactly why services shouldn't have been in the hands of Quayle, Ashford and Hooper !