Independent Review Highlights Shortcomings in Manx Care Model

A recent independent review has revealed that the health and social care model in the Isle of Man, established with the founding of Manx Care, is not functioning as effectively as initially intended. The findings will be discussed at the upcoming Tynwald meeting in December. The review evaluates the arm’s length relationship between Manx Care and the Department of Health and Social Care (DHSC) and presents four strategic options for moving forward: maintaining the status quo, dissolving Manx Care, fully implementing the initial recommendations from the report that led to its establishment, or enhancing partnerships between Manx Care and the DHSC.

Consultants from MIAA have indicated that doing nothing is not a viable option. Their assessment raised concerns about the effectiveness of the current model while noting a “minimal appetite” for reverting to the previous system. Tim O’Neill, the interim chief officer of the DHSC, acknowledged that Tynwald may still consider this option, despite the report’s clear indication that stakeholders prefer not to return to the old model.

The report, commissioned after a Tynwald motion in October 2022, outlines six recommendations aimed at improving the current system. Among these is the development of a five to ten-year clinical strategy, supported by a three-year financial plan, which seeks to strengthen the partnerships between Manx Care and the DHSC.

Established in April 2021, Manx Care was created in alignment with the recommendations of an independent review conducted by Sir Jonathan Michael. The MIAA noted that while the current health and social care model is generally deemed appropriate for the island, its governance and funding structures are limiting Manx Care‘s ability to operate effectively as an independent entity.

The report emphasizes that the current funding model is a significant hurdle. It remains dependent on annual allocations, and progress in implementing the recommendations from Sir Jonathan Michael‘s review regarding funding has been minimal. According to the MIAA, this has led to a focus on addressing immediate overspending rather than promoting a more strategic, long-term approach to health care.

Furthermore, the governance model of the DHSC is reported to inadequately meet ministerial needs concerning engagement, information sharing, and accountability regarding Manx Care. Full implementation of Sir Jonathan Michael‘s recommendations is expected to clarify roles and contribute to a financially sustainable system. Nevertheless, the report cautions that achieving the proposed funding levels and standards may not be realistic.

The absence of a DHSC director of finance has been identified as a critical gap, limiting the department’s financial oversight capabilities over Manx Care. This situation has raised concerns about potential duplication of roles, as Manx Care already has its own finance director.

As discussions proceed in Tynwald, the focus will remain on identifying the best path forward for the health and social care system in the Isle of Man, with the aim of ensuring that it meets the needs of the community effectively.