Local campaigner Alf Caine has sent an open letter to Members of Tynwald following his 28 hours in A&E at Noble’s Hospital.
Mr Caine’s open letter to the Members of Tynwald is as follows:
I am writing to you following a recent and deeply concerning personal experience at Noble’s Hospital on Wednesday 8 April 2026.
At approximately 08:00 that morning, I attended my GP surgery with severe chest pain. I was advised to go immediately to A&E, which I did. Upon arrival, I was triaged within minutes and quickly identified as requiring urgent attention due to a dangerously elevated heart rate. I was connected to monitoring equipment and received rapid, professional care.
From the moment I entered A&E, the standard of care I received from nurses, doctors, and consultants was exceptional. Their professionalism, attentiveness, and compassion were evident throughout what was, for me, an uncertain time. I cannot praise them highly enough.
Unavailability of Beds
However, despite being assessed as requiring admission to a cardiac ward, I remained in A&E for approximately 28 hours due solely to the unavailability of inpatient beds.
During this time, I was continuously monitored and treated, but in an environment wholly unsuited to prolonged care. The noise, constant lighting, and intensity of A&E made rest impossible. This is not a criticism of staff, who did everything they could to improve conditions, but rather a reflection of the environment itself.
It was also evident that I was not alone. Many other patients were similarly stranded in A&E, awaiting beds. Inevitably, this contributed to delays in assessing and treating other patients, including those with less urgent conditions.
While this situation was entirely beyond my control, I would nonetheless like to offer a sincere apology to anyone whose care may have been delayed as a result of the prolonged time that I, and others, were required to remain in A&E due to system pressures.
Outstanding Care
One moment remains particularly striking. A nurse nearing the end of his shift was asked to extend to a 12-hour shift. He agreed without hesitation and continued to deliver outstanding care throughout. This level of dedication was not unusual; it was representative of the staff as a whole.
After approximately 25 hours, I was reviewed by a second cardiac consultant who expressed clear concern that I was still in A&E. Following a detailed assessment and adjustment of my medication, my condition stabilised and I was discharged shortly thereafter.
While I am grateful for the outcome and the care I received, I must be clear: spending 28 hours in A&E as a cardiac patient in 2026 is not acceptable in any modern healthcare system.
This experience reflects a serious and systemic failure in capacity planning, resource allocation, and operational management. It is not a failure of clinical staff. Quite the opposite. The clinicians and nurses are working under immense and unsustainable pressure, and it is only through their extraordinary efforts that patient safety is being maintained.
Systemic Failure
The current situation places patients at unnecessary risk, contributes to delays in care, and creates an environment of moral and professional strain for those delivering frontline services. This is neither fair to patients nor to the staff who care for them.
I urge Members of Tynwald to recognise that this is not an isolated incident, but part of a wider and well-documented pattern of pressure on hospital capacity. Meaningful and urgent action is required to address bed shortages, improve patient flow, and ensure that our healthcare system is fit for purpose.
We owe it to both patients and healthcare professionals to do better.
As Tynwald members will be aware, I have spent the past four and a half years holding this government to account on a wide range of issues. This has involved the submission of hundreds of detailed emails and Freedom of Information requests, amounting in effect to a full-time, unpaid role dedicated to scrutinising government decisions and exposing areas of concern on behalf of the Manx people.
My efforts over recent years have not been driven by personal recognition or self interest, but by a clear and consistent commitment to improving the lives of people across our island.
Create a Better Place
This latest experience has only strengthened my resolve to continue that work, and to take it further.
Those who have taken the time to read my evidence-based correspondence and my Freedom of Information requests will be fully aware of the depth, consistency, and determination I bring to matters of transparency and accountability in public life.
I am independent in both thought and means, and I am motivated solely by a desire to serve. My aim is simple: to leave the Isle of Man in a better place than it is today for the benefit of all who live here.
I have been self employed for most of my working life and have never relied on the public purse. I have been working since a young age and have built up over five decades of continuous experience in business and practical industry, including turning around and strengthening businesses through sustained effort, discipline, and a clear focus on outcomes. I have always believed in giving 100 percent to the task in hand, and that is the standard I would bring to public service.
Once my medical condition has stabilised, it is my intention to stand in the forthcoming General Election and put myself forward to serve the Manx people. It would be an honour to contribute directly to public life on their behalf.