The DHSC has admitted that core services listed in the Manx Care mandate could be deprioritised if budgets run short, despite repeated political assurances to the contrary.
The admission came during a Public Accounts Committee hearing when Rob Mercer MLC asked how the department prioritises which services can be “switched off” if they are already described as core.
Minister Claire Christian acknowledged the seriousness of the issue.
“I think you’re absolutely right, and that’s absolutely something that we all want to avoid, making sure that core services aren’t in the instance of this year.”
Contingency
She pointed to the controversial decision to slow elective surgery in January 2025.
Ms Christian said: “I obviously arrived in a very difficult scenario whereby these different solutions were being proposed, otherwise we were going to be or Manx care were going to be more over budget.”
She said the department’s new approach would be to slow down expansion services first rather than touch core provision.
“If needed, then we would slow down the start of those expansion services. To be able to pull those levers to be able to come within that budget.”
However, she stopped short of guaranteeing core services would never face cuts again. “We will always give priority to core services,” she said.
Finance Improvement Director Obi Hasan explained that clinical safety is the determining factor.
“The entire service isn’t going down. It is the rate at which one is performing that service. That’s a balancing act between the money that is spent and clinical safety, and that’s a clinical decision.”
The committee has asked to see the department’s list of priority levers for future service reductions.