Tynwald has voted to approve a £15.3 million supplementary vote for Manx Care to address its overspend for the 2024-25 financial year.
The motion passed with 18 votes in favour and five against in the Keys and seven to one in LegCo.
Health Minister Claire Christian introduced the motion, acknowledging the significant financial challenges faced by Manx Care.
“Manx Care continue to face significant financial challenges, similar to all health and care providers, including rising drug costs and often unpredictable, high cost packages of care,” she said.
The initial forecast overspend of £18.6 million had reduced to £15.3 million by year end.
Budget
The overspend was attributed to inflationary pressures and pay awards, with £15 million linked to pay and inflation.
Manx Care’s cost improvement programme saved £13.4 million through measures including reducing agency spending and optimising medicines, but this proved insufficient.
“Further work is still required to achieve more efficiencies, cost control and additional savings to balance financial sustainability,” Ms Christian added.
Opposition and Concerns
Several members voiced strong opposition, citing accountability and transparency issues. Rob Callister MHK said, “We have yet to address the crucial need for service improvements or backlog of operations or appointments that must be prioritised in the coming months.
“At some point, we must engage in a very difficult conversation with Manx Care because they cannot continue to rely on what is effectively becoming an open chequebook model since April 2021.”
Kirstie Morphet MLC criticised the recurring overspends, saying: “We cannot continue to fund the same service for the same price every year, and we therefore cannot hope to offer improvements and new strategies within budget as desired by the honourable members and the public”.
Lawrie Hooper however accused the government of misleading Tynwald about the financial impact of an 8% pay award for doctors.
“We were told repeatedly that the 4% additional pay award would not impact on the budget. Turns out, though, actually you do need more money for that,” he said.
“Ministers refuse to accept their decisions have consequences, and in this case, financial consequences.”
Governance and Reform Calls
John Wannenburgh described the situation as “nothing short of ridiculous,” but questioned where the government was properly funding the system.
Speaker Juan Watterson SHK highlighted systemic governance issues, calling Manx Care a response to past failures.
“We still have a three way tie, and no one is singularly responsible for squaring the circle between how much money we give to our health service, what scope that health service provides, and what we spend it on,” he said.
Support for the Motion
Treasury Minister Dr Alex Allinson MHK emphasised the need for reform but urged approval.
“The department has been working closely with Manx care, with Treasury and with the council ministers to come to a realistic plan of how we can start reforming the healthcare service we have and produce a better system, but also one that this country can afford,” he said.
Dawn Kinnish MLC also demanded clarity on medical pay. “Enhanced control and scrutiny have significantly reduced agency and bank spending. But what it doesn’t tell us is what has happened to those medical pay award salaries,” she asked.
Strong Criticism
Julie Edge MHK delivered the most scathing critique, listing multiple governance failures.
“There is inadequate consequences for financial failures.Today there’s been no record or any structural consequences for financial mismanagement that immediately is sending out the wrong signal,” she said.
Ms Edge highlighted delayed cancer treatments and whistleblower cases, adding: “Unless we get a grip of it, we are going to be in the courts ourselves, with individuals that have been let down without the treatment they should have they are entitled to for cancer.”
Minister’s Response
In her closing remarks, Ms Christian defended the request while acknowledging challenges.
“Manx Care have made a saving of £33.7 million since establishment, which was actually only against the target of £18.1 million,” she revealed.
On job planning reforms, she admitted progress was slower than desired but insisted improvements were coming.
The vote passed, but the debate exposed deep concerns about Manx Care’s financial and political sustainability, especially with that you know what coming into view…
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