The cost of reforming the island’s long-term care system could reach £131.8m annually by 2044, according to a major government report.
The Nursing, Residential and Home Care report, published by DHSC Minister Claire Christian, reveals that forecast costs for the two preferred reform options have risen significantly due to Island-specific care data and an estimated 1,500 people with previously unmet care needs who would become eligible for support.
The current ‘Do Nothing’ model, already described as financially unsustainable, is projected to rise from £7.4m today to £18.5m by 2044.
The Free Personal Care model, based on Scotland’s NHS-style approach, would cost an estimated £65.5m by 2034 and £131.8m by 2044.
Under this model, the government’s share of total care spend would increase from 12% to 58% by 2044.
The Mixed Model, inspired by Jersey’s threshold-and-cap system, is forecast at £42.2m by 2034 and £66.5m by 2044, with the Government share rising to 21%.
“The forecast costs have come in higher than earlier estimates for two main reasons: the use of updated, island-specific care cost data; and the inclusion of additional service users,” the report states.
Costs
A 2024 Cost of Care exercise found Manx Care domiciliary care costs are approximately 88% higher than the UK local authority average at £55.13 per hour compared with £29.30.
The report notes that a public consultation received 1,227 responses, with “93% support for a new model, with willingness to contribute more if funds are ring-fenced and transparently managed”.
However, it warns that “improving equity, individual affordability and supporting care closer to home comes at a high cost to government.”
A separate Treasury consultation in 2025 received more than 3,800 responses indicating public opposition to general Income Tax/NI rises as a funding mechanism for health and care.
The matter will go before Tynwald for a general debate later this month, which will focus on inviting members’ views, rather than seek a binding decision.