Report into Isle of Man health service: It’s time to deliver

Noble's Hospital

Noble's Hospital

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The Isle of Man’s health services have been branded a ‘strategic policy vacuum’ in a report by an independent watchdog.

The Health Service Consultative Committee (HSCC) has urged the Department of Health to either endorse or discard their 10-year Health Strategy, first published in 2011, which ‘appears to have been marginalised without an alternative taking its place’, according to committee chairman John Whitehead.

The HSCC’s annual report, published last week and covering April 2014 to March this year, has also called on the Department to publish the delayed Strategic Vision for Health as soon as possible.

‘Despite the strong commitment of its staff it is items such as this that cause much frustration,’ Mr Whitehead said. ‘It is imperative that the Department and the leadership team deliver on its promises so that the staff and patients can have confidence in the long term future of health services provision.’

The HSCC provides independent scrutiny and advice on the performance, effectiveness and operation of the island’s health services.

They acknowledged that the recent restructuring of the Department to take on new services and the loss of all five divisional managers at Noble’s Hospital within 12 months had created ‘significant challenges’.

But they went on to criticise both the pace of change and the lack of visible progress in the last year.

Mr Whitehead said that although some progress had been made, ‘this has not been as quick as we could have reasonably expected.’

‘There is also minimal evidence that ongoing progress is visible to the Department’s staff and patients, in particular with regard to the direction of health services in the Isle of Man,’ he continued. ‘The previous Health Strategy appears to have been put to one side and yet to be replaced by an alternative.’

The Committee praised some ‘notable areas of success’ including the Ramsey Cottage Hospital, which it described as ‘a positive role model in the provision of intermediate care’. A recent drive to recruit nurses, progress in Mental Health, encouraging staff to report and learn from incidents and improved listening to patients was also praised by the committee.

However, they noted that issues continue in the recruitment and retention of staff, waiting lists, housekeeping and portering services.

The report also revealed that the out-of-hours emergency doctor service, known as MEDS, is almost entirely dependent on locum staff to operate, with temporary agency staff comprising 90 per cent of the on-call doctors.

HSCC also urged politicians to focus on strategic and policy issues relating to Noble’s Hospital, noting that political intervention, however well meaning, can ‘erode the willingness of staff at all levels, who continue working in the best interests of the patients, despite unclear strategic direction and an ever-evolving management structure.’

Meanwhile ‘serious damage’ has been done to staff morale in the Public Health Directorate, which has undergone three separate reviews and assessments in the last year. The report said: ‘During this period, serious damage was done to staff morale, sense of direction and purpose. Still having no clear indication of their future role, they were unable to produce an annual plan of their activities.’

Responding to the report, Health Minister Howard Quayle said: ‘The committee plays a valuable role as “critical friend” to the Department looking at the effectiveness of delivery across the full spectrum of health services and providing objective scrutiny of activities and performance.

‘The Department will now take some time to consider the report’s recommendations and looks forward to continuing the open dialogue between the Department and the committee, supporting the process of change and the provision of quality health services.’

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