Chief Minister Alfred Cannan has warned that the island’s healthcare spending has ‘exploded’, doubling over the past five years, and said tough decisions may lie ahead if costs continue to rise at the current rate.

Speaking on Manx Radio’s Mannin Line on Friday lunchtime, Mr Cannan said government investment in healthcare has increased significantly since the start of the current administration, driven by both reform and rising demand.

‘Over the last five years, we’re now investing double the money,’ he said. ‘We were almost double the money come the next budget than we were at the start of this administration.’

The warning comes against the backdrop of continued pressure on public finances, with Moody’s credit noting an £11.1m forecast overspend by Manx Care, contributing to a projected £7.2m net overspend within the Department of Health and Social Care, despite the island retaining its Aa3 stable credit rating.

The Chief Minister said changes were initially made because of concerns around operational standards and effectiveness when services were delivered under the former Department of Health and Social Care structure.

‘We’ve moved forward. We’ve professionalised that in many ways,’ he said, but added: ‘There’s no question about that – healthcare spending has exploded.’

Mr Cannan pointed to substantial post-Covid investment to reduce waiting lists, including around £20 million used to deliver approximately 4,000 operations ‘in double quick time’.

He also said progress was now being made on dental waiting lists, with ‘clear evidence of that progress over the next 12 months’.

However, he warned the current trajectory of spending was not sustainable without consequences elsewhere in government.

‘If the spending continues at the current rate, something will have to give,’ he said, explaining that either government accepts the current model and the pressure it places on public finances, or it looks at how services are governed and whether efficiencies can be found.

He added that wider questions would need to be addressed over the next year, including whether alternative ways of funding healthcare should be explored, particularly given medical advances, increased life expectancy and changing demographics.

When asked who was responsible for solving the issue, Mr Cannan said: ‘It’s everybody’s job… you can’t just point this at one person.’

He added that while government must support healthcare delivery, it also has a role in challenging systems and developing preventative policies to help people live healthier lives and reduce long-term strain on the service.

Mr Cannan covered a wide range of topics on the national broadcaster’s Mannin Line, including public finances, government reserves, and the island’s broader economic performance.

He referenced the recent Moody’s credit opinion, which confirmed the Isle of Man’s Aa3 stable rating – the same as the United Kingdom - and forecast robust GDP growth of 2.5% in 2025, stabilising at 3% in the medium term.

The rating report noted the island’s recovery from pandemic-related contractions and highlighted confidence in its long-term economic stability.