Visitors to Noble’s Hospital could be charged to park there.

If the move went ahead, Manx Care believes it could generate up to £600,000 a year.

Details of Manx Care’s Financial Plan for 2023-24 were released after a Freedom of Information request.

As well as considering charging people to visit their relatives at Noble’s, charges for face-to-face GP appointments and reopening the private patients’ unit have all been tabled as the island’s health care provider seeks to offset its projected overspend.

However, Health Minister Lawrie Hooper has pledged on Twitter that charging people to see a GP was ‘not on the cards’.

While historic funding gaps in health and social care were something that was meant to be consigned to history by the Sir Jonathan Michael review, this has proven not to be the case, with Manx Care anticipating a funding gap of some £18.9m from where it expected to be.

In its financial plan for the year 2023/24, Manx Care said that following a comprehensive review of its service requirements, it has ‘identified total funding pressures of £66.5m’.

This figure includes £42m of unavoidable cost pressures, the primary driver of which are inflation pressures of about £28m, continued use of agency staff due to vacancies across the system, implementation of NICE technical appraisals, IT system upgrades, Primary Care GP contract obligations and some long term, high-cost specialist off-island Mental Health placements.

Other costs include statutory requirements, core service delivery, enhanced service delivery, additional service delivery and mandated requirements.

Manx Care has said: ‘Manx Care is mandated by the Department of Health and Social Care to provide certain services and outcomes.

‘The mandate for 23/24 has not yet been determined so it is not possible to calculate what the cost of that might be.

‘This represents a risk to the 23/24 Financial Plan and any funding requirements will need to be addressed from the DHSC Reserve Fund.

‘Under the Manx Care Act, all mandated objectives must be adequately funded. However, of the 11 Mandated Objectives for 22/23, there are a number of elements that are not currently fully funded.

‘This will impact Manx Care’s ability to deliver fully against these objectives in 22/23 so appropriate funding will need to be secured in 23/24 to ensure delivery.’

As it attempts to recover some of its expected overspend, Manx Care says that car parking charges were to be introduced in 2022-23, however this never happened.

It added: ‘It is expected that the private patients’ unit, which has been closed since before Manx Care was established, will re-open fully in 23/24 which will address one of the significant pressures on Manx Care finances for the past two years.’

It is believed that this can generate an income above £890,000 per year.

In its own financial report, the Department of Health and Social Care said that while an £18m increase in its budget was agreed for Manx Care, this has ‘been consumed by pay awards; drugs spend and other internal business cases’.

It added: ‘Consequently the June 2022 forecast position for the DHSC is a £1.4m overspend, excluding the impact of tribunal costs which DHSC may need to incur.’

The DHSC also refers to the potential overspend at Manx Care and said it has been ‘clear with Manx Care that it is expected to remain within its budget’ and listed mitigations that could be applied.

The mitigations that have been considered, though not all accepted or pursued, include a freeze on recruitment, excluding front line staff, not operating on patients with a body mass index over 30 (obese), closing Ward 8 (elective surgeries) and reducing capacity at the Secure Children’s Unit.

Other mitigations explored, which are listed as ‘implement only if unavoidable’ include closing Ramsey Cottage Hospital and consolidating services at Noble’s Hospital, introducing ‘bed blocking’ charges and making staff pay to park on site.

If parking charges were introduced at the hospital, there is no indication of how much it would cost.