The health and social care department does not know if it is providing taxpayers with value for money on consultants’ pay.

Chief executive Dr Malcolm Couch made the admission in an exchange with the Speaker Juan Watterson.

However, Dr Couch said the Department of Health and Social Care was changing.

During a sitting of the public accounts committee, Dr Couch was questioned by committee chairman Mr Watterson over consultants pay.

It was previously revealed after a Tynwald question by Mr Watterson that some consultants at the hospital earn far more than their NHS England counterparts.

Mr Watterson said: ’With some of the highest paid [consultants] being paid more than 75% more than the UK average, it would be remiss if I didn’t ask if the Manx taxpayer is getting value for their money?’

Dr Couch initially began to answer by saying it is important to understand activity and job planning in terms of the consultants and what is required of them in their roles.

He added: ’They need to be able to say what they’re delivering, then if you call us back in six months or a year, I think I can answer the question better.

’Our pay arrangements are what they are. They’ve built up over a period of time. We can see decisions that have been taken that have led us to our particular position.

’Our wish is to move forward on a much more transparent basis that everybody understands.

’And then as part of my job as accountable officer for the department, I should be able to say to the committee, Tynwald or the public it is value for money.’

He also said that the department is still doing studies to understand the situation better.

However, Mr Watterson was not satisfied with his response and said if consultants’ pay was brought more into line with the UK average ’that there is £1m to be saved from just 40 to 60 staff’.

Mr Watterson added: ’What you’re telling us is that at the moment, the department does not know if it’s getting value for money on that rather large sum of money.’

Dr Couch said he accepted Mr Watterson’s analysis but added: ’We have a group of employees, who are doctors, who are paid in a certain way at this point. We cannot simply change that over night’.

In an earlier exchange between the two, Mr Watterson released his inner Jeremy Paxman (or Bamber Gascoigne) in offering up what he called ’a starter for 10’ when he asked Dr Couch and departing hospital director Mike Quinn if the department would be on budget this year.

Dr Couch replied: ’Our current projections are mixed and there seems to be quite a lot of variation month by month on expenditure.

’Sometimes, with public finances, and as most members of the committee will know, it is difficult to predict with great accuracy even at this distance from the end of the year.

’However, our September figures indicated that we were looking as if we would come in on budget.

’But our October figures were quite negative and I’m a little bit concerned we are over again.’

Dr Couch said that November seems to have calmed down and figures were looking positive.