The Health Minister has denied claims that Manx Care’s management is ‘top-heavy’ and insists it is wrong to describe the organisation’s financial position, which is £30m over-budget this year, as ‘overspending’.

Lawrie Hooper was responding to concerns raised by the executive committee of the Isle of Manx Medical Society.

The group, made up of leading medics, has called for a major shake-up of the way Manx Care is run and has proposed a seven-point ‘robust recovery and reform’ plan.

It says the current top-heavy management structure is ‘clearly not fit for purpose’ and the organisation needs to be medically-led.

Funds should be allocated efficiently and under proper accountability, it says, with resources redirected to frontline services and priority given to under-invested areas like Primary Care.

Manx Care was set up by the government in April 2021 as an arm’s-length body to take over the day-to-day running of health and social care services. It has gone over-budget each year and this year went £30m in the red.

Mr Hooper said he read the document with interest but wanted to ‘put straight some clear misunderstandings’.

He said the assertions that Manx Care had ‘overspent by £30m in the 2023-24 financial year’ and that funding was ‘primarily drawn from reserves and higher taxation rates’ were not ‘entirely accurate’.

Mr Hooper said while it is the case that Manx Care is over-budget for this financial year, the situation was more to do with structural funding issues, with the single largest factor being the extra cost of covering pay awards for front line staff, rather than this being an issue of ‘overspending’.

He said it was also incorrect to state this year’s additional funding to cover the over-budget position was drawn from reserves or higher taxation rates – pointing out it was largely met from increased tax revenues, and the tax rate did not change during the year.

Criticising the ‘top-heavy’ management structure at Manx Care, the IoM Medical Society said there are currently 30+ medical managers in addition to more than that number of non-medical managers in Noble’s alone.

It said that an efficient structure should have less than half this number for the whole of Manx Care and argued the total management expenditure should remain between 5-6% of the organisation’s total budget.

But Mr Hooper responded: ‘Currently the cost of the “top” of Manx Care, its board including all the executive and non-executive directors is around £1.2m per annum.

‘This represents less than half of one percent of the total Manx Care budget. Most of the rest of management within the organisation is undertaken by clinicians and professionals engaged on frontline or support roles as part of their normal course of duties as you would expect with any organisation of around 3,000 staff.

‘I have no intention of allowing an increase in executive management expenditure to balloon to a limit of 5-6% of the budget proposed in your letter.’

The Minister also dismissed comparisons made in the medics’ document of spending on healthcare in other jurisdictions. Contrasting the DHSC’s annual gross expenditure of more than £4,000 per head with Jersey’s health spending of £2,729 per capita, the UK’s £3,477 per person and Scotland’s £3,782, the Medical Society said Manx Care’s budget should be ‘more than adequate to fund a safe, effective and efficient health care system’.

But Mr Hooper said the costs quoted were not directly comparable as Manx Care’s budget includes social care costs which are not included in the NHS budgets in the UK.

‘When comparing to Jersey, it is also worth noting they have a part privatised healthcare system, and I will not support moves to privatise healthcare on the Isle of Man,’ he added.