Minister for Health and Social Care David Ashford had asked members to support what has become his annual request for extra money to cover the department’s overspend.
As many members admitted, they were left with little choice but to grant the money, but several warned they still want change. Some members said this had to come from the department, while others turned their fire at Treasury Minister Alfred Cannan and accused him of not funding the DHSC adequately.
Mr Ashford said that the required funds were higher than his department had projected in December, when it believed it would be asking for a further £5.4m, but he said that costs at Noble’s Hospital and from UK referrals had risen, the latter costing £10m more than last year as demand rose by 14%.
However, the Minister also noted that there has been increased demand for clinics such as endoscopy while the emergency department had also seen an increase.
He said: ’The requirement primarily comprises of £9.2m for Noble’s Hospital and £4.4m for contracted services with the overspend there coming from costs of UK health providers.
’Offsetting those are a £4.2m existing central contingency and net favourable variances of £2.4m in other divisions. Last year the net expenditure for the department was £220m and the current year’s forecast is expected to be £230m.’
However, while costs were rising in most areas, the island was able to reduce its drugs bill by £1m. By comparison NHS England has seen an increase of 5% in its annual drugs budget.
Speaker Juan Watterson criticised the DHSC, both for its overspend and the revolving door of senior management. It is on its third chief executive since April 2019 and he suggested Velcro door signs ’to make them cheaper to change’.
Mr Watterson said that while the island has to ask ’can we afford another £8m?’ it was clear that members would be forced to grant the money.
He added: ’Without causing significant damage to the health department, we have to approve this.’
Lawrie Hooper (Lib Vannin, Ramsey) highlighted that the department has now received £42.5m extra funding over the past five years and told Treasury Minister Alfred Cannan that the ’budget for DHSC is not sufficient’. Mr Hooper also challenged Mr Cannan to introduce what he called a ’realistic budget’.
The Liberal Vannin MHK attached an amendment to Mr Ashford’s requests for cash which will require his department to present to Tynwald by June its plans and time line for bringing staff costs into line with its pre-approved budget. He said he did this because he wouldn’t vote for a ’blank cheque’.
His fellow Ramsey MHK Dr Alex Allinson said he shared the frustration of Mr Ashford and other members and warned that the goodwill of Tynwald is ’getting tired’.
Dr Allinson added: ’Are we dealing with an overspend or an underfund? Because that was the question asked this time last year and I still haven’t been given the answer to it. I suspect we’re talking about under funding.’
MLC Kate Lord-Brennan also attacked the funding system and suggested that Mr Ashford was playing ’something between Operation and Monopoly’ where he ’goes to Tynwald and collects a lot more than £200’.
Mr Cannan defended the current model and said that the government is following the advice of the Sir Jonathan Michael review into the island’s health care with regards to extra funding.
He also noted that he believes it would ’be unwise’ for the Treasury to ditch the current funding mechanism until the changes brought in through the review are operational.
Members supported Mr Hooper’s amendment and Mr Ashford’s request for more money unanimously.
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