No work has been done to assess how much extra capacity is needed at the hospital and GP services to accommodate a population of 100,000.

Douglas North MHK David Ashford asked ministers about provision for an extra 17,000 people by 2050.

He questioned health minister Lawrie Hooper, asking what assessment has been undertaken of the additional GP services which would be required to support the population increase.

The minister said no specific work has yet been done to determine the additional GP and hospital services that may be required.

He said: ‘In the department work has started on our estate strategy, which will include the buildings that health and care services operate from, their use, capacity and condition in the context of the economic strategy.’

Mr Ashford cited the Sir Jonathan Michael independent review completed in 2019, which led to the setting up of Manx Care.

In the report, its author states that based on a population growth to 100,352, which was the high population forecast by 2035/36, it would require an increase in GP appointments by 17.7%.

Mr Hooper said: ‘That review document is very high level by necessity and makes a lot of assumptions.

‘Some of the forecasts there were around a no change scenario in terms of if the transformation programme was not being delivered and was not successfully altering the demographic patient profile of the island.

‘Is it a good starting off point? Yes.

‘Does it need updating and refining and placed more within the broader context of the economic strategy? Yes.’

Currently, the GP services in the island support 83,500 people.

Mr Ashford felt the current ratio of patients to GPs could be making the workload of GPs ‘unsustainable’.

To this, the minister said it wasn’t a new issue.

‘You will see an increase in the number of patients per GP,’ he said.

‘That is predominantly though because of refocusing and reforming primary care around broader health professionals, so hopefully the reliance will be less on GPs and a bit more on other primary care specialists like pharmacists or allied health professionals also providing some of the service and taking some of the burden.

‘The transformation programme is designed to radically alter the way that primary care is delivered, hopefully reducing the pressure on individual GPs but ultimately delivering a better standard of care for everybody.’

Mr Ashford asked the same question but in relation to capacity at Noble’s Hospital.

Citing Sr Jonathan Michael’s report once again, he said: ‘In terms of a 100,000 population, for A&E it’s an increase of up to 53% of capacity, outpatient capacity 58%, admissions 59%.

‘A&E seems to be at certain times struggling now and there’s actually some of this work around increased capacity just for the population that we already have needs to be done sooner rather than later.’

The minister pointed out that the review was done pre-Covid, adding: ‘Covid has and will keep having this enduring impact on our health services so we are seeing more attendances at A&E than would have been forecast in 2018 simply as a result of the rate and prevalence of Covid and the damage that has done to individuals.

‘These forecasts are a good starting point but they need to be revised and changed to take note of where we are.’

Mr Ashford said these forecasts need to be done ‘sooner rather than later’ as the lasting impact of Covid will ‘only drive the figures one way’.

‘Even if you look at the no change option, if you look at the medium forecast which barely moved the population it was still showing that by 2035 there’d be a need for A&E services to increase by 30%,’ he said.

‘We are already starting to see pressures in certain areas of the system that are in line with what Sir Jonathan was predicting.’

Mr Hooper agreed and said the department’s focus is on service delivery and improvement rather than ‘going over old ground’.

He added: ‘The intention is certainly not to import another 17,000 people to the Isle of man and hope for the best.

The economic strategy is very much around planning and developing the services and that infrastructure first to encourage and enable the relocation of people.

‘There is no target to attract 100,000 people without having infrastructure in place.’

Following this, Education Minister Julie Edge (pictured above) was asked about additional capacity in schools.

She said: ‘The number of 100,000 is an ambitious target to develop our infrastructure and services to support a population of 100,000.

‘Currently the department annually forecasts figures for all schools upon registration of the next uptake.

‘This allows the department to regularly review capacity within our estates and look forward to understand what infrastructure needs may be required in the future.

‘The department has carried out a strategic review of the south and the strategic intent for a development on that site. The department is currently commencing a strategic review of the east and its requirements going forward.

‘The department is also conducting a review of the catchment areas and the results might help with any capacity issues that may arise going forward.’

She said capacity in the east is the ‘most pressing’ at the moment but there is availability in other areas, which is why she felt the catchment area review was so important. She added mobile classrooms can be used.

When asked which schools are over capacity, she said the ‘most obvious to all of us’ is Ballakermeen High School.