Outgoing Manx Care chief executive Teresa Cope and current Health Minister Claire Christian were giving evidence separately to a session of the Public Accounts Committee.
Former health minister Lawrie Hooper asked why Tynwald had been asked to approve a Pink Book budget figure of £357m for Manx Care in 2025-26 only for the healthcare provider’s own operating plan, laid before the court the following month, to have a figure of £361.8m.
‘Why were those two number different?,’ he asked.
.jpg?width=209&height=140&crop=209:145,smart&quality=75)
-(Medium).jpeg?width=209&height=140&crop=209:145,smart&quality=75)
Ms Cope, who has announced plans to step down from her role in the summer after five years at the helm, replied: ‘I believe they're different because we were given money in the baseline to fund the medical and dental pay settlement. That was part of it.
‘I don't have the detail but I think there were three or four things, of which about £2.3m or £4m [were] for the recurrent impact of the pay settlement for doctors.’
Mr Hooper said: ‘Tynwald was asked to approve a mandate of £357m, that isn't actually what was then presented to Tynwald as part of the operating plan.
‘So at what point was that decision actually made to allocate additional resources to Manx Care above and beyond what Tynwald had approved?’
Ms Cope replied: ‘I'd have to check, but I think it was sort of quite late into that process.
‘We were in negotiation with hospital medical and dental unions in parallel with the development of the mandate and the operating plan.
‘There was a point where we actually understood the true recurrent costs of that pay settlement. I don't know the detail around the other aspects.’
Mr Hooper asked the Health Minister the same question.
Ms Christian replied: ‘I'll have to come back to you but we can certainly investigate.
‘From my recollection, I think it was budget within the DHSC budget that transferred to the Manx Care line.’
Ramsey MHK Mr Hooper pressed: ‘Why was Tynwald asked to approve a mandate budget of £357m when the department and Manx Care clearly knew they were going to be spending at least £361.8m?
‘Why didn't the department ask Tynwald to approve the actual mandate budget rather than a lesser number?’
Ms Christian replied that it came down to timing, with the operating plan and mandate coming in after the February budget. This year they were brought in at the same time.
Mr Hooper also asked when they first knew that a £10m contingency would need to be spent, in addition to the £357m that Tynwald had approved and the extra £4m that the ‘department had decided to hand over without Tynwald approval’.
Both said this was identified ‘early on’.
Ms Cope said: ‘We would have wished to have used it purely as contingency and only drawn it down when required.’
She explained that operating plan had items like high-cost patients' care packages sitting as costs which Manx Care didn't have the budget for.