Plan for 'meaningful reform' of health body

Measures should be introduced to "strengthen and simplify" the relationship between the Isle of Man's arm's length healthcare provider and the Department for Health and Social Care, a government report has said.

The option was one of four outlined in a review by the Mersey Internal Audit Agency which found that there were "fundamental issues" with how Manx Care could operate independently from the government.

Published in November, the document's options ranged from maintaining the current stance to the full reintegration of Manx Care into the department.

In its response, the department said strengthening its partnership recognised "the need for reform, while avoiding unnecessary disruption".

Manx Care was established in 2021 following a report from the former NHS Foundation Trust chief executive Sir Jonathan Michael.

The Department for Health and Social Care (DHSC) said that maintaining the status quo was "unviable" given the strength of the feedback it had received, and the full re-integration of Manx Care with the Department would "revert to a model previously considered ineffective".

The DHSC said its preferred approach "delivers meaningful reform without the disruption, cost, or risk associated with more radical structural change".

The review also highlighted fundamental challenges including poor relationships and a lack of trust between Treasury, the DHSC and Manx Care, overly complex decision-making pathways, as well as the absence of a commissioning strategy and service specifications.

To address these, the department outlined proposals including the establishment of a long term strategy - underpinned by a three-year financial settlement - as well as the redesign of board governance arrangements and improved strategic planning with the Treasury.

The department also made a commitment to clarifying its shared services functions and the modernising of relevant legislation.

Health and Social Care Minister Clare Christian said the review had provided "valuable" insight into the challenges facing the island's health system and demonstrated that "meaningful reform is both necessary and achievable".

"'By further strengthening the partnership between the department and Manx Care, we will develop clearer decision-making that directs investment with purpose, [and] provides lasting benefit for patients and service users," she added.

The DHSC's response document will be put forward for debate in Tynwald in February, when members will be asked to support the department's intention to progress with the option to strengthen its partnership with Manx Care.

If supported, the department said it intended to bring forward the governance structure and legislative plan to achieve the model for approval at the June sitting of Tynwald.

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