Bid for review of health provider framework

The relationship a health care provider and the government department that sets its annual mandate should be reviewed, the minister responsible for it has said.

Health and Social Care Minister Clare Christian will ask members to approve the setting up of a committee at the April sitting of Tynwald.

Manx Care was created as an arm's-length body in 2021 following a review by former NHS Foundation Trust chief executive Sir Jonathan Michael.

Christian will ask for the review to focus on the governance framework, the division of responsibilities, and the statutory relationship between the two bodies.

It comes as the same time as a shake-up at the Department of Health and Social Care (DHSC), which has seen two ministers step away as political representatives, with three new members appointed to the team.

Home Affairs Minister Jane Poole-Wilson and Cabinet Office Minister David Ashford were appointed to the DHSC on an interim basis since November 2024 after the resignation of former minister Lawrie Hooper.

The new appointees, Minister without portfolio Tim Crookall, Stu Peters MHK and Diane Kelsey MLC, now join Peter Reid MLC who was appointed to the department in March.

While Manx Care delivers the day-to-day running of health services, the department sets the policy and strategy, and creates a mandate for Manx Care to monitor its performance.

In January, the provider confirmed it was facing a projected £15m overspend for the 2024/2025 financial year and announced a raft of cost-cutting measures in a bid to to stay within its £346m budget.

Christian, who took on the post as minister in November, said as it was four years since Manx Care had become operational the time was right to "take stock and review the working arrangements".

She said: "I want to ensure that the island's health and care system, that we all value so highly, makes the best use of its resources and has clear lines of accountability."

The minister said she believed the proposal would "enable us to see what lessons we have learned" and "consider whether we need to make any improvements or changes that will ensure we can provide the best service to the public over the coming years".

Welcoming the move, chairman of the Manx Care board Wendy Reid said: "The review, due to be considered by the board, recognises that current legislation and oversight arrangements provide significant challenges regarding the independence, accountability and decision making for Manx Care."

If backed by Tynwald, the committee would be tasked with bringing the terms of reference for the review to the June sitting of the parliament for approval, with a final report due in December.

A general debate on the most recent Manx Care mandate and operating plan was rejected Tynwald last month.

Former minister Lawrie Hooper will ask members to support changes to the current mandate at the April sitting.

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