Isle of Man Medical Society raises concerns over Manx Care Mandate

"If the cuts are allowed to proceed, they will have severe and far-reaching consequences", says IOMMS

The Isle of Man Medical Society has published its review of the ‘Mandate to Manx Care 2025/26’ outlining both strength and areas of concern regarding the government’s framework for health and social care on the Island.

Strengths identified

The IOMMS acknowledges several positive aspects of the mandate, including its strategic vision, which sets out a structured plan for delivering integrated and sustainable healthcare.

Additionally, the society welcomes the focus on preventative care, particularly in terms of early intervention and community-based services, as well as the financial transparency within the mandate which details the fiscal accountability and efficiency targets.

Key concerns

Despite these strengths, the IOMMS has raised several significant concerns, particularly the potential impact of a two percent efficiency target on patient care.

The society warns that such measures could lead to reductions in secondary care services, affecting both quality and accessibility.

The report also highlights a lack of clarity in implementation, stating that objectives within the mandate don't have specific timelines, milestones and assigned responsibilities, which may hinder accountability and execution.

Further concerns include the absence of detailed service specifications, uncertainty over the volume of procedures and services to be provided, and a lack of a comprehensive needs assessment to ensure healthcare provision aligns with patient demand.

Consultation and workforce issues

The IOMMS is particularly critical of what it describes as limited public and professional consultation in drafting the mandate.

The society believes that its exclusion from discussions means key insights from medical professionals have been overlooked, which could affect the effectiveness of healthcare policies.

Furthermore, the society calls for a comprehensive workforce review, particularly of Manx Care’s management structure.  It argues that a leaner management system, led by medical and professional experts could enhance efficiency and decision-making.

Recommendations for improvement

The review proposes several actions to address these concerns, including:

• Conducting a thorough workforce review and streamlining management to ensure leadership is medically and professionally driven.
• Carrying out a detailed population health needs assessment to better inform service provision.
• Enhancing stakeholder engagement, particularly by incorporating input from medical professionals and the public.
• Providing clearer commitments on service volumes and procedures to improve transparency and accountability.
• Implementing balanced efficiency measures that protect essential services while achieving cost savings.
• Introducing more detailed implementation plans with specific timelines and measurable outcomes.
• Prioritising the development of an integrated care record system to improve patient care and provider coordination.
• Rationalising healthcare regulation to reduce bureaucratic inefficiencies and improve resource allocation.

Risks and future implications

The IOMMS warns that without these reforms, there is a significant risk of service reductions, which could have severe consequences for patient care.

The report states that delaying or cutting elective surgeries, for example, could lead to increased morbidity and long-term health complications.

Additionally, the society cautions that without a workforce review, inefficiencies and overspending will persist, potentially damaging Manx Care’s reputation and effectiveness.

The society concludes by calling for urgent reforms, greater transparency, and increased engagement with medical professionals to safeguard the future of health services on the Island.