Tynwald divided as £15m health bailout approved

Overspend blamed on rising care costs, staffing, and drug expenditure

The health minister has asked Tynwald to approve a supplementary vote of up to £15.3 million for the Department of Health and Social Care, to cover an overspend in the 2024-25 financial year.

Claire Christian told members that the additional funding was required due to increased employee costs, off-Island care, the development of new services, contract spending, and rising drug expenditure. She said Manx Care was continuing to face significant financial pressures, but was focusing on tighter spending controls, cost improvements, and increased income generation.

Measures being implemented this financial year include reducing reliance on bank and agency staff, reviewing high-cost contracts, medicine optimisation, supply reductions, and better workforce management. However, the minister acknowledged that even with these efforts, expenditure had exceeded the amount originally allocated. She said work would continue to balance financial sustainability with the delivery of high-quality care.

The request for extra funding drew criticism from several members of Tynwald, with some refusing to support the motion.

Onchan MHK Rob Callister said he could not support the request, warning of mounting staffing costs and calling for a wider conversation with Manx Care about long-term affordability. He claimed the Island had reached a point where the status quo could no longer be maintained.

MLC Kirstie Morphett also said she would not support the motion. She expressed concern about the lack of evidence that such requests would not continue on an annual basis and questioned the long-term sustainability of current spending levels.

Ramsey MHK Lawrie Hooper described the health service as underfunded and said he believed the current budget was inadequate. He questioned whether the true financial position was being presented and said he would not support the motion on the grounds that it continued a pattern of poor governance.

Arbory, Castletown and Malew MHK Tim Glover said he would not support the vote, describing the request for extra funding as a repeated occurrence. He criticised Manx Care's performance and said the organisation needed to take responsibility rather than offering excuses. He suggested a review may be needed to assess whether Manx Care is fit for purpose.

Douglas North MHK John Wannenburgh said it was ‘ridiculous’ that Tynwald was again being asked to provide additional funding for the health service. While he believed there had been a failure of financial control, he also acknowledged the possibility that government had not provided sufficient funding. He expressed concern that Manx Care was already forecasting an overspend in the early part of the current financial year and questioned how much more the organisation could cut before wider questions about funding levels were addressed.

Speaker of the House of Keys Juan Watterson said supplementary funding votes for health had been a recurring feature of the political landscape for more than a decade. He expressed disappointment that Manx Care had not delivered the transformation many had hoped for and said patience was running out. He noted the Council of Ministers would need to resolve ongoing governance issues within the next nine months.

Treasury Minister Dr Alex Allinson said that similar concerns had been raised for decades and reminded members that the Sir Jonathan Michael report had been commissioned to help determine what healthcare the Island could afford. He said the set-up of Manx Care had coincided with the global pandemic and inherited an underperforming system. He urged members to support the motion.

Onchan MHK Julie Edge raised long-standing concerns about Manx Care’s governance and financial oversight, saying the organisation lacked accountability. She described a decline in services and highlighted particular concern over the state of Children’s and Families Services, suggesting there could be serious consequences if the system fails.

Douglas Central MHK Chris Thomas said the debate should not solely focus on whether the health service was underfunded or overspending, but also consider the expectations being placed upon it. He said that delivering better healthcare should remain the core objective.

In her closing remarks, Health Minister Claire Christian acknowledged the concerns raised and said there appeared to be a lack of confidence. She pointed to £33.7 million in savings made by Manx Care since its inception, exceeding the original savings target by more than £15 million. She encouraged members to focus on solutions and said collaboration would be key to ensuring further requests for funding were not required in future.

Tynwald voted to approve the funding request, with support from both branches.

In the House of Keys, 18 members voted in favour and five voted against. In the Legislative Council, seven supported the motion while one voted against.