The 2014/15 Budget has seen an increase in spending for the new Department of Health and Social Care of 2% – £3.91m – but the Minister for Health, David Anderson MHK made clear in Tynwald that a national debate is needed on the future of the NHS model and how it should work in the second decade of the 21st century, some 65 years after its creation.
The Minister said:
'Government’s Agenda for Change has, at its heart, protecting the vulnerable which is a clear priority for Government. It is clear however that the new Department of Health and Social Care will face significant long-term challenges which need to be addressed; not least the impact of an ageing population, continuing advances in healthcare, and growing public expectation and demand. To address these issues, a national debate is needed on the future of the NHS model in the Isle of Man, a system which was adopted in 1948 with the promise of universal healthcare free at the point of delivery. The monumental changes to health and social care over the past six and a half decades mean that the system is beginning to feel the strain of the growing demands it faces, raising questions on its sustainability and suitability to deliver modern health and social care services.'
During his remarks in Tynwald, the Minister demonstrated the high level of demand for health services both in the community and at Noble’s Hospital:
- 2,500 patient contacts in the community everyday through services such as GPs, dentists, community nursing and paramedics
- 115,000 patient contacts per year at Noble’s Hospital
- Outpatient appointments at Noble’s Hospital have increased by 8% since 2010 and 21% since 2003.
The Minister also noted that at current levels, health expenditure could be as high as a quarter of a billion pounds by 2035, an unprecedented challenge given growing demand and the constraints on government spending due to reduced income from the revenue sharing agreement with the UK.
The Minister added:
'Despite the challenges we face, it is encouraging that Government has been able to continue its investment in health care, making money available to fund new buildings, equipment and initiatives, such as our Bowel Screening Programme which was introduced in 2011 and to date has potentially saved 15 lives. The Department is grateful for these additional resources.
'The impact that people’s lifestyle’s have on the demand for healthcare is the single most important factor likely to affect future demand for health care. Finding ways to manage this through education and taking a more preventative approach through screening and behavioural change will be more important than ever in the years and decades ahead, acknowledged in the Department’s Strategy for the Future of Health Services.'
The Budget also sees the creation of a new Health Inspection Fund. Given the quality reviews of the Island’s Health Service currently underway, the Department is aware that this may result in recommendations to bolster resources in some areas. The Council of Ministers wants to ensure that any increases in health budgets are targeted and that all possible efficiencies are found prior to giving additional funds, with the resources set aside only being used if necessary.
The Department of Health and the Department of Social Care will become defunct on 1 April, with the Department of Health and Social Care taking on many of the functions of the former departments. The newly created Department of Health and Social Care will have a combined net budget of £184.39m and will employ the full time equivalent of 2,761.73 FTE staff – making it the biggest Government Department in terms of both operational spend and personnel.
Despite achieving an increase in budget, further work to generate savings through consolidation of support services and other functions will be required in order to support the delivery of front line services.
This will prove particularly challenging, but the Department has delivered in the past and will continue to deliver in the future.
The Minister finished his remarks in Tynwald by paying tribute to staff within the Department of Health for their unceasing work for the benefit of the people of the Island. The Department will have existed for four years on the day it is dissolved, with David Anderson having been the Island’s only Minister for Health.
