Tynwald has this week agreed additional funding of up to £8 million to ensure the Department of Health and Social Care can meet the cost of providing services in the current financial year. The Supplementary Vote for funding tabled by Minister for Health and Social Care David Ashford was agreed unanimously, in amended form, at this month’s sitting of the Court. The amendment is welcomed by DHSC and requires the department to submit to Tynwald by June 2020 plans and a timeline to bring staffing costs in line with a pre-approved budget.
During the debate in Tynwald, Minister Ashford outlined the background to the additional expenditure which is predominately linked to increased activity across our health and social care services and the following key factors:
- The department continues to suffer from the impact of recruitment difficulties across the NHS. In October 2019, the Nursing Times reported that there were 43,000 vacant nursing posts in the UK - a 12% vacancy rate, which is similar to rates in the Isle of Man
- Despite a reduction in agency costs of £1m over the past two years, continued use of temporary staffing is necessary to maintain safe clinical care, particularly within Noble’s Hospital
- The cost of patient referrals to UK centres is expected to be £4.5m above the £19.3m budgeted for in 2019/20, driven by increased patient numbers and a number of highly specialised and complex costly cases requiring treatment in the UK.
The budget shortfall is expected to be just over £7m, against a budget of £223,120,000 in the year to the end of March 2020. The department recognises that transformation will be a lengthy and complex process, but has taken significant steps during the last financial year in this direction. For example, towards establishing a system of integrated care, where coordinated health and care services are provided as close to an individual’s home as possible, and a successful pilot project has been completed in the west of the Island.
Potential savings of £6m have been identified in the hospitals’ cost improvement programme, and it is expected £1m of these will be achieved in the current year. Spending on medicines fell by more than £0.5m in 2018/19 compared to the previous year, in contrast to the trend in NHS England. Further efforts to deliver efficiencies will however, substantially depend on the reconfiguration of services in line with Sir Jonathan Michael’s recommendations.
Minister Ashford said:
‘Specific factors influence activity demands within our health and social care services. We expect to spend around £10m more by the end of this financial year than we did in 2018/19 - growth of 4.5%. It’s worth remembering that Sir Jonathan’s final report confirmed that such growth is within the normal range for health and care. We are fully committed to the Transformation programme which includes the review and establishment of a sustainable baseline budget for our health and social care services, while identifying ongoing future efficiency improvements and savings.’
He went on:
‘I very much appreciate the attention paid by Members to the case put in Tynwald Court and their contributions to a crucial debate. On behalf of the department I am extremely grateful for the unanimous support from Members for the bid made today, and for their commitment to help with the challenges ahead.'
Minister Ashford concluded:
‘DHSC recognises the importance of transformational delivery and that we also remain focused on providing quality health and care services which matter to everyone in the Island. I am determined that we will design efficient, compassionate and responsive services and command the budget to deliver them.’