Medics 'vindicated' by governance review findings

Manx Care was created in 2021 as an 'arm's length' healthcare provider for the island

A review of Manx Care's "arm's length" relationship with the Isle of Man government recognises issues "consistently identified as requiring urgent improvement" by medics, a group representing them has said.

An independent governance review by Mersey Internal Audit Agency identified four "fundamental issues", namely funding and strategy; core processes; governance; and communication and engagement.

The report also highlighted the impact of staffing challenges and "siloed working".

The Isle of Man Medical Society (IOMMS) said it felt "vindicated" that its concerns had been highlighted in the review.

'Lack of meaningful engagement'

The review, which was published last week and will be debated by Tynwald in December, looked at the relationship between the island's healthcare provider and the Department of Health and Social Care (DHSC).

Manx Care was created in 2021 as an "arm's length provider" following recommendations in a report by Sir Jonathan Michael, a former NHS Foundation Trust chief executive.

The latest review found that although it was operating under the right model, the size and scale of the island and current governance and funding structures meant maintaining independence from the DHSC was "challenging".

The IOMMS said a "lack of meaningful engagement with medical professionals" identified in the report was among the "deficiencies we have long highlighted".

The society said it was ready to work with the health minister "in establishing a medically‑led governance structure that is fit to deliver the health care service our island needs".

'Not fit for purpose'

Calling for a fundamental change in the composition of the Manx Care board and its engagement with medical professionals, the society said the review had highlighted "persistent weaknesses in DHSC's governance capacity, commissioning expertise, and financial oversight".

Any overhaul should create a service that was "patient‑centred, doctor‑led, supported by nurses and allied health professionals, and facilitated - not directed - by management" as well as being overseen by an island-based board that was accountable to Tynwald, the society said.

"In short, we endorse the review's finding that the current governance structure is not fit for purpose and requires urgent reform," it said.

IOMMS members would "welcome constructive engagement" with both the health and chief ministers in "shaping the way forward", it added.

A full response to the report by the DHSC, along with an implementation plan, is due to be put forward for debate at the February sitting of Tynwald.