A total of 56 children’s appointments at Alder Hey have been deferred as Manx Care seeks to rein in its overspending.

The island’s arm’s length healthcare provider has issued a statement following the publication of email exchanges which showed off-island health trusts querying the decision to halt or delay planned treatment for all but emergency admissions.

Manx Care wrote to hospitals including Alder Hey on January 20 instructing them not to carry out any activity on Isle of Man patients between that date and March 31 as they were not in a position to pay the bill.

Alder Hey responded, outlining the implications of such a move, given there were ‘tens and tens’ of Isle of Man children, many already there, expecting surgery, dialysis, chemotherapy or outpatient attendances.

Manx Care had to clarify that time-critical or cancer-related procedures should not be deferred.

Now in a statement, the organisation said children’s appointments are being deferred as part of a review, but only where clinically appropriate.

A spokesperson said: ‘Recent delays to off-island appointments were announced by Manx Care at the end of January, and have been further explained throughout February and March.

‘These delays are happening because, over time, we’ve seen an increase in reliance on off-island healthcare providers, which is essential in some cases, but may be unnecessary for some patients, meaning that excess budget is being spent where it should not be.

‘Therefore, to ensure sustainability in the midst of financial constraints, we’re conducting a comprehensive review to better control off-island tertiary activities. Alder Hey appointments form part of this review, alongside all of our UK providers.’

‘As we progress, some individuals’ care is being repatriated to the island (but only if clinically appropriate).

‘Clinicians are reviewing patient lists to explore repatriation possibilities for patients with off-island appointments. This means that some children’s appointments have been deferred where clinically appropriate, as the option of repatriation of care is explored. ‘

Manx Care said as part of this process, around 56 children’s appointments have been delayed as their clinicians review their need to travel off-island - although the figures are subject to frequent change.

‘This is in accordance with Alder Hey clinicians’ agreement on what is safe,’ the spokesperson said.

‘However, around 28 children’s appointments are unaffected, as their off-island care has been deemed time-critical by their clinicians.’

‘It is really important, particularly for children and their families, that care can be provided closer to home where clinically appropriate.

‘These changes do not relate to “cuts”, but are about being more efficient and effective with funds for our referrals, ensuring our patients are able to get the care they need, where and when they need it.’

Manx Care said that following March 31 , it will continue to refer clinically appropriate patients to Alder Hey and other UK providers.

‘We would like to reassure our community that these changes are taking place to ensure we can deliver sustainable care within current financial constraints,’ the spokesman said.