‘It did feel like we were damned if we do, damned if we don’t’, Manx Care’s chief executive told Tynwald’s Public Accounts Committee as she was quizzed over the announcement of health cuts.

Members of the PAC pressed Teresa Cope over her comments that she had felt undermined by politicians as the board battled to contain its overspend.

Tynwald will be asked next month to approve a supplementary vote of £15.8m for the island’s health and social care services.

Ms Cope told the committee: ‘We have been under immense pressure to reduce over overspend. I think it’s absolutely not how Manx Care would wish to communicate some very difficult decisions it’s had to make.’

The PAC launched its inquiry into the announced temporary stop on all non-urgent elective care being carried out across, and how Manx Care climbed down on planned cuts to on-island surgery following the intervention of the Department of Health and Social Care.

It’s raised questions over whether the healthcare body is being allowed to operate at arm’s length.

Giving evidence on Wednesday alongside Ms Cope was Manx Care’s finance director and two improvement directors Shaun Stacey and Pete Shanahan. who have been taken on as interim appointments to advise on reducing the overspend.

The committee heard that Mr Stacey and Mr Shanahan had drawn up the original mitigation measures which were approved by the Manx board on January 7.

Ms Cope said following the approval of the measures at the board meeting on January 9 there were ‘high level’ discussions with the department the following day. ‘At that point I took the view we were informing the department, not seeking permission,’ she said.

She said the press release about the changes had been signed off and they were ready to publicly share the plans.

But on the 15th she said it ‘became clear that the department wished us to hold off on our communications while further briefings and discussions were held. In the spirit of being collegiate I took the decision to hold off.’

Committee member Ann Corlett asked her: ‘Have you been directed by DHSC?’ She replied after a pause ‘No’, adding: ‘We’ve been directed in terms of there is a financial control total we must stay within.’

Mr Stacey said he didn’t expect any ongoing impact on waiting times for outpatient and treatment activity both on and off-island. It’s not going to affect routine care in any way,’ he said.

He said 25 patients will not have had their care in a timely way and these are now being offered appointments in April. He said of the 600 outpatient appointments that would have been cancelled, 425 have been, or are being, reinstated.

Mr Stacey said the board had been ‘disempowered’ when the DHSC had intervened - ‘for the right reasons’ - but the result hadn’t given a long-term affordable benefit and ‘it’s probably shortened your affordability going forward’.

The witnesses then sat in the public gallery to hear evidence given by Health Minister Claire Christian MHK, DHSC chief officer Paul Richardson and Sam McCauley, the department’s executive director of policy and strategy.

Asked by Rob Mercer MLC if the DHSC was micro-managing Manx Care, the Minister replied: ‘I hope not.’

The chief officer added: ‘We don’t have powers to veto communications or micro-manage Manx Care. Manx Care in legislation is able to take its own decisions and how it does things operationally. Nobody wants to put costs over patients. However, ultimately you have to operate within the budget.

‘I would contest the analysis that there’s a broken relationship with Manx Care. We are all working flat out on supporting Manx Care to actually drive the cost improvements it needs to make to stay on top of what is a very serious deficit.’

Ms Christian said the first she knew about the planned cuts was when she saw the embargoed press release which had been sent to the media on July 15.

She said they had not been full briefed on the impact and had requested an urgent Teams meeting to ask Manx Care to pause what was happening so they could review it and talk about the impact on patients.

Asked for her view on the comments about the Manx Care board feeling that the had been undermined by politicians, the Minister replied: ‘I can understand that they were working to a brief and there was a period of time whereby politicians and the department were seeking to help the Manx public to divert some of those in-year mitigations.

‘I would absolutely understand why that was the feeling, but it was for good intentions for the Manx public.’