Medics are calling for a major shake-up of the way Manx Care is run.

A ‘robust recovery and reform’ plan is being proposed by the executive committee of the Isle of Man Medical Society.

It says the current top heavy management structure is ‘clearly not fit for purpose’ and the organisation needs to be medically-led.

Funds should be allocated efficiently and under proper accountability, it says, with resources redirected to frontline services and priority given to under-invested areas like Primary Care and CAMHS (the Child and Adolescent Mental Health Service).

Manx Care was set up by the government in April 2021 as an arm’s-length body to take over the day-to-day running of health and social care services.

But it has overspent its budget each year and this year went £30m in the red.

The IoM Medical Society says the organisation has fallen behind in the quantity of service provided while quality and patient safety are ‘not faring much better’.

‘We are concerned that Manx Care is on a path to spending more and more with diminishing quality and throughput unless a strict and comprehensive recovery and reform plan is implemented,’ it warns.

‘Funding, primarily drawn from reserves and higher taxation rates, underscores the strain on the healthcare system.

‘While the pandemic has impacted service delivery, other factors contribute to Manx Care’s struggles. Quality, patient safety, and organisational culture assessments reveal concerning deficiencies.’

The Society has drawn up a seven point plan to address Manx Care’s ‘significant challenges’.

This includes overhauling the current top-heavy management structure and establishing a medically-led organisation.

There should be transparent reporting and budgeting with the new-look board demonstrating fiscal prudence, it says.

The IoM Medical Society says there has been a large proliferation of non-patient-facing, managerial positions, while there is a ‘serious dearth’ of funded medical and nursing positions, compounded by the unfilled funded posts.

There has also been a slippage in professional standards, with the appointment to consultant posts of doctors who are not fully qualified, it claims.

It says: ‘Currently there are 30+ medical managers (associate, clinical and deputy clinical directors) in addition to more than that number of non-medical managers in Noble’s alone.

‘An efficient medical management structure should have less than half this number for the whole of Manx Care.’

The total management expenditure must remain between 5% and 6% of the organisation’s total budget and doctors and nurses relieved from managerial roles should return to the frontline where there are shortages, it recommends.

The Medical Society says there is good worldwide evidence that medically-led organisations perform better and are safer.

And it says it is paramount that the Manx Care board should be chaired by an MHK, in the same way as Manx Utilities and IoM Post Office, and the board should have a majority of medical members.

Funds must be allocated properly and accounted for correctly, the Society says, with between 10-14% of the health budget allocated to Primary care – and the vast majority of this spent on frontline doctors.

It says if managed wisely, the current allocated budget should be ‘more than adequate to fund a safe, effective and efficient health care system for the island’.

It contrasts the DHSC’s annual gross expenditure of £313,780,000 plus £29m overspend this year, which works out at more than £4,000 per head, with Jersey’s health spending of £2,729 per capita, the UK’s £3,477 per person and Scotland’s £3,782.

The Society says there should be a robust workforce strategy to ensure appropriate levels of staffing at least on par with UK standards, with an open and transparent recruitment policy to eliminate the current trend which it says ‘blurs into cronyism and corruption’.

Finally, it says redundant structures can be removed, with the Transformation Board and a ‘vast majority of the current DHSC’ disbanded. It recommends the creation of an independent Health & Care Quality Commission.

The IoM Medical Society represents the interests of the island’s medical profession and incorporates the Isle of Man branch of the British Medical Association.