The significant impact on patients of health cuts imposed by cash-strapped Manx Care has been laid bare in extraordinary email exchanges released under Freedom of Information.
Manx Care instructed off-island health trusts to halt or delay planned treated for all but emergency admissions until the end of the current financial year as it wouldn’t be able to pay the bill.
Alder Hey Children’s Hospital queried whether the implications of this were understood, pointing out that scores of the Isle of Man children were already booked in for treatment.
And one hospital trust said it would be carrying on treating some Manx patients even though it knew it was not going to be paid.
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The emails were released following a Freedom of Information request submitted by former health minister Lawrie Hooper
They reveal confusion over how the cuts were communicated.
Manx Care’s service development manager Kurt de Freitas, emailed Gary Wadeson, associate director of income, costing and commissioning at Alder Hey Children’s NHS Foundation Trust on January 20, to tell him: ‘Due to our current financial situation please do not carry out any activity on Isle of Man patients between now and March 31 that is not classified as P1.
‘If you do, we will not be in a position to pay the corresponding invoice.’
P1 patients are emergency admissions.
Mr Wadeson replied 20 minutes later: ‘With respect, are you understanding of the implications of this?
‘There will be tens and tens of Isle of Man children (many here already), expecting surgery, dialysis, chemotherapy or outpatient attendances in the next few days.’
Oliver Radford, executive director of health services at Manx Care then clarified this the next day by asking Alder Hey to defer elective procedures and treatments which were not time-critical or cancer-related - and apologised for the confusion.
Jonathan Mathews, chief operating officer and deputy CEO at Liverpool Heart and Chest Hospital NHS Foundation Trust emailed Mr Radford, telling him: ‘As you can imagine this causes the Trust significant concern, as this will disrupt and increase pressure on services and more significantly disadvantage patients.’
Mr Mathews subsequently informed Manx Care on January 29 that there were 163 patients scheduled for out-patient appointments and that ‘although we understand these will not be paid for, we have taken the decision as a board to continuing this activity if possible’.
Liverpool University Hospitals NHS Foundation Trust wrote following the instruction to halt all planned activity: ‘We accept your request but do not feel this is appropriate for patients already listed for surgery. I understand you predicament and know this isn’t something you are doing lightly.’
Mr Radford then provided additional clarification, asking for procedures and treatments to be deferred from February 1 instead.
The emails reveal confusion among Manx Care bosses over what they were asking of the UK health trusts.
Mr Radford wrote to chief executive Teresa Cope as late as February 23: ‘I am personally still unclear what we are asking our tertiary providers to do. I appreciate the finances have worsened. However, we are at risk of becoming disjointed in our decision-making.’
Confusion over patient lists is also revealed.
Mr Radford wrote: ‘I’ve had a quick look at the list and don’t think these patients are all from the Isle of Man. There’s a couple of entries that says “Falklands patient” (that don’t live or certainly have never been to the hospital) and a few others I can’t find.’
Manx Care is forecasting an overspend this financial year of £15.8m.
But it says there are a further £5.8m in risks to that forecast including a potential £2.25m of extra costs for off-island patient care, resulting on a possible total overspend of £21.15m.