Isle of Man Medical Society slams Manx Care decision to cut operations
Reducing elective surgery is a ‘misguided effort’ to save money and will ‘exacerbate’ the already significant backlog of operations which people are waiting for.
The Isle of Man Medical Society is urging Manx Care to reconsider its decision to cut theatre lists - in general surgery, ENT and gynaecology – in order to save £220,000.
The IOMMS has written to the health body’s board saying it should be exploring alternative cost-saving measures which do not compromise patient care.
Manx Care’s plans were outlined in response to a Tynwald written question about theatre cancellations – you can read it HERE.
It claims reducing theatre lists by 5.5 each week – from 30 to 24.5 – will go some way to reducing its predicted £16.8 million overspend for this financial year.
But the IOMMS claims the decision is ‘shortsighted’ and fails to consider the long-term implications for patient outcomes.
It’s expressed ‘profound concern’ and ‘strong opposition’ to the decision saying the cuts will have severe and far-reaching consequences for patient care and the overall health of the community.
“We continue to stand ready to collaborate with Manx Care to find sustainable solutions that address the financial challenges while maintaining the integrity of our healthcare services. Let us not forget that our primary duty of care is to our patients, and we believe that together, we can find a way to uphold this commitment without resorting to detrimental cuts.” Isle of Man Medical Society
The society has also dismissed Manx Care’s pledge, via the Department of Health and Social Care, that urgent or cancer procedures will not be affected by these reductions.
The letter says: “Elective surgeries are not merely optional procedures; they are essential interventions that significantly improve the quality of life for our patients.
“Delaying or cancelling these surgeries will lead to prolonged suffering, increased morbidity, and potentially life and limb-threatening complications for those awaiting treatment and contrary to the minister for DHSC’s assertion that cancer procedures will not be affected, they will be, according to senior colleagues.
“Reducing elective surgery is not a cost saving but a deferred cost which in time will likely be higher because morbidity increases with time and so surgery becomes more challenging, adding to cost inflation and may form justification for further outsourcing to for-profit companies such as Synaptik.
“This will also increase demand on primary care appointments as patients seek treatment for symptoms while waiting for the surgery thus exacerbating the existing issues in access to general practitioner appointments.
“Furthermore the reduction in theatre lists will exacerbate the already significant backlog of elective surgeries, placing additional strain on our healthcare system.
“This backlog not only affects patients directly but also impacts the efficiency, skills- maintenance and morale of our medical staff, who are committed to providing the highest standard of care.”
The society goes on to say that the decision appears to have been taken with no clinical input and says for several of its members it will ‘constitute unilateral changes’ to the job plans and contracts.
It adds that investing in preventative measures, streamlining administrative process and seeking additional funding sources – like reopening the private patients' unit – should be looked at.
The letter has also been sent to Health and Social Care Minister Lawrie Hooper and Chief Minister Alfred Cannan.
Manx Radio has invited Manx Care and the two ministers to respond.
Manx Care has responded with the following statement:
"In order to bring Manx Care into balance this financial year there is a need to focus on specific areas where spend can be reduced with immediate effect such as bank and agency expenditure, freezing of vacancies, purchasing of goods and services, off island commissioning etc.
"As part of Manx Care’s financial recovery plan we have taken the decision to reduce the number of elective theatre lists by 5.5 lists per week for up to a maximum of six months in order to reduce expenditure on bank theatre and anaesthetic staff which are currently required due to a number of vacancies within both the theatre and anaesthetic teams.
"These reductions will be within ENT, general surgery and gynaecology.
"Theatres and anaesthesia on average have been spending £84k per month on bank staff costs in the first four months of 24/25, although this has been reducing in both areas since August thanks to the appointment of new permanent staff, a trend that is likely to continue throughout the year.
"Modelling has taken place within ENT, gynaecology and general surgery which indicates that based on the current waiting list position, the reductions in weekly list allocation will not cause those specialties to exceed the sustainable waiting list size.
"This is the number of people on the waiting list to maintain an 18 week wait between being added to the waiting list and being admitted for surgery.
"This approach means that the efforts that went into funding and delivering recovery and restoration phases 1 and 2 will not be wasted as the objective of the programme was to get waiting lists to the sustainable waiting list size on completion of the programme.
"In addition, after reviewing theatre productivity data, it has been identified that there are opportunities to improve theatre utilisation, particularly within general surgery and gynaecology, i.e. using the remaining lists more efficiently so that they can operate on the same number of patients in a reduced number of lists, thereby reducing the actual impact on patients.
"The weekly theatre planning meeting is leading on improving theatre utilisation by challenging surgeons to make the best use of the theatre list time allocated to them.
"Manx Care has recently been successful in recruiting substantive anaesthetic and theatre staff who are planning to join Noble’s Hospital over the next few months.
"Appointing new substantive staff members to the organisation is a positive development.
"Therefore as the requirement for additional bank cover reduces with the new permanent staff coming into post, the need to maintain these theatre lists reductions will be regularly reviewed as the opportunity to save will diminish and theatre lists will be reinstated accordingly.
"In the meantime the theatre team is taking a flexible approach to planning these reductions which will ensure that any urgent or cancer cases can be accommodated and any delays avoided wherever possible.
"Manx Care appreciates that taking this action is not ideal but is committed to minimise the impact on patients, restoring the theatre lists as soon as possible and meeting the requirement of our financial recovery plan."
Health and Social Care Minister Lawrie Hooper told Manx Radio: "As I am sure you are aware the Council of Ministers has made financial discipline a cornerstone of the Island Plan.
"Following a letter from the treasury minster outlining that Manx Care should enact its contingency plan to reduce expenditure and to try and come back within the allocated budget for the current financial year Manx Care have had to take operational decisions to try and achieve this.
"Manx Care and the DHSC have very recently presented to the Council of Ministers in respect of the financial pressures facing the health service, the decisions that will need to be made in order to achieve financial balance and the resulting impacts of those decisions.
"The position in respect of the importance of financial balance was made clear to Manx Care by the chief minister and treasury minister.
"Whilst any significant changes to services would require changes to the mandate, which would require the approval of the DHSC and the Council of Ministers, the decisions taken to date rest within the operational sphere of Manx Care and I would suggest the best people to speak to about this would be Manx Care directly."
The chief minister has not responded.
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