Our Government simply adores grandiose schemes which prove we may be British but not part of the UK and we do things our own way. But that means lots of reinvented wheels and sometimes it's just plain dumb!
Government loves to tell us how wonderful our health service is, and I wouldn't dream of denigrating the majority of dedicated people working within the DHSC. But many people I've been canvassing for votes have told me horror stories about interminable waiting lists, botched procedures and haughty, unapproachable staff who 'know best'.
“ Manx Care is in the driving seat of getting our health service back on track, but (to mix metaphors appallingly) it's Tynwald that calls the shots"
So rather than blow smoke where the sun don't shine, let's look at this objectively. Our health service professionals are often trained in UK hospitals to UK standards, take UK professional exams and many need to maintain UK accreditation. In fact the only part of our health service that isn't required to conform to UK standards is...our health service itself. Even Manx Care conceded at a recent briefing that if it was in the UK system, Noble's Hospital would be put into 'special measures'. In other words, in some significant ways our jewel in the crown 'new' hospital doesn't make the grade.
So 'what's up, Doc?': I was married to a nurse once. That's my only medical qualification! But talking to a couple of people who work within our health service I suspect that the problem is that Noble's tries to do too much. It provides specialist care to people with a myriad of medical problems. With a population of only around 85,000 people, maybe it's time to realise that Noble's can't be an effective 'one stop shop' for every ailment, as attractive as that may sound. If you're sick, of course you'd rather be treated locally. But putting emotion to one side, is it the best option clinically OR financially.
Money's too tight to mention: Pretty much every year the DHSC has to go to Tynwald cap in hand and tell Treasury it spent more money in the last financial year than had been budgeted. So there's the annual argument about whether health is under-funded. Here's a thought though; I reckon you could DOUBLE the annual healthcare budget and the medics would still spend it all - and more. So how could we make the system affordable and offer a better service?
That's a lot of dough, Joe: Many of us were surprised to learn recently that the average wage of a medical/surgical consultant in the UK is around £120,000 a year. Yes, they have to be smart, dedicated, spend years training and trying not to damage too many impatients, but it's not a bad stipend. Of course, in the Isle of Man we do better than that - average salary for the same skills and experience here is around £190,000. So we're effectively having to bribe medics to work here. I've been told that's because in the UK they'd end up working in a teaching hospital, often a Centre of Excellence specialist unit where they have a high throughput of interesting cases, are able to hone their skills by constant use and generally build a professional reputation. But there are too few cases like that in the Isle of Man, so even the low tax, huge salary boost and lovely countryside don't really cut it.
So how about this: And I hasten to add that I've not stress-tested this argument with medical experts, but it is a theory, it is MY theory, and it is mine (cf. Ann Elk)
“ Back to basics again. Do the do-able, and do it well”
Make Noble's Hospital the best general hospital we can. Set a lower limit on the number of patients needed for specific treatments or procedures to happen locally, and if we can't justify a consultant and support staff having a 100% caseload we ship the patient to a specialist unit in the UK. They'll probably get better treatment there anyway. Noble's would deal faster with more routine matters and be absolutely mustard at timely diagnostic medicine and coming up with a targeted treatment plan for every patient. All we want to know is what is wrong with us, quickly, and then be assured we are getting the best treatment possible!
We need to 'invert the pyramid' of healthcare to put the user at the apex. Too often patients are made to feel like an annoyance to be patronised and put up with. Some clinics are well managed and run to time (take a bow Blood Clinic) others require you to book half a day off work as you know you'll be kept waiting interminably while the consultant does More Urgent Things (have a meeting with their personal wealth manager maybe?). And why do you have to have a physical appointment to get the results of a test - can't medics use email or text messages more? When I was a child, the family doctor used to come to the house if any of us was properly ill or contagious. Now, you can't get an appointment at their surgery for 14 days!
We also need to realise that (and I'm sure they would deny it vehemently) some people seem to rely on our medics simply for company and a friendly ear. I'm sure not everybody in the waiting room really needs to be there quite so often. Maybe charge £10 per solus appointment (those with a recurring complaint exempted).
I've said in the past that we should have fewer people in business suits and more people in surgical scrubs working in our health service - wouldn't that be an improvement? Matrons and Sisters rather than Directors and Ward Managers. But realistically I have to concede that 'data' is the new darling. And any slip or mistake nowadays is often met by a huge compensation claim, whereas in the past they just used to apologise to the bereaved and bury their mistakes!
I have high hopes that Manx Care will get our health service back on track, and not just be another 'jobs for the boys' quango intended to take the heat off the Health Minister. They have the opportunity to rethink our health service, turn it into a world class diagnostic centre where we all get to know what's wrong with us, quickly, and have the reassurance that if we do need specialist treatment, we'll get it - and from the best facility in the 'other island'. We'll know in the fullness of time if that faith is justified. If we're spared...
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Best wishes
Stu