Creating a new Organisation to Provide Health and Social Care Services - Manx Care

Closed 17 Apr 2020

Opened 6 Mar 2020

Feedback Updated 2 Jun 2020

We Asked

We sought views and feedback on the proposed new Manx Care Bill via the public consultation “Creating a new Organisation to Provide Health and Social Care Services – Manx Care”.

You Said

We received 36 formal responses to the consultation: 4 of these responses were received from organisations and 32 individuals.

The majority of consultation responses received were supportive of the establishment of Manx Care and the proposals set out within the consultation paper and the Bill.

We Did

We have now reviewed all of the responses received which has proved useful in identifying some changes that have benefited the drafting of the Bill. A large amount of feedback was also received which will be useful for various other projects that form part of the wider Transformation Programme.

Results Updated 2 Jun 2020

The final consultation report on Creating a new Organisation to Provide Health and Social Care Services – Manx Care can be found below:



Following Sir Jonathan Michael’s Independent Review of the Health and Care Service, the Health and Care Transformation Programme within the Cabinet Office has been working to implement the recommendations.

Amongst the recommended areas to change was that the Department of Health and Social Care (‘DHSC’) currently sets the policy for health and social care as well as taking responsibility for delivering health and social care services. This means senior staff have a dual role and are not always focussed on delivering high quality care.

The Final Report outlined a number of key recommendations including the need for separation of operational delivery of services currently provided by the DHSC from the strategic direction setting, policy development and support for Ministers that it also provides. This recommendation requires the establishment of a new, arms-length organisation focussed on delivering health and social care services on the Island.

The benefits outlined for the establishment of a separate arms-length body (proposed to be known as Manx Care) include the need for:

  • a structure that provides clarity on who is responsible and accountable for the provision of care
  • the DHSC to adopt a more strategic (and less operational) role
  • senior management to focus on service developments and enhancing levels of quality as opposed to day-to-day management issues and
  • more leadership attention to strategic and operational planning and performance management

The first part of the transformational change is to establish a new organisation to deliver health and care services (proposed to be known as Manx Care). This will be a single public sector body with responsibility for delivering and commissioning all health and care services on the Island as an arm’s length body from Government. It will be run by a Board appointed by Government and approved by Tynwald.

The arms’ length body will be established as a Statutory Board which requires a new piece of primary legislation: the Manx Care Bill.

The legislation being consulted on is a structural Bill drafted to establish Manx Care and implement some of the high level recommendations within the Final Report. The content of the Bill focusses on how Manx Care will be set up and the requirement for the DHSC to obtain health and social care services via a written agreement ('the Mandate') with Manx Care.

The Bill makes reference to the current National Health and Social Care Service legislation for reference to the DHSC’s duties, which will either remain as the DHSC’s duties (for example, to promote a comprehensive health and social care service) or be discharged by Manx Care, on behalf of the Department (for example, to provide or secure provision of health and social care services).

A second Bill will be drafted to focus on National Health and Care Service reform, which will modernise the current legislation in line with recommendation 8 of the Final Report, which states that 'legislation should be introduced…in order to form a modern, comprehensive legislative framework. This legislation should address weaknesses or gaps in the current system as well as enabling the implementation of the recommendations contained in [the] Report'. Work is ongoing on this National Health and Care Service Bill and a separate consultation on that Bill will follow.

The following survey gives a summary of what has been included in each Part of the Bill alongside the legal wording. Feedback is requested on each Part in turn.

Why We Are Consulting

Whilst Sir Jonathan Michael engaged with the public as part of the Independent Review, there has not be a public consultation on the recommendations or the methods of implementing those recommendations. We are consulting to get the views of the Isle of Man community on the proposed legislation to establish Manx Care.

What Happens Next

After the consultation closes the responses will be reviewed against the legislation and the policies outlined within Sir Jonathan Michael’s Independent Review of the Health and Care Service to determine whether any changes are necessary to the Bill.

A summary of matters raised in the consultation, with responses where appropriate, will be published and the draft Bill will be finalised with a view to being introduced into the House of Keys before the summer recess.


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