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Tynwald Sitting 16 October 2006 18 October 2006

Question 30 | Question 31 | Question 32 | Question 33 | Question 34 | Question 35 | Question 36 | Question 86 | Question 87 | Question 88 | Question 89 | Question 90 | Question 91 | Question 92 | Question 93

The question number refers to the question order specified in the official Tynwald Question Paper. To read the answers, scroll down this page or select a link to a question from above.

Question NumberSubjectQuestion from
30DHSS Beds - DementiaMr Henderson, MHK
31Bordersley InquiryMr Henderson, MHK
32Office of Fair Trading Report - Nursing Home FeesMr Henderson, MHK
33Educational Facilities - Children's Secure HomeMr Teare, MHK
34Cost - Strategic Information ProjectMr Karran, MHK
35Foster CarersMr Houghton, MHK
36Foster PlusMr Houghton, MHK
86SouthlandsMr Gill, MHK
87Thie RosienMr Gill, MHK
88Percentage of Old Noble's Hospital being utilisedMr Duggan, MHK
89Dental Treatments - NHSMr Duggan, MHK
90Aids and AdaptationsMr Houghton, MHK
91Healthcare Commission ReportMr Henderson,MHK
92Orthopaedic ConsultantMr Quayle, MHK
93Incapacity - Disability BenefitMr Quayle, MHK

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Question 30 - Mr Henerson, MHK

For Oral Answer: The Hon Member for Douglas North (Mr Henderson) to ask the Minister for Health and Social Security -

  1. What are the current numbers of DHSS beds available to care for older people with mental health problems such as dementia; and
  2. What is the break-down of these beds for the various sections of the Island?


Mr President,

  1. There are currently 57 beds in total to care for older people with mental health problems.
  2. The breakdown is as follows:
    • 8 beds on Grianagh Court, Elderly Admissions Acute facility offering assessment and treatment for those clients who are acutely unwell requiring admission to hospital. (Island-wide);
    • 16 beds Surby Unit, Southlands, Port St Mary, catering primarily for the needs of clients in the Douglas area and surrounding Districts;
    • 16 beds Gansey Unit, Southlands, Port St Mary, inclusive of 4 respite beds catering for the needs of clients residing in the South of the Island;
    • 17 beds Gardner House, Ramsey and District Cottage Hospital, inclusive of 3 respite beds, catering for the needs of clients in the North of the Island.

Question 31 - Mr Henderson MHK

For Oral Answer: The Hon Member for Douglas North (Mr Henderson) to ask the Minister for Health and Social Security –

Will you make the contents of the Bordesley Institute Inquiry public given that any personal details referring to children are removed, and if not, why not?


Mr President, The Bordesley Institute report was commissioned by the Department following concerns raised during the Commission of Inquiry about services provided to the Department by MFS [Manx Family Services]. The Bordesley Institute, an independent expert body, undertook a full inspection of all services provided by MFS and reported to the Department.

The Department has decided not to publish the report because it is not felt to be in the interests of children and young persons or those individuals who gave information to the Bordesley Institute to do so.

Even if personal details were removed, the text of the report would enable the reader to identify the location of care homes and possibly of service users and it is not felt to be in the public interest that such information become known.

The Department has made the findings of the report known in its press release on the 18th August 2006.

Question 32 - Mr Henderson, MHK

For Oral Answer: The Hon Member for Douglas North (Mr Henderson) to ask the Minister for Health and Social Security –

  1. Can you inform this Hon Court if the inquiry by the Office of Fair Trading into pricing of nursing and residential homes is complete; and,
  2. if so, have you and the Council of Ministers discussed its contents and will they be made public?


Mr President, The Council of Ministers commissioned an investigation by the Office for Fair Trading on 30 March 2006, following concerns over significant increases in charges announced by nursing homes in the Island.

The report of the Office of Fair Trading has been completed and has been discussed by the Council of Ministers. It will be laid before Tynwald in the current sitting and is thereby made public.

My colleague, The Hon. Mr Gelling, Chief Minister, will be making a statement at this sitting of this Honourable Court.

Question 33 - Mr Teare, MHK

For Oral Answer: The Hon Member for Ayre (Mr Teare) to ask the Minister for Health and Social Security –

What arrangements have been made for the provision of educational facilities for our persons in your Department’s care at the Children’s Secure Home following withdrawal of the contract from Include?


Mr President, The Children’s Secure Home is operated by the St Christopher’s organisation on behalf of DHSS. They are an organisation with experience and expertise in employing Teachers and delivering educational programmes for young people in care. With this in mind, Treasury approval has been granted at the Department’s request for an extension of St Christopher’s current contract to include the educational provision. This came about following lengthy discussion with the Department of Education who have agreed to give professional oversight to the education element of the contract with St Christopher’s.

Question 34 - Mr Karran, MHK

For Oral Answer: The Hon Member for Onchan (Mr Karran) to ask the Minister for Health and Social Security –

  1. How much money has been spent on the Strategic Information Project and what has the money been spent on;
  2. Was there an evaluation prior to the project commencing and will there be one at the end of the project, if not why not;
  3. Has there been a feasibility study and if so what were the results; and
  4. Does this project represent value for money?


1. How much money has been spent on the Strategic Information Project and what has the money been spent on?;

Mr President, before answering this question from the Honourable Member from Onchan, I would point out that a similar question from the Honourable Member from Douglas North (Mr Houghton) was put in the House of Keys on 24th February 2004 for a written answer, and from the Honourable Member from Onchan (Mr. Karran) in Tynwald Court on 19th April 2005.

In re-iterating those replies and expanding as appropriate, I would state:

Between the years 2000 to the end of financial year 2004 the total programme expenditure was £966,375.32.

The split of this total was :

  • Taskcare Ltd £756,600.25
  • Consultancy £38,115.00
  • ISD hardware, software, support etc £162,660.07
  • Total - £966,375.32

2. Was there an evaluation prior to the project commencing and will there be one at the end of the project, if not, why not?;

The SIP Project was initiated by Dr. Ian MacLean, the then Director of Public Health and Chief Administrative Medical Officer (CAMO). It was approved as part of the Health IT strategy and by Health Policy Group. However, it was recognised that the strategy needed more work and Dr McLean, took the lead and recommended Mr Alan Thomas to the Department to undertake and complete a consultative study. Dr MacLean had previously worked with Mr Thomas on Information and Communication Technology (ICT) projects in Scotland.

In the latter part of 2003, following the completion of Phase 1, a review of the project was undertaken by the then newly appointed DHSS Director of Information Systems Development in conjunction with colleagues from the UK National Health Service Information Authority (NHSIA). Whilst there was found to be merit in the project, and confirmation that the concept was appropriate, problems being encountered in the UK with health IT systems, and a number of unresolved technical issues, a decision was taken by the Department that it did not wish to commit to Phase 2 of the project and it was formally closed on 15th December 2003.

I would add this decision was taken with full consultation and concurrence from Treasury Internal Audit and Information Systems Division (ISD).

3. Has there been a feasibility study and if so what were the results?

A feasibility study was undertaken by Mr Thomas, who I mentioned earlier that the Department had appointed as a consultant on the advice of Dr. MacLean. This was based on a consultative study following which he invited a number of companies to submit proposals. Presentations were arranged for the then Chief Executive and senior officers within the DHSS.

Following a lengthy evaluation process, which involved ISD and Internal Audit. A company called Taskcare, who had been involved in similar projects in New Zealand and Australia, was selected in February 2000 as the “preferred bidder” for a contract with the Department.

This included Taskcare submitting a controlling specification for the project. In December 2000 a contract for the supply of Phase 1 of the Strategic Information Project was signed by the then Chief Executive Officer and by the then Manager, Information Systems Division, Treasury, with development work commencing in January 2001.

4. Does this project represent value for money?

Mr President, I regret to say that the SIP project did not represent value for money and that was why the Department stopped the project and terminated the contract.

Question 35 - Mr Houghton, MHK

For Oral Answer: The Hon Member for Douglas North (Mr Houghton) to ask the Minister for Health and Social Security –

  1. How many foster carers are employed by your Department;
  2. How many foster carers have resigned over the last 12 months; and
  3. What were the reasons for these resignations?


Mr Speaker, For accuracy, the Department does not ‘employ’ foster carers. They are effectively self employed and receive a payment from the department.

  1. We are currently making payments to 21 foster carers providing placements for 28 children looked after. A further 3 disabled children receive regular respite in a dedicated foster placement.
  2. For the period September 2005 – September 2006, there were no resignations.
  3. When there have been resignations in the past, they were for various reasons; for example, people leaving the Island or retiring after many years service. We currently have 4 foster carers who are ‘on hold’ for such reasons as medical circumstances and family members, and pregnancy of a foster carer.

Question 36 - Mr Houghton, MHK

For Oral Answer: The Hon Member for Douglas North (Mr Houghton) to ask the Minister for Health and Social Security –

  1. What are the annual costs to your Department for engaging the “foster plus” agency; and
  2. Why does your Department need to employ this agency?


Mr President, The contract with Fosterplus costs the Department £332,500. It was awarded in 2004, following a competitive tendering process, as a result of which Fosterplus were determined to be the agency offering best value to the Department.

The decision to go out to tender for this work was based upon a strategy that sought to promote the development of fostering and also to develop specialist fostering schemes as these were seen as offering the best outcomes for children and young people and also offering best value in terms of the use of resources.

The Department did not have the specialist expertise or the personnel provision to allow us to develop and expand these services in-house. Fosterplus was recognised as having extensive experience and expertise in developing fostering schemes that would benefit the Island.

Question 86 - Mr Gill, MHK

For Written Answer: The Hon Member for Rushen (Mr Gill) to ask the Minister for Health and Social Security –

How many people are currently assessed as needing permanent accommodation in Southlands but cannot be accommodated?


As of 9 October Social Services currently have 14 older people who have been assessed as requiring permanent residential care within Southlands. We do not operate a “waiting list” in the sense that people are not “held in a queue”. Rather social services mangers are regularly assessing the relative urgency of each case on the basis of need through an allocations panel of relevant professional staff. When vacancies become available the top priority candidates are offered a place.

For those we are not able to offer a place immediately alternative arrangements are organised including social services homecare, social work support, community health services, assistance from befrienders. With the recent expansion of respite care at Southlands we are now able to offer very flexible and comprehensive respite provision which can help sustain support from family carers at home.

The further expansion of both respite care and permanent places at Southlands will be dependent on the allocation to the DHSS of further revenue and personnel resources to employ sufficient staff. It was always the intention to open Southlands on a phased basis as resources became available. This is necessary to be compliant with standards set by the Registration and Inspection service, which ensure appropriate staffing ratios for the maintenance of a high quality and safe service.

Question 87 - Mr Gill, MHK

For Written Answer: The Hon Member for Rushen (Mr Gill) to ask the Minister for Health and Social Security –

What is your current timetable for the location of services into Thie Rosien?


Thie Rosien became available for occupation at the beginning of February 2006. Since that date, the following services have been relocated to this building –

  • Adult Psychiatry, out-patient clinics;
  • Audiology;
  • Child and Adolescent Mental Health Service, out-patient clinics;
  • Counselling, out-patient clinics;
  • District Nursing;
  • Drug and Alcohol Service, out-patient clinics;
  • Health Visiting;
  • Occupational Therapy;
  • Podiatry;
  • Psychology, out-patient clinics;
  • Physiotherapy;
  • School Nursing; and,
  • Speech and Language Therapy.

In addition, part of the building has been made available to an independent dental contractor to provide NHS dental services.

Thie Rosien provides an administrative base for Home Carers to supervise work in the South of the Island and facilities for home carers to meet their supervisors. There are also facilities for Social Workers providing services for Older People. Part of the building is used for community based activities by Social Workers supporting people with Learning Disabilities.

The Southern Befrienders Scheme has an administrative office within Thie Rosien.

It is anticipated that before the end of this year, the Mental Health Service will have opened an Adult Psychiatry Resource Centre in the building.

The Department currently has no specific further plans to relocate or develop services at Thie Rosien. The general thrust of service development in the Health Service is towards providing more services closer to patients, in a community setting. It is highly likely that Thie Rosien will play an important part in future developments.

Quesiton 88 - Mr Duggan, MHK

For Written Answer: The Hon Member for Douglas South (Mr Duggan) to ask the Minister for Health and Social Security –

What percentage of Old Nobles Hospital is being utilised –

  1. By whom:
  2. Which parts are presently not being used, and does your Department intend to put them into use; and
  3. What is the total cost of heating and repairs for the last 12 months?


(a) Approximately 25% of the former Nobles Hospital is currently being utilised. The services that are provided from there are itemised as follows:

Looking at the hospital from Westmoreland Road and starting at the left hand side in the former new ward block, the following services are provided on the ground floor:

  • Physiotherapy
  • Occupational Therapy
  • Breast screening
  • Paediatric Occupational Therapy
  • Podiatry
  • Orthotics
  • Prosthetics
  • Wheelchair Assessment

On the first floor we have:

  • Psychology and Counselling
  • Human Resources Directorate
  • Registration and Inspection (Social Services)

In the former old ward block we have:

  • Finance Directorate offices
  • Carnane Dental Clinic (5 chairs)
  • Occupational Health

In the former Outpatients Department we have Kensington Group Practice.

The Government Analyst and Laboratories occupy the former laboratories associated with the hospital and the blood donor suite is on the top floor of that building.

The former Mortuary has been converted to Hillside Dental Clinic which has three dentists.

The Ambulance Service remains in the basement of the former Jane Crookall Wing and they also occupy a part of the ground floor. Also in the Jane Crookall Wing we have Family Planning and Speech Therapy and we are considering locating the Child Protection Service there in January.

We have a short term lease with the Manx National Youth Band for the Post Graduate Centre and we intend to enter into a long term lease with the Manx Foundation for the Physically Disabled for the former workshops (subject to contract).

(b) The following areas are not being utilised but it is intended that they will form part of the Central Community Healthcare Development which is in the Capital Programme for 2009/2010.

  1. Part of the Jane Crookall
  2. Ward 10
  3. Day Hospital
  4. Boiler House and associated buildings facing Ballakermeen Road
  5. Staff changing.

The following areas are not being utilised but it is intended to transfer ownership thereof to the Department of Education.

  1. Former Administration Block
  2. Accident and Emergency
  3. Operating Theatres and associated rooms
  4. Kitchens and Canteen
  5. X-Ray Department
  6. Physiotherapy Department
  7. Thomas Cubbon Wing
  8. Princess Alexandra Wing
  9. Renal Unit.

All of the above is subject to a report from the Working Party into the future of Nobles Hospital being presented to and being accepted by the Council of Ministers. (N.B. The Report cannot be submitted until the DHSS have surety that the proposal to relocate the ambulance to the Quarterbridge is accepted)

(c) The boilers in the former Nobles Hospital provide heat and hot water to the Nobles complex and in addition provides the same to the Nurses Home and Crookall House. The cost of providing heat and hot water to these buildings for the 12 months ending September 2006 was £240,000.

Maintenance Costs: The cost of maintaining/repairing Nobles Hospital for the 12 months to the end of September was £108,000. These costs include grounds maintenance, internal and external decoration, repairs to the fabric, fittings, fixtures and services including plumbing, heating and ventilation, lifts, filter plant, fire alarms, gases, electrical installations, etc.

Question 89 - Mr Duggan, MHK

For Written Answer: The Hon Member for Douglas South (Mr Duggan) to ask the Minister for Health and Social Security –

What is the present situation regarding dental treatment for patients under the NHS?


The Department of Health and Social Security provides dental services under the National Health Service Act 2001, to all residents of the Island. In order to provide this comprehensive service, the Department has contracts with 19 independent dentists and employs a further 20 dentists, and specialist staff to provide services.

NHS Dental Services are provided throughout the Island, with independent dentists being available in Ramsey, Douglas, Port St Mary, Port Erin and Castletown, with a new practice about to open in Peel. The Department also provides dental services in Douglas and at Ramsey & District Cottage Hospital.

The Department entered into new arrangements with independent dentists to provide NHS dental services from 1 April, 2006, which changed the way that services are provided. Independent dentists now have a contract with the Department for the provision of services, the value of this contract is determined on the basis of the type of treatment provided to patients and is negotiated individually with each dentist.

In recent years, the Department has experienced a reduction in the capacity for NHS dental services. This has been met initially by expansion in the Department’s dental services and is now being met by an increase in capacity by independent dentists. During this time the Department has provided a “safety net” to all residents of the Island through the Department’s dental service.

Whilst this “safety net” provides dental treatment when it is required, the Department recognises that it would be preferable for all residents to receive regular NHS dental services, regardless of whether they require treatment.

In June 2006, there were approximately 2,000 people to whom the Department was providing the “safety net” service whilst waiting to be allocated to a named dentist. By the beginning of October, this had reduced to just over 1,700 adults.

With the imminent opening of the new independent dental practice in Peel and expansion of services by an independent dentist in Douglas, it is expected that the number of people receiving the “safety net” service will be substantially reduced. It may not be possible to clear this list as, on average, the Department is contacted by 20 people each week requesting dental services. However, the aim of the Department is that residents will be on this list for as short a period of time as possible.

The Department is also planning for a further increase in capacity for NHS dental services, and negotiations have commenced with one independent dentist to double the activity carried out under their contract.

If any resident of the Island wishes to be provided with NHS dental services, they should contact the Health Services Division of the Department on 642662. If treatment is required on an emergency basis, they should contact one of the Department’s dental surgeries, who will provide them with information on when and where to receive treatment.

Question 90 - Mr Houghton, MHK

For Written Answer: The Hon Member for Douglas North (Mr Houghton) to ask the Minister for Health and Social Services -

Is your Department prepared to consider amending the Aids and Adaptations Financial Criteria to permit applicants who are disqualified from claiming financial support on the grounds of personal capital holdings to be eligible to claim a maximum of £2,000 towards their costs of providing an approved adaptation to their private premises?


The Department has a duty under Section 2(e) of the Chronically Sick and Disabled Personal Act 1981 to provide assistance for a disabled person in relation to adaptations of their home or provision of additional facilities. However, this duty is subject to the Department considering any such provision to be reasonable in all the circumstances of the case. In practice, the Department is only required to provide for private home owners as the public sector providers largely deal with the needs of their own tenants.

In considering what is reasonable, the Department has agreed Financial Criteria whereby it determines who is eligible for assistance. The current Financial Criteria, agreed by the Department in April 2004, disregard small adaptations on facilities under £2,000, but for any application above that cost undertake a financial assessment and if the applicant has assets in excess of £12,000, in line with Income Support Regs agreed by Tynwald, they are deemed to be ineligible for assistance as in the circumstances it is felt that they could afford to pay for the adaptation themselves. In a situation where the demand far exceeds the budget, this allows best use of public funds for those cases who cannot afford to undertake the work themselves and who might otherwise require to be admitted into health or social care which would be both costly and undesirable.

The Hon Member is requesting that in all cases we pay the first £2,000 of any application irrespective of the income of the applicant, which would increase our expenditure and would not, in the Department’s view, be the best use of public funds at a time when the Department’s budget is already under great pressure.

Question 91 - Mr Henderson, MHK

For Written Answer: The Hon Member for Douglas North (Mr Henderson) to ask the Minister for Health and Social Security -

  1. How much did the recent Healthcare Commission Report cost;
  2. Which Civil Servant authorised it;
  3. Can you confirm that you endorsed the proposal;
  4. How many people did the Healthcare Commission have in their team;
  5. Were each and every one of them eligible for expenses whilst on the Island; and, if so
  6. What was the total cost of all the expenses?


In answer to part (1) of the question, the Healthcare Commission Report cost £141,780 in total.

In answer to part (2) of the question, the proposed review by the Healthcare Commission was not authorised by a Civil Servant. I would confirm that I authorised the proposal for the Healthcare Commission review of Noble’s Hospital.

In answer to part (3) of the question, I would confirm that I endorsed the proposal for the Healthcare Commission review of Noble’s Hospital.

In answer to part (4) of the question, there were 16 people in the Healthcare Commission team who worked on the Noble’s Hospital Review. This included a Project Manager, Business Analysts, Auditors and Clinical Associates.

In answer to part (5) of the question, the £141,780 cost of the Healthcare Commission Report was inclusive of all expenses incurred by members of the Healthcare Commission team.

In answer to part (6) of the question, the total cost of the Healthcare Commission Report was £141,780, included all expenses.

Question 92 - Mr Quayle, MHK

For Written Answer: The Hon Member for Middle (Mr Quayle) to ask the Minister for Health and Social Security –

  1. Will you confirm when an additional Orthopaedic Consultant was employed, and will you provide a comparison as to waiting lists for hip/knee replacements etc before his arrival and currently;
  2. What would be the average number of hip/knee replacements done each year per Consultant and how does this compare with a Consultant in a UK District General Hospital; and
  3. Are you satisfied about the length of waiting lists, and if not, what action if any, is proposed to remedy the situation?


  1. A third Orthopaedic Consultant was appointed in September 2005. Prior to this appointment, the number of patients waiting for joint replacement surgery was 105. At the end of August 2006, the number of people waiting for this type of surgery was 84.
  2. The average number of total joint replacements is 74.7 per Consultant per year. In general terms, it would appear that the activity in Orthopaedic surgery at Noble’s Hospital is comparable to that found in an average English District General Hospital.
  3. The Department does not have the resources available to meet the demand placed upon us by the population of the Island. One of the aspects of this is that the waiting time for total joint replacements is longer than the Department would wish. In addition to the on-going service to provide joint replacements, the Department is using monies put aside to reduce waiting times to fund one additional joint replacement each week. In early November, this will be increased to two additional joint replacements, whilst these funds remain available.

Question 93 - Mr Quayle, MHK

For Written Answer: The Hon Member for Middle (Mr Quayle) to ask the Minister for Health and Social Security –

  1. What action is being undertaken by your Department to assist those on Incapacity Benefit/Disability Benefit/Long term unemployed to return to work;
  2. Would you not agree that if they are assisted to return to work, it would;
    1. improve a person’s self-esteem and financial circumstances.
    2. make a positive contribution to the Manx economy;
    3. reduce the need for importation of labour; and
    4. reduce your Department’s benefits payable, so that the money saved could be diverted to investment in healthcare?


(1) The Department’s Social Security Division provides various services, benefits and allowances intended to assist and incentivise persons who are not employed, but have the capacity to be so, in the transition from unemployment to remunerative work.

In relation to jobseekers who are registered with the Department, throughout the duration of their registration meetings are held at approximately two-monthly intervals with a trained Employment Officer who advises them on, inter alia:

  • the best places to look for job opportunities, such as the Jobcentre and the local papers;
  • how to go about applying for jobs;
  • Jobcentre services (e.g., preparation of a C.V. and Jobsearch Workshop courses);
  • training opportunities with the DTI Training Centre and at IOM College; and
  • benefits and grants which would be available to them if they were to secure employment.

If a registered jobseeker has a disability, the Employment Officer would also signpost them to the DTI’s Disability Employment Services.

For those who receive Incapacity Benefit, schemes exist which protect their benefit position whilst they undertake training or part-time work or if they move into full-time work but then fall ill again.

Incapacity Benefit recipients who undertake rehabilitation training in order to retrain for work can continue to receive their benefit if the rate of benefit payable to them is greater than that of any training allowance available.

A scheme known as “Permitted Work” also exists, which allows Incapacity Benefit recipients to keep their benefit whilst they undertake part-time work (i.e., for less than 16 hours a week) for up to 52 weeks, provided their earnings are less than £84 per week.

In regard to those who have been incapacitated for over a year and receive the long-term rate of Incapacity Benefit, if they leave benefit to go to work, they are guaranteed to return to the long-term rate of Incapacity Benefit if they become incapacitated again during the first year of their employment. This term is extended to two years where the person’s earnings have been supplemented by Disability Working Allowance.

For those who have been receiving income support or income-based jobseeker’s allowance for 26 weeks or more, a provision known as “benefit run-on” exists. Under this provision, if a person takes up work of at least 16 hours a week, which is expected to last for at least 5 weeks, the amount of benefits they were receiving immediately before they commenced employment will continue to be paid to them for the first 4 weeks of their employment, irrespective of any earnings they may be paid by their employer during the period.

For those who were receiving income support or income-based jobseeker’s allowance who are not eligible for benefit run-on, exceptional needs grants are available to ensure they have the same level of income as they had immediately before they commenced employment until they receive their first wage or salary payment. Additional grants are also available if they are required by their employer to have tools and/or protective clothing or footwear, which the employer does not provide free of charge.

The Social Security Division also provides what are known as “in-work” benefits to those who have low earnings, viz Family Income Supplement (FIS) and Disability Working Allowance (DWA). These benefits are income-related: entitlement is calculated by comparing a person’s income against a prescribed amount (according to their circumstances) and, where there is a shortfall, 70% of the difference is paid. FIS is payable to able-bodied workers who are either married (whether or not they have dependent children or young persons) or are a lone parent or a member of a couple bringing up children. DWA provides higher rates of support than FIS and is available to single people as well as couples and lone parents, where certain eligibility criteria are satisfied.

An Employment Services Steering Group, made up of officers from the Social Security Division and the DTI is presently looking at further ways of facilitating the long-term sick and unemployed to return to work.

(2)(a) The provisions described above have been designed to ensure that a person is always better off in work than on benefits. Social studies conducted in the United Kingdom have consistently shown that work is the best route out of poverty and social exclusion. However, it should be noted that not all those on benefits have the capacity to work, despite the incentives to do so. Indeed, it is likely that the majority of long-term Incapacity Benefit recipients will never return to work.

(b) A return to work does not necessarily mean a reduction in benefits expenditure. For example, a lone parent may be paid more in FIS (in addition to her earnings) than she would receive in income support whilst unemployed. However, whatever type of work she may undertake, it is likely to contribute positively in some way to the Manx economy.

(c) Of course, the utilisation of any local labour which is not currently employed would reduce to some extent the need for importation of labour. However, one needs to be cognisant of the number of long-term benefit recipients who may return to work and to their competencies.

(d) As stated above, a return to work would not necessarily mean a reduction in benefits expenditure, on an individual basis. However, over all one would expect there to be some saving. Whether or not a saving in social security expenditure could be made available to help fund the provision of health services would be a matter for discussion between the Department, the Treasury and the Council of Ministers.

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