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Tynwald Sitting - 10th July 2007 10 July 2007

Oral Question 17 | Oral Question 18 | Oral Question 19 | Oral Question 20 | Oral Question 21 | Oral Question 22 | Oral Question 23 | Oral Question 24 | Oral Question 25 | Oral Question 26 | Oral Question 27 | Oral Question 28 | Written Question 58 | Written Question 59 | Written Question 60

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

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

Question NumberSubjectQuestion from
Oral 17Kirk Michael SurgeryMr Cannan, MHK
Oral 18Social Services Budget DirectiveMr Henderson, MHK
Oral 19Social Services BudgetMr Henderson, MHK
Oral 20Social Services Budget CommentsMr Henderson, MHK
Oral 21Residential HomesMr Henderson, MHK
Oral 22Inpatient Food BudgetMr Henderson, MHK
Oral 23Misuse of Drugs ActMr Henderson, MHK
Oral 24Ambulance Paramedic Services & Dipped HeadlightsMr Gill, MHK
Oral 25Dental Ward 10 Mr Crookall, MHK
Oral 26Westview DentalMr Crookall, MHK
Oral 27Manx Pension SupplementMrs Cannell, MHK
Oral 28Manx Pension AssociationMrs Cannell, MHK
Written 58Actuary Report Mrs Cannell, MHK
Written 59Noble's Hospital 44MMrs Cannell, MHK
Written 60State PensionMr Karran, MHK

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Oral Question 17

For Oral Answer:

The Hon Member for Michael (Mr Cannan) to ask the Minister for Health and Social Security –

How is it you were able to make the statement that the projected annual manning cost over a 5 year period for the proposed General Medical Practice Surgery at Kirk Michael would be £1,500,000.00, but when asked what is the estimated annual running cost over a 5 year period in respect of the Castletown and Ballasalla surgeries you are unable to provide an answer? Answer

Mr President

In answer to the Hon Members question I can advise that the figure of £1,500,000 in relation to the costs over a five year period of manning a GP surgery in Kirk Michael was a notional figure based on the cost to the Department of running a newly established practice in the Douglas area of a similar size.

The question as regards the costs of running established practices such as Castletown and Ballasalla raises different issues as a significant element of the cost, for example, staffing and utilities, is met by the relevant Practice, the details of which therefore are not known to the Department.

These are distinctly different situations and cannot be subject to a direct comparison.

Oral Question 18

For Oral Answer:

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

  1. Can you confirm that an e-mail was sent by your Department Director of Social Services on 2nd May 2007 to budget holders and contract holders through the Social Services and stated:
    “at the meeting with the Minister and Chief Executive on 25th April, reference was made to the budgetary targets for this year. It is appreciated that this is very difficult and may involve the need to reconfigure services but there is no margin for overspend whatsoever. There will be a consideration of the implications of this situation by the department later this month. In the first instance, can you ensure that relevant budget managers receive this note and give an early indication of the impact on their service? This will be needed by 10th May at the latest as the information will need to be collected and forwarded to the Director of Finance on that date for consideration by the Chief Executive and Senior management team and then the department.”
  2. can you further confirm whether a similar directive was issued to the Health Services?

Answer

Mr President

The Department’s budget has been overspent in recent years and we are reviewing all options to try to bring the Department’s budget under control as Honourable Members would expect. As part of this process, I have advised all budget holders that they must manage within their budgets and this is the case within Social Services as much as any Division.

The Department is presently considering a number of options that may be required in order to meet our budgetary targets and following proper consultation decisions will be made.

Having given this response in the interests of transparency, I must observe that it is not helpful to the proper business of Government for Honourable Members to selectively quote from internal communications and it would be helpful in framing a more comprehensive reply if I could have access to the Honourable Member’s source document.

With regard to the second part of the question, Health Services are also working hard to contain their expenditure within budget and as is customary, budget holders will be issued with budgetary targets that must be adhered to.

Oral Question 19

For Oral Answer:

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

  1. Will you make a full and frank statement in relation to a statement issued by your Department Director of Social Services on 2nd May 2007 stating:
    “It is appreciated that this is a very difficult and may involve the need to reconfigure services but there is no margin for overspend whatsoever? There will be a consideration of the implications of this situation by the Department later this month. In the first instances, can you ensure that relevant budget managers receive this note and give an early indication of the impact on their service? This will be needed by 10th May at the latest as the information will need to be collected and forwarded to the Director of Finance on that date for consideration by the Chief Executive and Senior Management Team and then the Department”
  2. and within any such statement highlight the impact on services referred to in the e-mail directive as a result of all budget holders planning to make 10% savings during this financial year, and has the exercise been undertaken and, if so, what responses to impacts on service have been received and what impacts were outlined?

Answer

Mr President

it appears that both Questions 18 and 19 relate to the same email and on that basis, I have already responded to the Honourable Member’s question.

Oral Question 20

For Oral Answer:

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

Has your Department received back any comments from Budget/Contract Holding managers within the Health or Social Services relating to make 10% savings within their areas of budgetary control, and, if so, will you be acting on any of them and, if so, which and what will the effects be to that service and to patients?

Answer

Mr President

I refer to my previous answer on the same topic. The Department is exploring options that will make it possible to bring its spending within budget and all budget holders have been engaged in this exercise.

The Department is currently reviewing these options and will be consulting appropriately before coming to any final decision.

Some very useful suggestions have come forward from my colleagues within the Department. They (that is to say those on the shop floor) have told me what is possible and where it is possible.

However, it would be premature to make any further public comment at this time.

Oral Question 21

For Oral Answer:

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

  1. Can you confirm your Department Members’ assertion and revaluation in June Tynwald that elderly people in long term care in DHSS Residential Homes are only allowed a full day’s meal budget of around £2.00 per day;
  2. if not, what is the budget allowed per head per day in DHSS-run residential homes?
  3. Can you confirm if there is a budget in place for a day’s food per head for care of the elderly in short or long term nursing care within your Department and, if so, what is this?

Answer

Mr President

The average budgeted amount for meals per person per day across the 4 DHSS run Resource Centres is £2.28.

The quality and nutritional value of food provided is inspected by the Registrations and Inspection Unit who check the menu’s during every inspection and talk to residents. The inspections are conducted twice yearly. However, special dietary requirements are fully met for individuals with specific health or cultural needs.

In answer to the final part of the Honourable Member’s question, there is no budget in place because my Department does not provide nursing care, short or long term, for the elderly.

Oral Question 22

For Oral Answer:

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

Is there a budget per head, per day for any patient receiving in-patient care at the new hospital for daily food requirements and, if so, how much is that pitched at?

Answer

Mr President

There is no fixed budget daily budget per head, for inpatients at Noble’s Hospital. Food is provided on the basis of the nutritional needs of the patient and varies according to their needs. In some cases the needs are very complex and involve highly specialised diets. Thus, the current budget for food provisions is a cumulative allocation to provide patient meals for Nobles Hospital and Adult Mental Health Units. There is an element of the cost set aside for the generation of income. This enables products to be sold/charged to staff and other customers. The income received offsets any adverse variance created via the purchasing of provisions for this purpose.

The inpatient costs can really only be effectively identified retrospectively. This is due to the unpredictable fluctuation in-patient numbers and patient groups attending the hospital at any given period. The menus are designed to reflect this fluctuation with the catering department working very closely with the dietetics department to ensure that all nutritional aspects of the provision are met.

This method of budgetary allocation therefore enables the hospital to have a reasonable degree of flexibility in the preparation of a varied and nutritious diet to our patients using a high percentage of locally grown fresh produce.

Oral Question 23

For Oral Answer:

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

It was outlined during June Tynwald and you agreed to the point raised during Item 31 – Misuse of Drugs 1976 Act, Drugs Regulation (Application) Order 2007 - that it was technically possible through a loophole in the new regulations for any person to be in possession of “magic mushrooms” and not break the law: can you therefore bring further amending legislation to rectify this matter and what is a technically flawed Order?

Answer

Mr President

I thank the Honourable Member for this question, but as I am sure he will appreciate, this is a complex matter which requires proper investigation involving several Departments of Government. I therefore regret that I am unable to give him a definitive answer at this stage other than to assure him that this is a matter of concern, and that I will seek to take any appropriate action as and when the necessary investigations are complete.

Oral Question 24

For Oral Answer:

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

In considering a departmental policy will you advise this Hon Court what are the professional views of the Isle of Man Ambulance and Paramedic Service in relation to the merits or otherwise of considering introducing legislation requiring dipped headlights/ daytime running lights in vehicles driving on Manx roads?

Answer

The Island’s Ambulance Service would be supportive of any measures that enhance the visibility of road users.

Such a measure would however have wider implications than simply the Ambulance Service and needs to be seen in the context of the needs of Isle of Man as a whole. That is more properly a matter for my Honourable Colleague the Minister for Transport who responded to a related question from the Honourable member in the House of Keys on 22 May 2007 and I refer the Honourable Member to that answer.

Oral Question 25

For Oral Answer:

The Hon Member for Peel (Mr Crookall) to ask the Minister for Health and Social Services –

  1. How many people are currently on the health authority dental waiting list; and
  2. would you advise this Court of the budget that has been put aside to fund NHS dentistry in Ward 10 at the old Noble’s Hospital?

Answer

Mr President

In answer to the first part of the Honourable Members question, I can advise that there are currently 2,280 people awaiting allocation to an NHS dentist.

I should perhaps point out that a significant number of those people are currently attached to a private dentist, but on the basis of the Departments recent success in expanding NHS dental service provision now wish to transfer into the NHS.

Members will also be interested to know that within the last twelve months 4,214 people have been allocated an NHS dentist with 2,218 new contacts to the Department during the same period.

The number of patients under the care of an NHS dentist is at its highest level since 2002.

In answer to part two of the Honourable Members question, I should perhaps make it clear that the development of Ward 10 at old Noble’s Hospital for the provision of NHS dental services has been brought about by the need to vacate premises at Ballakermeen School Dental Clinic and Carnane Gardens at the rear of old Noble’s Hospital where there are currently five NHS clinic rooms.

It is anticipated that the revenue consequences of amalgamating these services onto one site will be cost neutral, and therefore I can advise that Honourable Member that no additional revenue budget has been put aside in relation to this project.

Oral Question 26

For Oral Answer:

The Hon Member for Peel (Mr Crookall) to ask the Minister for Health and Social Services –

Why was a second contract value for the Westview Dental Practice in Peel, effective April 2007, the offer of which was confirmed in writing in March 2006, retracted, after the services of an additional dentist had been contracted?

Answer

Mr President

In answer to the Honourable Members question, I can advise that in a letter from the Department to the principal dentist of Westview Dental Practice, in March 2006, it was confirmed that the Department would be supportive, in principle, to the employment, by the practice, of a second practitioner early in 2007.

Such a development would, of course, be subject to further discussion with the practice at the time of the proposed expansion of the NHS service provision, prior to formal approval being granted.

In that regard the principal dentist approached the Department further in April 2007, making reference to the agreement in principle, and wishing to discuss confirmation of the second contract prior to reaching agreement with an interested dentist. It is not agreed that the service of an additional dentist had already been committed by the Department.

At a meeting on 18th April 2007 with Department officials the principal dentist was advised that due to funding constraints the Department was not in a position, at that time, to support further development of services, this was subsequently confirmed in writing. The situation will continue to be monitored closely should resources become available.

Oral Question 27

For Oral Answer:

The Hon Member for Douglas East (Mrs Cannell) to ask the Minister for Health and Social Security –

  1. How many pensioners are in receipt of the Manx Pension Supplement;
  2. how many pensioners are not in receipt; and
  3. what proportion of those not in receipt have actually paid into the Manx Fund for varying periods of time since the commencement of the Manx Pension Supplement scheme?

Answer

Mr President

In response to the first part of the Honourable Member’s question, I can confirm that around eleven and a half thousand pensioners are currently entitled to receive the Pension Supplement.

In regard to the second part of the question, I can confirm that of around sixteen thousand Island-resident pensioners, approximately four and a half thousand do not qualify for the Pension Supplement.

In relation to the third part of the Honourable Member’s question, I suspect the Honourable Member’s intention is not achieved by the wording of her question. The Honourable Member has effectively asked for the proportion of those pensioners who do not currently qualify for the Supplement and who have paid contributions on the Isle of Man for less than 10 years at varying times since 5th April 1993, i.e., when the original Supplement Scheme came into effect. I presume her intention was to request information about those pensioners who have paid contributions on the Isle of Man for less than 10 years at any time prior to their attaining State pension age, with a view to supporting a case for “pro-rata” entitlement from the Supplement Scheme’s inception. Assuming that to be the case, I can confirm that this information is not to hand and that it would take considerable time and resources to ascertain. If I am mistaken, then the Honourable Member will, no doubt, correct me.

I am also able to advise Honourable Members that the Department is reviewing a number of facets of the Supplement Scheme, in light of, inter alia, proposed reforms to the existing State pension arrangements, as set out in the Pensions Bill currently before Parliament.

Oral Question 28

For Oral Answer:

The Hon Member for Douglas East (Mrs Cannell) to ask the Minister for Health and Social Security –

In respect of the Isle of Man Pensions Association’s January 2006 proposal to the Department, how can the Department reach conclusions on pension supplement eligibility when insufficient facts have been given to the UK Actuary’s Department?

Answer

Mr President

I can confirm that the Government Actuary’s Department was furnished with all the necessary statistics it felt it needed to reach the conclusions it did and which have subsequently been relayed to the Isle of Man Pensioners Association.

Written Question 58

For Written Answer:

The Hon Member for Douglas East (Mrs Cannell) to ask the Minister for Health and Social Security –

  1. With regard to the UK Actuary’s latest Report on Isle of Man Pensions, why is it reported that 3.95% of contributions received are deducted and paid to the National Health Service; and
  2. does the same figure apply in the United Kingdom?

Answer

The following is a consolidated response to both parts of the Honourable Member’s question.

It is stated at the foot of page 27 of the Report by the Government Actuary on the operation of the Social Security Acts in the Isle of Man for the period 1st April 1997 to 31st March 2002 that “Note: The contribution rate payable to the Fund in 2004-05 is 19.85%, being the sum of the employees and employers rates of 11% and 12.8% respectively less the allocation of 3.95% to the National Health Service.” This is, in fact, a statement of the position in the UK and does not reflect the position in the Isle of Man, where the allocation to the Health Service from employee’s and employer’s contributions is only 2.95%. However, the contribution rate payable to the Fund in both the UK and the Isle of Man is, in fact, 19.85%.

The difference between the countries is that whereas in April 2003 the increase of 1% in employer’s contributions which was introduced in the UK was applied to the Island, the increase of 1% in employee’s contributions which was simultaneously introduced in the UK was not applied to the Island. The additional 1% contribution (payable by both employers and employees in the UK and by employees (only) in the Island) is entirely ring-fenced for the Health Services. It was devised by the New Labour Government as a way of increasing revenue for the Health Services, for the purpose of driving down waiting lists, without offending a manifesto commitment not to increase the basic or higher rate of income tax. Therefore, it does not, and should not been seen to, comprise part of the contributory benefits and pensions system. It is, quite simply, tax by another name.

Thus, the position in the Island which has existed since April 2003 has been that the contribution rate payable to the Fund is 19.85%, being the sum of the employee’s and employer’s rates of 10% and 12.8% respectively less the allocation of 2.95% to Health Services.

It has been confirmed with the Government Actuary’s Department that the contribution and NHS allocation rates applicable to the Isle of Man were, in fact, factored into the report referred to above and that the footnote on page 27 was a mistake on their behalf.

Written Question 59

For Written Answer:

The Hon Member for Douglas East (Mrs Cannell) to ask the Minister for Health and Social Security –

  1. What has happened to the £44 million borrowed from the Fund towards the cost of the new Noble’s Hospital; and
  2. is it not a fact that if such monies had not been borrowed the Department would not be in financial crisis as at present?

Answer

In answer to Part A of the question, the £44 Million referred to was invested in the Hospital Estate Development Fund, the purpose of which is to fund the loan charges in respect of the Capital Expenditure on the Hospital Estate Development.

Attached is an extract from the Detailed Government Accounts for the financial year ended 31st March 2007, which provides information in relation to the fund.

In answer to Part B of the question, as Honourable Members will note, a total of £8,500,018 was transferred to the Department to meet Loan Charges in the financial year to 31st March 2007. Without that transfer to the Department, the Department would have had to either fund the loan charges from existing resources or a further £8,500,018 would have had to have been added to the Gross Revenue Expenditure Budget to absorb the cost.

So on the contrary, the money invested in the Hospital Estate Development Fund to fund the cost of Loan Charges, I believe this investment has had significant financial benefit to the Department.

Written Question 60

For Written Answer:

The Hon Member for Onchan (Mr Karran) to ask the Minister of Health and Social Security –

How many UK pensioners in receipt of the state pension, with (10 years) or more, as permanent residents in the Isle of Man do not receive the Manx Pension Supplement?

Answer

Both the Department and Tynwald have consistently maintained that entitlement to the Pension Supplement should be on a contributory, rather than a residency, basis. Entitlement to the Supplement rests, inter alia, on the payment of a minimum of 10 years contributions on the Island.

There are around 4,500 Island-resident pensioners who do not currently qualify for the Pension Supplement because they have not paid contributions on the Island for at least 10 years prior to attaining State pension age. The Department’s computer systems do not record periods of residence on the Island, so it is not possible to state with any certainty how many of these pensioners will have been resident on the Island for 10 or more years.

The expression “UK pensioner” may be interpreted in a number of different ways. Without clarity, I am unable to provide any further comment.

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