Isle of Man Medical Society warns against elective surgery cuts following leaked Manx Care email

Health workforce body urges Manx Care to reconsider reductions, citing risks to patient care and service backlogs

The Isle of Man Medical Society (IOMMS), which represents the Island’s health workforce, has issued an open letter voicing “deep concern” over proposed reductions to elective surgery sessions, as revealed by Manx Radio yesterday. (5 August)

The letter was sent in response to the publication of a leaked internal communication from Manx Care management, which warned of a projected year-end overspend of £5,761,000 and outlined the need to reduce elective theatre sessions from 25 per week to 20, starting in November 2025 if urgent savings cannot be found.

Manx Care has since stated that no reductions to the number of patients treated are planned, and that any changes would be focused on increasing efficiency, not cutting care. However, in its letter, the IOMMS states that while it recognises the financial challenges facing Manx Care, it “strongly opposes” any further cuts, warning that such measures will have a detrimental impact on patient care.

The Society argues that elective operations are vital for improving patients’ quality of life, and that reducing these sessions could lead to longer waiting times, increased morbidity, and potential life-threatening complications.

The IOMMS also highlights existing pressures within the Island’s cancer services, noting that Manx Care is already struggling to meet key targets. These include the 62-day referral-to-treatment standard, with only 44 percent compliance recorded in December 2024, and 28-day Faster Diagnosis Standard, where compliance was 64 percent - the target is 80 percent.

The Society warns that any growing backlog of elective surgeries would add further strain to the healthcare system and negatively affect staff morale, making it more difficult to maintain high standards of care.

A particular concern raised by the IOMMS is what it describes as a lack of consultation with clinical stakeholders, including itself, in the decision-making process.

The Society says this approach undermines transparency and collaboration, and calls on Manx Care to explore alternative cost-saving measures that do not compromise patient care. Suggested options include recruiting and retaining permanent staff, investing in preventive healthcare, streamlining administrative processes, and considering the reinstatement of the private patients’ unit as a source of additional income.

The letter also references previous proposals from the IOMMS, which include calls for enhanced political and managerial accountability, a medically led governance structure, transparent.

IOMMS concludes by urging Manx Care to reconsider the proposed reductions and engage in constructive dialogue with clinical representatives to find sustainable solutions that prioritise patient well-being.

Manx Care responded to the letter:

There are no reductions to the number of planned patients going through surgical theatres.
 
The mention of a “reduction in elective activity” does not refer to a reduction in the number of patients treated. It instead refers specifically to the number of theatre sessions available (typically consisting of a four-hour block).
 
Operating theatre utilisation is one of the highest cost areas within hospital services, at approximately £25 per minute.
 
By increasing productivity in this space, with more patients going through each session wherever possible, we reduce spending while maintaining, and in some areas improving, service delivery.
 
It’s important to note that this pertains only to the financial performance of the Critical Care, Theatres, Anaesthetics and Surgery Care Group, and does not apply to Manx Care’s overall budget. This means that opportunities to create savings in other areas will offset the costs of heavily patient-facing services. 
 
Manx Care regrets that this internal email was shared outside of its intended context. As a caring and accountable organisation, we remain fully committed to delivering the highest standards of patient care while managing resources responsibly. Central to this commitment is ensuring there are no reductions to the level of patient contact or clinical activity set out in the 2025/26 Manx Care Mandate.

Meanwhile, following yesterday’s coverage, Health and Social Care Minister Claire Christian wrote to all Tynwald members noting the issue came to light after the leak of an internal email and assuring members that this was being “addressed by Manx Care in the appropriate way”.

The minister confirmed that the Department became aware in late July that additional elective surgery sessions would not proceed as originally planned, with Manx Care opting instead to revert to levels already set out in its Mandate and Operating Plan.

Ms Christian emphasised that, as these sessions were “in addition to the agreed workload for this year”, no formal process for a significant change was required.

She reiterated that the proposed changes are intended to ensure budgetary efficiency and will not affect the number of planned patients undergoing surgery, with the organisation continuing to deliver all commitments set out in this year’s agreement.