Teresa Cope: Island's healthcare 'needs to look very different in 10 years' time'

'We need to invest now' Manx Care's outgoing CEO tells Tynwald committee

The Island's healthcare 'needs to look very different in 10 years' time' - that's the warning from the outgoing chief executive of Manx Care.

Teresa Cope has been giving evidence to Tynwald's Public Accounts Committee regarding this year's budget for the body, and how it should be shaped going forward.

In the week that she announced she'll be stepping down from her role after five and a half years, this committee hearing could perhaps be deemed her swan song.

It'll be the last time she'll appear before its members, and she spent her slot explaining the logic behind Manx Care's operating plan versus the Department of Health and Social Care's (DHSC) mandate, and the ever-present difficulties the body faces regarding funding versus spending.

Now right near the end of the session, she was asked how the three elements of the mandate, the operating plan, and the Budget interlock, and how Tynwald members can be assured of which one will actually prevail when they vote:

Ms Cope told the committee: "If there is one thing which fundamentally will help better manage the finances moving forward, it is a very clear health and social care strategy for the next 10 years. What does health and care look like? What do the policy frameworks look like?

"At the moment, we are just delivering what we've been asked to deliver, against rising demand, rising costs, and we don't necessarily have the leverage to make the level of substantial changes which we need."

She said a 'much bigger strategic conversation with the public' was needed about what services need to look like in 10 years' time.

'LEFT SHIFT'

She said: "I think we've started it with the left shift, but there are a lot of unanswered fundamental questions.

"I think we've got a lot of policy and legislation-based decisions to make, which will ultimately give a clear direction about what the mandate will look like in the future and then consequently how Manx Care would respond to that in terms of an operating plan.

"But healthcare needs to look very different in 10 years' time, and we need to make the left shift."

According to the National Association of Primary Care (NAPC) - a membership association for Primary care professionals in the NHS - "left shift" in population health refers to 'the movement from treatment to prevention and analogue to digital in equal measure'.

"What we really want, and should be doing, is delivering care in communities, removing care from hospital, using digital and focussing on early intervention and prevention." - Teresa Cope, Manx Care CEO

And the warnings from the chief executive regarding our lagging digital capacity were stark.

Ms Cope cited an inspection visit from the Deanery, the body responsible for monitoring doctors in training, in which it was noted that the Isle of Man is 'the only area in the North-West without electronic prescribing'.

She said: "We're considerably off the pace with the Manx Care Record, with electronic prescribing, and more broadly using digital capabilities to really enhance patient care.

"There are some amazing technologies out there, but we are nowhere near ready and quite far behind in that.

"That would significantly reduce cost in health care. And we need to invest now for health services to look very different in 10 years' time."

DHSC RESPONSE

In the next Public Accounts Committee evidence session, which took place immediately after Ms Cope's, Health Minister Claire Christian was asked to respond to the chief executive's comments.

She confirmed her department is looking at creating a three-to-five-year healthcare strategy, with Treasury already committed to funding it:

She told the committee: "It's fundamental as part of the governance review. But yes, we are looking at a three-to-five-year healthcare strategy. That will be part of this piece of work, but it certainly won't be in this administration.

"But we will be looking at bringing that forward for next administration. And that would fundamentally hope, well, I say hopefully, Treasury have absolutely concurred that they will give us a three-to-five-year financial settlement on that as well. So, we'll be working with them to do that.

"But it is crucial that we have that, and this demand piece of work that we're working on now is part of that and in informing that for the future."

10-YEAR PLAN?

But what about Ms Cope's call for an even longer strategy?

Finance Improvement Officer for the DHSC, Obi Hasan told the committee that ultimately, the goal is a 10–20 year strategy:

On the matter of funding, former health minister and current Ramsey MHK Lawrie Hooper couldn't suspend his disbelief that the strategy already has Treasury backing, and had Ms Christian reiterate that fact:

MANX CARE'S FUTURE

This all comes in the week Ms Cope has announced she'll be stepping down.

So how does Manx Care envision its future after her? And will her replacement share her vision?

We asked the chair of the board, Wendy Reid, what they'll be looking for:

You can hear more from Manx Care Chair Professor Wendy Reid in our latest Newscast, available now.