Health and social care on the Isle of Man is the responsibility of the Department of Health and Social Care. Healthcare in Isle of Man is free for residents and visitors from the UK, and there is a reciprocal health agreement with the UK. For several years, it has required a supplementary vote to balance its budget at the end of each year. The Reciprocal Health Agreement only covers three months from the point of arrival in the UK.
Organisation
Sir Jonathan Michael conducted a review of arrangements for health and social care services on the Isle of Man which was published in May 2019. He recommended that they should be delivered "at arm's length" from the government and that arrangements for clinical support from the NHS in England should be improved. The chief executive of the Department of Health and Social Care and his deputy resigned.
Funding
In 2013, about £178.4 million was spent on healthcare. £138 million came from the Manx government and about £40 million from income National Insurance contributions, prescription charges and private patient fees. About £80 million was spent on Noble's hospital. In March 2018, Sir Jonathan Michael was asked to conduct a review of the service because of concern that current funding levels are "unsustainable". The Council of Ministers estimated that funding would have to be increased by 23% – an additional £60 million by 2022/23.
Primary care
The fourteen general practices have a list system. Patients have to register with a GP. Temporary residents from the UK can use the service without charge. The practices on the island have an average of 1900 patients per GP. A digital facility for patients to make GP appointments and view their own health information online was launched in September 2017. The Manx Emergency Doctor Service is available when the practices are closed, from 6pm to 8am and at weekends and bank holidays.
Dentistry services are available on a similar basis to those in the UK, with charging on a banded basis and exemptions for children, students, pensioners, pregnant women and people in receipt of Income Support, Income Based Job Seekers Allowance or Employed Persons Allowance, war disablement pensioners and blind people.
Annual eye tests are provided free to Isle of Man residents. NHS vouchers are available towards the cost of spectacles.
Manx prescription charges have been set at £3.85 per item since September 2010, less than half the charge in England. People get free prescriptions who have chronic conditions, as well as people who are: under 16 years old, under 19 years old and in school full-time, pregnant, on public assistance, prisoners, on a pension and under 75 years old, or over 75 years old.
In April 2018, there was an announcement that NHS dentists on the island were at full capacity and that it could take years for new patients to be registered.
Secondary care
There are two hospitals on the island, the main one being Noble’s Hospital, with 314 beds, giving about four beds per 1,000 residents, around the European average, but considerably higher than in the UK. Tertiary services are provided by the English NHS. The much smaller Ramsey Cottage Hospital has 31 beds and is situated in the town of Ramsey, on the north of the island.
The Isle of Man Ambulance Service is based at Cronk Coar on the Noble's Hospital site. It has nine accident and emergency vehicles, four patient transport vehicles and rapid response vehicles.
Since 24 May 2019, it is lawful to have an abortion during the first 14 weeks of pregnancy at will, then until the 24th week, so long as criteria specified by the act are met, and then onwards if there is a serious risk of grave injury or death. Abortion is governed by the Abortion Reform Act 2019.
History
Before 1948, there was a Mental Hospital Board which was responsible for Ballamona Hospital under the Poor Relief Acts and three voluntary hospitals: Ramsey Cottage Hospital, Noble’s Hospital and the Jane Crookall Maternity Home on the island. Each had its own management committee, and there was a Hospitals Contributory Scheme. White Hoe Hospital was run by the Corporation of Douglas. There were proposals, by the Corrin Trustees who had collected funds, to establish a hospital in Peel but they were halted by the outbreak of war. Domiciliary services were provided by district nurses, employed by the twelve district nursing associations. There were also two infant welfare health visitors and seven infant welfare clinics.