Andy Onchan

It's perfectly useable, I gather it up this time of year to put on my veg plots. No need to wash it. Find somewhere where you can dry it and chop it up (I put it through my second hand garden shredder) and then leave it on top of the beds and cover it with cardboard and let nature take it's course.

I think ASITIS is referring to pre-COVID, in the days when they actually had money and a growing external investment portfolio.

But it's not just the geriatrics, it's all the new residents piling in from foreign climes.

The one you need to watch out for is dilithium.

Yes, when you read job adverts IOMG proudly, yes proudly, state that they are the Island's largest employer! It's like they're in competition with another government. The organisation is screwed, well and truly screwed.

Do you think I'm wrong?

I would think the issuance of the VISA is contingent on the applicant paying the IHS first. The problem we might have is that some might apply for IOM Visas as a back door (after a period of residence on IOM) to getting into the UK, thus avoiding the IHS altogether.

https://www.gov.im/media/1385016/202205_manxcare_structurechart_0824_mini-august-final-version-uploaded-050824_compressed.pdf It would appear two out of three are being covered by Interims, Nursing & People (although the medical director position is confusing, on one slide it says interim and on others not). From the charts it doesn't show a vacant position anywhere for Quality & Safety, which is a bit worrying. Plenty of people on various quality committees but no executive director. Will the interims be paid as if they were permanent positions? If so, then the costs for those are already included. So no saving there. If they're not being paid the full whack but are offered the positions then it's just the difference between what they're being paid now and the pay for the actual position. But it's hard to tell where those people would fit into the charts if they weren't interims.

On the subject of appointments - I attended an "ology" outpatients department recently and there writ large was the usual report on the notice board of the number of appointments missed or DNAs as they prefer to call them. On making my way out I asked one of the staff if they knew the reasons why so many people were DNAs. No idea was the reply. Which got me to wondering who, if anyone, has ever done the sensible thing and contacted the DNAs to ask why they didn't attend?

Somebody has dropped a massive bollock on that IHS fee. Even it was just 50% of the UK then it would go a long way to plugging a hole.

I don't think it does to be honest. I'm looking for a definitive split in costs between tertiary and elective. MC have said that delaying elective operations will save £220K. How do they (or even we) know that if the costs for that are included with tertiary and other costs? On the basis that it's a nice round number would suggest they don't really know. As has been said, £220k is a spit in the ocean compared to the shortfall/overspend of millions. If they can't or won't separate the costs for different types of services to justify their decisions then they deserve every bit of crap thrown at them.

Wow.... so there's no way of saying how much elective only procedures cost, on & off island?

Wouldn't tertiary services require more resources.... specialised personnel, equipment and consumables?

That's the issue that we should all be asking. Without detailed accounting and other supporting data you really can't make an informed decision. I'm probably wrong but wouldn't there be big differences in costs between tertiary and elective processes? I get that a lack of cases might preclude employing a specialist on-island but MC do themselves no favours when there appears to be no rational explanation, other than saying we don't have the money. It's no wonder folk get hacked off with both MC & DHSC in equal measure.

No. Not sure how you came to that conclusion. I was referring to non-life threatening elective surgery. Although you would think that all areas would be under scrutiny.