Manx Care budget has gone up significantly though, it's one of the biggest items on the tax bill (over 1/3rd of discretionary spend) and it's been going up well over 6% per year for the last 5 years.
Adult services spend has doubled in 5 years
Mental health service spend gone up 50% in 5 years
CEO office big numbers last couple of years and still up 210% this year on 5 years ago
Nobles (approx half of total) spend up 40% in 5 years
Patient transport largely the same
Primary healthcare up 7% in 5 years
So the privatised GP/pharmaceutical side has clearly been squeezed, whilst the rest of the health service has ballooned. And the more admin spend clearly hasn't translated into cost control.
To me the issue isn't that they're cutting services to meet costs (it's not tenable to have year on year MC increases well in excess of inflation), it's that they've got to month 10 of the financial year and realised they've ran out of money and therefore cuts have a much more significant impact on patient care and outcomes then properly planned measures.