The chief minister says he will be considering who should be the next health and social care minister over the coming days.
It follows the dramatic resignation of former post-holder Lawrie Hooper and a subsequent war-of-words with Alfred Cannan.
The political spat has raised questions about confidence in Mr Cannan's leadership - and that of the Council of Ministers - with calls from some for a vote of no confidence.
Manx Radio’s Political Correspondent Phil Gawne has been speaking to him:
Talk into Chief Minister Alf Cannon, and you had some fairly stern words for the departing Health Minister this morning. Well, I needed to make absolutely clear that this fabrication of privatisation that he accused me and the Councilor Ministers of was a fabrication. It was his clear strategy to avoid taking any responsibility for the financial position that makes care finds itself in, and I accept that he's finding it too much and he wants to walk away and that he just thinks we should bring more taxation in to pay for more health care so the cycle goes on and on. I and the Councilor Ministers want to find a responsible solution to this, and we also need to be in a position of absolutely ensuring that the health care system is capable of spending to its budgets, and we also understand what it can deliver for its budget, and a lot of that, as you will have seen from the audit report that the Minister has been sitting on for the last six months. There is a lot of work that needs to be done, and that must be approached as an immediate priority before anybody starts talking about more taxation and more funding for a health care service. And we've heard from clinicians and doctors over the last few months that they believe that that is a red herring and that actually efficiency and effective performance within makes care is the answer, not more money. And that report, I mean it's quite concerning, you've obviously shared it with Timmold members because you referred to it in your speech, and it says things like a review of financial management of makes care concluded an unacceptable assurance rating for both design and application of financial controls, it also said overall there is a lack of management actions to address overspending areas which would help to push greater assurance that management is actively managing financial performance. These are quite disturbing things to read in a report about how makes care is working. So absolutely, so it's not right to go and purport the message continuously that makes care is underfunded when there is absolute clear evidence that the system itself, that the organisation itself needs to get on top of its financial controls, its financial planning and its financial management. Now we need to make sure that it has the tools to do that, but do it we must, and we must do that at a very fast pace, we have another budget coming forward in a matter of months time, and Timmold on behalf of the public must be going into that budget with with some confidence that the healthcare system knows how it is about to apply the money it's going to receive, and also that we understand what we are going to receive for that money. So that is the first point that needs to address it, it's not right for people just to sit on that level of audit report with that type of exposure being reported and then continue to claim it's purely a funding issue. So before we get to funding and how that may be applicable in the future, if indeed it is needed, we need to know for certain that the organisation is spending its money effectively. And perhaps we should maybe get a little bit of clarity on that report because Laurie Hooper is now suggesting, bearing in mind, he hasn't actually heard what you said, so he's reserving his comments a little bit, but he is suggesting that perhaps you've misled Timmold in relation to that report. What is your understanding about the report? When did Councillor Minnesot get an opportunity to see it? Well, Councillor Minnesot, I've released that report as interim health minister and Councillor Minnesot, I've never saw that report until I released it and I made that choice as a minister because one of the very first things I established literally in the last 24 hours is that report existed and that there were a number of clear requirements laid out in that report that needed to be addressed. Now, I understand that some further action has been taken, but my absolute point is that that report existed, that level of detail in terms of a clear requirement for Monkscare's team to get a grip of the financial performance issue was absolutely made crystal clear and therefore the minister's continued exhortation that they were underfunded was not the full story and that we needed to know more. And the critical point, of course, who's misled Timmold is in fact the minister by claiming that I and the Councillor ministers want privatisation, that is a falsehood and was a slur on Council. I made that point today, but the critical point is Phil, points have been made. I'm not going into a tit for tat with Laurie Hooper. Timmold made its clear expression today that they want now to get on and sort out the issues and that's what I'm going to do along with a number of colleagues I know who want to get in and get some of these issues resolved as quickly as possible. Should you, bearing in mind, it was pretty obvious there was a breakdown between you and Laurie Hooper, the various public comments both from yourself and indeed from the minister or former minister now, should you have sacked him? Well, look, I think you would have had to have been fairly ignorant in my position not to have been aware that he was trying to get himself into a position or contrive himself in my view into a position where he would either get sacked, in the end he chose to resign. You know, I'm sorry clearly, sorry that someone's chosen to resign, but clearly his positioning in terms of just expecting everything to be funded from taxation was at odds with the majority view, the very strong majority view in the council and I think we've all recognised, even before this report was brought forward, that banks can, needed to clearly demonstrate it, value for money in terms of the money that they've been getting and they needed to properly address some of the concerns that have been very publicly laid out by the medical society and they shouldn't just be dismissed. There have been a number of other issues raised this morning in debate by honourable members that they want to see addressed. It will take a collective drive to sort, to resolve some of this. There is absolutely a role for tin wood in this, there's a role for the DHSC, the administer and there's an absolute role for makes care. I think we should all need to come together, some of these factions need to come together now. We need to understand quickly where those issues are and I think some of them were pointed out on the floor today and we need to drive to resolution so that makes care as an organisation can move forward together and Tim will can move forward with some clarity about the funding position and also the mandate position in terms of what we're expecting from makes care in terms of delivery. Do you understand though why some members are concerned that Council of Ministers was not, well according to the Health Minister, was not prepared to unequivocally state that they believe in a health service free at the point of delivery. Do you understand why they might see that as actually there's going to be elements of the NHS that will be charged for that perhaps some elements of the of the service will be contracted out. Do you see where that might come from? No because I think this is pretty much a contrived position that's been put in front of the Council of Ministers in order to achieve an end objective by the Health Minister which was his resignation in order he can go pursue his own political ideologies and beliefs and that's fine. Council of Ministers quite rightly sensibly have taken the position of saying before anybody comes to us and starts telling us that we've got to raise certain levels of taxation. We need evidence that the system is running and managing itself properly from a financial perspective. It has financial discipline applied that budget holders know what their budgets are and how to manage those and the money that it is being given is being spent effectively and in the right places and there's plenty of evidence to suggest there is a lot of work to do in that area. We need to address that as quickly as possible that's my very first task I met with Treasury this morning I met with the Chief Officer from DHSC. We are working now with MaxCare to get in place those individuals with the expertise and experience to help get that to us to that position and more importantly most important we need to be able to apply that to the budget next year. Only then and with proper analysis will we then be in a position to determine whether or not we are underfunded inverted commas and how one might then set about addressing it and that will take that will not be an immediate and quick solution. We do need proper public engagement if indeed that is the case but plenty of people are saying there are other ways to address this and that we need to listen to some of the people delivering the health care in more detail in order to get and drive forward the efficiency and effectiveness from an operational perspective most importantly to deliver better outcomes of course in all this for the people of the island. Mr Hooper has told me in an interview yesterday that he asked in the last financial year for assistance from Treasury to try and pull together the problems or try and resolve some of the problems that MaxCare was facing in terms of managing its budget and was told that no help was available he would need to just use shared services apparently subsequently Treasury is now stepping in and trying to help is that your recollection of events? Clearly I'm not in every meeting and I don't necessarily know what discussions have happened between Treasury and a minister at any particular given point what I do know is that there is clear evidence so said before that the MaxCare financial management and process in terms of its strategic planning needs quick improvement and that needs to be done I also think that in all this people have to take responsibility whether that's the minister whether that's MaxCare whether it's MaxCare's board whether it's those responsible for budgetary controls we have to have some responsibility I think we need to stop this constant moaning and we need to start delivering within the budgets that we have got to the very very best capability and if that means having difficult decisions about some of the options around delivery for MaxCare in terms of some of the services they're delivering then we need to have those we need to have those before the financial year not six months into the financial year or seven months into the financial year and puts everybody in a difficult position and finally I must just emphasize you know this I know that some of this over expenditure has been going on for years in different levels and different places within the health care system but the fundamental point is after a 10 percent effectively a two pounds but 10 percent rise in income tax last year right an extra 43 million pounds a condition promise that they were going to stay within budget to smash that by 16 million pounds that forecast is 16 million pounds is going to cause us real problems you know effectively this compound overspend is just being built in more and more into future budgets and the cost of delivery of health care and the current trajectory without any changes will damage our reserves in a serious way and we need to address it for and we've got to be responsible and one of the reasons why I've had to be so forceful about this is because I have an absolute level of responsibility to you to the public to make sure that people understand that there is a potential problem if we do not get the solutions and I hope that by being bold enough to stand up and identify that despite all the trauma that's coming with it we can actually move ourselves into a better position. One of the problems associated and I know this from my own experience in particularly in the Department of Infrastructure you do as a politician you spend all your time working with the staff in a particular department you get to fully understand and appreciate all their issues and problems and I think the term is you end up going native do you think that's what's happened with Laurie Hooper? Well listen I mean look Laurie Hooper is a bright intelligent person but you know he's clearly gone off at a tangent from from his colleagues that's fine he was very clear yesterday he knew he had to resign and he's done he's done that he could have been a bit more forthcoming with his plans and it allowed at least some courtesy of informing his colleagues in advance and we could have done without the fabrication and slur around privatisation because that's absolutely never been mentioned at all around the councilor ministers table and neither is it to the best of my knowledge health either by me or any of my colleagues but what we do hold is I believe a sensible position of wanting makes care to get back into some sort of financial order to have trust in that financial position and then to understand more fully whether in fact this underfunding argument which continues to be put forward is accurate because we've given the organisation so much more money and if indeed that does prove to be the case in the future then we need and we've got that assurance that the finances are operating it's to the very best of our ability then of course we need then to start discussing what else we might need to consider but we need to do that as an island and not just in an individual silo or just because the liberal and party thinks so already we're recording this interview on Wednesday morning Laurie Hooper has responded up to your statement on Twitter suggesting that it was outrageous and asking whether your ministers are prepared to follow someone who will react in this sort of way are you concerned that perhaps a rebellion will come that a vote of confidence or no confidence in the government is likely to be the next move? Well I need to also take the responsibilities of ensuring that where I believe there is a real crisis point that the issues around that are properly brought to the fore and that's why I've had to raise this issue so publicly around makes care and the financial performance and the need for it to get back into budget and the reasons for that and the long-term consequences on our funding so I have to take it within my stride clearly the health minister is disenfranchised he will do everything now possible to undermine and destabilise because that's what the liberal van and party want and some elements of the labour party they want capital gains taxes they want inheritance taxes they want higher income taxes and my position is very clear as is my colleagues within council before we go anywhere down that route efficient effective delivery within budgets so that we understand what we can and can't pay for and particularly we need to sort that out before the budget next year so there's a distraction and we just need to get on with the job is that pretty much your message? absolutely there is a big issue it is of national concern but we now need to take the steps necessary and that's really about providing the right financial support to makes care to get this problem resolved get it resolved to the satisfaction of the treasury minister he can present his budget and then as I say we need to make sure we've got the services that have been delivered properly within that budget we understand what those services are and then we can move on properly to understand if we want more services or increase delivery in some areas how that might be appropriately funded and of course that's the wider challenge foot in world but also it does involve the community's input into reaching any fundamental changes because this is a whole island problem and it shouldn't just be stuck in an ideological box and very very finally then any ideas who would be willing to take on the Department of Health and Social Care challenges as the new minister I think we had a couple of volunteers this morning and certainly a couple of names put forward look you know I will consider that in the next two or three days what I do need to do is get going with some of these issues in terms of addressing them I've now seen this Kirby consultancy report about the position of makes care I know some work has been going on but we need action now Phil not more reports not more more consultations I need action with makes care in terms of this we will work that together I'm sure there are people in makes care and the chief executive officer and the board who want to see this resolved as quickly as possible get that done or get the budget prepared for next year and also in the meantime I'll be considering you know who supports from Timball members in terms of the department who comes in as a minister and how we also also engage with Timball and the greater public when needed in terms of resolving any other issues particularly around service delivery. Thank you for making it to the end of the Manx Radio newscast you are obviously someone with exquisite taste may I politely suggest you might want to subscribe to this and a wide range of Manx Radio podcasts your favorite podcast provider so our best bits will magically appear on your smartphone thank you you [MUSIC PLAYING]
