When the Levee Breaks ..
- Fear & Loathing IOM
- Apr 20
- 6 min read
Updated: Apr 21
When the Levee Breaks was first recorded by Memphis Minnie and Kansas Joe McCoy in 1929 re-emerging again in November 1971 as the final track on Led Zeppelin's untitled fourth album. The song's lyrics recount the story of a man who lost his home and his entire family in the Great Mississippi Flood of 1927. And the slow sense of foreboding and dread transmitted by the track, especially in full on Robert Plant mode, appears to be fairly apposite for where the Isle of Man currently is in relation to its proposed IOM Health Levy nearly 100 years later.
Crying won't help you, praying won't do you no good.
When the levee breaks, mama, you got to move!
Yes your own personal fiscal tsunami is already ominously brewing out there and readers only have to scan the news reports of the last few weeks, and observe the completely loaded [non] Consultation Document recently issued by Treasury, to feel the eerie sense of trepidation and fear at what may soon devastatingly sweep through the Island and destroy parts of your already fragile household budget. Because last years disastrous temporary tax increase clearly didn’t even touch the sides (Manx Care's budget was increased by an extra £14.8 million in the 2024 budget, and yet less than six months later Tynwald was asked to approve another £20 million plus of overspend for 2024-25) and when the health levee finally breaks its going to be one of the most unfairest taxes created by any government. A tax so that you can continue to receive vaguely acceptable health services that you already pay for even if you already pay for private health insurance as well!
So how did we get here?
Well it's the usual tale of Isle of Man public sector incompetence and mismanagement really but before we even get onto the Manx Care part let’s first go back a few years to 2017 when Treasury Minister Alfred Cannan announced the high profile launch of the Securing Added Value & Efficiencies (SAVE) Project which was designed to establish a new task force to uncover £25 million of savings within government - and where the Manx public were even invited to submit their ideas to help Treasury identify where money could be saved.
From Manx Radio:
This was nearly 10 years in advance of Elon Musk and his failed US Government DOGE Project which claims to have kicked hundreds of thousands of government workers out of the door and saved trillions of dollars. However readers may recall that not unlike the early DOGE messaging of the hopeless savant Musk there was also a reasonable level of excitement around the SAVE Project at the time and a belief that the public might be finally listened to and that government might just be starting to make moves to shrink into a more sustainable footprint by finding what should have been a fairly easy £25 million of savings. Indeed there were over 1,300 responses received from the public detailing 2,300 proposals as to how Government Officers might cut their cloth in a number of ways. Although readers might also recall how all hopes came predictably crashing down fairly quickly when the initial figure of £25 million was revised back to £15 million by the time the update on the SAVE initiative took place at the June 2018 sitting of Tynwald. And ultimately as the document linked below attests they couldn’t even find £15 million of actual savings despite being instructed by 1,300 residents of the Isle of Man as to where they should look.
In the end virtually none of the suggestions were implemented although it's good to revisit the document that was produced at the time.
The full report can be found here:
Of particular note is page 33 which notes:
The first two phases of this programme will have delivered some considerable successes and reductions in spending will arise from the investment that has been made. However as illustrated below in figure 5.1, these cumulative savings fall below the SAVE target of £15M
The main savings identified were summarised in usual woolly civil servant language as: Public Defender Unit: £1M, HE Consolidation: £1M, Bus, Rail Services £1.0M, Other Government Services TBC, Casual/Agency Worker: TBC, Contracts Review £2M, Efficiency review £0.5M, Asset Management £0.25M.
These proposals were from government officers who spent circa £1 billion in 2017-18 according to the relevant Pink Book. So after a review which considered the input of 1,300 Isle of Man residents, and received 2,300 specific recommendations which they claimed they reviewed, government couldn’t even find £15 million (or 1.5%) of actual cost savings. Indeed since 2017 the Island has additionally spent circa £160 million on its covid response, has been consistently taking money out of reserves to balance the budget each year, and will this year spend over £1.4 billion (including taking around £110 million from reserves) - which is over £400 million more than it spent in 2017 when it decided that it desperately needed to SAVE money.
Are we working out why we need a Health Levy yet before we even get to Manx Care?
Manx Care
In May 2019 the Sir Jonathan Michael’s Report (which cost the IOM taxpayer over £900,000 to compile) was released concluding, via 26 specific recommendations, that the current Isle of Man health and social care model is unsustainable from both a clinical and financial perspective.
The full report can be found here
At the time many stated that the creation of Manx Care would lead to extra costs and the duplication of many roles that already sat within the DHSC. However despite these concerns Tynwald voted to establish Manx Care as an arms length organisation via the Manx Care Act 2021.
At the time of its launch Manx Care’s Chairman Andrew Foster was quoted as saying that he would work with health care staff to use their expert knowledge to deliver better services and that he hoped within three to five years, to have the Isle of Man as being one of the best small health care systems in the world. And that the new organisation would live within our own means by increasing efficiencies while improving the quality of care.
From the BBC:
This was a mere four years ago now and the reality of such bold statements appears to be that none of these things have actually happened and furthermore Manx Care can’t blame covid either as all of the service delivery and budget overspend issues have happened since the pandemic after which Manx Care was formally established. In fact Manx Care currently boasts on its website that it employs over 3,300 dedicated staff, providing hospital care at Nobles Hospital and Ramsey District Cottage Hospital, integrated mental health services, social care, the Isle of Man Ambulance Service, and primary care and community services with a budget this year, including already allocated overspend, of circa £372 million.
Let us remember that in 2017 when we actually set out to find government savings via the SAVE Project the Health & Social Care budget was a mere £264 million and yet the Manx Care projected spend this year will be around £372 million - and this is after a disastrous temporary tax increase last year which raised a rumoured £20 million of extra ring-fenced cash for Manx Care of which they instantly blew another £25 million within a few months
From Manx Radio:
So the levee is now breaking and crying won’t do you no good as it seems that WE now have to cut our cloth via an extra NHS Levy against our income that will affect all low income and middle income workers, and which is unlikely to improve any of the vaguely acceptable services currently offered by Manx Care, because Tynwald and our highly paid government officers have now spent eight years trying to save £25 million a year but have in fact this year managed to spend an extra £400 million than it did before if decided that it needed to save money and ignored 2,300 perfectly sensible suggestions submitted by the public as part of the SAVE Project.
Ever had the feeling you’ve been cheated?
In closing we observe that it's generally accepted in health and social care circles that the best way to stop a drug addict from their self-destructive behaviour is not to supply them with more money with which to buy drugs. But is to cut back their line of credit and apply more supervision so that they might ultimately modify their behaviour and save themselves. The Health Levy is simply a step too far and means that everyone in the Isle of Man will be asked to pay even more into the general incompetence and mismanagement fund so that government officers don't have to modify or change their behaviour in any way at all. Just as they did nothing in 2017 & 2018 despite the feedback of thousands of residents who only had the Island's best interests at heart.
Crying won't help you, praying won't do you no good.
When the levee breaks, mama, you got to move!
Led Zeppelin. When the Levee Breaks ..
Part two shortly ..
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