As Onchan MHK, Peter Karran told Manx Radio this morning (Tue 12th May) “…there is not a lack of money in the health services it is the way it is run” and added the consultation is, “an excuse for not addressing bad governance”.

DHSS Minister, Eddie Teare, and his chief executive, David Killip have launched the latest round of consultation, on the future of health and social care in the IOM; but the Manx Herald wonders it is already too late to save the ‘patient’.

As recounted in a related article, the Manx Herald has been contacted by a number of people with complaints about the service, and we share their concerns about the quality of the service the public is currently is receiving.

The reality seems to be, judging by the stream of complaints about the DHSS – and that’s just the ones we know of - the services provided by his department are deteriorating rapidly; yet, instead of getting on with correcting this position, he and his chief executive are luxuriating in yet another costly PR exercise. It’s reminiscent of an emperor fiddling whilst his city burns.

The exercise may fool some of the public into thinking the department is keen to get their views, on the future of health and care services in the IOM - and what they say will make a difference – but we would caution readers, whenever someone (particularly the government) tries to stress to you, like the DHSS is, the ideas put forward, by them, are not a “foregone conclusion”, you know you have good reason to become concerned.

This sham consultation process highlights one of the inherent ‘failings’ of the current system of government operated in the IOM.

In a party system the competing parties would develop their policies on health, social services and benefits etc and put them before the public at an election. The public could decide which policy they prefer and vote accordingly.

In our system, the Minister essentially decides the policy, not before he is elected, but on the hoof once the jobs are divvied-up by the Chief Minister after an election. If you do not like his policy, and you do not live in his constituency, you have no real power, whatsoever, to do anything about it. Conversely, if you support the policy, and do not live in the appropriate constituency, you can not do anything either.

As Onchan MHK, Peter Karran told Manx Radio this morning (Tue 12^th May) “…there is not a lack of money in the health services it is the way it is run” and added the consultation is, “an excuse for not addressing bad governance”.

The evasive manner in which the DHSS Minister is dealing with the issue of poor management in his department, as evidenced in the correspondence sent to him (and copied below), is sufficient enough for us to agree with Mr Karran’s last point.

24^th March 2009

Hon Eddie Teare MHK,

Minister DHSS

Markwell House

Market Street

Douglas.

Dear Minister,

Re: Compliant Miss X & Miss Y & other health service related matters

The Manx Herald has been provided with a file of papers relating to a complaint regarding the treatment of a former DHSS patient Miss Y.

It appears to the Manx Herald, on the basis of the information provided to it, that aspects of the complaint have never satisfactorily been dealt with by the DHSS; or at least to the satisfaction of the complainant.

Two issues in particular appear, to the Manx Herald, to require further investigation and resolution; albeit the Manx Herald recognises that one of the issues relates to the conduct of an employee who no longer works for the DHSS.

The two issues that the Manx Herald has identified, in relation to this specific case, and wishes you to comment on are:

1) A letter dated 17^th March 2006 sent by David Cooke, the then Director of Social Services, in response to a complaint made by Miss X, alleges that Miss Y arrived at Grainagh Court, in November 2005, with “a number of areas of the body that were bruised, swollen, cut and ulcerated, including the ulcer Y is currently having treated at Nobles Hospital”.

Miss X alleges that the part of the statement, relating, in particular, to the bruising and the ulceration, is false and that the Department has refused to properly investigate her complaint in respect of this specific issue.

Certainly it would appear that - on the evidence of the medical records that were eventually released to Miss Y - her allegations are well founded; and is a matter which the Manx Herald believes - regardless of whether the alleged false part of the statement was made knowingly or not - should be of serious concern to the Department.

It is our understanding - and certainly we have seen no evidence to persuade us otherwise - no specific investigation has been undertaken to find out how, and why, this apparently false statement came to be made in the letter; nor an adequate explanation provided to X & Y of why no such investigation or review has been conducted.

If such an investigation has been conducted, then the results of that investigation have not been made available to Miss X; unless the DHSS considers the letter, dated 20^th September 2006, sent by Peter Smallridge fulfils this purpose.

The Manx Herald is sure the DHSS would wish to establish whether the apparently false statement was as a result of innocent error, maladministration or something more sinister – so measures could be taken to improve procedures if failings in the system are identified.

2) It would appear, on the evidence in the Manx Herald’s possession, the standard of medical care offered to Miss Y - during the period 15^th November 2005 and January 2006 - was not of the standard expected of the health service; that an ulcer was allowed to develop, and inadequately treated; and without the intervention of her family in late January 2006, early February 2006, the situation is unlikely to have improved.

An allegation has been made, to the effect, by Miss X, Miss Y was sent, by employees of the DHSS, to Southlands to die.

This case may have escaped closer scrutiny by the Manx Herald were it not a fact that this is not the only allegation, made by members of the public, patients are sent to Southlands to die. You may recall a public meeting, held in Douglas, during which a member of the public accused the DHSS of operating a policy of involuntary euthanasia at Southlands.

As stated above the Manx Herald would like you to comment on these two issues.

Furthermore, if internal reviews or investigations, into the matters discussed, have been conducted, and the findings not previously released, the Manx Herald would like copies providing to Miss X and ourselves; and if there are such reports and you decline to make them available, please indicate under which section of the Code of Access to Government Information you rely upon and the reason.

In respect of the wider subject of health services, the Manx Herald’s concern has also been heightened by a number of adverse comments made by the Coroner directed at elements of the DHSS.

Eddie Lowey MLC, asked a Question in the Legislative Council, on the 3^rd February 2009, in respect of three such cases; and it appears that an admission was made of systemic failure being responsible.

It is perhaps pertinent, to the X/Y case, that in the final part of the answer given to Mr Lowey it is stated “We openly share our findings and are able to demonstrate where we have changed our practises”. The Manx Herald wonders if that is entirely true in the X/Y case.

It is also noted that in the recently published public consultation document, on a draft strategy for the future of the health services, refers to the Healthcare Commission Report 2006 and acknowledges that certain matters still remain unresolved.

The Manx Herald would therefore appreciate, whilst acknowledging that the majority of the public are satisfied with the service they receive, an explanation as to how the DHSS specifically intends to address the systemic failures where identified in the health service.

Please note that the Manx Herald intends to publish a report on the issues raised in this letter; and your responses, or explanation for declining to respond, are likely to form part of the article.

If you, or a nominated officer, wish to discuss the contents of this letter, prior to issuing a formal written response, then please make a suggestion for a suitable time to meet.

I look forward to hearing from you.

Yours sincerely,

Andrew Jessopp

Editor

c.c. Peter Karran MHK

P.S. The reason for copying this letter to Mr Karran is that amongst the file of papers, provided to the Manx Herald, is letter from Mr Karran requesting Miss X’s allegations to be investigated; and reply from you effectively saying the matter is considered closed.

-----Original Message-----
From: Herald Editor [mailto:heraldeditor@manx.net]
Sent: 24 April 2009 11:42
To: 'Eddie.teare@gov.im'
Subject: recent correspondence

Dear Minister,

I thought I would allow you time to get Tynwald out of the way before contacting you again.

I am very disappointed that you chose to hand responsibility for responding to my letter to the DCEO, who then replied, to a three page letter, in barely more than three lines.

The fact that none of the issues in my letter have been responded to – even the ones of ‘health service related matters’, which did not relate to specific patient/customer complaints – does not show the department in a very ‘open, transparent and cooperative’ light.

Clearly I offered to come and discuss the issues I raised but that appears to have been dismissed out of hand: why?

Clearly some of the issues raised relate to ‘administration/maladministration’ within the DHSS rather than directly to the patient; and had I just said I wish to discuss maladministration in the DHSS, the first question would have been – have you any evidence? I provided evidence in advance to avoid that scenario arising; but it seems that is still not good enough.

It may be of interest, since I wrote to you in March, another case, involving a complaint about mental health care, has been brought to my attention; which with other experiences that have been related to me, suggests there is an issue with the provision of mental health services.

As the reply, from Ms Keenan has not refuted or responded to any of the points made in my letter then I will have to draw the conclusions that it is irrefutable that the DHSS is suffering from systemic failure, it is ok for DHSS employees to write letters that contain statements that are untrue, the DHSS would rather ‘cover-up’ rather than properly investigate complaints, the DHSS sends patients to Southlands to die etc. and this should form the basis of the story I publish.

However, I am sure you personally do not believe this; and I am willing to give you another opportunity to respond more fully or to arrange a meeting to discuss these issues.

I look forward to hearing from you.

Regards, Andrew