Stop reviewing. Start doing.

Health and care are one system on this Island: the same beds at Noble’s that back up because of delayed discharge are the beds that lengthen every waiting list. So this page treats them together — the reviews and the screening, and what it takes to grow old here.

1 · Reviews, screening & workforce

Our health service has been reviewed 10 times in 7 years. 7 of those reviews were published. Between them, they identified 59 known actions — and only 15% are actually complete. Meanwhile you can’t get a GP appointment. (Every review and action is tracked, sourced and benchmarked against five other British islands in the Observatory’s healthcare explorer — the full list of reviews and actions is on its Governance page.) I fully support the integrated health and care system — and its managers, clinical and otherwise, deserve political support to turn around decades of entrenched behaviour. I’ll also be honest with you: real fixes take time before they show — we fund the change, make it, then see the improvement. Anyone promising instant results is selling something.

It’s easy to blame management. But the people doing the work don’t agree that management were at fault — so I went looking myself, and the results are on the Observatory.

What I’d do:

• Push for the remaining reviews to be published, and build a public tracker of every recommendation and whether it’s been acted on, updated monthly — because finishing the homework is how waiting lists come down.
• Properly commit to the arms-length, depoliticised Manx Care arrangement, with professional managers and clinicians politically backed and supported.
• A new deal for GPs: options to integrate into Manx Care, with better information exchange between practices and the wider system — and new contracts so GPs aren’t required to run a small business on top of practising medicine.

Invest in prevention:

• Extend bowel screening: England, Scotland and Wales now screen from 50, the US and Australia from 45 — we still wait until 60. I’ll push to phase screening down towards 45, backed by funded endoscopy capacity, at an estimated £150,000–£300,000 a year — catching a small but real number of cancers each year at the stage where nine in ten people survive instead of one in ten.
• Build our clinical workforce deliberately: funded education-to-jobs routes for Manx clinicians, more resident doctors, and formal links with the Royal College of Surgeons of Edinburgh’s remote and rural surgical training pathway — the programme that staffs Scotland’s island hospitals — so specialists come from a network and generalists live here.
• Form an inter-island collaborative to benchmark ourselves against comparable islands and learn from each other — Orkney, Shetland, Jersey, Guernsey and Na h-Eileanan Siar (the Outer Hebrides).

Invest in mental health:

• Despite a similar pattern across islands, there’s no evidence we — or any comparable island — have a higher incidence of suicide. The strongest, most consistent risk factors, here and everywhere else, are unemployment, relationship breakdown — especially in the weeks right after a separation — area deprivation, and poor or delayed access to care. That’s where prevention should actually be aimed, not guesswork — and it should be Public Health’s own data demonstrating it, published in full, not a private analysis from me or anyone else.
• Measure unemployment and underemployment properly: the Chamber of Commerce says roughly 1,000 jobs have been lost — where do those people actually show up in the statistics? Early retirement, underemployment, something else — we can’t act on a constraint we don’t measure.
• Publish the underlying data quickly, in a properly anonymised form, closer to the real dataset than a periodic summary review — so the patterns above can actually be spotted and acted on, not just written up after the fact.
• Fund early, non-judgemental support for separating parents where children are involved, in the weeks it matters most — backing the third-sector groups already doing this work, not duplicating them.

2 · Growing older on this Island

Deaths have exceeded births here every year since 2017. That means care — how it’s funded and where it’s delivered — is becoming the Island’s central service question, and it’s also what blocks beds at Noble’s, which backs up outpatient and elective work, which is why waiting lists grow. It is one system.

What I’d do: more care delivered at home, with community support around it — and Hospice funded the way our neighbours fund theirs: Jersey covers around 44% of its hospice’s costs and the UK average is about 36%; we cover roughly 24%, and this spring that gap meant redundancies. The third-sector funding review due in September 2026 is the moment to fix it. And because everyone already knows which way this is heading, I want that honesty matched with transparency: open, publicly accessible, costed care pathways, so families can see in advance what care looks like, where it’s delivered and what it costs — not find out only when they need it.

Summerland Villas is a genuine success story worth building on — I want a proper public discussion about why it worked, and where else the model could apply.