Health Minister David Anderson says a national debate is needed on the future of the NHS some 65 years after its creation.
He told Tynwald that, at current levels, health spending could be as high as a quarter of a billion pounds by 2035.
Commenting on an increase in spending of two per cent, or nearly £4million, for the new Department of Health and Social Care, Mr Anderson said: 'It is clear however that the new department will face significant long-term challenges which need to be addressed, not least the impact of an ageing population, continuing advances in healthcare, and growing public expectation and demand.
'To address these issues, a national debate is needed on the future of the NHS model in the Isle of Man, a system which was adopted in 1948 with the promise of universal healthcare free at the point of delivery. The monumental changes to health and social care over the past six and a half decades mean that the system is beginning to feel the strain of the growing demands it faces, raising questions on its sustainability and suitability to deliver modern health and social care services.'
Outpatient appointments at Noble's Hospital have increased by 8 per cent since 2010 and by 21 per cent since 2003.
Mr Anderson said: 'The impact that people’s lifestyle’s have on the demand for healthcare is the single most important factor likely to affect future demand for health care. Finding ways to manage this through education and taking a more preventative approach through screening and behavioural change will be more important than ever in the years and decades ahead, acknowledged in the Department’s Strategy for the Future of Health Services.'
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