The chief minister says he wants a public debate on how the National Health Service can survive in the future.
Allan Bell says the cherished system of free health care for all at the point of need is not sustainable for the long-term - as demand from the public continues to expand.
Last week Mr Bell stepped into the controversy over patient safety and management at Noble's and asked unions for a six point action plan to deal with the most pressing issues.
But Mr Bell says the bigger picture is far more serious and needs to be addressed:
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Activities paused at Douglas RNLI as 'precautionary' step
'Meaningful change' needed to ensure long-term future of sidecars at TT
The future of bus travel?