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:
Clip 1

Study finds Isle of Man's clothing offering rates poorly for women
Charity implores people to 'adopt responsibly' as it faces capacity issues
Positive response to decision to let dogs on beach all year