Politicians have backed an overhaul of the Manx healthcare system which will see health services delivered at arm's length from government.
An independent body known as Manx Care will be established to provide frontline health and social care.
The body, which will be headed by an independent board, will report to Tynwald on an annual basis.
The review was commissioned after a series of overspends by the Department of Health and Social Care.
It was carried out by Sir Jonathan Michael, a former chief executive of several NHS foundation trusts.
All 26 recommendations were unanimously supported during a Tynwald meeting on Tuesday.
Health minister David Ashford described the report as a "once-in-a-generation" chance to put patients "at the centre of everything we do".
While development of future policy and strategy will remain within the health department, the changes mean practical healthcare will be delivered by the new organisation.
The changes are expected to take five years, and £5m has been allocated to cover the cost.
Other changes include the introduction of a 24/7 patient transfer service for those in need of acute care at UK hospitals, increased use of telemedicine, and the transfer of the public health directorate to the Cabinet Office.
Welcoming the report, Lawrie Hooper MHK said it highlighted "fundamental weaknesses" in the current system, and that "nothing short of a complete overhaul" was needed.
He added: "The government needs to commit to delivering an action plan and delivering on that plan as a priority.
"This cannot be achieved by the health department alone."
Former health minister Kate Beecroft said the recommendations should be "implemented in full".
"Let's not make a mess of it with any half-hearted attempts," she added.