Tynwald has voted overwhelmingly in favour of spending more than ?1.6 million on a new GP surgery in Jurby.
A number of moves to postpone the decision were defeated during a debate lasting more than four hours.
Earlier, the chairman of Michael Commissioners, Steve Hamer, addressed members from the bar of the court.
He made a plea for two new health centres to be built, one in Jurby and another in Kirk Michael.
But Health Minister David Anderson said Jurby was the right place for a regional health centre, serving the the village itself, Andreas, Ballaugh and Kirk Michael.
He also offered reassurance to patients unable to travel to the new facility (play audio file):
The vote in favour of the new surgery in Jurby was 20-4 in the House of Keys and 8-1 in the Legislative Council.
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