A former Manx government minister says any cuts to be made in health care must not affect front-line services.
Dominic Delaney, who retired as an MHK two and a half years ago, is echoing Onchan MHK Peter Karran's call for an examination of middle management at the DHSS.
Earlier this week, the health department launched a major consultation to assess how healthcare should be funded in the future.
Mr Delaney says the process is only the start of an exercise which needs to be carried out across the whole of government, in the face of the current economic squeeze.
But he is warning, people want to see services maintained:
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