More doctors and nurses quit their jobs in the north and north-east last year than anywhere else in the country.
A damning new report on the state of the NHS has revealed staff turnover at hospitals across the region was higher than anywhere else in Scotland.
NHS Grampian has even had to advertise vacancies as far afield as New Zealand and South Africa to try to plug gaps.
Bills for sending patients for private treatment and hiring temporary staff also soared as health boards battled to keep frontline services operating.
One NHS board was forced to pay an average hourly wage of more than £84 to agency nurses.
Last night, Labour’s health spokeswoman and North East MSP Jenny Marra warned the Audit Scotland report showed the situation had reached crisis point and demanded immediate action from the SNP administration at Holyrood.
She said: “Time and time again we are being given warnings about NHS staffing problems in the north-east with no action from the Scottish Government in Edinburgh.
“Until we get some recognition that we have a particular problem attracting staff to the north-east then we will continue to miss targets, make patients wait longer and heap pressure on our under-pressure doctors and nurses.
“I would again call on Health Secretary Shona Robison to meet the health board and council leaders to come up with a north-east-specific plan to fill the gaps in our NHS staffing.
“This can’t go on any longer.”
But Ms Robison said the report showed “the Scottish Government has increased the frontline resource spending on our NHS”.
She added: “Scotland’s NHS is now performing better against tougher targets, and as Audit Scotland highlights, we have a record high workforce and the level and quality of care provided to patients has contributed to people living longer along with continued advances in diagnosis, treatment and care.”
According to the Audit Scotland report NHS Shetland, Grampian, Western Isles and Orkney had the highest turnovers in the country, losing a minimum of one in 10 staff members in 2014-15.
NHS Highland had a slightly lower staff turnover of 9% and launched a new website to attract staff from Spain and Holland, Audit Scotland said.
Just under a third of consultant doctor positions were vacant at NHS Western Isles last year – the highest in the country – while 19% were unfilled at NHS Orkney.
NHS Shetland also had the highest nursing and midwife vacancies of anywhere in the country – with 19 posts empty – and was forced to offer an average of £84.05 an hour to temporary staff in a bid to plug the gaps.
NHS Grampian has had to post job adverts in countries as far flung as New Zealand and South Africa, according to the report.
Audit Scotland said posts at largely rural NHS boards were proving the most difficult to fill across the country.
The report warned: “Unsuccessful recruitment can lead to difficulties for boards in maintaining service levels.
“It can require boards to re-evaluate how they deliver services to ensure there is no risk to patient safety or care.”
A spokeswoman for NHS Grampian said: “We face a number of staff recruitment and retention challenges in the north-east – the comparatively high cost of living, the availability of suitable and affordable accommodation and more lucrative opportunities in the private sector.
“However, we are actively recruiting to a whole range of posts across the organisation. Our vacancies are advertised locally, nationally, internationally and on social media as appropriate and recruitment staff attend various job fairs.
“We believe that Grampian is an attractive place to work and live and we continue to seek new employees to join us.”
The four boards with the highest turnover in Scotland were NHS Shetland (13.3%), NHS Grampian (11.1%), NHS Western Isles (10.4%) and NHS Orkney (10.2%).
Other health boards said that they recognised the difficulty in retaining staff in rural areas but were working hard to resolve the problem.