Courageous conversations need to be held if Moray Integrated Joint Board is to balance its books.
The organisation responsible for health and social care in the area has spent an extra £1.07 million on services between the beginning of April to the end of June.
While the board holds almost £1.6m in general reserves that can be used to cover the overspend, it will not be enough if current spending continues for the rest of the financial year.
The largest spend was £824,942 in older people and physical sensory disability services, £238,182 on primary care prescribing and £201,811 on mental health.
There were also underspends of £207,784 on in-house care services and £93, 266 on community nursing.
‘We need to have some courageous conversations’
At a meeting on Thursday, board member Sandy Riddell said: “Every time we have a report there are huge overspends. It’s actually like a family that’s maxed out on their credit card.
“Covid aside, we need to have some courageous conversations about strategy and that the financial situation requires some action.
“I feel collectively we have to have some discussions about shifting things and doing things differently.”
Chief financial officer Tracey Abdy told the board the extra spend on older people’s services was a problem across Scotland not just in Moray, and there had been issues recruiting some mental health staff roles that had to be covered by locums.
She said: “We still have funding that has to be allocated but it wouldn’t be enough to cover the whole spend if it continues at the same level.”
Vice-chairman of the board Dennis Robertson asked for time to be set aside so members could discuss the matter in relation to strategic priorities.
He said: “There are some very difficult decisions to be taken but we can’t divert them.
“Treading water can be very difficult and we need to stroke out at some point.”
It was agreed to undertake discussions to tackle the problem.