The Scottish Government has underfunded north and north-east health boards by more than £20million this year.
A shocking new report has laid bare the extent to which NHS Grampian and NHS Highland are being starved of cash.
Audit Scotland estimate the north-east health board is £12.2million short of its funding target, while the north health board has also been shortchanged of £8.5million.
MSPs lashed out at the government over the figures, accusing the administration of damaging the NHS in north and north-east Scotland.
The independent report also catalogues how medics fear staff shortages are putting patient care at risk.
Health Secretary Shona Robison said NHS funding was at record levels and that both health boards have received additional cash.
But North East MSP Lewis Macdonald said: “£12.2 million would be enough to pay the salaries of an extra 400 registered nurses, or 200 surgeons.
“It could be used to pay for much-needed procedures and treatments, or to replace equipment that is no longer working as efficiently as it should.
“The people of the north and the north-east are being short-changed by this SNP Government when it comes to health funding.
“Ministers must meet their commitment to fund health boards like NHS Grampian and NHS Highland properly or it is patients and their families who will suffer.”
Excluding a national funding package to boost social care, NHS Grampian was given 1.4% less than the National Resource Allocation Committee (NRAC) target in 2016/17, while NHS Highland was given 1.5% less in the same period.
Highlands and Islands MSP Donald Cameron added: “This is a damning report, and shows the dire state that our NHS is currently in.
“It paints a picture of an NHS in crisis, with short staffing leading to worsening patient care and budgets becoming increasingly under pressure.”
As well as the funding issues, the Audit Scotland document highlights concerns that staff shortages could be impacting patient care.
Examples in the report include stretched staff being unable to provide sufficient care for patients with pressure ulcers and an increasing number of patient falls.
Spending on agency staff at NHS Grampian has risen 2700% in the last five years, while it has shot-up by 200% in the same period at NHS Highland.
A spokeswoman for NHS Grampian said: “We continue to work closely with Scottish Government in securing funding in line with our NRAC target allocation.
“This position has consistently improved in the last four financial years and we have welcomed the positive steps that have been taken.
“We anticipate that further progress towards our target allocation will continue over the next three financial years.”
NHS Highland confirmed in a statement that they had been short-changed for £8.5million this year – up from a £6million gap in 2015/16.
The health board’s chairman David Alston described the current situation as “very challenging” and added he would “welcome” an opportunity to move back towards the Scottish Government’s funding target.
But Health Secretary Ms Robison said: “To bring health boards closer to parity, they have received additional funding with a further £1million going to NHS Highland in 2016-17 and a further £15million to NHS Grampian, on top of the record levels of funding already provided to all boards.”