Radical cost-cutting measures are to be implemented at the Scottish NHS in order to make up for an apparent £400m shortfall in funding, according to papers leaked to the BBC.
The papers were presented to a meeting of health board chief executives and civil servants last month. They have been leaked to the media by a senior NHS whistleblower, who claims to have become frustrated with Scottish independence campaigners vowing to protect the Scottish NHS and suggesting it is under threat from Westminster's policies.
It is actually the Scottish government which is applying pressure to the NHS, the whistleblower alleges.
"The status quo and preservation of existing models of care are no longer an option given the pressing challenges we face," the documents read.
The Scottish government had passed a legislation to transform the NHS by 2020 by implementing more community care.
But the papers state that this plan will actually increase the cost of hospital care and they will need to find an additional £400-£450m in the next fiscal year, which the authors describe as "a level significantly in excess of that previously required".
Although the SNP vowed to stop closing services and centralising hospitals, the paper contends that these measures may need to be taken if it is to come up with the figure.
"Radical and urgent decisions need to be made regarding the shape and configuration of services."
"We need to commit to these priorities and accept that significant changes require to be implemented," the leaked document concludes.
The Scottish government said that these discussions were par for the course as it looks to protect Scotland's NHS.
Health Secretary Alex Neil told the BBC: "We've protected Scotland's NHS from the Tories cuts, and with independence we can ensure that it is never again under threat from Westminster's dangerous obsession with austerity.
"Despite Scotland's budget being slashed by 7.2% by George Osborne between 2010/11 and 2015/16, our increases in health spending means that the NHS is receiving record high funding, with a budget increase of over £1bn between 2010/11 and 2015/16."
"To ensure we can continue to develop the NHS, it's important that NHS boards regularly discuss their future plans to inform budget discussions with Scottish government officials, and to identify how we will continue to deliver quality care and treatment," he said.