NHS Grampian’s recruitment crisis has led to increasing use of locum surgeons, and left the health board millions out of pocket.
Last year, the north-east body spent more than £1million on locum staff in its surgical departments between April and September.
In the previous financial year, £2million was spent on hiring locum medics to carry out procedures.
Patients have previously spoken out about problems caused by hiring staff from outside agencies.
In 2015, a patient who suffered complications during surgery was abandoned for more than 24 hours at Aberdeen Royal Infirmary – because his locum consultant caught a flight home to Belgium.
The previous year, NHS bosses flew a consultant in from Jamaica after the Aberdeen hospital was left without a top anaesthetist amid staff shortages.
Earlier this year, a patients group said the recruitment woes had been exacerbated by a lack of funding from central government.
Professor Jamie Weir, of the Patient Action Coordinating Team, said: “It’s the same problem we have had before in that a lack of permanent staff leads to an increase in costs because of agency and locum staff.”
NHS Grampian said the “main reason” for the rising use of locum surgeons was the need to cover vacancies while posts are being recruited.
However, the Scottish Government stressed that it had given the health board “record funding”.
Health Secretary Shona Robison, said: “This year, we are providing NHS Grampian with record funding of £882.3million – a 6.6% increase on the year before and the largest budget uplift of any mainland health board.”
In February, health ministers began working on new measures to help NHS Grampian better predict and plan for staffing troubles.
The workforce planning document encourages a move away from heavy use of agency staff.
It says: “We need to fill gaps within our workforce, as far as possible from within employed staff resources, rather than from expensive agencies.”