Thousands of people are being forced to travel to other parts of the country to undergo vital treatments, new figures have revealed.
Last year more than 225,000 people requiring a variety of procedures were taken out of their own health board areas to receive care.
That accounts for around 10% of all patients in 2015/16 but does not include those who sought private care or those who went to the National Waiting Times Centre at the Golden Jubilee in Glasgow.
This works out that on average more than 600 people a day are travelling sometimes hundreds of miles to access the NHS.
This is the first time ISD (Information Services Division) Scotland has published statistics on “cross boundary flows”, and covers new outpatient attendances, day cases, elective and non-elective patients.
Geographically, there is huge disparity in the number of patients forced to travel, particularly in smaller health board areas with fewer specialist services.
However, the data also reveals that 20.8% of new outpatient attendances in major boards like Highland were sent elsewhere.
In NHS Grampian, the figure was only 2.3%, while it was 19.8% in Orkney, 15.6% in Shetland and 17.9% in Western Isles.
Scottish Conservative shadow health secretary, Donald Cameron, said: “There will always be cases where travelling is the best thing medically for a patient, just as there will also be those who choose to go elsewhere to access quicker care.
“However, these figures reveal how hundreds of patients every day are being inconvenienced by having to travel considerable distances.
“That should tell the SNP that it needs to think again about the level of service delivered in some areas.”
Health Secretary Shona Robison defended the figures. She said: “There are very good reasons why people are treated outside their board areas. Specialist care is provided in the most appropriate environment, regardless of board boundaries – this often provides better outcomes, as the clinicians involved have a sufficient volume of cases to maintain and improve their skills.
“Also in many cases it is easier for a patient to go to a hospital in a neighbouring board area, because it is nearer to their home.”
She added: “Where clinically appropriate we will continue to plan and deliver services at a local level.”