The number of north-east patients being forced to seek treatment outside the NHS Grampian area has soared.
Shock new figures show that almost 4,000 people had to travel away from the region for operations in 2014 – compared with just over 2,000 in 2010.
The rise of 74% over the four-year period was the highest in Scotland.
The number of patients requiring treatment elsewhere rose by a fifth between 2013 and 2014.
Last night, Scottish Liberal Democrat health spokesman Jim Hume accused the Scottish Government of letting down communities in the north-east.
He said: “How long will it take for the Scottish Government to recognise that considerable additional support is needed by this languishing health board?
“There are a number of reasons why patients may be referred to other parts of Scotland for treatment.
“But in general, patients should be able to attend hospital appointments as close to their homes as possible – the difficulty of travelling further afield is not only inconvenient but can also aggravate the very health conditions they are being referred for.
“Reimbursing patients’ travel costs also puts substantial strain on the already under-funded National Health Service in Scotland and is a waste of money if treatment is already available locally.
A spokeswoman for NHS Grampian said: “It has always been the case that patients are referred outwith Grampian if, for example, specialist services are not available locally. These referrals are made to NHS and private facilities.
“We are committed to meeting waiting times target for all patients. Currently it is not always possible for us to do this locally. When this is the case, and it is clinically appropriate, we offer the patient the option of being referred outwith NHS Grampian.
“We anticipate a reduction in referrals outwith NHS Grampian for elective care as the impact of the significant investment in new theatres and additional staffing take effect.
“The recent announcement confirming Scottish Government support and funding for a dedicated elective centre in Aberdeen will ensure that we have the capacity necessary to meet future growth in demand.”