Local politicians have said the financial crisis engulfing NHS Borders is "extremely concerning" and it is "distressing" to learn that health services will suffer.
Reports have revealed "significant and radical decisions" will be made about local healthcare services in the coming months as a result of the perilous financial situation at the local health board.
On Friday, NHS Borders released a statement revealing its opening financial position in April 2024 will be a deficit of £30 million, which would rise to £45 million by March 2025 without any cost savings.
NHS Borders Chief Executive Ralph Roberts said this is "clearly unsustainable". He said the level of savings required "will have an impact on the services we provide."
He added "we recognise that our services will feel different for our staff, patients and communities."
NHS Borders said they cannot provide any detail at this stage. They plan to come up with options in the next few weeks and engage with staff and communities on planned changes prior to a new financial plan being agreed in April 2024.
Scottish Borders MSP, Rachael Hamilton, said: "It is extremely concerning to learn how bad the financial situation is for NHS Borders.
"Tens of millions of pounds worth of cuts will have a devastating effect on many vital local services.
"The SNP Government must step up and support rural health services like NHS Borders. If they don't, Borders residents will face the prospect of a second-class NHS service and dedicated staff will be stretched to breaking point."
Scottish Borders MP, John Lamont, said: "What the SNP have done to rural health services is an absolute scandal. Local residents cannot be made to suffer the consequences of the financial crisis at NHS Borders.
"It is highly distressing to hear that 'significant' and 'radical' changes will need to be made to NHS Borders services to balance the budget.
"Humza Yousaf has the biggest block grant ever from the UK Government, so there is no excuse for leaving Borders health services in the lurch. The SNP must deliver more funding to stop these cuts."