Health boards across Scotland are facing swingeing budget cuts which are certain to impact directly on core services for patients and staff.

Boards are proposing cuts as a result of lower than anticipated funding from the Scottish government, higher than expected pay settlements and soaring energy costs.

NHS Glasgow has given warning that £42 million of cuts this year are in the pipeline and it emerged yesterday that managers at NHS Highland are looking for “scary” savings amounting to £36 million by 2012.

Papers obtained under the Freedom of Information Act by The Times show that other health boards are facing a similar dilemma. NHS Grampian is looking to save £40 million over three years, while it is believed that NHS Tayside may be forced to implement £16million of savings.

Various boards are considering making staff redundant, cutting front-line care for patients, rethinking GP out-of-hours services, a freeze on staff recruitment and reductions in emergency admissions.

The possible cutbacks mark the end of what have been relatively good years in tersm of funding for the NHS in Scotland which has seen the health budget well ahead of England in terms of spending per head of population.

Figures compiled at Westminster show that as a result of the separate spending plans in London and Edinburgh, by 2010-11 every Scot will have £2,087 spent on his or her health against £2,002 in England. That is a turn-around from 2007-08 when spending per head in Scotland was substantially ahead, at £1,996 compared with £1,780 in England.

The narrowing of the spending gap between is explained by the annual real-terms rise planned for both countries. As a result of last year's Comprehensive Spending Review, funds available to the NHS in England will rise by an average of 4 per cent over the three years from 2007-08 to 2010-11. In the same period the Scottish government, according to its budget priorities announced last year, will increase spending by an average of 1.5 per cent in real terms.

Overall this year £10.2 billion will be spent on health in Scotland, against £90.3billion in England. In three years' time, the figures will be £11.5billion for Scotland and £109.8 billion in England.

Critics of the Nationalist government say that the annual increases in NHS spending announced this year are significantly lower than in the past. In 2004-05 spending on the NHS in Scotland was £8.1 billion, rising to £9.3 billion in 2006-07 and £10.09 billion in 2007-08. The budget for this financial year is £10.64 billion and is projected to rise to £11.5 billion in 2010-11.

Garry Coutts, chairman of NHS Highland, has admitted that funding is tight: “We are going to have to make some tough decisions, but NHS Highland is focusing on making sure that we maintain the quality of outcomes for patients and that we do not get into deficit,” he said.

Richard Simpson, Labour's health spokesman, called on Nicola Sturgeon, the SNP Health Secretary, to “stand up and take responsibility for cuts in the health service”. “When health boards describe the cuts they are facing as scary ministers must step in and provide them with adequate resources,” he added. While Labour will seek to attack the cuts, its tactic will be undermined by the fact that during last year's Scottish election, Labour ministers could not say how much extra cash they would devote to health boards.

This issue was highlighted by Alex Salmond when the issue arose at First Minister's Questions yesterday. Mr Salmond said that if Labour was still in power, health would have received no more than annual “consequentials” through the Barnett formula .

A Scottish government spokesman said that despite an extremely tight settlement from Westminster, the SNP had delivered record investment to NHS Scotland, which will exceed £11billion by 2010-11. “In addition to the initial general allocation, boards will have access to additional funding that will be allocated throughout the year,” the spokesman added.

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