Department heads have, however, been ordered to draw up plans to cut their staffing budgets by five per cent. If they do not, they will not be allowed to fill any posts that become vacant.

That is just some of the measures being taken as NHS Borders tries to save £10million over three years.

Chief executive of NHS Borders John Glennie told TheSouthern: "There will be no compulsory redundancies but vacancies will be scrutinised as they arise. There will not be a vacancy freeze but a proportion of vacancies will not be filled."

One of the most emotive and controversial cost-cutting decisions is the merger at the BGH of the palliative care Ward 14 with the stroke unit of Ward 11.

Neither ward is fully occupied and Mr Glennie says it has the support of clinicians.

He told us: "The professionals feel this is the best way to tackle the problem. Clinicians are comfortable with the mix and discussions on whether it should become permanent – the mix not the closure – are taking place. They feel it is an appropriate clinical mix. It could be argued that what is happening is better than filling the wards with medical cases."

And he gave an assurance that although several capital-spend projects were being examined, the board remains committed to these projects.

With particular reference to the £12million project for an Emergency Care Centre at the BGH he said: "We are committed to this project but we are asking if we have to do it the way we have planned."

We asked Mr Glennie if he was confident – despite the changes – he could still deliver the services that the people of the Borders expected and demanded. He told us: "Absolutely. We are rich in the way we provide our services. We are doing (this) alongside the clinical leaders and we will protect and drive forward our service.

"It will not be easy. But the people of the Borders will expect us to rise to the challenge and continue to provide this service."

Lib Dem MSP Jeremy Purvis told TheSouthern: "These are real and devastating cuts to the health service squarely as a result of the settlement the health board received from the Scottish Government.

NHS Borders has been forced into this situation. The Scottish Government refuses to recognise that providing healthcare in rural areas costs more than in other areas."

And he warned: "This is the biggest single threat to NHS services in the Borders for a generation."

He blamed the SNP administration for changes to the financing formula.

Cabinet secretary for health and wellbeing at Holyrood, Nicola Sturgeon, said: "No board will receive less funding than it does at present under the new formula.