Scotland's health service will continue to fail to meet targets unless major changes take place, the head of a watchdog has warned.
Dame Denise Coia, chairwoman of Healthcare Improvement Scotland (HIS), said the way healthcare is run across Scotland needs to change.
Giving evidence to Holyrood's Health and Sports Committee, she said: "I think the important thing to get at with targets is if we keep doing the same things that we do at the moment, the way we run acute care and chronic care, we are going to continue failing.
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"We have to change the way we run healthcare in Scotland and I think that's part of the work we are beginning to do at the moment.
"The NHS and social care in Scotland has got a finite budget that is really problematic. We're going to have to decide in Scotland, and it's a public debate, about how much we are going to spend on state-of-the-art acute care and how much we are going to have to spend on chronic care that shouldn't be in hospital and should be out in communities.
"What I would like to see in Scotland is a far more honest debate about do we want to spend the money more on chronic care or do we want to continue to have the seriously hi-tech acute care, because it just gets more and more expensive."
She was responding to concerns raised by committee convener Neil Findlay, who asked if HIS is succeeding in its mission to improve healthcare since Audit Scotland reported last year that NHS Scotland failed to meet seven out of eight key national performance targets, such as waiting times.
Mr Findlay also questioned Dame Denise on whether she has seen cuts to health and social care services in Scotland due to funding.
She said focusing on cuts risks going down a "negative rabbit hole", and she refused to discuss if they are happening.
She added: "It's not about cuts to services, it's about people actually shifting resource. In fact in some areas it's about taking some money out of areas and putting not even the whole amount back.
"What we need to say is we can do a lot better with the money we actually have at the moment."