First Minister John Swinney has tabled radical plans to reform councils and slash the number of quangos, with the number of mainland health boards set to be cut from 14 to just two.
Unveiling the SNP's programme for government, Swinney announced NHS Grampian, along with its counterparts around Scotland, will be brought under the control of two giant health boards in an east-west split.
The 80-page document details sweeping changes including reshaping how the country's 32 local authorities operate.
The next step in the process is a three-month consultation period, during which the pooling of back-office functions and larger, region-wide decision-making will be among the issues discussed, The Times reports.
Swinney said: “We are faced with the reality that some of our councils are too small to be strategic and some are too big to be local. The government believes that should change.
“Our actions are about improving public services and at the heart of this approach is the need for simpler and more coherent decision-making structures."
The number of public bodies, currently over 130, will also be reduced, with Transport Scotland brought into central government.