First Minister John Swinney has demanded "dramatic action" at NHS Grampian following a damning watchdog report which exposed serious leadership failures and risks to patient safety.
Speaking at First Minister's Questions, Mr Swinney described the Healthcare Improvement Scotland findings as an "appalling read" and condemned the revelation that Dr Gray's Hospital in Elgin had continued carrying out surgery on children despite instructions to stop.
"It was crystal clear that the requirements to end surgery for children at Dr Gray's Hospital was not followed by NHS Grampian and that is reprehensible," he told MSPs.
"It is unacceptable that arrangements that should have been stopped for proper patient safety reasons were not stopped."
The First Minister confirmed immediate changes had been made to the health board's senior leadership, with Health Secretary Angela Constance due to outline further action in a statement to Parliament on Tuesday.
"The report has some of the most serious issues which will have a detriment to staff and patient morale in NHS Grampian but I want the public to hear loud and clear that dramatic action has been taken," he added.
Ms Constance described the findings as "extremely serious and deeply concerning" and demanded urgent improvements before the end of the year.
"Patient safety must come first, and people in Moray and across NHS Grampian must have confidence in the care they receive.
"This must be a turning point for NHS Grampian and the board must act with urgency in addressing the serious concerns."
The watchdog identified "major deficiencies" across the health board, including failures to learn from mistakes which resulted in "repeated and unavoidable harm" to patients.
NHS Grampian chief executive Laura Skaife-Knight, who commissioned the review, apologised to patients and families but ruled out resigning.
"I am completely committed to NHS Grampian and leading the organisation forward," she said.