First Minister John Swinney has promised there will be no compulsory redundancies under plans to dramatically reduce the number of health boards in Scotland.
The Scottish Government intends to cut the 11 mainland territorial health boards to two strategic boards, although final decisions will only be taken after consultation and arrangements for the island boards have yet to be confirmed.
Swinney acknowledged the reforms would mean fewer public sector jobs but told BBC Radio Scotland: "I will maintain the no compulsory redundancy commitment. There is no question about that in my mind."
He said: "I have said that for all the time I have been first minister that there will be a need for public sector employment to fall.
"I have to live in the realities of the financial situation we face but I also need to ensure that we deliver sustainable services and improvements in services to members of the public."
Swinney said the shake-up would free up more capacity for treatment and give patients "equal access to the health service", arguing that existing administrative arrangements "put obstacles in the way of doing that".
Scottish Labour acting leader Dame Jackie Baillie welcomed the proposed simplification but said: "I welcome the simplification but it needs to be accompanied by a focus on primary care, preventative services and social care delivered in our community."