Soaring costs mean, in real terms, the health service is facing cuts and so staff are facing a pay freeze and 2000 jobs, including more than 300 nursing posts, are being axed at NHS Lothian.
The delays and uncertainty facing hospital building projects is just the latest blow.
The long-planned community hospital for East Lothian and the rebuilding of the Royal Edinburgh Hospital may now be delayed, as well as the new Sick Kids hospital at Little France.
At the heart of this particular problem is a fundamental difference of opinion between health chiefs and the Scottish Government.
The SNP government is committed to funding such projects through private partnerships using its Scottish Futures Trust.
There continues to be deep concerns within the health board about this form of funding following its often traumatic experience with the privately-financed Royal Infirmary at Little France.
It is difficult to see how this situation can be resolved to everyone's satisfaction, unless next year's elections deliver a new Scottish Government.
But, even then, what guarantee is there that things would be any better?
It is the future of public services like local hospitals which is likely to spur many people to vote next May. It will be a key election battleground.
It will be up to the opposition parties to spell out exactly what they would do differently in order to better protect the services most valued by the people of the Lothians.
THE fact that a 15-year- old pupil can be attacked in the grounds of his own school in front of staff during his lunch break will disturb parents across the city.
But having already locked the back entrance to the Royal High School to deter intruders what more can headteacher Jane Frith reasonably do?
Our high schools cannot be sealed off from the rest of the surrounding community from first bell until last.
We can only hope that the police can soon track down those responsible so that they can be appropriately dealt with by the courts.