NHS Scotland made 251 payments for clinical negligence in 2015-16, up 38 on the previous year and almost double the 132 made in 2010-11.
The figures were revealed by health secretary Shona Robison in response to a parliamentary question from Scottish Conservative public health spokesman Miles Briggs.
Mr Briggs called on the Scottish Government to explain the “extremely worrying” rise, which now means taxpayers north of the border have to fund the settling of a negligence case almost five times each week.
The Conservative MSP said: “It’s right that when someone has suffered as a result of clinical negligence they should be compensated. “But the increase in these payments is extremely worrying. Either the NHS is becoming more negligent or simply quicker to address failings with a pay off, and neither of those outcomes are positive.
“The NHS can’t simply sweep incidents of clinical negligence under the carpet with a compensation deal. Lessons have to be learned and those responsible held accountable, otherwise these payments will just continue to increase in number.
“It is also clear that this increase in the number of clinical negligence payments will be impacting already hard-pressed NHS budgets.”
A Scottish Government spokesman said: “The number of cases settling from year to year varies due to some claims taking several years to conclude.
“Because of this, the number of compensation payments made in any one year does not reflect the year in which the incident took place.”
In her parliamentary answer Ms Robison added that some delays could be down to disputes around liability and the access to legal aid.