Speaking at Holyrood today, Ms Dugdale suggested integration joint boards (IJBs) across Scotland were facing funding shortfalls, causing services to be cut “to the bone”.
The Labour MSP claimed the Edinburgh Integration Joint Board had been forced to make £11.6 million worth of cuts for the coming financial year and could still face a further funding black hole of £12.6m.
Ms Freeman said a total of £711m, representing a 29 per cent increase on last year, had been committed to health and social care in the budget for 2019/20.
“I don’t accept that this Government has done anything other than absolutely prioritise the health budget, including health and social care,” she said.
“What I require integration authorities to do is to look at how they reform the delivery of their services in order to get the best value and deliver what patient care needs.
“That is both the health board and the local authority.
“The point of integration is to devolve those decisions to integration joint boards who should be best placed to determine what their local population needs with that significant additional funding from this government.”
Ms Dugdale said: “Can I say to the Cabinet secretary that she needs to lift her head from a spreadsheet and look at exactly what’s happening in the real world.
“In order to balance its books, Edinburgh is considering cutting mental health services and slashing its drug and alcohol partnership funding.
“If Edinburgh can’t afford to stand still, how on earth will 2,000 of my constituents get the help they desperately and urgently need?”
Ms Freeman responded: “It is a bit ironic to have someone from the Labour Party suggest that I live in the real world. Trust me, I live in the real world and it would be helpful to move away from the rhetoric.”
The health secretary also urged MSPs to focus on the plan agreed between the Government, Cosla (Convention of Scottish Local Authorities) and councils to help increase the pace and the delivery of integrated health and social care.
Ms Freeman said: “Every single one of our IJBs needs to improve what they are doing, but Cosla and I have committed to direct action to intervene and support where that is necessary.
“But once again this Chamber has to remember that if you want to devolve decision-making to local bodies, like IJBs, you have to allow those decisions to be made and not constantly want the Government to jump in and fix things because you don’t like what the local decisions are.
“We have to allow that local flexibility but where that does not meet the overarching priorities of this Government then of course we will actively assist them to do so.”
Scottish Conservative MSP Miles Briggs suggested there was a growing financial crisis across IJBs in the country.
“This isn’t about fixing things, it’s about stopping them being smashed in the first place,” he said.
“Across Scotland we’re seeing proposals to close care homes for alcohol and drugs partnerships, and primary care transformation funds to drive forward GP reforms, all being raided.
“The integration of health and social care is something we all agree with across this Chamber, but this is putting that at risk.
“This isn’t how it was supposed to be.”