The chairman of NHS Tayside says it could take three years for the health board to turn its finances around.
John Brown said it would be unrealistic to expect the board to be back in the black before 2022 given its long-running financial problems.
The latest estimate is that Tayside will post a £22m deficit for 2018-19, which is on top of £45m of overspending recorded in previous years.
Mr Brown, who was drafted in last year as chairman after the previous leadership was ousted, said the financial situation has “stabilised” and the board is driving forward changes to deliver more savings.
“This level of change won’t happen overnight,” he told a Holyrood committee on Thursday.
“There is a long history of problems within Tayside going back six years.
“So I think for us to be aiming to be in financial balance and having performance improved over the next three years is a realistic ambition for us.”
Tayside has required government loans, known as brokerage, to break even since 2012-13.
If Mr Brown’s aim to be in the black in 2022 is realised that would amount to a decade of over-spending at the board.
The Scottish Government has wiped the slate clean so boards including Tayside do not have to pay back any of the brokerage.
Health Secretary Jeane Freeman also ended in October the requirement to balance the books every year, introducing a three-year cycle.
The key drivers of Tayside’s failure to break even in recent years have been high levels of spending on staff, prescriptions and the estate.
Progress has been made in reducing reliance on agency nurses, productivity improvements in elective care and savings in areas including medicines, corporate services and facilities, the health board says.
Health bosses will lay out in more detail its plans for improving the finances at next month’s Tayside board meeting.
The Dundee-based organisation was mired in financial scandals last year, including using charitable donations to cover general expenditure and the manipulation of digital healthcare funds to make the finances look more favourable.
At last week’s public audit committee, Labour MSP Anas Sarwar challenged Mr Brown over missed performance targets, including “shocking” waiting times for child and adolescent mental health services (CAMHS).
Mr Sarwar said: “Six out of 10 children not getting their mental health treatment in time. That’s not good enough is it?”
Mr Brown said he agreed entirely, adding their “programme of change will deliver services in a different way so that we can improve that access”.