Such development and growth had been his aim since he was appointed the foundation neurosurgeon for the Christchurch unit in 1981, he said in an interview.
The new South Island Neurosurgical Service could be "very important" in leading the way for the development of many services across the country, not just neurosurgery.
Mr MacFarlane, who was in Dunedin to inspect facilities and meet hospital staff and University of Otago health sciences pro vice-chancellor Prof Peter Crampton, said people had been welcoming.
Respect for sound clinical practice should supersede any other "political rubbish - or it should do", and that was what he had always tried to do.
In his advice to staff before yesterday's visit, Southern District Health Board chief executive Brian Rousseau acknowledged there had been a lot of tension and "words" between Dunedin and Christchurch over the neurosurgery issue, but the expert panel recommendations had been delivered and "are cast in stone".
It was time to move on and work constructively with "our South Island colleagues".
In recent years, Mr MacFarlane has been a strong advocate for a one-site service based in Christchurch with outreach clinics to other centres, which would have meant no neurosurgeons based in Dunedin.
However, implementing the panel's recommendations will involve him developing a service with three neurosurgeons based in Dunedin, two of them with academic duties, and increasing the number of neurosurgeons in Christchurch from four to five over time.
Asked if his arm had been twisted to take on his new job, Mr MacFarlane said the role of developing a South Island-wide service was one he had been "begging" to have created for 20 years.
He spoke of the advantages of being able to cross district health board boundaries in the new development.
This could include some patients having surgery in North Island centres, if that was best clinically.
Asked whether he was concerned he might be blamed if attempts to implement the panel's recommendations failed, for whatever reason, Mr MacFarlane said that in any work such as this, there could be some things that "aren't achievable" and others that were "better achieved".
It was a work in progress.
Service implementation manager Joy Farley said whatever decisions were made would be transparent and involve representatives from the South Island district health boards and the other members of the governance board.
Mr MacFarlane said recruiting staff to all levels of the service might be the most difficult aspect, not limited to the discipline of neurosurgery.
There was a limited pool of people with appropriate training.
Few New Zealand trained neurosurgeons had remained in the country in the past decade.
He agreed that the academic positions to be offered in Dunedin could prove attractive, possibly for those at an age where they found 2am calls "wear a bit thin" but were still keen to contribute to the profession.
Ensuring there was appropriate resourcing for staff, equipment and physical space and "how it's applied to enable what is good clinical practice" would be important for the new service.
Mr Rousseau said the amount of media coverage about the new service could also improve the ability to recruit because it would be seen as "something new and exciting".
Ms Farley said advertising would begin soon for a clinical position in the Dunedin node of the service, where the unit has been managing with locums, and for one of the two academic neurosurgery positions.
The quest for a professor would be "managed differently", she said.
Mr MacFarlane said there would also need to be a 0.5 appointment at Christchurch to cover his position.
All the other Canterbury neurosurgeons, some of whom have been critical of the panel's recommendations in the past, were "happy to continue" and fully supported the South Island Neurosurgery Service, he said.
After viewing the hospital facilities, Mr MacFarlane said Dunedin had some issues in common with Christchurch in terms of the age of its buildings, older equipment, shortages of space and resources, difficulty in recruiting all staff and constraints on bed numbers.
