The trust did not have the resources to fly acute patients to Christchurch on a regular basis, and to do so could adversely affect the service provided to Otago and Southland residents.
Winter conditions, which regularly preclude safe flight through North Otago and South Canterbury, especially at night, complicated the matter further.
Mr Black, a former chairman of Healthcare Otago, said he was also "seriously concerned" Health Minister Tony Ryall, former director-general of health Stephen McKernan and Canterbury District Health Board chief executive David Meates were quoting the words "safe and reliable" as the focus for the expert panel advising on the future configuration of South Island neurosurgery services.
"It's far too narrow and risks predetermination."
He urged Otago and Southland communities to obtain assurance that the group's terms of reference also took into account the region's comparative geographical isolation, widespread population and extreme weather conditions and the challenges they presented to achieving timely emergency care.
The whole community should be also alarmed at the warnings of loss and risk to life being expressed by many senior southern medical specialists, and make sure the panel gave those views due regard.
The Otago Regional Rescue Helicopter Trust had a proud record of delivering emergency services across the region within the recognised "golden hour" objective (the rough time period following traumatic injury during which there is the best chance that medical treatment will prevent death), but the job would be made considerably more difficult were it necessary to transport acute patients to Christchurch.
The trust - which must fundraise between $400,000 and $500,000 each year - did not have the resources to regularly have a helicopter, pilots and advanced paramedics out of the region for extended trips.
Mr Black, who was the chairman of the Healthcare Otago board when Dunedin Hospital faced a neurosurgery challenge from Christchurch in the late 1990s, urged Mr Ryall to do as the minister at that time did and require that the alternatives for the future of the provision of neurosurgery were robustly compared - both for medical safety and total cost - including the considerable additional travel and accommodation costs local families would incur travelling to visit and support neurosurgery patients in Christchurch Hospital.
He said he also shared the concern of Dunedin Hospital director of intensive care Mike Hunter that the two neurosurgeons on the panel advising on the future configuration of South Island neurosurgery services had a big city viewpoint, and urged Mr McKernan to appoint to the panel former Dunedin neurosurgeon Sam Bishara to ensure the benefit of local delivery in a smaller centre was understood.
It was an issue that the local community must see resolved positively, he said.
"It is our lives potentially at stake, the lives of our children and the lives of the increasing number of overseas visitors to our unique region."
