The issue was raised by former board chairman Richard Thomson during discussion of the hospital-capacity review, which is looking at the provision of hospital services in Otago and Southland for the next 20 years.
Mr Thomson said while he was a "huge supporter" of the independent trusts running the rural hospitals and not in favour of a return to a centrally owned hospital system, which would be "disastrous", there were issues with how to plan a public-health system when some providers were individually owned and had to look after their own interests.
While what happened in Dunedin Hospital was public information, similar scrutiny did not necessarily apply to all rural hospitals and this had been one of the difficulties in getting information needed for the hospital-capacity review.
Chief executive Brian Rousseau said this could be resolved by requesting information in contracts, but Mr Thomson said if it had to be done that way, then "already you've got a problem".
Board member Dr Branko Sijnja said the rural hospitals would be providing information yearly to the board.
Member Malcolm Macpherson said the mission statements of the individual hospitals were at variance and until they were aligned, it did not matter about data or contracts because they were "not all rowing in the same direction".
Chairman Errol Millar said he had attended a positive meeting with rural hospitals recently and had come away impressed, but then, "everything that has happened since gave a complete lie to that".
He was hopeful another meeting early next week would redress the situation.
It was important all sectors of the health community worked together, rather than taking a swipe at each other "all over the park".
Mr Rousseau said the relationship between the board and the rural hospitals was not as open as it should be.
Money woes were driving the tension between the board and the hospitals.
"They want more money and we haven't got it."
Mr Thomson said the issues were more than just about how many beds the hospitals might provide in future.
A report on the review is expected to be completed by late September or early October.
