During discussion of the National Health Board panel's report on Wakatipu health services member Dr Malcolm Macpherson said there was a looming crisis in after hours and emergency care in some parts of the South.
He suggested there was a risk that this could now be exacerbated.
Walk-in emergency departments were less sustainable in some other places.
Chief executive Brian Rousseau said the national framework around EDs was that they had walk-in access, which meant some of Southern's rural hospitals did not meet that.
Neither the Balclutha or the Dunstan Hospital have walk-in access and deal with either ambulance or GP referrals.
Dr Peter Foley, who headed the panel looking into the Wakatipu services, said looking at what was available in the other communities was beyond its terms of reference.
In response to questioning about whether a panel with two emergency medicine specialists could have arrived at another point of view regarding the Lakes District Hospital, Dr Foley reiterated the fact the panel had to comply with the national guidelines for emergency departments.
He said he had a personal view of what might happen over the next few years and whether that approach was sustainable, but "at the moment that's the reality".
He referred to trying to get primary care providers working more closely with emergency department doctors and nurses but "that's a bridge too far, at this stage".
Member Richard Thomson asked whether any other board was required to fund six emergency departments.
Mr Rousseau said he did not think any other board would have six, although Waikato would have "a few". (It has five).
To a further question about whether the rural adjuster payment under population adequately compensated for ED provision, Mr Rousseau said it had been acknowledged by the National Health Board that the adjuster "needs work" in terms of how it was made up.
The national board had said it was timetabling some work on this in 2013-14.
Questions raised earlier with Health Minister Tony Ryall about population based funding are being treated as an official information request.
Initially, Mr Ryall's office said there had been some concerns raised from the Taranaki District Health Board some years ago.
He issued a two- sentence statement saying there had been the odd complaint by a board getting less than the national average.
"I haven't had any complaints from a DHB getting more."
The Otago Daily Times had sought specific information on any concerns raised about the formula and the response to them.
Under the formula, Southern receives $2255 per head of population annually, compared with the national average of $2300.
