He told the Southern District Health Board's recent hospitals' advisory committee in Invercargill that some patients with minor ailments should be seen by general practitioners.
Across the board region, it appeared there were two types of service, one which people paid for and one which they did not pay for.
There needed to be consistency in how people were treated, or people in Queenstown and Balclutha and other places would consider it unfair.
People had differing perceptions of what was an emergency and "we need to be prepared to say some of these things are not emergencies and turn them away".
At the board meeting yesterday chief executive Brian Rousseau cautioned members against assuming that all people in the triage five category should be seen in the community.
Triage categories defined the time it should take to treat a patient.
There would be some triage five patients whom it was appropriate to see in ED.
Dr Sijnja agreed, pointing out there were also some patients in triage three and two categories who could be seen by GPs.
Mr Rousseau said comparisons with other large hospitals showed that Dunedin had a higher ratio of attendances in the triage four and five categories, which was some indication some of those patients could appropriately be seen in the community.
Chief operating officer for Otago Vivian Blake said there had been an improvement in the staying times for patients at Dunedin Hospital's emergency department in April, with 78% being dealt with within the six-hour target.
In the previous month, it had been 71.91% and for months the hospital has been consistently around 70%, well below most other centres.
A report to the committee on access times showed the percentage of the population attending the emergency department in Dunedin had risen 3% from 2008-09 to 2010 to reach 19.8%.
Mrs Blake said when comparing Dunedin Hospital with other large hospitals in the country it had a higher rate of presentations at triage five, at 5.19%.
Data comparing Dunedin with large and medium hospitals' areas showed it had a higher number of GPs per head of population than other places.
Mrs Blake said information provided by the Dunedin Urgent Doctors and Accident Centre showed its numbers had dropped by 1000 patients a year every year for the past three.
Southland chief medical officer David Tulloch said data gathered at Southland Hospital showed a significant number of people were only outside the target time by up to an hour.
A survey of people visiting the Southland ED showed only 18% of people were concerned about the cost of seeking care elsewhere and there was a wide range of reasons people went to the ED.
Kaye Crowther suggested a main reason was that people had tried to access after-hours care in the community but could not get it.
Treatment Protocol explained
| Triage | Condition | Treatment time Goals |
| 1 | Immediately life-threatening | 100% seen immediately |
| 2 | Imminently life-threatening | 80% seen within 10 minutes |
| 3 | Potentially life-threatening | 75% seen within 30 minutes |
| 4 | Potentially serious | 70% seen within an hour |
| 5 | Less urgent | 70% seen within two hours |
