A combined Otago-Southland district health board could be in place before next October's local government elections.
This possibility is revealed in the public consultation document on the possible merger, released today.
The public has until December 11 to make submissions on any merger, which the 20-page document says would not be a take-over, nor just about cost cutting.
Otago board chairman Errol Millar said the boards were expected to make a decision on the issue in February.
If it was decided to go ahead, Health Minister Tony Ryall could move "reasonably quickly" to change board boundaries.
If that happened, existing board members would form a united board until the election of a new board in October.
Mr Millar said board members attending public meetings on the issue were being encouraged to do so with an open mind rather than to lobby for a particular view.
One DHB would improve the clinical and financial sustainability of their services, the document says.
The boards, expecting deficits totalling $15 million dollars this financial year, hope the move would enable them to meet the Government requirement to break even from 2011-12.
Combining the boards would give potential direct annual savings of more than $500,000.
Such savings would come from reduced board and committee fees, election costs, internal and external audit fees, certification and accreditation costs and administration.
While this was small in the overall budgets, which total more than $817 million this year, it was a "significant benefit".
The boards expected that other as yet unknown cost savings would be at least another $500,000 a year.
These would include sharing more costs, simplifying management structure, reducing duplication in accounting processes and halving board meeting time for managers.
Mr Millar said estimates on savings were conservative.
In response to questions at a press conference on the consultation, Southland chairman Paul Menzies said savings from closer collaboration of the boards in recent years would amount to millions of dollars.
The document notes that the boards are receiving a clear message from the Government that change is needed and all South Island boards are already working together to plan long-term sustainable services.
The consultation document lists six things the boards are trying to achieve.
These are keeping health services close to communities, providing greater choice about where to get board services, reducing administration costs, long-term financial sustainability and supporting the boards' relationships with the health sciences division of the University of Otago.
One board would give some people greater choice, the document said, pointing out that although the boards share the Southern Blood and Cancer service there can be restrictions on where people are treated because of the way funding is allocated.
People who live in Queenstown and who needed chemotherapy, for instance, had to access treatment at Invercargill when they might prefer to have treatment at the closer Dunstan Hospital.
A larger population base from the two regions would help to keep health services in the South.
"This particularly applies to the more sophisticated hospital-based services such as radiation therapy," the document stated.
Asked what might happen if Southland people were against a merger and Otago people were for it, Mr Menzies said the boards would "cross that bridge when we come to it".
Similarly, what impact it would have if staff opposed the idea could not yet be known.
Mr Menzies said he was "pretty confident" management and clinicians saw the benefits of the two boards working together.
The boards already share several committees.
Under a section "Possible Concerns" the document notes there may be worries about the potential to lose representation.
The document refers to concerns relating to differences in the culture and approaches within each board where some staff may not support a single board and retain a "narrower provincial focus".
The document acknowledged staff could feel anxious because the paper did not cover details of changes which could result from a merger.
There would be further consultation processes with staff and unions if the proposal went ahead.
Work on regional clinical services would continue whether there were two boards or one.
Other possible concerns were increased travel costs and logistics and some one-off costs such as new logos.
