The Southern District Health Board has tried to stay true to the process being followed to review neurosurgery services in the South without "selling ourselves short", chairman Errol Millar says.
While people might have wanted the board to be more vocal about the situation, it had agreed to the process with the other South Island boards and "it had to be given a chance".
Board members had been kept informed of what was going on.
Under the protocol established by the boards, South Canterbury chief executive Chris Fleming has been the designated spokesman on the issue.
Discussions, over many months, have been behind closed doors and documents on the issue were only released this week.
They included the report from independent consultant reviewer Dr Ian Brown, recommending a one-site model with all six neurosurgeons resident in Christchurch.
This coincided with the announcement from Director-general of Health Stephen McKernan that he was appointing an expert panel to advise him on the impasse.
The documents show Southern believes the change supported by the other boards would be less safe and more expensive, and the wider implications for Dunedin and the University of Otago have not been understood.
The board says its alternative, with two neurosurgeons living in Dunedin, has not been properly explored, along with the financial implications of either idea.
The sensitivity around publicity is illustrated in a memo Mr Fleming wrote to his fellow chief executives reporting on a May 14 meeting at Dunedin Hospital where 40 people, including civic leaders, University of Otago representatives and clinicians gathered to share their concerns.
SDHB chief executive Brian Rousseau told that meeting he had not heard any evidence of the benefit of all acute services being in one location and would not be supporting it.
He hoped the chief executives would reach a decision quickly, but if not he would be advising Mr McKernan he would be moving immediately to appoint permanent neurosurgeons.
Mr Fleming's memo, released this week, described this statement as being unfortunate and said it had been done "very publicly", something which provoked a response from Mr Rousseau the following day in a letter to the South Island chief executives.
He said the meeting was not public and those invited had been made aware of that.
The invitation to "key Dunedin City stakeholders" was a deliberate strategy to manage this matter "other than through the media".
Mr Fleming's memo indicated he considered the only alternative to advising the Ministry of Health that a stalemate had been reached would be if the group believed someone could "articulate the clinical rationale" as to why the single location would provide a better outcome over having two centres working as an integrated service.
