Southern Primary Health Organisation chief executive Ian Macara said from time to time telephone complaints were received from patients about the cost of after-hours services, but not about waiting times.
The PHO strongly encouraged people with ailments which could be seen in the community to seek help there and was concerned that patients were "inappropriately attending" emergency department for such ailments.
He acknowledged payment for after-hours services was a requirement for patients and encouraged people to first make use of Healthline 0800 611 116.
The Otago Daily Times raised the waiting times issue following recent concerns raised by three patients, two of them in letters to the editor, about waiting times in the main Dunedin after hours service, the Dunedin Urgent Doctors and Accident Centre.
These patients, who believed they were doing the right thing by not clogging up emergency departments with ailments which were not life-threatening, were concerned at the length of the wait for a service they were directly paying for.
In one of the cases, after a wait of more than three hours in the after-hours service, the patient was seen and then referred to the hospital's emergency department late one Saturday night, noting "with wry amusement", given ongoing publicity about ED staying times, the waiting time there was much shorter.
He had deliberately chosen not to go to ED as it was a Saturday and he did not think his injury, which was eventually found to require acute surgery, could be classed as an emergency.
He pointed out that if people chose not to go to ED in Dunedin, and their GP was involved with the Dunedin Urgent Doctors and Accident Centre, after hours they had no choice but to go to the centre.
"If you are unhappy with the service, and you are not supposed to go to ED, what do you do?"
In response to questions on the issue, the Ministry of Health said it had not received any complaints about waiting times for after-hours services. It pointed out that triaging was used in after-hours services to ensure those who were in most urgent need of attention were seen first.
However, when services were busy with high patient numbers, triage often meant extended waits for patients with more minor injuries or illnesses.
Southern District Health Board finance and funding manager Robert Mackway-Jones said primary care after-hours services were not emergency services and therefore did not operate to the same standards as EDs.
All publicly-funded services had specifications which included quality requirements against which they could be audited.
The requirement in the agreement was to provide first-level services around the clock so it was the same service after hours.
Practices which used nurse telephone triage would not see some patients until business hours which was "perfectly appropriate" depending on the assessment of the condition.
At present, there was no maximum waiting time specified and no information collected on waiting times in the community. (In the major hospitals, data is collected from emergency departments. They are supposed to have 95% of their patients spend no longer than six hours in their care before either being sent home or admitted to hospital.)
There could be some risk of patients getting worse in crowded waiting rooms in urban areas, but people with severe pain or distress would need to transfer to emergency services.
The steering group for the PHO after-hours plan would be identifying issues and developing a plan for the whole district health board area, he said.
In its annual plan on after-hours and urgent care, the board notes there are many influences outside the control of health care providers which make it challenging "if not impossible" to achieve access 24 hours a day, seven days a week in a safe and sustainable way.
Issues included the burden on staff who had worked through the day already, poor co-operation and collaboration between staff, costs, and patients visiting EDs for "free" care.
The board is seeking greater collaboration and integration of services, making the best use of the workforce available and reducing the burden on general practitioners, nurses and other frontline staff.
It also wants patients provided with clear understanding of how to access services after-hours.
