Almost a month after he was asked to urgently resolve the southern neurosurgery services row, Director-general of Health Stephen McKernan yesterday announced he will convene an expert panel to address the issue.
He hopes to have this done within four weeks.
The panel will include independent neurosurgical expertise and an independent chairperson.
He will make a decision on the issue based on its recommendations.
In a statement yesterday, he said the panel would also oversee the implementation of "the new service configuration".
Asked why it had taken since May 27 to make the announcement, a Ministry of Health spokesman said the time had been taken up working out how to progress a complex issue.
Requests from the Otago Daily Times for further information and an interview with Mr McKernan on the matter were declined.
Mr McKernan's statement coincided with the release of the April draft South Island neurosurgical services report by independent consultant Ian Brown, which has been considered behind closed doors.
It recommends the neurosurgery service be based in Christchurch with a comprehensive outreach programme.
The Southern District Health Board wants two of the six neurosurgeons for the service to be resident in Dunedin.
While Canterbury considered the one-site service a safe option, the former Otago board said having no full-time neurosurgeons in Dunedin would put some Otago and Southland lives at risk.
The Southern and Canterbury boards have been unable to agree on the financial implications of the proposal.
Mr Brown's report does not say whether the option he suggests is financially sustainable.
The May 27 letter to Mr McKernan - from the chairman of the South Island chief executives John Peters and South Island Health Services Planning chairman Chris Fleming - says other South Island boards support Mr Brown's recommendation.
The provincial district health boards noted a significant portion of the South Island received services on the basis deemed unacceptable by the Southern board for reasons of patient safety and travel.
The letter asked Mr McKernan to appoint an arbitrator to ensure the impasse was resolved urgently.
In Mr Brown's report, the Otago board says one site in Christchurch might be convenient for the neurosurgeons but not for lower South Island patients.
Christchurch's record on outreach services is poor, the board says, whereas " Dunedin's record is impressive".
The four Canterbury neurosurgeons, including two who previously worked at Otago, backed the Canterbury model, where all planned and elective neuro-surgical operations would be carried out in Christchurch.
The only procedures performed at other centres would be for urgent/life-threatening conditions when the risk of delay in treatment travelling to Christchurch was considered too great.
General surgeons would be trained to undertake emergency procedures in such instances, including those involving drilling through the skull.
It was estimated only about 10 such procedures would be required annually in Dunedin.
Outpatient clinics would be provided weekly to Dunedin, along with some teaching.
This would involve one neurosurgeon and a neurosurgical registrar who would visit for two days.
There would also be a monthly planning visit. In Invercargill, there would be a monthly one-day visit.
Mr Fleming agreed last night there was no full financial comparison between the Canterbury and Southern options in the report.
This did not mean the boards were going to make a decision in the absence of financial analysis, but there was no point in financial analysis "if there is no clinical acceptance".
Scant reference is made in Mr Brown's report to concerns raised by the University of Otago about training.
He says academic training can be delivered by the service, regardless of the option chosen.
He also says the impact of any loss of neurosurgery on the ranking of Dunedin Hospital's intensive care unit is unclear.
Mr McKernan has asked the boards not to make any permanent appointments before his decision is made.
Southern has used locum staffing for its neurosurgery service for more than a year.
It had interest from neurosurgeons wishing to join its permanent staff but is unable to offer positions because of uncertainty over the service.
