Despite these concerns, the hospitals' advisory committee will recommend to today's full board meeting that management identify what needs to be done in relation to the 45 actions sought by the NHB and develop a plan showing completion times.
Board chairman Joe Butterfield suggested management needed to work out which issues it could deal with and which were issues for the board.
Member Dr Malcolm Macpherson said the report appeared to confuse the district health board and the hospital, something which could have been clarified if the DHB had had input into the report.
Member Richard Thomson welcomed most of the recommendations, agreeing the board had not made enough progress on lean thinking processes, but was critical of the report being labelled as a joint one between the two organisations when it was "nothing of the sort".
He was disappointed some of the wider "contextual material" which had originally been in the committee papers had been withdrawn.
The management paper before the committee listed the 45 actions and gave a series of "status updates" on them, outlining what had been done to date and what was planned.
Mr Thomson said he accepted that operational costs could be reduced and patients would benefit, but the NHB report did not address the question of capital costs which were critical to "making sure this works and staff have confidence it is going to work".
Member Neville Cook said much of the report was based on perceptions, rather than facts, and he felt the NHB did not appreciate how much work had gone into the amalgamation of the two boards.
Both the Southland and Otago boards had been under financial constraints for years and "throwing money at a number of physical things" was simply not possible.
He hoped the report would give some impetus at national level to the board's call for funding for improvements at Dunedin Hospital.
Committee chairman Paul Menzies said he felt the recommendations crystallised issues which "we have been talking about around the board table for a long time".
Member Mary Flannery said she agreed with those who felt the language in the NHB report was not "necessarily helpful" and some statements lacked an evidential base.
The focus should not just be on Dunedin Hospital, but the whole health service delivery across the region.
Member Kaye Crowther agreed, also expressing concern at the lack of board consultation by the NHB team.
Chief executive Brian Rousseau said about a quarter of recommendations were not about Dunedin Hospital but the whole of the board's systems.
Mr Thomson and Dr Macpherson expressed some reservations about the call by the NHB for a new overall structure for the organisation.
