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The concerns of doctors in Southland who oppose a merger of their health board with the Otago District Health Board are understandable and could be comparable to Otago doctors' concerns if they faced a merger with Canterbury, a Dunedin specialist says.
Southland Hospital senior medical staff have written an open letter to the Southland public opposing the merger of the two boards, a day before submissions on the proposed merger close.
Dr Charles Lueker, who chairs the senior medical staff committee in Southland, said the letter was signed on behalf of "well over 90%" of senior doctors at Southland Hospital.
The doctors expressed concerns about services being centralised to Dunedin and the loss of the board's advocacy for the people of Southland.
Association of Salaried Medical Specialists Otago representative Dr Chris Wisely said he had not experienced "any great sense of concern" from Otago doctors about the possible merger.
"I think down south there is always that concern, or fear, they will somehow get submerged into the bigger conglomerate.
"I think it is very important we do reflect on the views of Southland doctors - that is the democratic process."
Different doctors would be affected differently as more clinical services were regionalised and travel between Otago and Southland could become a "huge problem".
One doctor had wondered if boards could share resources but maintain some independence.
Dr Lueker said while there were examples of regionalised services working well, health services to "satellite areas" would be degraded with centralised services.
When patients had to travel to other areas for health services there was always a question whether the patients would have the same access to those services as locals.
Southland's experience with services such as neurosurgery, with some patients having to travel to Canterbury for treatment or diagnosis, was it "actually could be a bit difficult" to get the same access, he said.
Regionalising clinical services was "not necessarily a bad thing", but clinical practice should be driving the process, not the other way around, with changes to administration structures leading the way.