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Under the Official Information Act, the board last week released submissions on a major restructuring it is implementing over the next few months.
The submitter fearing a Southland takeover pointed to the considerable difference between Dunedin Hospital and Southland Hospital, which had fewer services and beds.
Overarching managers and clinical leaders will head five departments, and they are as likely to be based in Invercargill as in Dunedin.
Submitters broadly agreed services in the board's two main centres must be more aligned, but many feared the new structure would not work.
The new set-up was similar to how Southland Hospital was run at present, which did not take into account Dunedin Hospital's relationship with the University of Otago, one submitter said.
Comparing Dunedin and Invercargill's intensive care units, another said Invercargill's had a much lower budget, no dedicated intensive care doctors, and doubled as the cardiac care unit.
"To amalgamate these units under a single management system is laudable, but will take either a lot of financial investment, or an acceptance that models of care delivery must be quite different between sites."
Citing the right of staff to speak freely, the board withheld the names on submissions, despite the fact staff had clearly stated whether they desired anonymity. This decision was labelled "most odd" by the head of the senior doctors' union, Ian Powell, who said staff should be allowed to choose whether they wanted to be identified.
The Otago Daily Times has complained to the Office of the Ombudsmen about the decision.
Last month announcing its proposed structure would go ahead, the board said it would work to address submitters' concerns, including those who feared additional travel posed a safety risk.
As well as road safety, increased travel could lead to staff burnout and could hurt family life, submitters said.
Many said the top roles were too big, and managers risked being too remote from staff.
A new decision-making system putting clinician leaders on an equal footing with managers concerned submitters, who feared it was impractical.
Many criticised a reduction in top nurses, including the removal of the deputy chief nursing role, which the New Zealand Nurses Organisation criticised when the decision was announced last month.