Health Minister Tony Ryall is encouraging primary health organisations (PHOs) to combine voluntarily or risk Government intervention.
Mr Ryall has previously criticised the 81 PHOs, saying there were too many bureaucrats adding to $30 million annual cost.
PHOs are funded by district health boards to provide essential primary health care services and the Government use them to roll out subsidised services.
Mr Ryall said four PHOs catered to 30 percent of the population, while at the other end of the scale, 41 looked after 12 percent.
He said PHOs should take it upon themselves to amalgamate to end wasteful duplication of bureaucracy, or risk Government intervention.
"The Government and taxpayers want to be spending less on administration," he said.
Mr Ryall has told the three PHOs in the Eastern Bay of Plenty to merge. "Having three PHOs in the Eastern Bay can't continue in these tight financial times," he said.
"They need to get together and decide they should take an Eastern Bay approach."
Eastern Bay PHO chief executive Stephen Mann said innovative solutions to health issues arose from each of the Whakatane, Opotiki and Kawerau-based PHOs.
That was more valuable than any top-down regional approach to community problems, he said.
Mr Mann said the Whakatane-based Eastern Bay PHO, Opotiki's Te Ao Hou PHO and the Kawerau PHO already worked collaboratively to cut costs.
The Eastern Bay PHO recently secured funding to provide a men's health initiative that the three PHOs would work together to deliver.
"We're not convinced that chopping out PHOs would make health delivery any more effective."
PHOs had proved so effective at narrowing the gap between Maori and Pakeha health outcomes that other countries were taking note, Mr Mann said.
