In an open letter to all three district health boards in the area which will be considered by the Otago board today, Mr Fraser, a former Otago regional planning and funding general manager, and now a health consultant, describes himself as an interested member of the public.
Possible changes to the existing 10-PHO arrangement have been under discussion recently following the controversial proposal from South Link Health suggesting a PHO across all three board areas which it says would save $1.3 million annually in administration costs.
Mr Fraser said independence, expertise, capability and resources should be the criteria used for establishing any new PHOs and it was clear the South Link Health proposal failed the independence criterion, "both real and perceived".
Progress in the South had been significantly slower than in other parts of New Zealand in primary health care, although there was some "very good work" going on in Otago and Southland.
He named Mornington PHO, with which he once had a public spat over a funding issue, as a notable example.
If boards wanted a more cost-effective structure without the risk of monopoly, his preliminary analysis of eight possibilities favoured two large PHOs, without boundaries, across all three board areas.
Mr Fraser said the key to creating PHOs with a visionary approach was to include a group of clinical people on boards who represented the mix of services the PHO could deliver, not just general practitioners, along with community and Maori representatives.
Today's board meeting will consider Mr Fraser's letter and a report from regional chief executive Brian Rousseau about initial meetings with PHOs and South Link Health to develop requirements for PHOs in the three regions.
It was expected that the requirements paper will be circulated for comment before being submitted to the July board meeting, he said.
Mr Rousseau will also be seeking confirmation from the board on his interpretation of the May decision about the requirements meetings.
PHO representatives thought they were to agree a set of goals for existing PHOs, while Mr Rousseau said the board, after consultation, would approve "partnership goals for effective PHOs" and then explore the most appropriate way to achieve them.
If his interpretation was not correct, according to the board, the process would have to start again, Mr Rousseau said.
