Health Minister Tony Ryall acknowledged yesterday in Parliament he is accountable for the neurosurgery decision.
However, he insisted the decision was not his, but would be made by the Director-general of Health.
Dunedin North MP Pete Hodgson had asked Mr Ryall if he would make the final decision if "wide consensus" could not be reached.
Mr Ryall said the fact the South Island district health boards (DHBs) had escalated the matter to the Director-general of Health to arbitrate indicated they would stand by the decision. Mr Hodgson's question was "hypothetical".
Mr Hodgson appealed to Speaker Lockwood Smith, who said Mr Ryall's answer was reasonable.
Asked if he would take the matter to the Cabinet, Mr Ryall again said that was a "hypothetical question".
Dunedin neurosurgery had faced considerable challenges with recruitment and retention, losing three neurosurgeons in three years and relying on locums since 2008, he said.
Everybody taking part in the process wanted to ensure a "safe and reliable service" .
To a question over whether an "unelected official" would make the final decision about South Island neurosurgery, Mr Ryall replied that it was the minister who had to "stand up in Parliament and give an answer" regarding such matters.
To a question about why Mr Ryall had refused to answer media and other inquiries about "one of the most important decisions his portfolio faces", Mr Ryall replied that Dunedin lost three neurosurgeons while Mr Hodgson was the minister of health and now relied on locums. The DHBs had agreed they could not reach agreement, he said.
An outcry has erupted in Otago and Southland since an independent report in June recommended all six of the South Island's neurosurgeons should be based in Christchurch.
