About 35,000 people marched to the Octagon on Saturday, protesting government proposals to downscale the new Dunedin hospital.
Before the march, Dunedin Mayor Jules Radich firmly opposed the government’s direction.
"They say they have a budget of $1.88 billion, just build it for that."
He accused the government of putting up a "smokescreen" by suggesting the hospital could cost $3b.
"Because they are bringing in a whole lot of other things that are out of scope, trying to introduce them into the mix to make it look worse."
"Just get on with the job and build that building as they have committed to do and keep their promise."
Renovating existing hospital buildings was deemed unfeasible years ago, and was a "nightmare scenario", he said.
"Logistically, it is diabolical and you are not going to end up where you want to be."
Trying to renovate a building that was designed in the ’60s and built in the ’70s would be an "absurd idea".
He urged the government to keep its election promises.
"There is a way they can build a building and keep their promise.
"So, naturally, we want them to keep their promise, build the thing once, build it right, and do it now."
Speakers at the Saturday protest echoed the mayor’s comments.
Clinical transformation group chairwoman Dr Sheila Barnett said the final design reflected the region’s future needs.
The hospital community were "shocked and disappointed" at potential design changes, she said.
NZ Nurses Organisation Dunedin delegate Linda Smillie warned inadequate facilities would harm patients.
"There is no doubt inadequate clinical facilities will result in patient deaths."
Health New Zealand Te Whatu Ora (HNZ) head of infrastructure delivery Blake Lepper said it was working urgently to develop options that could be achieved within the budget and deliver modern, fit-for-purpose health facilities that would enhance clinical safety and enable new models of care.
"We welcome the clear parameters and additional funding ministers have provided and are working at pace to assess the impact of changes and recommend a preferred option to them."
Over the coming weeks, it would consult with critical stakeholders, including clinical leaders, to ensure it understood the benefits and risks before a final decision was made.
Minister of Health Dr Shane Reti said the government was committed to building a new hospital in Dunedin.
"In fact, our government has significantly increased funding for the new Dunedin hospital by hundreds of millions of dollars.
"We promised $30 million during the campaign.
"We have set aside $290m in government — but the independent review has shown that the project has now become so troubled that this still is not enough."
Last week’s announcement was difficult but had to be made to ensure other important builds across the hospital system could be supported, he said.
"Hospitals in Nelson, Whangarei, Hawke’s Bay, Palmerston North and Tauranga could be at risk if Dunedin continues to go so far over budget.
"That’s not scaremongering — it’s a financial reality."
He wanted to assure the people of Dunedin and the South that HNZ and ministers were fully committed to making sure long overdue solutions to the region’s health infrastructure were delivered, Dr Reti said.
A government spokesperson said the total appropriation for the new Dunedin hospital was $1.88b, but recent estimates exceeded this by several hundred million dollars.
There would also be added costs of about $400m for a pathology lab, carparking and building decommissioning or reuse.