She would like to see the district health boards become more active in consultation over this.
It was time to "start again" with a co-ordinated planned approach.
Solutions appropriate to communities needed to be considered.
There was no point, for instance, in suggesting that all people in Ohai had to drive to Invercargill for after-hours care if it was found those people did not have transport and the nearest ambulance would take an hour to get there.
Consultation should also involve nurses as well as doctors.
Mrs McMillan said ways needed to be found of providing support to solitary GPs who had provided after-hours care for many years.
"We need to look at after hours creatively. The best medicine happens after hours in our view."
Regional planning and funding general manager David Chrisp said the Government had recently announced extra funding of $9 million nationally for after-hours services and boards would be putting plans to the Ministry of Health on how they could best use that money.
Contract manager Kiri Corbett would discuss the situation with community health-care providers in the next month to get their views.
Such consultation was not expected to take the form of public meetings.
He acknowledged Otago and Southland's share of that was not expected to be great and there were some intractable issues in after-hours care which it would not solve.
South Link Health interim general manager Baden Ewart said while he was not yet familiar with the particular issues of the rural area in Otago and Southland, after-hours care had been an issue nationally for some years.
While there had been working parties and investigations into the issue it had proven to be something of a "Gordian knot".
After-hours care should not be an ad hoc service. It was important that if people were unwell and needed to see a clinician in the middle of the night, that person was awake.
It was not necessarily very safe to have a clinician getting out of bed to drive across town at two or three in the morning to a patient.
It is not only in the rural areas that after-hours care has been controversial.
In the Dunedin area, the long-running dispute over who should provide the care and how it should be paid for was settled only recently.
Under the arrangement, Well Dunedin, Taieri and Strath Taieri primary health organisations and the student health services at the University of Otago and Otago Polytechnic pay a fee per patient for Dunedin Hospital to provide cover from 11.30am till 8am.
The practices concerned will pay a fee to the Otago District Health Board based on the practices' enrolled population.
At the Southland and Otago district health boards' community and public health advisory committee meeting this month concerns were expressed about a report listing Southland services which was from 2006 and which Southland members said was out of date.
