In an opinion piece published in the Oamaru Mail this week, Dr Jon Scott has criticised the Waitaki Health Futures survey, led by Health New Zealand Te Whatu Ora (HNZ).
It concluded on October 13 and sought to engage Waitaki residents over a month.
"The questions are nonsense," Dr Scott wrote.
"People do not know what they want from health services until they need them and discover they are not available.
"This risks serious or fatal outcomes," he said.
The survey was under the agreed transition with Waitaki Health Services Ltd when the Oamaru Hospital was ceded to HNZ in July.
In his op-ed, Dr Scott said the way the survey had been framed, by asking people what they wanted, overlooked the severely underfunded reality.
"What this review is about is reducing services."
Things were so financially and professionally challenging, stretched general practitioners were considering quitting.
"Increasingly, doctors refuse to be put in this position so patients find themselves not having access at all," Dr Scott said.
At the same time, the medical workforce crisis was near terminal.
It had been officially known for 25 years, Dr Scott said.
Having an increasing population and no more funding, Waitaki residents should have been asked, what services they were "prepared to lose", he said.
As it was, the Oamaru weekend urgent-only GP clinics were on the verge of collapse, he said.
"You have already lost on-call, after-hour GP services during the week."
HNZ community integration group manager Aroha Metcalf said the project was within an HNZ "place-based planning approach".
The focus was "improving co-ordination" of Waitaki services to "better meet" community need,
including hospital and specialist provision, primary care and other community services.
"It aims to overcome some of the challenges in accessing health services and inequity of health outcomes that some rural communities experience."
Reducing travel to access specialist care, such as "virtual consultations" was an example of a possible outcome, she said.
But Waitaki District Health Trust board member and former Waitaki District Health Services Ltd chief executive Keith Marshall said the survey belied a "harsh logic".
"If you keep the money the same, what gives?"
The health service survey for Waitaki was needed, he said.
It was years overdue because the former Southern DHB had never done a full assessment.
"The one thing they had never done was quantify what the health services need to be."
But with no new funding, any expectation of new services was very limited.
"All you do is move around the existing services."
Both the Oamaru GPs and emergency department were already at a crisis point, he said.
"You can’t have both if the funding is capped. There-in lies the problem. Where do you rob Peter to pay Paul?"
Waitaki residents already could not see a dentist, there was up to a 4 week wait time for GPs and the ED was "overwhelmed".
The Oamaru Hospital’s emergency department had been funded for 4000 presentations for decades, Mr Marshall said.
Yet it had been receiving up to 10,000 per year for some years.
Ms Metcalf said the survey was to "improve clinical sustainability" through "more flexibility" in the system when there were "unplanned shortages".
The feedback would be used to change how they did things.
It was also necessary to understand the "current services" in the face of a changing population.
"For example, Oamaru is one of the fastest growing Pacific populations per capita outside Auckland," she said.
Waitaki Mayor Gary Kircher said assessing need and then matching a funded service that actually fitted the local population was "a question of process".
"We’ve got decisions made in Wellington, or where ever, that funding goes to an agency in Dunedin for Otago.
"By the time Dunedin is sorted, there is not much left."
