In a letter to the Southern District Health Board, Dr Rodwell, an emergency medicine specialist, slams Oamaru Hospital's planned ''new model of care'' and calls for a rethink.
''Since I have drawn back from providing specialist services at Waitaki - as a consequence of this fiasco - at least 12 patients have been transferred to Dunedin for procedures that previously would have been managed within Oamaru.
''The extra cost of these patients' care would have totalled [about] $200,000. The new model of care proposed is not a new model but rather a failed old model.''
While the changes would not take effect until July, Dr Rodwell has already pulled back from specialist emergency care in anticipation. He still works at the hospital.
The SDHB is pushing the changes on the back of recommendations from its contracted reviewer Dr Carol Atmore.
Dr Rodwell's position is at odds with that of Waitaki District Health Services (WDHS), which owns and operates Oamaru Hospital. It supports the changes.
In his letter, Dr Rodwell says the DHB makes much of providing equal access to services for patients across Otago and Southland. In Oamaru, that appeared to mean running down the existing service.
''The cost of this dumbed-down service is no less than what we have now ... and the end result in terms of increased transfer of patients and longer patient average-length-of-stay means the real cost will probably be significantly greater.''
Dr Rodwell argues that too much of the DHB's funding is spent in Dunedin and Invercargill, and patients in other areas miss out. Oamaru's CT scanner was bought with local funds, and the DHB was not funding its running costs, he said.
''The SDHB continues to refuse to fund the operation of this community-provided scanner. The Dunedin and Invercargill scanners remain fully funded 24/7 by the SDHB.''
The proposed changes needed to be ''urgently revisited'' before ''standards fall any further and many of the medical staff walk out in protest'', he added..
Dr Rodwell copied the April 3 letter to the Otago Daily Times.
Last night, in a joint statement, SDHB chief executive Chris Fleming and WDHS chairman Chris Swann said they disagreed with Dr Rodwell's ''interpretations''.
''Southern DHB and Waitaki District Health Services are working in partnership to progress recommendations from the joint review of services ...
''This work will result in a new model of care that ensures continued access to urgent care and medical inpatient beds at Oamaru Hospital, including enhancing services provided by community nursing and allied health teams.
''The rural hospital medicine specialists model of service delivery is increasingly recognised as appropriate for providing high-quality care in smaller New Zealand hospitals,'' the pair's statement said.
The DHB's Waitaki health review released last year says Oamaru Hospital emergency department presentations had increased to about 7500 per year.
The hospital was funded for 4000 presentations per year, the report says.
''Oamaru Hospital employs a 0.2 full-time equivalent vocationally registered emergency medicine specialist as required by a Ministry of Health audit established in 2003.
''However, there are now alternative models made possible through the development of the rural hospital medicine specialist vocational scope,'' the review says.
