Health New Zealand planners admit Central Otago and Queenstown Lakes patients are undertaking roughly 60,000 travel events annually that "shouldn't be happening", as they respond to a deadline from the Health Minister to deliver a new service plan before Christmas. 

The admission came during a community meeting in Cromwell yesterday (Wednesday, November 26), where officials signaled a departure from standard planning models to cope with the region's unique growth. 

Rachel Haggerty, Health New Zealand’s national director of strategy, planning and performance, told the meeting the current reliance on Dunedin and Invercargill for routine care was placing an unsustainable burden on patients. 

"We've identified...about 60,000 travel events that shouldn't be happening when people are having to drive to Dunedin or Invercargill," Rachel said. 

She described the reality for many locals - driving hours for a 10-minute appointment or a simple diagnostic test - as a failure of localised service delivery. 

"10 minutes in a room, half an hour...in a waiting room, and you go, 'Why did I do that? Was that worth it?'" 

The urgency to fix this disparity has escalated to the Beehive, with Rachel confirming the current process is operating under strict time pressure from Health Minister Simeon Brown. 

She told the meeting the minister has "really leaned into this", demanding a set of options and advice be on his desk before Christmas. 

"He's said, 'I want to understand, I want to know what the options or the solutions are...I then want to take it away with me and think about it over that period of time,'" Rachel said. 

This accelerated timeline reflects growing pressure from local community leaders who have long argued the region's health infrastructure has been outpaced by population growth. 

The proposed solution, however, may not look like the traditional “base hospital" model many residents expect.  

Instead, officials outlined a strategy focused on "ambulatory" and digital care, bringing high-frequency treatments into local communities to wipe out those 60,000 trips. 

Rachel pointed to chemotherapy treatments, renal dialysis, and advanced radiology (CT and MRI) as services that advances in technology and safety protocols now allow to be delivered safely in primary care settings or rural hospitals like Dunstan and Lakes District.

The goal is to handle "infrequent events" (like major surgery) in Dunedin or Invercargill, but keep "high frequency" care (like cancer treatment) local. 

"We are moving towards a service that is closer to communities, closer to people's homes," she said. 

While digital appointments can solve some travel woes, officials acknowledged they cannot solve one of the region’s most emotive pinch points: maternity care. 

With no surgical obstetric service in the region, women requiring emergency C-sections face high-risk transfers to Dunedin or Invercargill. 

"One of the big issues we've identified here, of course, is obstetrics," Rachel told the meeting.  

"What we know about obstetric care is things can turn on a dime...it is something that we really see as quite a stressful issue for people." 

While stopping short of promising a fully staffed surgical unit immediately, she noted the status quo of relying solely on midwives without local specialist backup was a key focus of the report going to the minister. 

Underpinning the entire plan is a significant shift in how the government counts the local population. 

Typically, Health NZ uses conservative ("medium") growth projections. 

However, Rachel confirmed they are now using "high" projections for this region - a move she noted they "would not do elsewhere in New Zealand". 

She debunked the myth Central Otago is simply an aging retirement hub.  

Instead of the traditional "population pyramid" (lots of young people, few old) or the "inverted pyramid" of retirement zones, this region has become a "rectangle". 

"[Which] has meant you've got a bit of everything going on here," she said. 

It means the health system is being hit from both sides: a boom in maternity and pediatric demand from young families, simultaneously with high-complexity care needed for retirees. 

With major private infrastructure proposals on the table - including the Roa hospital project in Wānaka and discussions around the Regional Deal - questions were raised about whether Health New

Zealand is negotiating directly with developers to fill gaps. 

Rachel was firm the planning process begins with clinical need, not with what developers are offering to build. 

"Clinical service planning is not about who provides it. It's about what do you need...[then] we form a view around the utility of some of those [private options] and...provide advice to the minister," she

said. 

She clarified that developers do not negotiate directly with Minister Brown, who relies on Health New Zealand to assess which private proposals are clinically useful. 

Health New Zealand Southern chief medical officer Dr David Gow added the clinical team had been vigilant against "anchoring bias" - the risk of warping the regional health plan simply to fit around a

private developer's pitch. 

"That is one of the concerns that underpinned when we set off on this process...whether or not there would be anchoring bias relating to some of the opportunities that came through," David said. 

He said he was "incredibly reassured" the process had remained unconstrained, focusing on patient safety and network needs rather than commercial opportunities. 

However, Rachel noted private investors remain free to build facilities regardless of government contracts.  

"They don't need a minister...to do that. And so that's important that people have those choices." 

Detailed planning on the preferred options is expected to begin in 2026, following the minister’s review of the advice over the summer break.