Whangaroa Health Services Trust members say a proposal to close an aged-care facility and GP beds in Kaeo is flawed because it doesn't take into account the area's isolation and rural character.
The trustees also say the consultation process currently underway is rushed and "a sham".
The Northland District Health Board is consulting on a proposal to reshape health services in Whangaroa which, unlike most places in the country, are delivered free by a community trust.
The key problems are ever-increasing demand, a frozen budget and a 20-bed aged care facility, Kauri Lodge, which health board consultants say is too small to be viable. As a result, it has to be propped up with funding which should go to prevention and primary health care.
In a statement last week, the trustees say they oppose any proposal to close Kauri Lodge or the two GP beds. While the proposal had some merits, it failed to address the reality that Whangaroa was a rural area, where patients lived in isolated areas and already travelled considerable distances to access health services.
Closing Kauri Lodge would cost local jobs - 37 has been touted as a worst-case scenario - and put other businesses, such as the pharmacy, at risk. It would also mean that the elderly unable to be cared for at home would have to move away from friends and family.
The trustees accepted their governance and management needed improving, but questioned why the review had focused only on services provided by the trust and not other providers working in Whangaroa.
They were also unhappy about rushed consultation. It had been "something of a sham" with consultants shaping evidence to fit the desired conclusions, they claimed.
Kaeo trustee Brendan Tuohy told more than 80 people at a public meeting last week the trust was looking into ways of expanding Kauri Lodge to make it financially viable. It was currently being subsidised by about $400,000, he said.
Others at the meeting suggested asking patients to pay $10 to see a GP. A staff member offered to replace the current unobtrusive donation box with a "bells-and-whistles" version and challenge patients to use it.
Health Board representative Kim Tito, who led the public meeting, stressed that the proposal was not a done deal and that consultation was genuine.
The health board is reviewing all its contracts as it grapples with burgeoning demand, driven by an ageing population and the diabetes epidemic, coupled with a squeeze in government funding.
The review is aimed at making sure the board is spending its money in the right places to get the best health outcomes.