However, Ngati Hine Health Trust has now pulled out, throwing the project into disarray.
Trust chairwoman Gwen Te Pania-Palmer said the decision to not proceed was based on an architectural design which had become unaffordable in the current environment.
"The project has faced unprecedented increases in building costs which are being experienced across Northland and New Zealand," she said in a statement.
Health board chief executive Nick Chamberlain said the board would consider its options for building a new primary care facility at Kawakawa at its August 21 meeting.
The board's preference was to keep the integrated, wellness-focused model of care that Ngati Hine had planned.
Another option was getting the health trust to build a smaller facility.
Whatever was decided it was unlikely the original design would be used, Dr Chamberlain said.
Work was under way to "refine the model of care and operational procedures" at the Kawakawa site, which would then be used to come up with a new design.
If the health board decided to pay for the facility it would need extra funding from the Health Ministry.
In that case a special business case would be prepared for the Ministry's Capital Investment Committee as quickly as possible.
Work on the hospital rebuild was due to be completed in July 2018.
It includes a two-storey building with an accident and medical department and a 20-bed ward.
The new primary health facility was likely to be delayed, depending on the size and construction method of the final design, Dr Chamberlain said.
Mrs Te Pania-Palmer said the health trust and health board would jointly consider a revised plan for a "neighbourhood healthcare home". It would still involve joining up general practices, be whanau-centred and co-located with other services.