The Lakes District Health Board has suffered a budget blowout of more than $5 million - a position its chief executive has described as "very concerning".
Ministry of Health figures released by Labour's health spokeswoman Annette King show the 2015-2016 year-end result for Lakes District Health Board was a $5.2 million deficit and $5.8 million unfavourable to budget.
Chief executive Ron Dunham said in a statement the board was trying to live within its budget but it also needed to ensure services were provided to people who needed it.
He said patient care was and remained the priority.
"We do not turn patients away because we think providing treatment for them will adversely affect our budgeted spending."
Mr Dunham said the board was concerned demand for emergency services appeared to be increasing every year, and that was the first priority.
The ministry had put the health board on performance watch - which meant it worked with the board to look at the issues it faced and the actions it needed to take to "reduce [its] exposure", he said.
"We meet on a monthly basis."
He said the forecasted budget for the 2016-2017 year was still to be signed off.
"However we are planning to have a surplus at year end."
Mr Dunham said one example of the cost cutting measures was getting control of the use of locum doctors.
The ministry also has the health board on watch for other performance issues - including key performance indicators emergency department waiting times and smoking advice in the primary sector.