Dunedin's mayor says a protest over the weekend was the city's biggest in decades, and has a warning for the government: people are just getting started.

About 35,000 people marched through the city on Saturday, amid outrage at the Government's plans to scale back the redevelopment of its hospital.

The government says it is unaffordable, and has been accused of breaking an election promise that still features on the National Party website.

"I was thrilled and very proud of the people of the south, because people came from all around the region to attend that protest and no one expected it to be as large as it was," Mayor Jules Radich told RNZ's Morning Report on Monday.

"This is the start of a programme of activity and it will be ongoing, and the thing is that it's not too late for the government to keep its promise. okay? They have announced [this] bunch of excuses as to why it's difficult - that doesn't mean it's impossible.

"They can do it, they can keep their promise. And they made a firm promise during the last election and all coalition partners agreed with that, and yet they're here now trying to set the ground and make excuses for not keeping it."

A report commissioned by the government found current plans for the hospital could not be delivered within the $1.88 billion budget, which could balloon to $3 billion.

Jules Radich. Photo: Supplied

Radich called the report a "smokescreen".

"They've added in extra costs to try and cloud the issue. For a start, refurbishment. No one's ever talked about refurbishment being in the scope of this project, refurbishment of old blocks. I mean, they're talking hundreds of millions for that.

"They're talking about car parks - car parks have been long since taken out of the scope of this project other than you know, parking for staff, and it's very easy - all we have to do is give some private developers a suitable site, and there's plenty of sites around the hospital, and they all build the car parks, no problem at all.

"And pathology is the other one that they're talking about - [it] has already been taken out of scope by the previous government and agreed to by this government when they were in opposition. So it's a smokescreen."

Artist's impression of the planned new Dunedin Hospital from Te Whatu Ora website. Photo: Supplied / Te Whatu Ora

Radich said it was not too late for the government to go back to the plan it promised.

"Dr Reti is saying, well, they are going now to discuss all of the options. They laid out two options last week. But those, the way they were laid out, neither of the options were unacceptable, but the least acceptable of course is keeping the old building.

"I mean, if they think they're going to build a modern health system by starting with a 50-year-old broken-down building and patch that up, I mean, that is no way to build a modern health system."

Patients in tents

Dunedin Hospital emergency doctor Joshua Smith said the current hospital was old, cramped and not meeting the region's needs.

"We're seeing on a daily basis patients and corridors, huge numbers of patients in the waiting room," he told Morning Report.

"Some days we have patients ramping, which means that they arrive in an ambulance and there's simply no room in the department for them to be handed over. And that means they have to stay in an ambulance in the car park for hours at a time, or even be cared for in a tent by ambulance staff.

"It's simply not acceptable. It's unsafe. Where do we want it?"

Prostate cancer survivor Robert Scott, who lived near Port Chalmers, said the government needs to spend the money and build the hospital right.

"It made a huge difference for me being able to access the care. I could go in each day and get my treatment every day for a month, you know, it was only a 10-minute drive from my house."

Carolines lives in Owaka - an hour-and-a-half away by road or 20 minutes by helicopter.

"I know so many people who have had major medical events and needed to be here… if Auckland can get so many roads, surely we can get a hospital."

Another said the time for broken promises is over.

"It can hardly cope now, and they're going to make it smaller and they're not looking to the future. It's short-sighted."

Health Minister Dr Shane Reti said the government remained committed to building the new hospital, but it needs to deliver for hospitals across the motu as well.

Health Minister Dr Shane Reti. Photo: RNZ / Samuel Rillstone

Over in Westport, more than 1000 people silently marched through the streets to protest the healthcare crisis on the West Coast. From Tuesday, a phone and video service will replace GP clinics for after-hours primary care.

Ros Bradley from Carters Beach was worried about getting sick on the weekends because there was so little cover

"I really feel for… people older than us. I mean, we're both in our 70s, but you know, there's people that can't get out, they're vulnerable, and that's terrifying."

Alan Gregg said he was worried about the threat to medical services in Buller. He said they hear the rescue helicopters transferring people on a near daily basis.

"At the end of the day that's a cost to the medical area, and probably if we had a hospital that was well-stocked, well serviced and well-maintained, those costs could be saved in other areas."

Allen Morris says he is sick of the local health services being run down. Photo: RNZ / Rachel Graham

Del Morgan, from Reefton said the government - and the last - had decimated the health system.

"We're stuck with the telehealth thing. We're stuck with doctors who we don't know because they change all the time. You can't can't build a rapport with them."

Reti said he had been assured in-person care would remain available on the West Coast alongside more after-hours care.

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