North Coast Area Health Service chief executive Chris Crawford, along with other North Coast representatives, took part in the high level half-day talks.

About 60 doctors, nurses, managers and other health experts from across the state met with Premier Kristina Keneally and NSW Health Minister Carmel Tebbutt in Sydney on Monday.

Issues raised included fears hospitals could boost revenue, under the federal government proposed health shake-up, by admitting people who could otherwise be treated in the community.

Mr Crawford said the seminar was part of the advisory process.

It follows the federal government’s proposed health system overhaul under which the commonwealth would pay for most of Australia’s public hospital system.

It also is proposed to introduce hospital networks to run small groups of hospitals in a bid to better respond to the community needs.

The existing Hastings Macleay Network brings together Port Macquarie Base Hospital, Wauchope District Memorial Hospital and Kempsey District Hospital.

But doctors and nurses said under the federal government’s proposed system, it could be possible to have some small hospitals not linked to a larger hospital.

Mr Crawford said it could be argued it would be more sensible to have flexibility in the number of hospitals in country networks under the new model.

Concerns also were raised that smaller hospitals, without the economies of scale, would not be cost effective under the government’s activity-based funding model.

Meanwhile, the state government will ask its federal counterpart to protect the state’s rural and remote hospitals under the proposed commonwealth reforms.

“We want to protect smaller country hospitals and maintain the high standard of health care provided by them” Ms Keneally said.

“Rural and remote hospitals have higher costs and unique demands because they have a low population base and geography so it is essential any funding model takes this into

consideration.”

People can have a say on the federal government’s plan at https://health.reform.discussions .nsw.gov.au/