The cost of the Ngati Porou Hauora Maori health service is becoming hard to sustain, chief executive Rose Kahaki says.
A consultancy group is reviewing all health services on the East Coast after public submissions on how and where they should be based.
Rose Kahaki, of Ngati Porou and Ngapuhi, said the group was looking at services provided by the area's clinics and Te Puia hospital, and it was clear something would have to give.
She said they would first have to determine what the facility would look like and what services it would provide.
Mrs Kahaki said Te Puia hospital had maternity services and elderly care and altogether about 20 beds. However, maintaining the costs to run those services was becoming untenable.