Half Westport's population have taken to the streets to protest the government's plan to replace the town's 35-bed hospital with a 10-bed integrated family health centre (IFHC).
More than 2000 protesters marched around Victoria Square then down Westport's main street this afternoon chanting: "When Buller health is under attack, stand up, fight back!"
One of the protest leaders, 90-year-old Phyl Phipps, said the turnout was "wow".
"We must fight for our rights ... we are not guinea pigs, " she said, addressing the crowd.
Another member of the Buller Hospital Action Group, Anita Halsall-Quinlan, told the protesters the IFHC's patient-to-bed ratio would put Buller's health services on a par with Indonesia's.
"We, the people of the Buller District, will not accept this," she said.
Protesters said they were furious about the plan.
"We are entitled to health care as much as the rest of New Zealand," Diane Eckersley said.
Others were angry about the proposed funding model - ACC would own the IFHC and lease it back to the West Coast District Health Board.
Terry Archer said the government had refused to say how much the lease expense would strip from Buller health services.
And he said the government's failure to consult the community about the IFHC had been "abysmal".
Buller Mayor Garry Howard said the proposed IFHC was not fit for purpose and the Ministry of Health had "failed completely".
"They are not communicating with the community. They are not communicating with senior staff and management. They have switched off from any correspondence."
A Hands around Buller Hospital protest a week ago attracted more than 1000 people.
The Ministry of Health said many district health boards in New Zealand leased premises at commercial rates.
It has said architects would work with user groups to refine the design of the facility - which is expected to open 2019.