South Taranaki's Ngāruahine iwi has joined neighbouring Ngāti Ruanui in rejecting threatened health cuts in the south of the region.
Taranaki District Health Board has proposed halving the number of beds at Hāwera Hospital to 10 and and moving six of the remaining beds to a rest home.
Instead of being at the hospital overnight, 24-hour emergency doctors would be on call.
The changes would see more patients taken to New Plymouth, and the offer of consultations by phone and email.
Ngāruahine kuia Te Rawanake Hēmara was one of 2000 protestors who marched on a DHB consultation meeting on Monday.
She says in rural townships, like Manaia, high-speed broadband is almost non-existent.
Mrs Hēmara then criticised DHB board members for sitting while some of the elders had to stand at the meeting. She said it showed how they didn't care or have respect for kaumātua.
Economic growth may suffer - Ngāti Ruanui
Meanwhile, Ngāti Ruanui is warning the Government that the threatened cuts undermine the push to expand the petroleum industry.
Managers from hazardous petroleum and food processing plants have signed a letter of opposition.
Te Runanga o Ngāti Ruanui fears the hospital will close, and its chief executive Debbie Ngārewa-Packer says economic growth would suffer.
She says closing the hospital is not an attractive option for the district, and will send the wrong message to big businesses who want to set up shop there.