The French Polynesian health minister, Pia Hiro, has resigned to become the fourth minister in Oscar Temaru's government in just over a year to step down.
Her decision follows a range policy disagreements, with her accusing the president of giving health low priority by urging spending cuts.
She has also taken exception to claims that private doctors are behind the high cost of health care and warns of staffing problems once the new hospital in Tahiti is built.
Ms Hiro says she also disagrees with government plans to send medical students to Fiji rather than France.
She says the training in Fiji is much shorter and will lead to a two-tier health care system in French Polynesia.
Ms Hiro has been replaced as minister by Charles Tetaria, who is the head of the local blood service.
