In what is thought to be an Australian first, Shellharbour Hospital could reject a $66,000 offer from nearby Warilla McDonald's because health officials believe it sends the wrong message about fast food.

Hospital bureaucrats are reviewing the offer from outlet licensees Glenn and Katia Dwarte, which would go towards emergency department equipment over the next three years. The couple - who won the Shellharbour City Council charitable business of the year award in 2007 - have made donations to the hospital before.

In 2009, they donated $35,000 for a medical transport cart to take intensive care patients to and from the helipad. In 2008, the hospital accepted a $30,000 breathing machine after the Dwartes raised funds for it.

But a spokeswoman for the Illawarra Shoalhaven Local Health District said the couple's latest offer was still being considered. ''All sponsorship agreements must comply with stringent NSW Health policies.

''McDonald's Warilla has in the past made significant donations. These donations are genuinely valued and the local business has been recognised for its contribution.''

Existing McDonald's signs at the hospital are also being reviewed.

A spokesman from the NSW Department of Health said he was unaware of other hospitals refusing fast food company sponsorship and local health districts ultimately decided what were appropriate sponsorship or donation deals.

''NSW Health prohibits sponsorship from a company involved with tobacco products. It also warns against dealing with sponsors that produce other products damaging to the physical or mental health of the community,'' he said.

A McDonald's Australia spokeswoman said donations to hospitals had never been rejected. ''We are incredibly proud of the meaningful contributions we make to the communities in which we operate.

''Katia and Glenn are very invested in their community and have played an active role in supporting local organisations for a number of years.''

Jane Martin, the Obesity Policy Coalition senior adviser, supported the hospital's response and said McDonald's used relationships with hospitals, junior sports and schools to ''weightwash'' its image.