MAJOR upgrades to the Warrnambool and Camperdown base hospitals should have commitments by 2024, but when exactly the works will begin remains unknown.
South West Healthcare launched a vision for the next four years on Tuesday, including plans to secure government commitments for the upgrades.
But the public health service's chair Bill Brown said he was hopeful works would begin earlier.
"My optimistic side says that the state and federal governments will be looking for infrastructure opportunities to help with employment," Mr Brown said.
"We would love the development to be brought forward if that was decided by government."
He said there was also a risk the pandemic would slow down decision making.
"Our hope and expectation is that by the end of this planning period, the community will know when this facility will open," Mr Brown said, referring to upgrades in Warrnambool.
South West Healthcare chief executive Craig Fraser said the stage two developments for the Warrnambool Base Hospital and the upgrades for Camperdown had not yet been costed.
"We have our plans to a point where they can be costed, but not full costed," Mr Fraser said.
The strategy outlines that South West Healthcare is delivering 84 per cent of the region's health needs, which Mr Fraser says makes it the most self-sufficient rural area statewide.
"We want to reduce that 16 per cent wherever possible, but we are also mindful South West Healthcare and our partners in the region can only provide care to a certain level," Mr Fraser said.
"What is that percentage that need to seek care out of region because we can't provide, we're not 100 per cent sure of that yet. We do know the more services we offer locally the more people who will seek care."
The strategy also points out the pressure on mental health inpatient services, which saw admissions increase by 1035 patients, or nearly 22 per cent, from 2014-15 to 2018-19.
"Access to inpatient services is capped and it is accepted that there is significant unmet demand," the strategy says.
Mr Fraser said the failures in the system were not due to the commitment of staff but "under funding", something he pointed out a Royal Comission was intended to address.
The plan also includes a major upgrade to the health service's IT systems that Mr Fraser says was in the works prior to a 2019 cyber security attack.
"We are in a lot better space now from a cyber security point of view than we were," Mr Fraser said.
"This is taking a bigger approach and looking at an all encompassing IT strategy to see how we can better integrate our ICT systems and how they can become more contemporary."
Mr Fraser said during the pandemic South West Healthcare was "operating two systems" of care, one for coronavirus health provision and one for normal health services, and that meant in the next 12 to 18 months some services would be "reformed".
Mr Brown praised the effort of the region's health workers during the pandemic.
"We will be eternally grateful for the work they have put in place in case the worst happens," he said.
"Our health care workers have been mentally and physically dealing with this for months and if there were to be an outbreak and even if there wasn't to be an outbreak here, we can't fail to remember the fantastic work they have done."
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