Former Victorian premier and Member for Portland Denis Napthine has told the state government to "keep its hands off" the city's hospital.
He joins a growing cohort fearful of an underlying amalgamation agenda following the recent appointment of the Portland District Health board, where only two locals remain.
However the chair of PDH's new board has dismissed claims there's a renewed push towards a merger.
Peter Matthews was appointed by Health Minister Martin Foley without consultation, replacing Dr Andrew Levings who resigned.
In recent years he oversaw the amalgamation of Kyneton and Hepburn health services.
"I have been involved with amalgamations but there's no desire for that in Portland," Professor Matthews said.
"The new board has not yet met and so obviously there could not have been any discussion about voluntary amalgamation, nor is it likely to be discussed.
"I have been part of a successful amalgamation, but they only happen if the boards of all the amalgamating parties agree to even discuss it as a first step. That is not the situation in Portland.
"The board's priority is to work with staff, the community and government to provide the necessary health services to the Portland community in a financially sustainable manner."
He said Portland was facing financial, workforce and geographical challenges.
"Anyone in receipt of government funds wants more of it," he said.
Six out of the nine board members are out-of-towners.
Just over a year ago eight of the nine members were local.
Dr Napthine said he was "extremely disappointed" by the lack of local representation.
"I think it's absolutely essential for a regional and rural hospital that the board is made up largely of local people who know the local issues, who will fight for local services and who will ensure the local hospital meets the needs of the community," he said.
"I am shocked and disappointed there are so few from the local community on the board.
"The community don't want to travel to Warrnambool or Geelong for care, and people won't move past Melbourne and Geelong if they think the health services are not up to scratch.
"We have to fight to maintain them and it beggars belief a government would appoint people to the board who don't live in the region and who have no skin in the game when it comes to looking after the local health services."
Just two locals remain on the board - Michael Bartos and Michael Bailey.
Continuing member Alex Campbell has strong ties to the region. Mr Matthews, Nadia Baillie, Andrew Long, Jed Macartney, Dr Lucy Cuddihy and Dr Sue Wilson are also on the board.
Former board members Anita Rank and Associate Professor Laura Fuller resigned in June 2021.
Local Dr Ann Miller's term expired on June 30 and she was unsuccessful at being reappointed to the board.
Ministerial delegate Marcus Kennedy, who was appointed in July 2020, has been on two boards that went through merger talks.
Former PDH chair and board member Mike Noske said there was pressure from the department for a merger for more than a decade during his time with the health service.
"I'm of the opinion this round of appointments were quite out of the ordinary, and when things happen out of the ordinary you have every right to question the motives," Mr Noske said.
He said the hospital was "chronically underfunded" to service its population base of 19,700 within the Glenelg Shire region.
"We have three significant employers that run in Portland - Keppel Prince, Portland Aluminum and the Port of Portland. In all operations there's significant risks of incidents resulting in major injury to people.
"With something like 1500 people employed across those three sectors it's critical to have a well-equipped and capable accident emergency centre.
"Portland has also reached a critical point in terms of GPs to the point there's people leaving to places like Port Fairy, Warrnambool and Hamilton just to see a doctor.
"We were always concerned about the level of funding available to PDH."
A spokeswoman from the Health Minister's office said there were no plans to amalgamate PDH with any other health service.
"Our top priority is ensuring that the Portland community continues to get high quality local health and aged services and that the hard-working staff are well supported," she said.
"Each of these new appointments comes with a wealth of experience and a commitment to rural and regional health and importantly a strong desire to support the Portland community.
"The priority for any board appointments, whether they are for a health service or other government board, is that they are skills based appointments. Local representation is also considered as part of this process."
Liberal South West Coast MP Roma Britnell believes the Andrews Labor government's design, service and infrastructure plan for Victoria's health system showed a move towards a centralised health system.
"The government has denied that is the case, but it's in black and white in that report," she said. "Now we see local people being sidelined from these important local leadership positions in favour of people from outside the region.
"The government knows locals would never allow a merger or cuts to services to take place because they understand what a detrimental impact that could have on the community they then had to continue being a member of.
"The Andrews government can say there are no plans to merge PDH - but plans change quickly."
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