The generalist anaesthetist training rotation has been cancelled at Portland District Health, after the service failed to replace what's known as a FANZCA specialist last year.

In an email seen by The Standard, the training has been scrapped and moved to Hamilton due to the absence of the specialist.

PDH acting director of anaesthetics Dr Peter Reid said it was a huge blow for the service after it became the smallest hospital to gain accreditation for the training of generalist anaesthetists last year.

"I can't stress this enough, to get to be the smallest place in Australia to get this training was huge," Dr Reid said.

"To lose it within a year is heartbreaking.

"The hospital supported it, the executive supported it, and the board is not listening to anyone, not even the executives."

Dr Reid said to train generalist anaesthetists a hospital needed one FANZCA and two general anaesthetists, which PDH had last year.

"The registrars rotate to us from metropolitan hospitals for three months," he explained. "The mother hospital pays for the training, it doesn't cost us a penny.

"The FANZCA anaesthetist resigned last year and the board refused to allow the hospital administration to re-advertise the position.

"We need a full-time permanent specialist anaesthetist."

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Dr Reid said the board finally advertised the position recently, but only for a term of one year.

"No-one that I know from a metropolitan area will accept that - who's going to come to Portland on a one-year basis? It was a Clayton's advert in the first place."

A PDH spokesman said the service had not been advised of any changes to anaesthetic training arrangements.

Dr Reid refutes this, saying the acting chief executive was informed before the visit from Victorian Health Minister Martin Foley on Wednesday.

It's another blow to the hospital, which has temporarily suspended birthing services, seeing mums-to-be forced to travel to Warrnambool to give birth. The hospital's only eye surgeon quit last week, and the community fears the service will be downgraded.

In response, the hospital's midwives wrote a letter to the board this week expressing support for the obstetrician, while outgoing eye surgeon Dr Robert Harvey claims the number of midwives had not changed when the suspension of services was announced.

Portland's midwives have been working short staffed and have been on call every day, Australian Nursing and Midwifery Federation Victorian Branch Secretary Lisa Fitzpatrick said.

"They're seriously fatigued. It's incredibly distressing for the local community but it's not a safe work environment for the midwives and it's not safe for women and their babies to continue the birthing service without more midwives," she said.

"The midwives are very keen to provide a full maternity and birthing service as soon as it is safe to do so."

The ANMF has offered to work with PDH to support the implementation of a primary caseload model similar to Castlemaine Health which works closely with Bendigo Health.

Midwives in this model see a caseload of women - up to 45 - per year. They're also rostered once a fortnight at Bendigo Health for experience and exposure to the care of women who meet the risk criteria of that higher capability service.

"This model gives midwives significant job satisfaction and provides a safe, high-quality continuity of care to women and their babies," Ms Fitzpatrick said.

"We would like to see South West Healthcare invest in the midwifery student employment model.

"This is an ANMF initiative, supported by the Andrews Government, that health services across the state have successfully used to boost their workforce capacity during the pandemic."

The model gives Registered Undergraduate Students of Midwifery (RUSOMs) paid employment while they study.

They are rostered above the legislated minimum ratio and gain valuable experience prior to graduation.

"The program also helps students develop a relationship with a health service which could help build midwifery workforce capacity at the Warrnambool hospital and the smaller surrounding hospitals."

Dr Harvey and Dr Reid fear birthing services will not continue at Portland.

"Personally, I have no confidence yet," Dr Reid said. "There was a glimmer of hope with this visit from Martin Foley - I don't care if it was political or not, I don't care. He came and I got to I got to engage with him.

"There's a town of people out here and they always miss out.

"This little corner of the world, they always miss out."

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