However the service refutes concerns, labelling them as a campaign to "discredit and fear-monger."

There will be no hospital medical officers in the urgent care centre at Portland District Health from April 23 until May 1, an internal memo to staff seen by The Standard states.

Instead, a nursing team is on-site and telehealth services are available.

It comes after a number of service impacts at the hospital, including the suspension of births.

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Former PDH surgeon Dr Robert Harvey, who recently resigned over a contract dispute, said it was a dangerous situation and "unprecedented" for the town, with Warrnambool's emergency department constantly filling up.

"It's just not safe, you cannot really practice proper medicine like that," Dr Harvey said.

"There might be something glaringly obvious a doctor on the floor would see which somebody acting remotely just isn't aware of.

"Telemedicine is all very well and good in certain situations, but doesn't cover all bases.

"You want a doctor on-site for both rapid diagnosis and quick intervention."

A PDH spokesman said the service continued to provide safe care.

"This continued campaign to discredit and fear-monger, does no service to the community and it undermines the good work of our current staff, who provide an excellent standard of care," the spokesman said.

"Our urgent care centre remains open, safe and effective as always - we have experienced registered nurses 24/7 and several senior doctors on call and our clinical staff are drawing on telehealth services including My Emergency Doctor where necessary.

"We have already hired an extra locum anaesthetist who is doing excellent work to support the health service."

In addition to the anaesthetist, two locum midwives have been hired until the permanent position is filled. The hospital said all decisions were made by the board independent of the health department and the health minister.

Deakin Centre for Rural Emergency Medicine Warrnambool director Dr Tim Baker said even one staff member out of action could cause a deficit at a smaller service like Portland.

He said one doctor typically staffed both the wards and urgent care centre overnight.

"Every year, there's usually a small period of time when Portland finds it hard to cover its staff," Dr Baker said. "Portland has a 'plan B' which is used in these occasions.

"Most small hospitals find it hard to cover when some critical staff are away or on leave or unwell.

"It's much better to have doctors there to treat patients, but at the moment they can't."

He said emergency departments across Victoria were struggling to maintain workflows.

"They're experiencing a real increase in patients, including Warrnambool, and that makes the code yellows more common," Dr Baker said.

"The problem is getting people out to the wards because the wards are full, and the wards are full because it's hard to get people into residential aged care and community support.

"The system gets backed up, and the pressure point is the emergency department and the entry where the ambulances are ramped.

"It's a whole-of-system problem."

He said it was crucial urgent care centres were able to treat sick people.

"If the ambulances are out of town urgent care centres are there to be able to stabilise you until an ambulance is available."

Victorian president of the Rural Doctors Association of Australia Dr Rob Phair is concerned by the situation at Portland.

"Portland has a population of over 10,000 and there is no doctor available overnight. It's clearly very concerning and we have to ask, how did it get to this?" Dr Phair said.

"It means the community is getting a significantly lower standard of care than they would be getting in big cities such as Melbourne and that's not acceptable.

"We have to plug those workforce gaps urgently."

Dr Phair said telehealth services are being increasingly relied on in rural areas.

"It's only a stopgap, it's not a solution for any long period of time," Dr Phair said.

"Portland is actually quite a remote town, it has quite a big population, and the population is sicker than average compared to other towns that are a similar size close to Melbourne.

"It needs more resources and support, it can't just operate on the same budget as a town close to Melbourne."

Dr Phair agreed it was a system-wide issue and was calling for reforms, including better pay and better conditions for rural healthcare workers.

"It's not about building a shiny new hospital as we're seeing in Warrnambool - who is going to staff the hospital?

"We have a real shortage of experienced rural doctors, trainee doctors and doctors that can work night shifts in emergency departments.

"We also have a very competitive free market arrangement where health services have to bid against each other to secure staff. The system in its current form is broken."

Dr Phair raised Portland directly with Victorian Health Minister Martin Foley during a visit to Gippsland last week. The association will meet with the health department this week to discuss Portland's issues.

Emergency physician Simon Judkins, who sits on the board of Victoria's branch of the Australian Medical Association, said access to specialist care was an issue playing out in many regional and rural areas.

"The further you are away from the specialist, the less likely you get access to that specialist care," he said.

"Telemedicine should be seen as a complementary service, not replacement service.

"COVID really shone a light on the fact that we're working in a system that was walking a very fine line between managing and not managing. I think COVID has tipped us into a situation where we're seeing a lot of deficits in healthcare delivery.

"This is an opportunity to build back better, and actually build a better system that's accessible to everybody."

South West Coast MP Roma Britnell said it was another crisis for the Portland community.

"Having nurses or telehealth services for acute emergencies requiring airway support overnight for an extended period of time is a recipe for disaster," Ms Britnell said.

"Services are disappearing before our eyes and this government needs to start taking action to ensure the future of PDH."

Despite a full commitment to implement the 2019 Hillis review into the hospital, Victorian Health Minister Martin Foley could not say how many had been actioned during a recent visit to the service.

Dr Baker said while south-west Victoria wasn't unique in its workforce struggle, the region's medical school could be an example of how to fix the rural workforce.

READ MORE: New rural training stream gives region's medical students priority places

"In the early 2000s rural health was in a terrible mess. We basically stopped training anyone for 20 years in rural hospital medicine, and we're coming back from that," Dr Baker said.

"For 10 years we've had a medical school in Warrnambool that's been training people locally.

"Most emergency departments in rural Victoria rely on locum emergency positions to cover most of their shifts - almost all the senior shifts in the Warrnambool emergency department are covered by people who live locally.

"We still require some locums for weekends, and that is a bit of pressure point, but every year at Portland the service becomes more trained and better resourced. I think we're moving to a plan of having a solid rural generalist workforce at the Portland urgent care centre."

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