The state government is preparing an unprecedented overhaul of Victoria's health services.
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The Standard flagged the move back in February, putting the issue on the minds of south-west residents.
This week it became real with news a draft plan is preparing to slash the state's health services from 76 to 12 through a series of forced amalgamations.
Just what that means in south-west Victoria is not clear. One possibility is Warrnambool becomes a hub for Portland and Hamilton hospitals and other health services like Port Fairy's Moyne and other smaller operations in the district. Another, more likely option, is all health services in the region come under Geelong's Barwon Health.
Why is this change significant?
The cash-strapped state government needs to improve our health system; improvement requires extra investment but when the coffers are bare, how does it achieve that? The amalgamations would result in significant management cuts. Chief executive officer roles and associated high-level management positions wouldn't be needed at say Portland and Hamilton if Warrnambool became a hub. The government would be able to divert millions in staff costs to improving services.
It has already tried it with Ballarat, Horsham, Stawell, Edenhope and Dimboola health services being brought together as Grampians Health in 2021. Some say it's a success. Another says the jury remains "well and truly out" on the Grampians Health experiment. "Just mention the name down the street in Horsham, Stawell or Edenhope and be prepared to duck."
New South Wales did it not so long ago too.
And seismic change like this has happened in other sectors. In the early 1990s the Jeff Kennett-led Victorian government drastically reduced the number of municipalities. There were huge costs savings and efficiencies.
But we also know both those changes came with considerable pain. Councils suffered a massive brain-drain, local knowledge was lost and so too consistency in decision-making. In NSW, its health restructure later promoted a rural health inquiry in 2020 because care in some regions declined.
We don't want that.
No one will argue with the Victorian government wanting to improve health services and reduce waiting times. But is such a rationalisation the answer?
John Vogels, a former state MP in South West Coast, entered politics after a long period as chair of Timboon District Health Service. He fought for years to keep services in the rural area. He fears local communities will lose control and voice, "which will undoubtedly result in funds being diverted from smaller hospitals, leading to the loss or reduction of local services and jobs".
His concerns are real.
The government, which has yet to consult communities, could be in for a fight unless it can guarantee local services won't be reduced and patients forced to travel further than they do now for care. When it comes to organisations, bigger isn't always better.