A health policy expert says a massive restructuring of the hospital system in western Victoria will benefit the region, but only if the government makes certain iron commitments.
In July, the Ballarat, Horsham, Stawell and Edenhope health services agreed to merge and submitted a proposal to the Victorian government for approval.
Despite nine months of counseling prior to the move, many residents say they know very little about how the merger will play out.
The community champion
After 34 years as a surgeon and board member at Wimmera Base Hospital in Horsham, Ian Campbell hung up the scrubs.
But he feels the need to speak out amid plans to pool health services in western Victoria.
Retired surgeon Ian Campbell says he should speak out against the plan. (
ABC Wimmera: Alexander darling
“The big concern is that there is a limited health budget due to a lack of local control,” he says, “and we want as much as possible to be spent in our region.”
Mr Campbell says he is, like many others, concerned that the smaller hospitals will lose services and jobs to Ballarat.
Each health service has been granted at least one seat on the nine-member board of directors of the proposed new organization, with the government determining appointments based on skills required.
Wimmera Base Hospital currently offers 80 different health services, including multiple doctor’s offices and obstetric services, which Campbell says shouldn’t be outsourced.
The health services say a merger will help them attract, not remove, staff for the smaller hospitals.
Maree Aitken, chairwoman of the Wimmera Health Care Group, which runs the hospital, says her organization is struggling to fill many specialist positions.
“[Amalgamation] won’t be the solution to all of our staffing problems, “she says,” but it will hopefully put us in a much better position, particularly to attract a better range of clinicians. “
More than 2,200 people travel each year outside of Wimmera, which has 50,000 residents, to either Ballarat or Melbourne for hospitalization.
Wimmera Base Hospital in Horsham currently offers 80 different health services. (
According to the hospitals, there has been a 12 percent increase in surgical waiting lists and a 5.8 percent increase in service levels in Ballarat over the past five years, while admissions in Edenhope and Stawell have declined.
The health services also report that Wimmera residents have higher rates than the national average of certain types of cancer, diabetes, heart disease, respiratory disease, and hospital admissions for preventable diseases.
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The independent voice
Professor Stephen Duckett of the Grattan Institute, who has advised the government on previous mergers, supports the plan.
He says it could help hospitals with fewer resources improve staff training and patient care.
Professor Stephen Duckett believes the plan has some advantages. (
“There’s not much money to be saved in these small rural towns, so you have to protect what’s there and make sure what happens is of better quality,” he says.
“I think 10 or 20 years ago there were a lot of mergers in New South Wales that resulted in the deprivation of resources of the small hospitals.
“You have to be very careful with the motivations and also with the safeguards that apply to the smaller services as part of the merger.”
Professor Duckett says he doesn’t think the government wants to see more mergers in the Victoria area.
But he says the state government must guarantee the benefits of every hospital if the health minister approves the plan.
“When you say to the smaller town, ‘Look Edenhope, you have that now, you will have this and it will get better’… you say that will happen so that the town can be confident that it is doing the right thing, not just for today, but also for the future, “he says.
Edenhope Hospital is one of the smaller hospitals in the state of Victoria. (
Delivered to: Edenhope District Memorial Hospital
The ABC filed a Freedom of Information motion for the merger business case, but the state government refused to release it.
The lack of information was noted by residents of western Victoria with a petition against the plan, which was drafted by MP for Lowan Emma Kealy and received 3,648 signatures.
The health department says it will only support a merger that guarantees better quality or safer services and not downsizing or closing facilities.
She did not respond directly to Professor Duckett’s suggestion for a post-approval written commitment.
Often people from the Wimmera seek treatment at Ballarat Base Hospital. (
ABC: Dominic Cansdale
Ballarat Health Service chairman Natalie Reiter said she had written from the government that it had no plans to cut funding for any of the hospitals if it approves the merger.
In addition to operations and contracts, Campbell says Horsham doesn’t want to lose the community spirit that locally controlled health services can maintain.
“If you know your coworker needs time off for whatever reason, you’ll be happy to cover him and know that he’ll reciprocate the deal for you,” he says.
“And the larger the organization, the more individual control and flexibility in the workplace disappear.”
Minister Foley’s decision on the proposal is expected by the end of the year.
Stawell Regional Health sees less than 10 percent of the patients that Ballarat Health Services does. (