A health policy expert says a massive shake-up of western Victoria’s hospital system will benefit the region, but only if the government makes certain iron-clad commitments.
In July, Ballarat, Horsham, Stawell and Edenhope’s health services agreed to amalgamate and submitted a proposal to the Victorian government for approval.
Despite nine months of consultation before the move, many residents say they know very little about how the merger will work.
The community champion
After 34 years as a surgeon and board member at Horsham’s Wimmera Base Hospital, Ian Campbell has hung up the scrubs.
But with plans afoot for an amalgamation of health services in western Victoria, he feels the need to speak up.
Mr Campbell says he is, like many others, worried it will see the smaller hospitals lose services and jobs to Ballarat.
Each health service has been guaranteed at least one seat on the nine-person board of the proposed new organisation, with the government to make appointments based on the necessary skills needed.
Wimmera Base Hospital currently offers 80 different health services, including several surgeries and obstetrics services which Mr Campbell says should not be outsourced.
The health services say a merger will help them attract staff to the smaller hospitals, not remove them.
The managers
Maree Aitken, chair of the Wimmera Health Care Group which manages the hospital, says her organisation struggles to fill many specialist positions.
More than 2,200 people travel outside the Wimmera, which has a population of 50,000, to either Ballarat or Melbourne for hospital admissions every year.
According to the hospitals, there has been a 12 per cent increase in surgical waitlists and a 5.8 per cent growth in service levels in Ballarat in the past five years, while admissions have been decreasing in Edenhope and Stawell.
The health services also report Wimmera residents have higher rates of certain cancers, diabetes, heart disease, respiratory diseases, and hospital admissions for preventable conditions than the state average.
The independent voice
The Grattan Institute’s Professor Stephen Duckett, who has advised the government on previous mergers, is backing the plan.
He says it could help hospitals with fewer resources to improve staff training and patient care.
“There’s not much money to be saved in these small rural towns, and so you’ve got to protect what is there and ensure that what’s going to be happening is better quality,” he says.
“I think there were a lot of mergers in New South Wales going back 10 or 20 years ago, which resulted in stripping out resources from the small hospitals, so they were more done as budget cuts, rather than as quality improvement.
Professor Duckett says he doesn’t believe the government wants to see more mergers in regional Victoria.
But he says the state government must guarantee the benefits to each hospital if the Health Minister approves the plan.
“When you say to the smaller town ‘look Edenhope, this is what you’ve got now, this is what you will have and it’s going to be better’ … there ought to be a signature on a piece of paper which actually says that’s going to happen, so that the town can have comfort that it is doing the right thing, not only for today, but into the future,” he says.
The government
The ABC filed a Freedom of Information request for the business case of the merger, but the state government refused to release it.
The lack of information has been noted by residents in western Victoria, with a petition against the plan drafted by Member for Lowan Emma Kealy, attracting 3,648 signatures.
The health department says it will only support a merger that guarantees better quality or safer services and no reduction in workforce or closure of facilities.
It did not directly respond to Professor Duckett’s suggestion for a written commitment following approval.
Ballarat Health Services chair Natalie Reiter says she has in writing from the government that it has no plans to reduce funding to any of the hospitals if it approves the merger.
Beyond surgeries and contracts, Mr Campbell says Horsham also doesn’t want to lose the community spirit locally-controlled health services can sustain.
“And in the bigger the organisation, the individual control and workplace flexibility disappears.”
Minister Foley’s decision on the proposal is expected by the end of the year.