The boards of the four health services have worked on plans to come together during the past 18 months, with a business case supporting the partnership sent to the Victorian health minister for approval this week.

"This is a fundamental system rebuild, building a rural voice in to this new health system in a way no other health system in Victoria currently does," said Wimmera Health Care Group board chair Marie Aitken.

The four services will each retain their identities, including name, logos, staff and fundraising.

Members from each of the four hospital boards assured their communities the partnership would allow them to provide more services locally, increase access to specialists, reduce the need for patients to travel, improve career pathways and training opportunities for staff, and provide the ability to share resources and administration.

At a joint conference, the chairs of the four health services addressed questions about the amalgamation process and how it might affect the provision of health care in the Wimmera.

Ballarat Health Services board chair Natalie Reiter, Wimmera Health Care Group board chair Marie Aitken, Stawell Regional Health board chair Rhian Jones and Edenhope and District Memorial Hospital board chair Phillip Sabian attended the conference.

Since the beginning of the COVID-19 pandemic, the group had started exploring the idea of potentially stronger, focussed partnerships between the regional health services.

Ms Aitken said she approached Ballarat Health Services with the idea 18 months ago to address the "terrible inequalities facing our local communities".

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"From there we started to engage with a consultant to explore whether this was a good idea or not. That was about 18 months ago that we set the ball rolling and we have gone through a very extensive process through that time," she said.

Once the ball was rolling on the amalgamation talk, Wimmera Health Care Group, alongside Ballarat Health Services, approached the various regional health services across the Wimmera with the health service merger idea.

How will all the competing priorities of many diverse communities be considered to ensure that smaller communities don't miss out through this process?

Edenhope and District Memorial Hospital board chair Phillip Sabian said there were discussions between the health service boards to ensure "local voices" were maintained in any further amalgamated health service.

"Chairing up a board that is surrounded by small communities, there are multiple mechanisms that we have put in place to make sure that the local voice will continue to be put at the centre of service planning decisions," he said.

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"These will include governance, financial, strategic and clinical planning, and legal mechanisms.

"We need to ensure that we do everything to improve the long term health benefits for all communities following the creation of a new entity.

"This means providing more services closer to home for more people, so that patients have to travel less distances, less often to receive the health care that they need."

Will there be a loss of services?

Mr Sabian also addressed concerns about a loss of services in the Wimmera under a new health service - agreeing that although services may change in the future, by-laws would be codified to retain local services.

"With a new health service, there would be many elements in place to protect the long term interests of local health care," he said.

"The constitution and by-laws of the entity would embed the requirement to provide health care services in each local community.

"Services provided at each location would be subject to service planning processes, which include consultation with the local community. The local community would have a say in any proposed changes to services in their area.

"The new health service would have performance requirements from the Department of Health that include clear service delivery requirements. Any proposal to change these requirements would have to be approved by the Department and the Minister.

"Rural experience and representing the communities involved would be a priority for the board of a new entity. Community-specific advisory committees would also be established to advocate for local services and ensure their importance is understood."

Mr Sabian said the new health service would have region-specific key performance indicators, overseen by a board committee that selected its members from across all of its representative communities.

What does this mean for health service staff?

Wimmera Health Care Group board chair Marie Aitken said the amalgamated health service would provide greater opportunities to staff employed by the four health services and denied the merger would lead to any lost jobs.

"Together the four health services will be one large employer able to attract and sustain a large workforce pool, especially for specialist roles. It will also reduce the reliance on temporary staff in regional and rural communities," she said.

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"Staff shortages are a major challenge and under the current arrangements are resulting in less local service delivery.

"Creating a new health service is not a 'magic bullet', but it will make it easier to attract and retain staff to the region in many ways.

"Staff working at Horsham would get the benefits of working in a more personalised, smaller health setting and in a rural community while also getting the training, development, research and career opportunities that a bigger service offers."

What can staff and community do to be engaged in this co-design process?

Ms Aitken encouraged community members to involve themselves in the amalgamation process.

"While the Department of Health reviews our proposal we will be meeting with community members to discuss the reasons we have made this decision and about how the new health service can increase the quality of health care in our region," she said.

"You can be as involved as you would like to be; reading information on our website, attending a coffee catch up meeting, participating in a co-design workshop or joining an advisory committee, there will be lots of opportunities.

"It is crucial that this process is an active collaboration with all health services involved."

Ms Aitken said the process would also draw from staff across the four health services, who would be invited to contribute their thoughts and ideas about the new service.

How can we guarantee there will be local board representation?

Under the new health service, a health board would be formed among the representative communities of the entity.

Stawell Regional Health board chair Rhian Jones said local representation was an issue that was considered in the initial planning stage and would be enshrined under the new health service agreement.

"Something we have proposed to the minister is that we ensure we have local representation for all of the communities across the new board," she said.

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"We have also written it into an agreement that we have asked for the four services to sign. We have also ensured that we have the right representation and the right skills from the community to make that new board the best representation of each local community.

"The fundraising that our ladies auxiliaries and our sporting clubs have provided will always remain to the entities they were intended for. That has also be unwritten into the agreement and the request we sent to the minister.

"They were things we were not willing to give up, they are really important for the identity of our local services."

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