Does being in a 'safe seat' influence whether your hospital gets an upgrade?
Jacinta Allan will seek re-election as Victorian premier in November. (ABC News)
In short:
Advocates say regional hospitals in so-called "safe seats" are being overlooked for funding due to a lack of political appetite from the state government.
There are active campaigns to secure funding for public hospitals at Mildura, West Gippsland, Hamilton and Daylesford.
What's next?
A political analyst says Victoria should have an independent infrastructure authority to allocate funding on a needs basis.
Does the political landscape in regional Victoria determine whether your local hospital gets money for an upgrade?
Advocates across the state say run-down or outdated facilities are being snubbed for funding due to the area being in a "safe seat" or "lacking political relevance".
As Victoria approaches a state election in November, there are calls for state funding to be allocated by an independent body free of political interference.
The safe seat problem
In 2022, Western District Health Service's then-chief executive Rohan Fitzgerald led efforts to secure state government funding to upgrade the aging Hamilton Base Hospital, a 3.5-hour drive west of Melbourne.
Despite an impassioned public plea from staff, the calls for a $32 million upgrade fell on deaf ears.
Mr Fitzgerald no longer works at the hospital but said the upgrades were still desperately needed.
Rohan Fitzgerald ran the Western District Health Service for 10 years. (Supplied: Western District Health Service)
"[The emergency department] is like two shipping containers have been stuck together … it's the size of a sardine can,"he said.
"It's heart-breaking … and distressing, not only for the staff, but for the community as well."
Mr Fitzgerald, who unsuccessfully stood for the Liberal Party in the 2008 by-election in the federal seat of Gippsland, said he believed Labor had no political appetite to commit money to the project because Hamilton was in Lowan, a seat held safely by the Nationals since it was re-established in 2002.
"Lowan is a Nationals heartland, which is fine," he said.
"But surely we've got to look over these political gains that are played by both sides of politics."
The Coalition promised to contribute $17 million towards the Hamilton hospital upgrade if it won the 2022 state election.
Management at the Western District Health Service says interim upgrades are not a long-term fix. (Supplied)
The health service's current chief executive Rowena Clift said it was funding its own $4 million upgrade to the emergency department as an interim measure.
"It is not a substitute for a full redevelopment, which is needed to meet current and future demand," Ms Clift said.
Politically irrelevant
It's a similar story at the Mildura Base Public Hospital, where staff say the hospital needs an extensive upgrade to handle growing demand in the north-west Victorian regional city.
In 2021, the Labor state government spent $2 million on a feasibility study for a full redevelopment and hinted a new hospital was on the cards, but is yet to release a master plan or commit funding to a redevelopment.
Build The Base campaign spokesperson and Mildura Mayor Ali Cupper said she believed a lack of "political relevance" was behind the lack of funding for a full-scale redevelopment.
Labor has never won the Mildura electorate. It has swung between the Liberals, Nationals and independent MPs since the 1950s, with Cr Cupper holding the seat as an independent from 2018 before losing to the Nationals in 2022.
Ali Cupper is campaigning for hospital funding in Mildura. (Facebook: Ali Cupper)
"Political dynamics matter. They can have a huge influence on an electorate's fortunes,"Cr Cupper said.
"When you're politically relevant, you're in a strong bargaining position to secure big ticket infrastructure.
"When you're not competitive, or when you're an opposition MP, it can be a lot harder."
The hospital was brought back into public hands in 2020 after 22 years of private operation and since then, the Victorian government has funnelled $30 million into the facility.
Mildura Base Public Hospital is more than six hours north-west of Melbourne. (ABC News: Wade Stephens)
Ahead of the 2022 state election, the Coalition promised $750 million for a new hospital in Mildura if it won.
Mildura Base Public Hospital was approached for comment.
Taken for granted
In central Victoria, two side-by-side electorates have seen vastly different hospital funding outcomes.
Labor hung on to the marginal seat of Ripon last state election, with the Victorian government spending $115 million to upgrade the Maryborough Hospital in 2021.
Meanwhile, just over the electorate border in the safe Labor seat of Macedon District, Daylesford locals have given up on hopes that their 160-year-old hospital will be rebuilt any time soon.
Community members have given up on a campaign to redevelop Daylesford Hospital, pictured in 2022. (ABC News: Bridget Rollason)
Labor has held Macedon since 2002, with former Victorian health minister Mary-Anne Thomas in the seat until her retirement this year.
The Labor state government provided $6.14 million to upgrade the Daylesford hospital's operating theatre in 2021, but community pleas for a $75 million rebuild of the hospital have been ignored.
Daylesford Hospital Upgrade Community Campaign committee member Kathleen Murray said the region felt overlooked.
"The seat is taken for granted. We feel that somehow our rural postcode is not as important as a metropolitan or a big regional city postcode,"Ms Murray said.
The project drew a $75 million pledge from the Coalition opposition if it won the 2022 state election.
Daylesford is about a 40 minute drive from the nearest main hospital in Ballarat. (ABC News: Patrick Rocca)
Ms Murray said the community group felt there wasn't enough political interest in the hospital to warrant another campaign ahead of this year's election.
She said she and her partner were considering moving to Ballarat to be closer to health care, despite her love of Daylesford.
Central Highlands Rural Health chief executive Maree Cuddihy said the $6.14 million operating room upgrade was not enough to address the aging hospital's infrastructure needs.
A Victorian government spokesperson dismissed the claims regarding the Hamilton, Mildura and Daylesford hospitals.
"These claims are wrong. Projects are funded and delivered, based on community and population needs, not politics,"the government spokesperson said.
They said the state government was continuing to build and open new hospitals so that more Victorians could get the care they needed, closer to home.
'Transparent' funding authority needed
Australian National University political marketing lecturer Andrew Hughes said safe seats being neglected by both sides of politics was a perennial issue.
"It always has and always will be [a problem] in Australian politics," Dr Hughes said.
"There's no need to spend money in [a safe seat], because they always vote for party x, and unless party x is in government, then those people in that area miss out.
"It's making politics very much based on punishment and reward from a voter's perspective. That's really unfair."
Dr Hughes said governments did fund projects based on genuine community need.
There are examples of hospitals being generously funded by the state government in electorates held by the opposition.
The Latrobe Regional Hospital in the Latrobe Valley received just over $223 million for an expansion, completed in 2024. This followed a previous $73 million upgrade that wrapped up in 2017.
The area falls within the Nationals' electorate of Morwell, which the party reclaimed at the last election. The seat had been held by Russell Northe, a former Nationals member who left the party in 2017 and won the seat as an independent before choosing not to recontest.
Despite budget blowouts and delays, the $396 million rebuild of the Warrnambool Base Hospital is well underway in the seat of South West Coast, which has been held safely by the Liberals since 2002.
An artist's impression of the Warrnambool Base Hospital redevelopment, due for completion in 2027. (Supplied: Victorian Health Building Authority)
But sometimes a promise comes with a catch. In West Gippsland, the state government promised a new hospital in Drouin, but works haven't started four years on from the announcement.
Andrew Hughes says an independent infrastructure body is needed in Victoria. (ABC News: Timothy Sweeney)
The region is in the seat of Narracan, held by the Liberals since 2006.
Dr Hughes said he believed it would take a change of government for the West Gippsland hospital to progress.
"Politically speaking, there's no benefit to a Labor government helping out a Liberal Party candidate or Liberal Party MP," he said.
"That's really sad to say, because people then miss out on health services they need."
Dr Hughes said the states should follow the federal government's lead in removing some of the political influence from project funding.
Infrastructure Australia's priority list aims to provide independent, evidence-based advice to the Australian government on what projects it should invest in, including Melbourne's suburban rail loop.
Dr Hughes said each state would benefit from its own independent infrastructure authority.
"It's transparent, it's open, it can't be persuaded by politics or by passionate pleas. It's done on a logic and reasoning basis,"he said.
"Victoria needs that."
But Dr Hughes said the tide could be turning on the thinking around safe seats, and that was already visible at a federal level.
He said the rise of One Nation and the teals, as well as high-profile independents such as Alex Dyson, had created political uncertainty in traditional Labor, Liberal or National strongholds.
"That gets people thinking, 'Hang on, maybe this seat isn't safe after all, maybe it's marginal and therefore, if we put some money into it, maybe we can swing it,'" Dr Hughes said.