Ms Kealy said she believed the new Grampians Health Service would inevitably lead to an erosion of quality health provision in the Wimmera, and pointed to past instances of centralisation as examples.

This comes after Ms Kealy led a campaign against the proposal for a new health service throughout 2020 and 2021 - starting a petition which called on the board of the Wimmera Health Care Group to reconsider the amalgamation.

"Ballarat Health Services has its own considerable issues which have been found through recent auditor general reports," she said.

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"Even on the day it was announced we saw three nurses stood down because they had not provided appropriate supervision and care to a patient with mental illness who later took their life.

"It is a culture and attitude to safety and quality that we don't see in the Wimmera regions and there are certainly a lot of people who are concerned with the bulk of the governance coming out of Ballarat."

Ms Kealy said her petition received more than 4000 signatures from Horsham residents against the idea.

"The overwhelming feedback from the community was that they did not want to see an amalgamation with Ballarat," she said.

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"That was based on a variety of reasons. We have seen so many times before that centralisation of services coming from Ballarat or Melbourne at the end of the day means a poorer outcome for our local region.

"The further you are from the centre of control the poorer the outcomes are, because you quickly become forgotten."

She also voiced concerns about the reluctance from the group's leadership to release the business case for the proposal, which was presented to Health Minister Martin Foley before he approved the new service.

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"We have seen so many times before - as many times the people who are paid to sell this proposal to us say it will be great - there is actually no evidence to say how it will be great," she said.

"The business case is still a secret document, which is a real concern to people who want to see that document. So we can only judge it on past history and in every instance, centralisation results in poorer outcomes for country people."

At the Grampians Health Service launch on Monday, new board chair Bill Brown said the group looked to "leverage each other's capacities", using the strengths of the four health services to build health outcomes across the region.

Documents released by the Wimmera Health Care Group in early 2021 showed the health service was unable to meet the health care demands of the community with its existing infrastructure.

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Proponents of the amalgamation said sharing resources and specialists across the region could address this challenge, however Ms Kealy said Ballarat Health Services had a poor record of extending partnerships to smaller regional health services.

"It is not enhancing partnerships, it is a takeover by Ballarat.

"If you look at other regional health services, even in our local area, Western District Health Services in Hamilton has always built itself on trying to be the Mayo Clinic of the southern hemisphere.

"They (Western District Health Services) certainly haven't taken the fact that they are a regional hospital in rural Victoria to be a challenge, they use it as an opportunity. Instinctively they support other health services in that south west region of Victoria.

"That is something that has never been the case in the Ballarat region. Ballarat never provided support to Horsham let alone Edenhope when I was the CEO of the hospital there.

"The department failed to hold Ballarat to account. I do not see how an amalgamation will change that deeply entrenched acceptance by the government's department that it is okay for Ballarat to not support other regional health services."

Ms Kealy also said the executive team lacked Wimmera representation - pointing to the fact that Mr Brown came to the role from Warrnambool.

She also said several of the group's board members lived in Melbourne.

"I am deeply concerned about the board chair coming from Warrnambool. They might have the best understanding of health care, but I find it astonishing that no one from the Wimmera region, or the Grampians region was seen fit to be able to head up this important health board for this part of the state," she said.

"This is in respect to people who will try to do the best for the community, whether they live in that community or do not live in that community.

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"There is no doubt they will try their best but the numbers are not there."

"This is what people are scared about, we will lose our decision making and power - at the end of the day the money and the service will go to where the most voices are, and the most voices will support Ballarat and the services closer to Ballarat and Melbourne."

In response to Ms Kealy's comments, Grampians Health Service chief executive Dale Fraser defended the decision to appoint Mr Brown as chair.

"Bill Brown was appointed by the Minister for Health as chair of the new board of ten directors, which is made up of at least nine representatives from the previous boards of Edenhope, Stawell, Horsham and Ballarat," he said.

"The 10 board members come from the regions and together they are skilled and capable.

"As a group, it is well positioned to fulfil its role, delivering services the community deserves alongside our staff. That is our focus.

"A Warrnambool resident and Chair of South West Healthcare, Bill Brown is a proud rural Victorian and looks forward to delivering the safe, quality healthcare rural communities deserve, alongside his board colleagues."

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