THE future of country hospitals could be threatened by the Rudd Government's health care reform, the Victorian Health Care Association says.

Chief executive Trevor Carr told The Weekly Times the National Health and Hospital Network plan was "city centric" and brought "serious risks" for country Victoria.

Victoria's 44 small health care services receive block funding, rather than case-mix funding, which is dependent on the number of patients the service treats.

However, under the reform plan, the small services would be "back in the paradigm where you get funding on volume", Mr Carr said.

"Sustainability becomes a big question," he said. "Case-mix funding is volume-driven, so it's only suited to metropolitan and large regional areas."

The plan to create local health networks - small regional health care clusters - would work in other Australian states, Mr Carr said, but not necessarily in Victoria where local health services are already run by boards.

He said areas with a board governing a local service might now come under a larger regional provider and be forced to compete for funding.

"The Prime Minister needs to work with the states for a set of national minimal standards ... so he doesn't dismantle what we've got," Mr Carr said.

"This way, funding will go directly from Canberra to the local health network - it's just different management, there's no advantage."

Changing funding arrangements would not end the "blame game" being played by state and federal governments, he said.

West Gippsland Health Service chief executive Ormond Pearson said rural Victoria already had integrated health services.

"We'd be wary that integration (of services) would break down (under the new plan)," Mr Pearson said.

"Some 44 hospitals get block funding. If they went back to case mix funding, I suspect they would have some serious concerns for their ongoing viability."

Mr Pearson called for more detail to be released and asked if there was new money in the plan.

A spokeswoman for federal Health Minister Nicola Roxon had not returned calls at the time of going to print.