Border Medical Association chairman Scott Giltrap has slammed "Band-Aid" efforts to prop up the future of a "substandard" health service for Albury-Wodonga.
In a letter distributed to doctors on Thursday, the BMA renewed its calls for a single high-quality hospital system transcending state government lines.
It warned persisting with "large expenditures on revamping individual services" for the two-campus model would not deliver sustainable health services over the next 30 years.
"This is inefficient, unsafe and looking like an incredibly expensive way to develop a substandard health service into the future," the letter stated.
Speaking to The Border Mail this week, Mr Giltrap said the people of this region deserved better, and both doctors and patients were being sold down the river.
"We are one of the biggest health services and they have spent peanuts on us," said the Albury fertility specialist who was awarded an Order of Australia Medal for service to medicine in regional areas.
"We are going down the gurgler.
"The problem is neither (the Victorian or NSW) government wants to commit big dollars; neither wants to put big dollars into infrastructure that might be across the river from their state."
Compared to other major health regions (see graphic) Albury Wodonga Health had the highest number of emergency department presentations, the highest number of births, the lowest number of beds, the highest number of wait list admissions and the lowest capital funding, the letter stated.
The average for all the other health areas over recent years is $430 million compared to $30 million for Albury Wodonga Health.
Mr Giltrap said AWH had done a "terrific job" in the past decade "within the constraints of being spread over two campuses and the financial and safety issues this imposes".
AWH chief Michael Kalimnios said the service was undertaking a "detailed service and master planning exercise to determine our future needs and related infrastructure requirements" including exploring the option of a single site.
Mr Kalimnios, who acknowledged BMA as a "key stakeholder", said the process would involve all clinicians and was supported by NSW and Victorian health ministries.
On Thursday, Victoria's health minister Jenny Mikakos said the state was "doing our bit to deliver a brand new emergency department at Albury".
"AWH master-planning work has identified the most pressing infrastructure priority is the expansion of the emergency department," she said.
Ms Mikakos said the project should "be completed and caring for border communities at the end of 2022".
A spokesperson for NSW Health said state governments were working to "refresh the current intergovernmental agreement for AWH to ensure health services meet community needs now and in the future".
"The NSW Government is committed to ensuring the community has access to high-quality facilities and is providing $30 million for the expansion of the current emergency department and $45 million for acute services, both at Albury," they said.
"The new emergency department for Albury Hospital is set to significantly increase the capacity for patient care ... it will take the total number of ED treatment spaces from 16 to 42."
However by the time "they finish the architecture" it will be outdated given the number of ED presentations are already pushing 65,000, according to Mr Giltrap.
He said obstetrics facilities "were not up to the standards you would expect", adding it was ludicrous babies were born at Wodonga while ICU and the blood bank were located at Albury.
Mr Giltrap said the reality was the Federal Government needed to come on board to provide the funding needed to develop a single hospital system for Albury-Wodonga that would deliver health services equivalent to other regions and metro areas.
He reiterated the provision of high-quality services was critical in attracting doctors - "and we are already running into real problems with this".
If AWH and the state governments are not prepared to address the needs of the local population the BMA states it "will have no choice" but to lobby the Federal Government to finance a new hospital in the lead-up to the next election.
Farrer MP Sussan Ley said if AWH's planning indicated a new single hospital campus was on the table, both states would have to back it.
"My understanding is Albury Wodonga Health will finalise its forward plan over the next few weeks, and I am keen to get across the various options they will put forward," she said on Friday.
"I don't think we can say 'the Albury-Wodonga Health agreement isn't working' ...
"But if the community across Albury-Wodonga and our wider health region wants to see one hospital, on one site, it will be a true test of this unique cross-border arrangement," she said.