When Deborah Martinez began haemorrhaging late at night in the small town of Swifts Creek, in Victoria's High Country, the only person she could call was the bush nurse.At 36 weeks pregnant, Ms Martinez's water broke about 10:30pm. With Ms Martinez in pain and concerned for herself and her unborn baby, nurse Sue Carroll quickly determined the situation was life-threatening."We were both in a bit of danger, and I was experiencing something called a placental abruption, where my placenta had come away from my uterine wall, and I was haemorrhaging," Ms Martinez said.But the service will no longer provide out-of-hours care because of a lack of funding from Victoria's Department of Health.A pay rise to public sector nurses and midwives in their latest enterprise bargaining agreement (EBA) means the centre's funding no longer covers overtime and penalty rates.The Victorian government funds the centre to provide care from 9am to 5pm from Monday to Friday.Ms Martinez said during her care at home, Ms Carroll liaised with the local hospital and ambulance service to arrange transport as her condition worsened.Ambulance shortages in the High Country meant Ms Martinez faced a long wait while haemorrhaging before eventually meeting paramedics about halfway to Bairnsdale Hospital."It's lifesaving," Ms Martinez said."We are so lucky to be able to, or have been so lucky to be able to, access support so far away."The main street of Swifts Creek, in Victoria's High Country. (ABC News: Madeleine Stuchbery)A long historyThe Swifts Creek Bush Nursing Centre in East Gippsland has delivered nurse-led healthcare since 1918 and is now a locally supported not-for-profit that provides care to the remote community.Tony Skelton is among the many locals who rely on the centre for emergency healthcare."I'd pulled a tree down on myself and broke five ribs and split my kidney in half … I could not have been taken by road. So that sort of shows us how isolated we are," Mr Skelton said."I thought I was going to bleed to death."At 75 and still working, Mr Skelton fears health outcomes will worsen for the region's aging population."We're a forgotten area when it comes to medical," he said. "And there's a whole lot of people that are getting on in their 80s and 90s up there that it's critical that we have access to a bush nurse 24 hours, seven days a week."Vital serviceBush Nursing Centre board president Eddie Mauger said rural communities needed to fight to protect their health services.Eddie Mauger, pictured with Tori Betts and their daughter Daisy, says the Bush Nursing Centre is a vital resource. (ABC News: Fiona Broom)"Our health services need to be funded appropriately," Mr Mauger said."One, so we're not relying on burning out staff that are getting run off their feet … it's really important that the funding stays consistent with the EBA across all services for rural Victoria."In addition to public funding, the centre relies on grants and community donations to provide additional services.While ambulance community officers service the area 38 hours a week, residents remain concerned there is a significant gap in emergency care.Ms Carroll began relief nursing at the Swifts Creek Bush Nursing Centre nearly 29 years ago and said there had always been a nurse on-call during her tenure because emergencies "don't happen Monday to Friday, nine to five"."We've had somebody come in with an anaphylaxis … and we've had to treat them immediately because that's such a severe condition that if they're not treated, they will die," she said."Just recently, we had a young man who had a heart attack, and so we had to sort of start transporting him down and then he was given the clot buster and then transferred out by Helimed."Community members fear the hour-long drive along the winding Great Alpine Road to seek emergency healthcare could put lives at risk."We are focused on implementing alternative care pathways, including the Victorian Virtual Emergency Department and Nurse on Call for free, 24/7 care as well as the virtual women's health clinic and the mobile women's clinic van," a Victorian government spokesperson said.Telehealth no substituteAs overnight services are scaled back, health authorities are increasingly turning to virtual care options.A Royal Flying Doctor Service virtual healthcare pod is being trialled in Swifts Creek.The pilot is being delivered alongside local health services and the Victorian Virtual Emergency Department (VVED), with plans to expand to other rural areas.The pod is a box that patients sit inside and it connects them to a clinician at the VVED at any time of day.It is able to measure their heart rate, oxygen levels and blood pressure before they are given medical advice. But deputy chair of the Royal Australian College of General Practitioners Rural Faculty, Christie Rodda, said nothing could replace face-to-face care.Christie Rodda says using telehealth is becoming increasingly common in rural communities. (Supplied: Christie Rodda)"I would say that telehealth is something that is definitely valuable, but it works best when it's there to support local systems," Dr Rodda said."It's not a replacement for somebody who knows you and your family and your health well."Dr Rodda said it was becoming increasingly common for rural communities to be offered telehealth and virtual solutions to address workforce shortages and distance."When you see the loss of these services, you can see how terrifying that is for communities and how much of a loss it is," she said.Email address