$50 Crutches, $1,800 Bill: How a Simple Mobility Aid Exposes a Costly Flaw in Aged Care Reform

A pensioner’s GP told her plainly what she needed: a $50 pair of crutches to stay safely mobile. What should have been a straightforward purchase instead became a three-month ordeal that cost taxpayers $1,800 – a case now being held up as proof that Australia’s overhauled aged care system is failing the very people it was designed to protect.

The case was revealed by outgoing aged care inspector-general Natalie Siegel-Brown, who told the National Press Club that flaws in the government’s Aged Care Act overhaul are harming older Australians while doing nothing to control the sector’s rising costs.

Under the government’s Support at Home program, the pensioner couldn’t simply act on her GP’s advice and purchase the crutches. Instead, the system required a separate, funded occupational therapy assessment before it would approve funding for equipment her own doctor had already deemed necessary.

“Under support at home, those same $50 crutches cost the taxpayer $1800 and a three-month wait,” Ms Siegel-Brown said. “Why? Because the system insists that an in-home occupational therapist assessment must be funded before it can fund what a GP had already said was necessary.”

The three-month wait wasn’t just a bureaucratic inconvenience. During that time, the pensioner’s risk of falling increased significantly and her confidence declined. Had she fallen, Ms Siegel-Brown said, the consequences could have been severe and considerably more expensive.

“If she had fallen, we would have been dealing with hospitalisation, rapid decline, and – if she could get a place – residential aged care at a cost to the taxpayer of about $123,000,” she said.

A system built around the wrong goal, inspector-general warns

Ms Siegel-Brown, who is resigning early from her role to take up a position with the United Nations, argues the crutches case is symptomatic of a much larger design flaw. Labor’s new Aged Care Act took effect in November, intended to better support older Australians while putting the sector on a more financially sustainable footing. But she says the reforms have prioritised supporting people once they enter formal care over helping them stay independent at home for longer – undermining the very goal of ageing with dignity that the legislation claims to champion.

“The plumbing of the reforms is undermining the poetry of the act,” she told the Press Club. “We say we want people to age in place, yet we discourage people from accessing support at home … we say we cannot build enough beds while making it harder for people to stay out of them.”

She warned that the system’s current design was forcing taxpayers to spend far more than necessary supporting older Australians, precisely because it makes early, low-cost interventions harder to access than expensive, later-stage care.

Ms Siegel-Brown drew a pointed comparison to another area of public policy debate, cautioning against reactive, punitive approaches that ignore what the evidence actually shows works.

“If I look across this country at the youth justice debate, the answer that seems to gain popular grip is ‘lock the kids up’ when we have decades of evidence that that doesn’t work,” she said. “My fear is that we might be doing that in aged care in various places.”

Political reaction

Opposition aged care spokeswoman Anne Ruston backed the substance of the criticism, arguing that greater emphasis on early intervention made both economic and human sense.

“The question that really needs to be asked is: what is the government doing to try and stop the cost inflation that’s been built into the aged-care sector by its own actions?” Senator Ruston said.

A spokesman for Aged Care Minister Sam Rae disputed Ms Siegel-Brown’s characterisation, saying the government’s reforms had transformed residential aged care for the better.

“While we know there’s much more to do, our aged-care system is on a stronger, more sustainable footing as a result of our reforms and we’ll continue to work to strengthen it as our generational reforms bed down,” the spokesman said.

The government points to its own projections as evidence of progress: by the end of the 2026/27 financial year, the number of older Australians on the new Support at Home scheme is expected to have almost tripled compared with those on a home care package back in 2020.

Whether that growth in numbers translates to genuinely faster, simpler access to basic equipment like a $50 pair of crutches, though, remains the question at the heart of Ms Siegel-Brown’s warning.