Frontline providers sound alarm over aged care reforms

Just months after Australia’s biggest overhaul of home aged care in years, concerns are mounting that the new Support at Home program may not be delivering on its promise to help older Australians remain independent for longer.

A poll of aged care managers and professionals has revealed widespread dissatisfaction with the reforms, while the nation’s outgoing Inspector-General of Aged Care has issued her own warning that aspects of the rollout are “causing harm”.

Together, the criticism paints a troubling picture of a system designed to simplify home care but which some working within it say has instead become more complex, more expensive and less effective.

Frontline frustration

The latest concerns emerged from the Ageing Australia Queensland Conference, where about 150 aged care managers and professionals took part in an anonymous poll reported by HelloCare.

According to the survey, 94 per cent believed older Australians were experiencing worse outcomes under Support at Home than they did under the Home Care Packages program it replaced. More than half described the situation as “much worse”, while just four per cent believed the reforms had improved outcomes.

The survey was not a scientific or nationally representative poll, a point acknowledged by those involved.

Adrian Morgan, General Manager of home care provider Flexi Care, said the results nevertheless reflected the experiences of people delivering care every day.

Among the concerns raised were higher out-of-pocket costs for some services, increased administrative complexity, delays in accessing funding, and reduced flexibility for some families seeking support at home.

Watchdog raises separate concerns

Speaking at the National Press Club in Canberra, outgoing Inspector-General of Aged Care Natalie Siegel-Brown warned that aspects of the rollout were “causing harm” and risked undermining older Australians’ ability to remain living independently.

She has argued the system remains geared towards responding to crises rather than preventing them, warning that delays and administrative barriers may ultimately push some older Australians into hospital or residential aged care sooner than necessary.

Real families feeling the impact

The concerns are not just being voiced by providers and policy experts, as they have also been reflected in the experiences of some older Australians and their families.

News Corp publications earlier this year highlighted the case of 87-year-old Townsville man Mervyn Pether, who lives with dementia. His family said he was initially left without funding for daily shower assistance after receiving only part of his assessed Support at Home package. Following media attention, his funding was restored and the Federal Government introduced a new escalation pathway allowing some disputed assessments to bypass the standard 90-day review process.

The Guardian Australia previously reported on journalist Emma Nicolle’s experience navigating the home care system for her terminally ill father, writing that approved equipment, including a mechanised bed, did not arrive until after it was needed.

While these are individual cases, they echo broader concerns now being raised across the aged care sector about delays, assessments and whether the reforms are translating into better outcomes on the ground.

What is Support at Home?

Support at Home replaced the Home Care Packages program as part of broader aged care reforms introduced following recommendations from the Royal Commission into Aged Care Quality and Safety.

The reforms were designed to simplify home care, introduce more tailored funding, improve transparency and help more older Australians remain safely in their own homes for longer.

However, implementation has attracted criticism from providers, consumer advocates and some experts, particularly around assessment processes, waiting times and consumer contributions.

Government asked for comment

Starts at 60 contacted Aged Care Minister Sam Rae’s office seeking comment on the concerns raised by providers and the Inspector-General, including whether the Government accepts the rollout has created significant challenges for some older Australians and whether further changes are being considered.

No response was received before publication.

As Australia’s population continues to age, the effectiveness of Support at Home is likely to remain under close scrutiny. While the reforms were intended to improve care and independence, many working on the frontline believe more work is needed before the system delivers on that promise.