Aged care reform ‘only half done’, new Alliance paper warns
Its core message is blunt: the machinery of aged care has been rebuilt, but the model has not been transformed.
Australia may have a new Aged Care Act, but a major sector coalition says the system is still a long way from delivering what the Royal Commission promised – and that the next phase must be led by the sector, not Canberra.
A new discussion paper, Aged Care Reform: How Effective So Far?, has been released by the National Aged Care Alliance (NACA), whose members span consumer peaks, providers, unions and professional bodies.
Funded by the Commonwealth and authored by veteran policy adviser Ian Yates AM (pictured top), the paper was written before – but published after – the 1 November commencement of the Aged Care Act 2024.
Its core message is blunt: the machinery of aged care has been rebuilt, but the model has not been transformed.
NACA credits the Federal Government with major moves – wage rises, mandated minutes, stronger Standards, IHACPA, Star Ratings and a more visible regulator – and notes the pace of implementation is “unprecedented”.
Quality without outcomes
But the paper argues quality is still being measured by inputs and compliance, not outcomes. Australia has no national outcomes framework, no shared definition of “high quality care”, and limited visibility of whether older people’s wellbeing is actually improving.
Dementia and palliative care remain inconsistent despite new funding, while allied health and lifestyle services have contracted under care minutes.
On Support at Home, NACA warns rationing, wait times and affordability pressures will persist unless co-contributions, assessments and CHSP integration are closely monitored and adjusted. It also points to “emerging crisis” signals in residential supply, particularly in regional areas where the economics of new beds no longer stack up.
A call for sector leadership – and the rise of Plan T
While backing stronger safety and transparency, the Alliance highlights sector frustration with rising compliance costs – and the vacuum left by the abolition of ACFA.
Here, the paper echoes a growing theme across the sector: the next phase of reform can’t be Government-led – it has to be sector-led. It’s the same case being made by Plan T: that providers must prototype, prove and scale new models, then force policy to follow.
The next step, the paper argues, is clear: get serious about long-term sustainability, finally fund an outcomes framework, refresh the dementia strategy and rethink workforce planning – but, critically, stop waiting for Canberra to fix what only operators can redesign.
A useful pause for thought as we head into 2026.
You can download the NACA Aged Care Reform paper here.
