Built to fail: why aged care needs Plan T – and why the sector must lead it
For years, aged care has been treated like essential infrastructure but regulated like welfare. Price caps choke capital. Care minute rules choke productivity. Compliance smothers innovation.
The system can’t fix itself. Operators must.
Australia’s aged care system isn’t just strained – it’s structurally jammed. And while Canberra delivers reform speeches and resets the rules, the uncomfortable truth remains: Government cannot untangle this. Only the sector can.
For years, aged care has been treated like essential infrastructure but regulated like welfare. Price caps choke capital. Care minute rules choke productivity. Compliance smothers innovation. Every lever that might attract new investment or new workers has been locked down by design.
Minister for Aged Care Sam Rae’s recent address to the Australian Association of Gerontology captured the ambition perfectly:
But the system is still built to fund decline, not prevent it. It rewards activity, not outcomes. It hands providers people already unwell and then measures the minutes spent managing that decline.
Support at Home may improve access, but it doesn’t change the fundamental architecture.
And Canberra has no more money, no more workforce and no appetite – or political oxygen – to remake the system from scratch.
That leaves one option: the people inside the system must rebuild it from the inside out.
The best example we have is coming from providers who have stopped waiting for permission.
Look at Bupa’s Wellness Hubs, which are delivering nurse practitioner-led, digitally enabled, clinical care.
It is prevention, workforce optimisation and digital care – the very things every review and Taskforce says Australia needs.
Yet the model doesn’t “count” toward care minutes.
That’s the point. Transformation will always sit outside the rules until the rules catch up.
This is why Plan T has to be sector-led. It’s not a lobbying document; it’s a survival framework.
Providers are the only actors with real-time visibility of what works, what breaks and what older Australians actually need.
They are also the only ones capable of proving – with data, not statements – that better models deliver better outcomes at lower cost.
Government can fund, regulate and incentivise – but it cannot redesign a system it doesn’t operate.
If aged care wants a future built around wellness, prevention, independence and dignity, the sector must build the prototypes, prove the outcomes and force policy to follow.
Because the alternative is already visible: older, frailer residents; blocked hospitals; no workforce relief; and a regulatory machine designed to support places, not people.
Plan T isn’t about waiting for Canberra. It’s about leading now, before the system collapses under the weight of its own design.
