Home care’s future hinges on the Budget

Aged care has rarely been under this much pressure – and this week, it came from all directions.

But the moment that cut through came from outside the sector.

The Australian’s veteran business commentator Robert Gottliebsen issued a direct warning to Aged Care Minister Sam Rae: fix the system, or risk pushing older Australians into hospitals.

It is a stark assessment – and one that has highlighted a growing chorus of alarm about the Government’s Support at Home program.

Former Liberal Aged Care Minister Richard Colbeck and Shadow Minister Anne Ruston, who supported the legislation, are now raising concerns about its impact.

No reset coming

But for all the noise, one reality remains: the Government is unlikely to throw out Support at Home.

Not five months in.

Despite the criticism, the Government’s messaging has been consistent. It wants to see how the system performs, where the gaps emerge and how behaviour shifts under the new settings.

With a number of Senate inquiries underway, any tweaks to the reforms – as forecast by former Acting Inspector-General of Aged Care Ian Yates – will take months, if not longer.

In other words – no immediate reset is coming.

The Budget moment

That makes the upcoming Budget the critical moment.

Because if the model isn’t going to be redesigned, it has to be made to work.

When Support at Home was announced in September 2024, the ambition was clear: by 2035, it would support 1.4 million older Australians to remain at home, with an additional 300,000 places created.

What will determine whether that goal is achievable is what shows up in the Forward Estimates.

A meaningful increase in Packages – and a delay or rethink on price caps – would signal that Government is prepared to back the system it has built.

Without that, the pressure will only intensify – and hospitals will absorb the overflow, as Gottliebsen warned.

As Ian has pointed out, the likely path is not redesign but targeted fixes. Some are obvious. The classification of showering and personal care as “independence” services, rather than clinical, is one example that could be revisited quickly.

The real test: productivity

The Government’s objective has been clear from the start: reduce the long-term fiscal impact of aged care. That means it is unlikely to subsidise inefficiency or unwind the core settings of the model.

Which brings the responsibility back to the sector.

If more funding is not immediately forthcoming in the Budget – and it may not be – then the question becomes: what can be done now?

Where can productivity be lifted? Where can models be simplified? Where can technology remove friction rather than add to it?

Because if the system is going to expand to meet demand, it will need to do more with what it already has.

Policy bandwidth at its limit

Aged care is politically vulnerable – but it is not the Government’s only priority.

There is only so much policy bandwidth, and aged care is competing with everything from cost-of-living pressures to global instability.

The Budget will set the tone – but it won’t solve the problem.

What happens next will determine who gets care.

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