Stop funding decline

One sentence in Natalie Siegel-Brown’s National Press Club address should reshape Australia’s aged care debate.

“We keep asking whether we can afford prevention... I think the better question may be whether we can afford continuing to fund preventable decline.”

The wrong debate

For years, Australia’s response to ageing has centred on supply. More beds. More workers. More funding. The debate has focused on how to expand the system to meet growing demand.

But what if we have been arguing about the wrong problem?

Through Plan T, The Weekly SOURCE has argued that Australia cannot solve its ageing challenge simply by expanding the most expensive parts of the system. The bigger opportunity lies in reducing avoidable demand before it occurs.

The outgoing Inspector-General of Aged Care has now reached much the same conclusion.

Australia has built a system that responds to decline well but does far too little to prevent it. Delays, fragmented assessments and administrative hurdles don’t just inconvenience older Australians – they push people towards higher-cost care.

That is more than inefficiency. It is a funding model that spends more money to achieve a worse outcome.

Natalie’s example of a pensioner waiting three months for a $50 pair of crutches made the point perfectly. A GP prescribed them immediately, yet the system required multiple assessments before they could be provided, turning a simple intervention into an $1,800 exercise.

“We’ve still built a system that would rather spend 36 times to delay support than what it would have cost to deliver it immediately,” she said.

Funding independence

The most expensive aged care place in Australia is not the one with the highest accommodation payment. It is the one that could have been delayed – or avoided altogether.

Every month an older Australian remains living independently represents expenditure the system never has to make elsewhere. Yet our funding settings continue to reward responding after people deteriorate rather than helping them avoid deterioration in the first place.

The sector has spent years arguing about whether aged care receives enough funding. Increasingly, the more important question may be what we are actually funding.

Are we funding independence? Or are we funding decline?

What makes Natalie’s speech significant is who delivered it. This was not a provider or industry advocate. It was Australia’s independent Inspector-General, drawing on almost two years of examining how the system works.

As she observed, “Low hanging fruit is the enemy of reform.”

Real reform is not another funding stream or assessment pathway. It is redesigning the system around preserving independence rather than managing dependency.

Natalie pointed to evidence that earlier intervention could save billions by delaying entry into residential aged care. She also highlighted Australia’s veterans’ aged care model, which keeps people at home almost 13 months longer, roughly halves entry into residential care and could save almost $2 billion annually if applied more broadly.

This is not an argument against residential aged care. Australia will need more beds as the population ages.

But it is an argument against assuming every future resident had to become one.

Australia cannot continue funding preventable decline and expect a different outcome.

That is the conversation the country can no longer afford to avoid.