The barometer of how well an aged care system is working is found in the lived experience of those needing or receiving care – not how well the government thinks it’s working. Not long ago, Australia had a system that worked quite well: access was straightforward; assessment determinations by clinicians, not algorithms; shorter assessment times; quicker access to subsidised home care; shorter waitlists for residential aged care and fast track prioritisation was a given. In recent years, this has changed dramatically.
As an ageing nation, we face the same challenges as the rest of the world. Every few years, I travel to explore how other nations meet these demands. This time I visited Singapore, the world’s sixth “Blue Zone”. And where soon 1 in 4 will be over 65. With a rapidly declining birth rate, childcare centres are being repurposed into community-integrated Senior Care Centres with creative active ageing, rehabilitation and dementia programs. These spaces were full of positivity, energy and fun and open from dawn to dusk – supporting multi-generational working households. Speaking to everyday Singaporeans on the street, they embed health and wellness into their everyday lives; however, have worries like us about high costs, the need to keep working, and affordability for health/medical/aged care for their ageing loved ones and as they age themselves.
In Australia we are fortunate. Our hospital and medical care is good, accessible and affordable. Hospitals though are struggling as people stay longer, unable to move to residential aged care (lack of beds), or can’t go home because funding is non-existent or inadequate.
The Federal Government controls the aged care system, determining regulation, program design and rules. The Support at Home Program has systemic design flaws putting people at risk. The ABC 7.30 Report reported issues with Support at Home assessments – computer algorithms making assessment determinations. Qualified clinicians performing assessments are blocked from overriding digital determinations, even if there is a clear need for higher care support. Aged Care Minister Sam Rae defended this as “equitable”. There is nothing equitable about a system that ignores human nuance.
Aged care is a human service; it should be a person-centred system designed to maintain peoples independence, dignity, and quality of life. People are falling through the cracks, not being assessed or funded for the care they need to remain living at home. Sadly 4,812 older Australians died waiting in 2024-25. This is not just a policy failure; it’s a moral one.
The recent Sunday Mail article “Elderly are Beaten Down by Reforms” exposed the harsh reality of government changes. Under Support at Home rules, providers must wrap all service costs including package management, travel, and overheads into hourly rates. Income and asset testing changes mean recipient contributions are now up to 80 per cent. We are seeing the heartbreaking result: seniors going without a meal or a shower because they simply cannot afford it. The government designed a system which is rigid and financially out of reach for the majority.
With some minor design changes, we would have a system that treats older Australians with the dignity and respect they deserve. They are not data points to be managed by an algorithm; they are people who built this country and deserve a system they can afford, and which puts them at the centre.
