WeRise · Policy platform
Aged Care
Key findings
- 839,000Around 839,000 people received Commonwealth home-support services in 2024–25 – aged care is mainstream social infrastructure, not a niche service. Source: Australian Institute of Health and Welfare · People using aged care fact sheet 2025 · 2026 []
- 293,000At 30 June 2025, 293,000 people were using home care – evidence that the centre of gravity is shifting toward support at home. Source: Australian Institute of Health and Welfare · People using aged care · 2026 []
- $39.8 billionGovernments spent $39.8 billion recurrently on aged care in 2024–25, showing that aged care is already a major national public system. Source: Productivity Commission · Report on Government Services 2026: Aged care services · 2026 []
- 148 recommendationsThe Royal Commission’s 148 recommendations show the failures were systemic – spanning care quality, workforce, rights, governance and funding. Source: Royal Commission into Aged Care Quality and Safety · Care, Dignity and Respect · 2021 []
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Part 01
The Case for Change
Why Aged Care matters
Care Before Crisis
Aged care should protect independence, not wait for a family to break.
Australia’s aged-care debate is often reduced to beds, waiting lists and budget lines. Those things matter. But the real issue is simpler: whether an older person can get the help they need before a small problem becomes a life-changing crisis.
A fall should trigger timely support, not a chain of events that ends with hospital admission, family exhaustion and a rushed move into residential care. Dementia should mean familiar routines, skilled support and continuity – not isolation, confusion or medication used because there are too few staff to provide time and care. Aged care is where the country decides whether independence is protected in practice, or only promised in theory.
In 2024–25, around 839,000 people used home support; at 30 June 2025, a further 293,000 were using home care and 204,000 were using permanent or respite residential care.1 These are not isolated cohorts. They represent older Australians in every electorate, plus families, workers and communities trying to hold care together. The system must be designed around the reality that care needs change over time: some people need help with shopping, cleaning or transport; others need nursing, medication support, dementia care, continence management or around-the-clock assistance.
The Royal Commission found that Australia’s failures were systemic. Its 148 recommendations covered rights, quality, workforce, governance, financing, access and accountability because no single repair can fix a system whose problems reinforce one another.2 Poor staffing undermines quality. Weak quality oversight allows poor providers to continue. Fragmented services shift work to families. Delayed support increases hospital pressure. Inadequate funding can cause providers to withdraw from rural, remote or specialised markets. And opaque consumer charges make care harder to access precisely when people are least able to navigate complexity.
Australia already spends at scale: $39.8 billion in recurrent government expenditure in 2024–25, with 98.9% funded by the Commonwealth.4 This is why the answer cannot be “just add money” or “let the market sort it out”. Money must be connected to enforceable rights, workforce capability, transparent provider accountability, viable regional delivery and a clear guarantee that essential care is affordable.
The direction of reform is right: a rights-based Act, Support at Home, strengthened quality standards and ongoing wage funding. But implementation must be judged against lived experience. Can someone get an assessment promptly? Can they afford personal care? Is there a local provider? Does their worker have enough time and skill? Can a family raise a concern without fear or confusion? Is residential care something we would choose for our own parents?
WeRise’s position is that care should follow the person, not force the person to follow the system. Home should be the first option where safe. Residential care should be humane and well staffed when it is needed. Family care should be supported rather than extracted. And the public should receive clear evidence that every dollar is buying safety, independence and dignity.
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Part 02
Evidence and Experience
Aged Care: what other countries show
What Other Ageing Societies Teach Us
Denmark · Japan · Netherlands · OECD comparison
No international model can be imported whole. Australia’s federation, geography, First Nations communities, provider mix and tax system demand an Australian design. But comparable ageing societies show four durable lessons: make home support a real entitlement rather than a residual service; maintain public responsibility for funding and market stewardship; allow contributions according to means without making essential care unaffordable; and treat care work as skilled infrastructure.
Denmark demonstrates the value of municipally delivered and tax-funded home support. Japan shows how universal long-term-care insurance can make care a social responsibility rather than a private family contingency. The Netherlands demonstrates personal budgets and purchaser arrangements that enable choice, though with administrative risks. OECD data show that home-based long-term care is becoming more common across advanced economies, but only where systems invest in workforce, assessment and coordination.7
Denmark · Long-running national and municipal long-term-care system; current model shaped by municipal responsibility since the 2007 administrative reform
Tax-funded home care, practical help and nursing-home care; municipalities organise, finance and largely deliver local long-term-care services 98 municipalities are responsible for local long-term-care delivery
- Home care is centrally available free of charge, including personal care and practical assistance. []
- Denmark has made an explicit policy choice to prioritise community care over residential care. []
- Municipal responsibility allows local delivery to be connected to housing, practical assistance and community services. []
- Denmark has relatively fewer people in long-term-care institutions than many European peers, reflecting its ageing-in-place orientation. []
Australia should not copy Denmark’s local-government structure directly. But it can learn from the principle that home support must be an ordinary public service, not a rationed add-on. Commonwealth funding should be matched with local coordination across health, housing, transport and community services.
Japan · Long-Term Care Insurance introduced April 2000; ongoing
Mandatory long-term-care insurance covering home, community and institutional care; financing combines premiums, public funding and user co-payments All people aged 40 and over are covered; municipalities operate as insurers
- Japan’s scheme was created to make long-term care a social responsibility rather than leave it primarily to families. []
- The system combines 50% public funding with 50% premium funding; user co-payments apply, with protections for high costs. []
- The program provides both in-home/community and institutional care under clear eligibility categories. []
- Long-term-care expenditure increased from around 0.7% of GDP in 2000 to more than 2% in 2019, demonstrating both social value and substantial fiscal pressure. []
Japan shows that transparent social insurance can normalise shared responsibility for care, but it also warns that ageing makes funding design unavoidable. Australia should retain public responsibility, protect low-income users and openly plan for long-term demand rather than defer the funding question.
Netherlands · Personal-budget model operating within Dutch nursing and care arrangements; 2024 rates cited
Personal budgets for approved nursing and personal-care hours, allowing people to arrange formal care; indicative maximum formal-provider rates of €41.96 per hour for personal care and €58.44 per hour for nursing in one 2024 insurer schedule Individual budgets are calculated from clinically indicated care hours; national long-term-care financing remains substantial
- Personal budgets can give recipients more control over who delivers care and how it is arranged. []
- 2024 published maximum rates included €41.96 per hour for personal care and €58.44 per hour for nursing under the cited insurer scheme. []
- Budget design depends on assessed need and annual budget controls. []
- Personal-budget systems require strong assessment, fraud controls, administrative support and safeguards against shifting risk onto families. []
Choice is valuable only when people have support to exercise it. Support at Home should allow meaningful flexibility, but not turn older people and families into unpaid care-system administrators.
OECD comparison · 2011–2021 comparative long-term-care recipient data
Cross-country comparison of formal long-term-care use rather than a single payment program OECD member-country indicator series
- The share of long-term-care recipients receiving care at home across reporting OECD countries increased from 67% in 2011 to 69% in 2021. []
- The shift toward home-based care is real but gradual; residential care remains necessary for a substantial minority. []
- Access, workforce supply and affordability vary markedly between countries. []
- A home-care strategy without workforce and service capacity can transfer care burdens to families. []
The policy aim should be “home where safe and wanted”, not a simplistic target to minimise residential care. Australia needs both better home support and better residential care, with clear pathways between them.
Part 03
Costs and Trade-offs
The cost of Aged Care
The Cost of Care – and the Cost of Delay
Australia already pays. The question is whether it pays for dignity early or crisis late.
Aged care has a visible budget cost, but poor or delayed care has costs too: avoidable hospital use, delayed discharge, carer withdrawal from paid work, premature or inappropriate residential admission, poorer health, family stress and provider collapse in thin markets. A serious cost assessment must distinguish gross spending from net cost and from cost shifted elsewhere in the public system or into unpaid households.
Government recurrent expenditure on aged care was $39.8 billion in 2024–25.4 The Aged Care Taskforce projected that government spending on aged care would rise from 1.1% of GDP in 2021–22 to 2.5% of GDP by 2062–63 without broader funding reform.8 That projection is not a reason to withdraw public responsibility. It is a reason to design funding, workforce and service systems early enough to avoid paying more for poorer outcomes.
The 2026–27 Budget allocated $1.4 billion over four years to strengthen Support at Home implementation and affordability, including $1.0 billion to make key personal-care services fully funded from October 2026.6 These are gross outlays. Their potential offsets – reduced crisis escalation, improved hygiene and continence care, less family-carer strain and safer ageing at home – are real but should not be claimed as cash savings without program evaluation. []
WeRise should therefore publish costings in three columns: direct Commonwealth cost, avoided or deferred costs, and non-budget benefits. A policy is not “free” because its cost falls on an unpaid daughter, a hospital emergency department or a person’s declining health.
LEDGER
| Item | Amount | Note |
|---|---|---|
| Commonwealth recurrent aged-care expenditure, 2024–25 | -$39.8 billion | Current public expenditure baseline; not the cost of a new WeRise package |
| Support at Home affordability and implementation package, 2026–27 Budget | -$1.4 billion over 4 years | Current-government investment, including home-care access and affordability measures |
| Fully funded personal-care services under Support at Home | -$1.0 billion over 4 years | Showering, continence management and dressing to be fully funded from 1 October 2026 |
| Projected government aged-care spending as share of GDP | 1.1% in 2021–22 to 2.5% in 2062–63 | Long-range Taskforce projection; indicates fiscal pressure, not a fixed forecast |
| Avoided acute-care escalation from earlier home support | Not yet reliably costed nationally | Plausible offset; requires Australian linked-data evaluation before inclusion in fiscal scorecard |
| Family-carer participation and income protection benefit | Not yet costed | Would require modelling against employment, Carer Payment, tax and superannuation settings |
| Workforce retention and reduced turnover benefit | Not yet costed | Improved pay, training and secure work may reduce recruitment and continuity costs; evidence requires provider-level analysis |
| Net cost estimate of full WeRise package | To be costed after Tier-4 policy design | Must combine direct outlays, revenue measures, provider reforms and independently tested offsets |
The strongest objections to Aged Care
1.
“A stronger public guarantee will be unaffordable as the population ages.”
This is the strongest fiscal objection.
The Taskforce projects government spending could rise from 1.1% of GDP in 2021–22 to 2.5% in 2062–63.8 The concern is genuine: demand is rising, workforce supply is constrained and public budgets face pressure from health, disability, defence, climate adaptation and infrastructure. The response is not to deny the cost. It is to distinguish between publicly funded essential care, fair means-tested contributions for accommodation and everyday living, and policy settings that allow costs to drift into hospitals and unpaid family care. The full WeRise package requires independent costing before adoption.
- “Home care can become a way to shift work onto families, especially women.”
Correct.
“Ageing at home” is not automatically progressive if it means a daughter leaves paid work, a spouse provides unsafe care, or a family becomes the unpaid workforce. The response is to make home care a genuine service entitlement, not a rhetorical preference: timely professional care, respite, nursing, allied health, carer income support, transport and navigation. Residential care must remain available and high quality.
- “Staffing mandates can close services in rural and remote areas.”
This is a real risk.
Uniform standards without workforce supply, travel funding, training pathways or thin-market subsidies can make services technically non-compliant but practically irreplaceable. The response is not to dilute safety for country residents. It is to combine enforceable national standards with tailored regional solutions: housing for workers, local training, telehealth where appropriate, mobile teams, loadings and public commissioning of essential services.
- “Provider profit is necessary to attract capital, build beds and innovate.”
Private and not-for-profit providers will remain important in a mixed system.
The issue is not whether a provider can operate sustainably; it is whether public subsidies purchase care, staff time and safe facilities rather than opaque financial extraction. Residential capacity needs investment, particularly where supported residents are concentrated. The 2026–27 Budget’s new supported-resident building subsidies recognise this.10 WeRise should regulate ownership, related-party transactions, staffing and outcomes more transparently, while allowing sustainable providers to invest.
- “More choice can overwhelm older people and create administrative burden.”
This is also true.
Personal budgets, provider comparison and co-contribution schedules can increase choice on paper while placing the burden of system management on people during illness or crisis. The Netherlands illustrates both the promise and administrative risk of flexible budgets.7 The response is supported choice: independent navigation, clear default pathways, culturally safe advocacy, simple pricing and a public service guarantee. Choice without accessible information, workforce supply or advocacy is not meaningful choice.
Part 04
The Australian Design
How Aged Care would work in Australia
An Australian System That Works
One public guarantee, multiple ways to receive care.
Australia does not need to choose between family care, professional home support and residential care. It needs a coherent pathway between them. The design principle is simple: use the least disruptive form of support that is safe, wanted and clinically appropriate, while guaranteeing high-quality residential care when home is no longer enough.
The Commonwealth already dominates funding and policy. In 2024–25 it provided 98.9% of government aged-care funding, while the Productivity Commission recorded $39.8 billion in recurrent expenditure across the system.4 The Commonwealth also regulates providers through the Aged Care Quality and Safety Commission, funds residential care and Support at Home, and administers national eligibility and assessment arrangements. States and territories remain crucial partners because hospital discharge, primary health care, ambulance, mental health, housing, transport and local service infrastructure all affect whether an older person can remain well at home.
The Aged Care Act 2024 and Support at Home provide a foundation for reform. The next phase should establish a clear public entitlement: an eligible older person should know what support they can expect, when it will arrive, what it will cost, what quality standards apply and where they can go if care fails. Personal care that protects hygiene and dignity should not be rationed by ability to pay; the 2026–27 Budget’s move to fully fund showering, continence management and dressing under Support at Home is a useful first step.6
WeRise would build on this foundation through seven linked reforms:
- Make family care viable with a simplified, wage-equivalent family-carer payment for substantial assessed care, designed alongside – not as a replacement for – the Age Pension, Disability Support Pension and a future UBI architecture.
- Set timely assessment and service-start standards, with transparent reporting by region and priority cohort.
- Make regular nursing, medication management, allied-health and dementia support easier to obtain at home.
- Build a national aged-care workforce compact: wage equity, portable training, minimum qualifications, registration, safe staffing and regional incentives.
- Fund residential care for quality and complexity, with transparent ownership, staffing, outcomes and enforceable sanctions.
- Establish a strong public-interest market-stewardship function to ensure rural, remote, First Nations, multicultural, homelessness and specialist services are viable.
- Integrate aged care with health, housing and transport planning through regional agreements and shared accountability for hospital discharge and preventable crisis care.
Implementation should occur over five years. Year one should establish baseline data, rights enforcement, regional supply mapping and detailed costings. Years two and three should phase in family-carer reform, workforce measures and service guarantees. Years four and five should embed public reporting, independent evaluation and adjustments based on access, affordability, quality-of-life and workforce outcomes.
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Part 05
People and Transition
Who Aged Care affects
Who Carries the Cost Now
Older people, families, workers and communities pay when care arrives too late.
The direct beneficiaries of reform are older people who need support to live safely and with dignity. In 2024–25, around 839,000 people used Commonwealth home support, while 293,000 were using home care and 204,000 were using permanent or respite residential care at 30 June 2025.1 Most people using aged care are women, reflecting women’s longer life expectancy and higher use of home care and permanent residential care.1
But aged care affects far more people than formal service counts show. Family members frequently coordinate appointments, transport, meals, medication, finances and advocacy. They fill gaps between assessment and support, and they carry the emotional risk when care fails. Because unpaid care is gendered, failures in aged care also become failures of women’s workforce participation, income security and retirement savings. This is why family-carer support belongs in the design, rather than being treated as a private matter.
Case study
“Lena” – composite scenario based on Royal Commission themes
Lena is 82 and lives alone in a small town with diabetes and early dementia. Her needs are increasing, but support is delayed and her daughter travels long distances to fill the gaps. Lena begins missing meals, falls repeatedly and is eventually admitted to hospital.
When she enters residential care, her family finds a service under pressure: rushed personal care, little time for reassurance, unfamiliar staff and a system that treats confusion as a behaviour to manage rather than a person to understand. This scenario combines themes documented by the Royal Commission – delayed support, family strain, poor nutrition, inadequate staffing and weak clinical governance – rather than describing a single identifiable person.2
First Nations older people, people in rural and remote communities, culturally and linguistically diverse communities, LGBTIQ+ people, people experiencing homelessness, and people ageing with disability can face additional barriers when services do not fit culture, place, language or complexity. The Commonwealth’s thin-markets grants specifically identify rural, remote and specialised services, including services for Aboriginal and Torres Strait Islander people and people at risk of homelessness or disadvantage.9
Case study
“Michael and Aunty Rose” – composite regional scenario
Michael lives in a regional town and supports his aunt, Rose, who wants to remain on Country. The nearest provider cannot reliably supply staff, allied-health visits are infrequent and transport requires long drives. Rose does not want to leave her community, but the family has little practical choice when home support cannot be staffed. A viable regional system would fund travel, local workforce development, culturally safe care and flexible service models – rather than treating geography as an individual family’s problem.
Opposition will come in different forms. Some providers will oppose stronger transparency, ownership disclosure or staffing requirements if these reduce margins or expose weak performance. Some fiscal conservatives will oppose public investment or a stronger entitlement. Some households with wealth will oppose greater means-tested contributions. These interests must be heard, but they cannot outweigh the right of every older person to safe, affordable and dignified care.
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Part 06
Related policies
Aged Care sits within a wider set of WeRise policies.
- Foundations of Dignity: more WeRise policies in this pillar
- WeRise: all 29 policies across seven pillars
Notes
Sources and Supporting Documents
- Australian Institute of Health and Welfare. People using aged care. GEN Aged Care Data. 2026. gen-agedcaredata.gov.au
- Australian Institute of Health and Welfare. People using aged care fact sheet 2025. GEN Aged Care Data. 2026. gen-agedcaredata.gov.au
- Royal Commission into Aged Care Quality and Safety. Care, Dignity and Respect: Final Report. Commonwealth of Australia. 2021. royalcommission.gov.au
- Royal Commission into Aged Care Quality and Safety. Care, Dignity and Respect: Final Report Executive Summary. Commonwealth of Australia. 2021. royalcommission.gov.au
- Productivity Commission. Report on Government Services 2026: 14 Aged Care Services. 2026. pc.gov.au
- Department of Health, Disability and Ageing. 2024–25 Report on the Operation of the Aged Care Act 1997. Australian Government. 2026. gen-agedcaredata.gov.au
- Department of Health, Disability and Ageing. Portfolio Budget Statements 2026–27: Health, Disability and Ageing Portfolio. Australian Government. 2026. health.gov.au
- Department of Health and Aged Care. Final Report of the Aged Care Taskforce. Australian Government. 2024. health.gov.au
- Department of Health, Disability and Ageing. Applications open for Support at Home Thin Markets Grants. Australian Government. 2026. health.gov.au
- Department of Health, Disability and Ageing. A stronger health system for all Australians: Budget 2026–27. Australian Government. 2026. health.gov.au
- Department of Health, Disability and Ageing. Better and fairer wages for aged care workers. Australian Government. 2026. health.gov.au
- OECD. Health at a Glance 2023: Access to long-term care. OECD Publishing. 2023. oecd.org
- National Bureau of Economic Research. Long-Term Care in Japan. 2024. nber.org
- National Institute of Population and Social Security Research, Japan. Long-Term Care. 2000. ipss.go.jp
- Ministry of Health, Labour and Welfare, Japan. Long-Term Care Insurance in Japan. Government of Japan. 2002. mhlw.go.jp
- Vrangbæk, K. The Long-Term Care System in Denmark. European Observatory background paper. 2010. files.ethz.ch
- Zorg en Zekerheid. 2024 Regulations Governing the Personal Budget for Nursing and Care. Netherlands health insurer. 2024. zorgenzekerheid.nl
- Health New Zealand. A review of aged care funding and service models. 2024. healthnz.govt.nz
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