Chapter 2Waiting for assistance

Behind every number is a person – someone’s parent, grandparent, neighbour – waiting for the care and support that allows them to live safely and comfortably in their own home.[1]

2.1The recurring theme of this inquiry has been one of waiting: waiting for new packages to be released; waiting for an assessment of needs; waiting for a Home Care Package (HCP) or Commonwealth Home Support Programme (CHSP) services; and waiting in hospital for residential aged care places or appropriate levels of in-home assistance. This waiting has significantly detrimental consequences for both older Australians and their loved ones.

2.2This chapter explores the evidence received in relation to current waiting lists including the National Priority System (NPS) waiting lists. This chapter also examines the evidence received in relation to the negative consequences lengthy wait times have on older Australians, their families and loved ones, and the negative impact on hospitals and health systems. It also examines the unique issues which arise in rural and regional communities.

Delayed commencement of the Aged Care Act 2024

2.3As noted in Chapter 1, the Australian Government deferred commencement of the Aged Care Act 2024 (Aged Care Act, new Aged Care Act) to 1 November 2025, and additionally deferred the release of 83,000 Support at Home (SAH) packages to the same date.

2.4Some submitters were supportive of the delay to the commencement of the Aged Care Act due to necessary preparations not having been finalised in time for a 1 July 2025 commencement. For example, the Office of the Inspector-General of Aged Care offered support to defer commencement and stated:

The Inspector-General considers it critically important that the transition to the new system is as smooth as possible for both aged care consumers and providers. The deferral made practical sense given the Rules supporting the Act had not been finalised and information technology systems were not available a month out from the intended 1 July 2025 start date.[2]

2.5The Older Persons Advocacy Network (OPAN) submitted that it ‘reluctantly supported’ the deferral of commencement because ‘older people didn’t have access to the level of detail they needed to make informed decisions about their aged care’.[3] Similarly, the Council of Elders submitted:

Council members were disappointed with the delay, especially as it hindered access to the safeguards provided in the Act, and the additional supports that will be available. However, we appreciate the need to wait for the systems to be in place to ensure a smooth transition for current participants and appropriate systems for new participants.

We are concerned that participants have access to all the information needed to make decisions about their future support needs and this includes reaching those who can or do not use digital channels or conventual approaches.[4]

2.6The Inspector-General went on to note that the deferral offers an opportunity for the Department of Health, Disability and Ageing (the department) to ‘provide greater support and guidance to aged care providers, enabling them to better prepare their clients, workers and systems for the transition’.[5]

2.7Although some submitters offered support for a delay in the commencement of the Aged Care Act for the above reasons, they nevertheless maintained concerns regarding ‘the delay to the release of additional Home Care Packages’ and described this as ‘problematic’.[6] Aunty Grace, a provider of home care services in Victoria, stated that the:

…benefits of additional preparation time do not mitigate the urgent need for immediate release of Home Care Packages to address the existing crisis. The two issues – system readiness for Support at Home and current unmet care needs – must be addressed separately and simultaneously.[7]

2.8UnitingCare Australia submitted:

The delay to the Support at Home Program is a decision that needed to be made in the circumstances; however, it remains a fact that thousands of older Australians continue to sit on the Home Care Package waitlist or are waiting to be upgraded to the package level at which they were assessed.[8]

2.9Ms Patricia Sparrow, Chief Executive Officer, COTA Australia, told the committee that ‘we did support the delay to the beginning of the new Act to 1November, but we did not support any delay in putting much needed new packages into the system’.[9]

2.10The evidence received in relation to calls for additional HCPs to be released and the impact of the deferral of the SAH Program is explored further in this chapter.

A history of wait times

2.11Before examining the evidence in relation to the impact of the deferral of the commencement of the SAH program, much of which relates to the large numbers of people currently listed on the NPS awaiting assignment of an HCP, it is important to establish a historical context to waiting times.

2.12Mr Ian Yates AM, the former Interim then Acting Inspector General of Aged Care, provided an overview of the trends in wait times, and offered an explanation for such trends.

2.13Mr Yates explained that when the ‘national prioritisation queue’ was established in 2017, there was a waiting list of at least 80,996 people approved and waiting for an HCP. Of these people, 20,276 already had a package that was lower than they had been assessed as requiring, and 60,720 had no package.[10]

2.14Subsequently, the worst quarterly waiting list was 31 March 2019 when 129,038 people were waiting, many for over 12 months. Of these people, 53,299 already had an HCP though at a lower level than required, and 75,739 had no HCP. After this quarter, as HCPs were regularly released, the waiting lists steadily declined.[11]

2.15In 2020/21 approximately 40,000 new HCPs were released, and subsequently in response to the findings of the Royal Commission into Aged Care Quality and Safety a further 40,000 HCPs were allocated in each of the 2021–22 and 2022–23 Budgets.[12]

2.16As a result, by 30 June 2023, the wait list reached a low of 28,665 people, with 21,816 having no HCP. For medium priority approval, the wait time was less than a month for Level 1 care recipients, 3–6 months for Level 2, 6–9 months for Level 3 and 1–3 months for Level 4.[13]

2.17However, from 2023, there has been a rapid increase in both the number of people on the waiting list, and the length of time they are waiting. Mr Yates submitted:

Although total waitlist numbers have not yet reached the early 2019 highest level:

a) the numbers of people who were without ANY package was then approaching (and has now predictably passed) [emphasis in original] the highest ever level, and by 1 November will be at a drastic level (see red row in table).

b) after reaching its highest recorded level in early 2019 the waiting list and wait times then decreased consistently with the provision of growing numbers of HCPs through to 30 June 2023 (over 4+ years). However, the numbers and times have since reversed direction and escalated again to very high levels, much more rapidly than they declined. This is an unprecedented reversal [emphasis in original] of trend HCP provision.[14]

2.18The Centre for Ageing and Research Translation (CARAT) noted that the release of HCPs has gone down over time. It submitted:

Release of additional Home Care packages has gone down over time, from 40,000 in the 2022–23 Budget (confirming a commitment of the previous government) to 9,500 in the 2023–24 Budget, and 24,100 in the 2024–25 Budget, subsequently supplemented by a further 7,615 packages under the 2024–25 MYEFO.[15]

Waitlist projections and analysis

2.19Submitters also provided the committee with analyses of wait times and projected outcomes for the future. For example, the City of Greater Geelong noted that projections suggest that the waiting list could rise to 100,000 by November.[16]

2.20Mr Yates provided the committee with a similar estimation with a prediction that by 31 October 2025, there will be an estimated 84, 638 people with no HCP and an estimated 17,745 people with no HCP on the waitlist – a total of an estimated 102,383 people.[17] Mr Yates submitted that these estimates are ‘conservative, based on average growth over the preceding 9–12 months’.[18]

2.21Mr Yates submitted ‘it is not clear why government allowed this to happen over the last two years’ and further:

A cynical explanation is that with the hopes of a new Support at Home program with strong co-contributions on the (twice postponed) horizon, government did not want to spend on the current HCP program with minimum co-contributions. That would also be an explanation for not releasing HCPs between 1 July and 1 November. If that is the case government has put fiscal gain ahead of the health and safety of older people who government agrees are in assessed need! [emphasis in original][19]

2.22As noted in Chapter 1, the department released updated data on the waiting list on 4 September 2025 and submitted that at 31 July 2025 there were 108,924 people on the NPS.[20]

Impacts attributed to the delay in commencement of SAH Program

2.23Some submitters such as Professor Kathy Eagar AM highlighted the specific impacts associated with the delay in the commencement of the SAH Program, rather than focussing on the broader issues of existing waiting times and the adequacy of funding. Professor Eagar submitted that the specific impacts caused by the deferral of the SAH Program vary by cohort. For example, there is little to no impact on those who are current recipients of an HCP, and whose needs are relatively stable.[21]

2.24Professor Eagar also submitted that those who have an HCP but whose needs increase in ways that cannot be met by that HCP are severely impacted. Similarly, those who are on the waiting list, or attempting to be placed on the waiting list, and who are not already in receipt of CHSP services are significantly affected. Professor Eagar told the committee that the ‘Commonwealth data collection is not good enough to quantify the size’ of these cohorts ‘with any level of confidence’.[22]

2.25Further, Professor Eagar highlighted that those who are recipients of CHSP services and who do not want to transition to the SAH Program are adversely affected by the deferral of the commencement. This is because the CHSP budget is:

…strictly capped and has not been increased to take account of the growing numbers of people needing CHSP while waiting for SAH. The CHSP cohort are thus competing with the SAH cohort for access to capped services and funds.[23]

2.26OPAN argued that the delay in commencement of the SAH Program has not only prevented the release of the expected 83,000 packages but also access to the three short-term pathways – the Restorative Care pathway, the End-of-Life Pathway, and the Assistive Technology and Home Modifications Pathway.[24]

Deferral of the release of packages

2.27 It was highlighted that it is ‘important to differentiate between the delay in the commencement of the new Aged Care Act and SAH Program, and the delay in the release of additional packages’.[25] Anglicare Australia submitted that:

…the most impactful aspect of the Government decision to delay commencement has not been the later start date for Support at Home but instead the withholding any additional Home Care Packages. The lack of any additional packages has placed greater strain on providers and a system that was already struggling.[26]

2.28Bolton Clarke submitted that it is ‘reasonable to assume’ that the 83,000 packages that are scheduled to have been released over 2025–26 under the SAH Program would have been released consistently throughout the year at a rate of about 227.4 per day. Accordingly, this would have meant that approximately 27,500 packages would have been released between 1 July and 1 November 2025.[27]

2.29As noted in Chapter 1, the department provided a submission that stated that HCPs ‘continue to be released in the lead up to the commencement of the Support at Home Program’.[28]

2.30Further, it stated that the HCP Program is ‘delivering record-level support’.It argued that in response to an increasing demand for home care, the government committed $531.4 million in the 2024–25 Budget for 24,100 packages, and $101.7 million at the 2024–25 MYEFO for 7,615 packages.[29]

2.31However, at the public hearing on 29 August 2025, department representatives clarified that the packages it stated continue to be released after 1 July 2025 were not additional packages, but are simply those that are reassigned through existing care recipients either dying or moving to residential aged care.[30] Mr Ian Yates AM, similarly described these packages as ‘recycled’.[31] In answers to questions taken on notice at the committee’s public hearing, the department explained that:

In 2024-25, a total of 132,110 HCPs were released. Out of those 132,110 packages, 111,310 HCPs were packages reallocated when an HCP participant exited from the program.[32]

Impact of lengthy wait times

2.32The overwhelming evidence from submitters is that the current waiting times are having severe adverse consequences for older Australians and their families.[33] The following sections outline the evidence received regarding the physical, mental, and emotional toll on older Australians and their families as a result of lengthy waiting times. It also examines the evidence received in relation to the resultant impact on hospitals and health care systems.

2.33The department acknowledged that ‘HCP demand currently outstrips supply’ and that ‘not everyone receives a package as soon as they need it’.[34]

2.34The department explained that HCP wait times are influenced by a range of factors, and have increased due to:

changing demographics including an increasing number of people aged over 65

an increase in assessments and approvals since June 2023

high uptake and low relinquishment of packages, reducing availability

an increase in high-priority approvals.[35]

2.35The department submitted that:

The Support at Home program will address wait times by better targeting support. It will add 300,000 extra packages by 2034-35, including over 80,000 new packages in the first 12 months of the program.[36]

Impact on wellbeing of older Australians

2.36Professor Eagar submitted that ‘there can be no question that delays in receiving necessary care and support at home have adverse consequences both for the older person and for their family carers’. Professor Eagar noted that ‘the international evidence is strong and consistent on this and has been for several decades’. Professor Eagar explained that these adverse consequences include, but are not limited to:

A decline in functional capacity and independence, ultimately accelerating severe frailty and cognitive decline and hastening death.

An increased risk of adverse events such as falls, medication errors and malnutrition.

Increased carer stress and burnout.

An increased risk of hospital presentations and admissions.

An increased risk of admission to residential care.[37]

2.37The Inspector-General of Aged Care noted that in consultations to inform the 2025 Progress Report on the Implementation of Recommendations of the Royal Commission into Aged Care Quality and Safety, the Inspector-General received many accounts of people waiting extended periods – in some cases, 12–15 months to receive care following assessment for an HCP. The Inspector-General noted:

Tragic instances of loved ones dying while waiting were relayed as was consistent messaging around the deterioration of people’s physical and mental health, which saw them needing even higher levels of support than accommodated for under their original assessment.[38]

2.38Dietitians Australia noted that the delay in receiving appropriate nutrition support has ‘profound impacts’ including malnutrition, and weight loss and associated consequences including increased hospital admissions, and a loss of independence and functional capacity.[40]

2.39The City of Greater Geelong also noted that delays in accessing home care services increase the likelihood of the hospitalisation of older people. It submitted that:

Studies show that for every additional day spent waiting for home care, the likelihood of hospital complications rises, placing further strain on families, CHSP services, and the broader health system.[41]

2.40The Inspector-General concluded, ‘given older people can experience significant physical and/or cognitive decline in the space of 10–11 months, it is not hyperbole to say that extended waiting lists can have fatal consequences’.[42]

2.41The department provided the following data outlining the mortality rates over the past six years for those on the National Priority System (NPS):[43]

Source: Department of Health, Disability and Ageing, Documents tabled at public hearing - Canberra 29 August 2025, p. 13.

2.42Mr Yates, the former interim and then acting Inspector-General of Aged Care, in a personal submission stated that:

It is important to note that the current situation frequently constitutes not only delay but actually denial of service [emphasis in original], because people either get ill and die without receiving services, or their health and capacity deteriorates to a degree that exceeds the capacity of an HCP to enable them to remain at home.[44]

2.43The Inspector-General of Aged Care also highlighted that:

People with lived experience repeatedly talked of about being ‘forced’ to enter residential aged care, counter to their preferences, or being hospitalised to meet their care needs, as a result of not having timely access to home care.[45]

2.44This was also confirmed by the Illawarra Retirement Trust (IRT) who told the committee that its data indicates a concerning decline in the average length of stay for HCP recipients in recent years. It explained:

By the time many consumers can access these services, their care needs have increased significantly, resulting in either a premature admission to residential care or a rapid decline in health shortly after entry into the HCP system. Unfortunately, in some cases, people pass away before receiving their package.[46]

Impact on families and carers

2.45Families and informal carers face increasing pressure as a result of extended waiting times. The City of Greater Geelong noted:

These carers, often family members or close friends, provide unpaid support that underpins the sustainability of aged care, yet they frequently do so without adequate recognition, support, or respite options.

Many carers report feeling exhausted, isolated, and undervalued, with some describing the experience as losing their sense of self due to the emotional, physical, and financial toll of constant caregiving.[47]

2.46Mr Yates submitted that the ‘immediate burden of trying to compensate for delayed support and care often falls on immediate family if they are geographically close, and/or a partner’. The consequences of this include ‘stress/burnout and illness for the carer’ and:

…also puts a loving but unqualified person in the key caring role dealing with issues like falls prevention, medication management, and dementia behaviours, instead of this being done by trained carers.[48]

2.47Aged Care Reform Now similarly noted that:

Family carers often find themselves in unfamiliar spaces, having to navigate complex care services with little knowledge of the systems in place. They often have caring requirements at home that risk being squeezed by needing to step up to support an elder family member, leading to the invidious reality of the sandwich generation. The push and pull of these caring responsibilities can create exhaustion, anxiety, depression and burnout.[49]

2.48The Older Women’s Network (OWN) highlighted that many of its members are aged in their 60s and 70s and are the primary carers for their partners who have a range of diagnoses including dementia, Parkinson’s disease or other chronic illnesses. Without timely access to HCP services, these carers are ‘forced to shoulder care alone, often providing complex nursing-level care at home without training and support’.[50]

Physical and psychological impacts on carers

2.49OWN’s submission included evidence from its members who described their experiences caring for their family members. One member:

…described the despair of applying for a higher-level package, only to be told she could wait up to a year [emphasis in original]. “I don’t know how I will last another year. I am already broken,” she said.[51]

2.50Aunty Grace noted that:

…carers experience twice the rate of psychological distress compared with the general population, with elevated risks of anxiety, depression, and chronic fatigue when formal support remains unavailable.[52]

2.51Aunty Grace highlighted the experience of James who cares for his father who is living with dementia who stated, ‘it was beyond a nightmare. It took me to have a breakdown to get the assessment. I called the My Aged Care phone line and cried. I can't cope anymore, I need help now…’[53]

Financial impact on carers

2.52The ‘economic consequences of delayed care access…invisibly extend beyond individual families to impact national productivity and workforce participation’.[54] Aunty Grace submitted:

Australian Bureau of Statistics data from 2023 indicates that one in five primary carers aged 45 to 64 years reduces their working hours or exits the workforce prematurely due to caring responsibilities. Deloitte's 2020 economic analysis estimated the national cost of lost income, superannuation, and productivity from unpaid care exceeds several billion dollars annually. For individuals, this translates to reduced lifetime earnings, diminished superannuation balances, and heightened financial insecurity precisely when families require maximum stability.[55]

2.53Aged Care Reform Now similarly described the ‘cost to families’ as ‘intergenerational’. That is:

Family members must step up to provide care, risking their own financial well-being and financial preparedness for retirement. This has intergenerational consequences.[56]

2.54It further noted that ‘being required to step in to care for older family members as well risks broadening the gendered superannuation gap and leaves these carers financially vulnerable as they age’. Aged Care Reform Now explained:

The reality that the majority of these carers are women means that a partial or complete withdrawal from employment weighs heavily on their capacity to support themselves in retirement. In 2023, the Association of Superannuation Funds in Australia found that, on average, women approach retirement age with a median superannuation balance 25 per cent less than men’s, largely as a result of child-rearing responsibilities.[57]

Impact on hospitals and health systems

2.55‘Without timely access to home care services, older Australians are more likely to experience preventable health events, resulting in hospital admissions and emergency department presentations’. This places strain on health systems already operating under significant pressure.[58] Aunty Grace noted that the Australian Institute of Health and Welfare data for 2023–24 shows that older Australians aged 65 and older accounted for 23 per cent of emergency department presentations (over 2 million presentations), with 52 per cent resulting in hospital admission. It explained:

The main reasons for these presentations include injuries (particularly falls), cardiovascular disease, respiratory illness, degenerative joint disease, and serious infections. When older people cannot access timely home care, these incidents increase significantly.[59]

2.56Aunty Grace explained that ‘insufficient home care access creates a domino effect throughout the health system’. It stated:

More older people present to emergency departments with preventable conditions. Hospitals struggle with increased unplanned admissions. Discharge is delayed when patients have no home support, creating bed blockages. Family carers experience increased stress trying to fill service gaps.[60]

2.57Professor Eagar describes state and territory hospital emergency departments and hospital wards as the ‘safety net under all Commonwealth funded health, aged care and disability services that fail to adequately meet community need’. Further, data is available that demonstrates:

…that public hospital use by older people is increasing at a rate that outstrips the Commonwealth contribution to states and territories via the Health Reform Agreements. No doubt this demand will increase before 1 November as older people wait longer for support at home.[61]

2.58The City of Greater Geelong noted that delays in accessing appropriate aged care accounted for ‘438,779 patient days in hospitals in 2022–23’.[62] Aged Care Reform Now submitted that:

It is estimated that, in Western Australia alone, around 200 beds a day are taken up by people eligible, but unable to access, aged or home care. This is causing huge pressure on the hospital system and has contributed to May 2025 being the worst month for regional ambulance ramping on record.[63]

2.59Older patients are also particularly vulnerable to deteriorating health due to delayed hospital discharge, which often occurs where there is a lack of appropriate home support. The City of Greater Geelong submitted:

Prolonged hospital stays can lead to physical deconditioning, cognitive decline, and increased risk of hospital-acquired infections. The absence of adequate home care arrangements, such as caregivers, equipment, or safe housing, can prevent timely discharge, compounding emotional stress and loss of independence. Poor coordination between hospital and community services further exacerbates delays, while family caregivers may face burnout if expected to manage complex care needs without support. These factors collectively heighten the risk of adverse outcomes for older patients.[64]

2.60Aunty Grace highlighted research which demonstrates that a 70-year-old who spends five days in a hospital bed can lose two kilograms of muscle mass. This is equivalent to three years of natural ageing, and this rapid decline ‘increases fall risk and creates a cycle of deterioration requiring even more intensive care’.[65]

2.61OPAN submitted that ‘the leading reason’ for long-stay older patients in hospitals, is that they are waiting for availability in residential aged care. It submitted:

This is a ‘wicked’ problem that requires both supply side and demand side solutions. Some state governments have implemented effective hospital diversion programs and hospital in the home programs, while other state governments have devised a variety of contentious solutions to attempt to shift the ‘problem’ of long stay older patients onto the Commonwealth government and to older people themselves.[66]

2.62CARAT similarly submitted that:

…data suggest[s] increasing difficulties in accessing residential aged care, which in combination with shortages of supply in care packages and CHSP can be expected to exacerbate the impact on hospitals.[67]

2.63OPAN argued that ‘older people shouldn’t be forced to move prematurely into residential aged care or to remain in hospital due to a lack of viable alternatives’. OPAN submitted:

The combination of lack of aged care supply, health system pressures and systemic ageism is driving them in a single direction. One in three older people enter aged care from hospital.[68]

2.64The committee also heard concerns that older people are occupying hospital beds when they are clinically ready for discharge but that residential care providers are ‘selecting future residents based on their diagnosis, complexity of future needs or capacity to pay’.[69] CARAT submitted:

…there are signs of providers being able to pick and choose ‘more desirable’ residents, and at least anecdotally, of residential respite care being used as a ‘trial’ by providers to determine the suitability of a resident for admission to permanent care. In particular, people experiencing changed behaviours associated with dementia are encountering difficulties in accessing care, inevitably leading to increased reliance on the public hospital system by a population group that is not well suited to acute care settings, increasing the likelihood of Hospital Acquired Complications (Bail et al., 2025) while posing a range of other difficulties for families, staff, and the people themselves.[70]

Government response

2.65The department told the committee that ‘the government is working closely with state and territory partners to improve discharge pathways and develop national guidance for coordinated action’. The department outlined a number of funding initiatives intended to improve the impact on hospitals and health systems. For example:

As part of the Strengthening Medicare package, the government committed $1.2 billion, including:

$598.8 million for states and territories to reduce delayed discharges and prevent avoidable hospital admissions.

$190 million to enhance the Transition Care Program, including a review - that will conclude in June 2026 - to ensure the program meets future needs.[71]

2.66This package also includes $57 million (2024–28) to deliver the Hospital to Aged Care Dementia Support Program. This program ‘helps prevent delayed hospital discharge by supporting dementia-informed hospital care and smooth transitions to residential aged care, or to home, with aged care support’.[72]

2.67The department also noted that the Australian Government provides the Transition Care Program with $373.6 million annually to ‘help older people transition from hospital back to their home or into residential aged care’.[73] Further:

Local solutions are also being supported through the department’s Local Network, recognising the most effective solutions will be place-based, collaborative, and responsive to local health and aged care system conditions.[74]

2.68The department noted that between April and June 2025, ‘hospital assessments for older patients were completed in a median time of 1 day, supporting timely transitions’.[75]

Higher levels of support due to delays

2.69As noted above, in the absence of appropriate home care services or due to lengthy waiting times, ‘many people will be required to move involuntarily and prematurely to residential aged care’ or require higher levels of care.[76]

2.70Aged Care Reform Now describes ‘forcing individuals into residential aged care’ as a ‘violation of their right to choose where and how they age. It noted that ‘living at home enhances independence, comfort and social connection, contributing significantly to well-being and the maintenance of health’.[77]

2.71Aged Care Reform Now also noted that ‘the residential system is considerably more costly than home care’ and:

Forcing people prematurely into residential aged care, rather than allowing them to age well in their homes, will disproportionately increase the costs of aged care to the community.[78]

2.72Similarly where older people have experienced a deterioration in their health due to a lengthy waiting period and therefore require a higher level of at-home support, there are additional costs to care recipients and the community. Aged Care Reform Now submitted:

A lack of assistance to, for example, prepare meals, shower, or attend medical appointments—the services offered through home-care support programs—risks a deterioration in the health status of these individuals. When they do eventually receive packages, even if residential care is avoided, their home-care needs will be greater, placing more demand on the aged-care budget. These costs to the individual and community would be avoided with the provision of timely home packages.[79]

2.73The Inspector-General of Aged Care argued that ‘up-front investment will deliver down-stream savings’. That is, ‘providing older people with timely access to the level of care and support they are independently assessed as needing is cost-effective’. The Inspector-General stated:

Many across the sector argue that keeping people in their homes, for longer, is a cheaper option for taxpayers. Home-based care is said to be significantly cheaper than residential care and clearly much more cost-effective than having people in hospital, especially when their stays are extended. Many contend that the financial impetus to keep people in their homes may not always be clear to the government, with respective costs borne by different levels of government.[80]

Rural and regional communities

2.74Older Australians in rural and regional communities face unique barriers to accessing appropriate home care services. These unique factors both contribute to and exacerbate the negative consequences of extended waiting times.

2.75OPAN noted that older people in rural, regional and remote Australia are more likely to access basic aged care supports through the CHSP and rely more heavily on the support of informal carers such as family and friends. They also experience ‘greater delays in accessing, or simply do not receive, the care they need, with increased risk of hospitalisation and premature entry into residential aged care’.[81]

2.76Whiddon, a not-for-profit aged care provider operating particularly in rural, regional and remote communities in New South Wales and Queensland, submitted that service availability is already limited in rural and remote communities where older Australians face geographic and social isolation. It submitted that ‘delays in care exacerbate these challenges, leaving individuals without essential support and placing additional pressure on families and local health services’.[82]

2.77Whiddon, like OPAN, noted that as a result of delays in accessing home care services, the burden on informal carers, particularly family members, is growing. It stated:

Many carers are providing complex care with little support, and the lack of access to respite services is compounding their stress and fatigue. This is especially pronounced in regional and remote areas, where residential respite beds and day respite programs are severely limited or non-existent. Without adequate respite, carers are at risk of burnout, which can lead to breakdowns in care arrangements and further strain on health and aged care systems.[83]

2.78As noted above, older people unable to access appropriate home care services may also be more likely to require hospitalisation. This presents additional risks for older people in rural and remote regions where hospital infrastructure is limited, and distances to access care can be vast.[84]

2.79The committee heard from Walpole Community Resource Centre (CRC), a locally managed, community-owned organisation providing services in the Walpole district, Western Australia. Walpole CRC told the committee that the Walpole district is geographically isolated, located a significant distance from hospitals and specialist medical services, and there is no access to CHSP services. This is despite Walpole having one of the oldest demographic profiles in Western Australia, with nearly half of residents aged over 60. As such, older people in the region are wholly reliant on HCP services.[85]

2.80Walpole CRC stated that the government’s decision not to release additional HCPs before 1 November 2025 has ‘immediate and dangerous implications for seniors in our community’.[86]

2.81The Darwin Community Legal Service (DCLS) told the committee that in the Northern Territory, older people face limited services and lengthy delays. In Darwin and Palmerston older people report waiting 9–12 months for package allocation, even when assessed at a medium priority and in regional towns such as Katherine and Nhulunbuy the wait is often longer. The DCLS also noted that ‘in some remote communities, people are unable to access providers at all’.

2.82Mr Tom Venning MP provided the committee with evidence in relation to the experiences of elderly constituents in the Electorate of Grey, which includes a number of rural communities. For example, Mr Venning submitted:

Constituent F - Rural Community- Northern Yorke Peninsula

Originally on a Level 2 package, 90 year old F was reassessed for a Level 3 package which he received 10 months later. He has since been reassessed for a Level 4 package and told there will be a 9-12 month wait. With Parkinson's disease and mostly wheelchair bound, he is unable to do very little for himself, including managing his medication. His daughter has had to give up her permanent job as a teacher and move in to look after him.

…

Constituent L- Rural Community- Eyre Peninsula

Constituent L, 74, has advanced cancer and diabetes. She has been assessed for a Level 4 package and needs immediate support but has been struggling to find a provider who can provide any services.[88]

Calls for early or additional release of packages

2.83As noted in Chapter 1, on 3 September 2025, the Minister for Health, Disability and Ageing the Hon Mark Butler MP and the Minister for Aged Care and Seniors the Hon Sam Rae MP announced that the Australian Government would immediately release 20,000 Home Care Packages. Further, the Australian Government committed to releasing 20,000 SAH packages between 1November 2025 and the end of the year, with the remaining (of the previously announced 83,000) packages being released in the first half of 2026.[89]

2.84Prior to this announcement, inquiry participants made a range of recommendations in relation to the early or additional release of funding for home care services. Some called for the immediate release of new HCPs[90], while others called for new SAH packages to be released as close to commencement as possible.[91]

2.85The Inspector-General of Aged Care told the committee that prior to the deferral of the commencement of the Aged Care Act they had expressed concern regarding existing wait lists and the impact such extended periods were having on people’s health and wellbeing. The Inspector-General noted:

The expectation that additional packages would start to be rolled out from 1 July 2025 was a source of comfort and optimism for many in the community. As such the Inspector-General was disappointed that the government did not support calls for an ‘early’, pre-1 November 2025, release of additional home care packages. Meeting community calls for an initial 20,000 packages would have gone some way to alleviating existing, and growing, unmet demand.[92]

2.86The Inspector-General called for ‘more home packages to be released as a matter of priority, preferably ahead of 1 November 2025’. However, in the event that the Australian Government does not agree to do so, the Inspector-General offered support for ‘the release of packages to be ‘front-loaded’. That is, a disproportionately high number of home care support packages should be made available as soon as possible’. The Inspector-General noted:

At present there is no indication of how the government intends to release the promised additional packages. With such a significant backlog of people waiting to have their assessed need for care to be met, a large injection of additional packages is needed as soon as possible.[93]

2.87Bolton Clarke, Australia’s largest independent not-for-profit aged care provider, stated that ‘at this point there seems to be no realistic prospect of a change in government policy leading to the release of additional packages prior to 1 November’.[94] It stated:

The most important action to address unmet demand would be to front-load the release of packages post 1 November to let the system catch up in response to the delay, with the release schedule shared with the sector as soon as possible to support planning.

The full 83,000 packages then need to be released by the end of the financial year, and it is likely that another 80,000 packages will be needed the following year to bring the queue down to less than 30,000 people with wait times of less than three months.[95]

2.88Similarly, UnitingCare Australia stated that ‘delaying the Support at Home Program should not be a barrier to releasing additional Home Care Packages, particularly when the wait list is estimated to be around 90,000 people’. It concluded with a call for the Australian Government to ‘urgently’ release additional packages to ‘reduce the waitlist and deliver care to those who need it’.[96]

2.89Anglicare Australia similarly submitted:

Everyone deserves to age with dignity and older Australians should not be made to wait any longer for the care and support they need. Anglicare Australia continues to call on Government to fund the release of enough Home Care Packages to cover the wait list prior to the commencement of Support at Home. Further, Government must work with the sector to provide detail on release of further packages, including the more than 80,000 new places that will be released in the first twelve months of Support at Home.[97]

2.90The City of Greater Geelong also called for the ‘urgent release’ of HCPs to ‘provide complex clients with support to reduce further deterioration and enable clients to remain living in their homes’.[98] Mr Tim Hicks, General Manager, Policy and Advocacy, Bolton Clarke, told the committee ‘the sooner the better, and the more [packages] the better’.[99]

2.91OWN called for the ‘immediate release of at least 20,000 additional Home Care Packages to reduce the backlog now’.[100] Similarly, OPAN submitted:

OPAN recommends that a minimum of 20,000 home care packages are released immediately, to address the ever-growing waiting list and ensure that older people can commence services prior to Christmas/New Year and summer holidays. Should no new Support at Home places be released until 1 November 2025, a large proportion of these will not be fully operational until February 2026, due to additional delays for older people to find a suitable provider and compatible workers and commence regular service delivery due to the holiday season.[101]

2.92The National Aboriginal and Torres Strait Islander Ageing and Aged Care Council called for releasing additional HCPs ‘as soon as possible’ with a ‘proportion marked for Aboriginal and Torres Strait Islander Elders and Older People’.[102]

Footnotes

[1]Juniper Aged Care, Submission 14, [p. 2].

[2]Inspector-General of Aged Care, Submission 20, p. 2.

[3]OPAN, Submission 28, p. 7.

[4]Council of Elders, Submission 32, p. 1.

[5]Inspector-General of Aged Care, Submission 20, p. 2. See also Flexi Care Inc, Submission 13, [p. 3]; Australian Multicultural Action Network, Submission 1, p. 2.

[6]Flexi Care Inc, Submission 13, [p. 3].

[7]Aunty Grace, Submission 37, p. 6. See also, Juniper Aged Care, Submission 14, [p. 2].

[8]UnitingCare Australia, Submission 27, p. 3.

[9]Ms Patricia Sparrow, Chief Executive Officer, COTA Australia, Proof Committee Hansard, Canberra, 29 August 2025, p. 2.

[10]Mr Ian Yates AM, Submission 101, p. 2.

[11]Mr Ian Yates AM, Submission 101, p. 2.

[12]Mr Ian Yates AM, Submission 101, p. 2.

[13]Mr Ian Yates AM, Submission 101, p. 2.

[14]Mr Ian Yates AM, Submission 101, p. 3.

[15]Centre for Ageing and Research Translation, Submission 40, p. 2.

[16]City of Greater Geelong, Submission 25, p.4.

[17]Mr Ian Yates AM, Submission 101, p. 2.

[18]Mr Ian Yates AM, Submission 101, p. 3.

[19]Mr Ian Yates AM, Submission 101, p. 3.

[20]Department of Health, Disability and Ageing, Additional answers to questions taken on notice – Canberra 29 August 2025 (received 4 September 2025).

[21]Professor Kathy Eagar AM, Submission 22, p. 2.

[22]Professor Kathy Eagar AM, Submission 22, p. 2.

[23]Professor Kathy Eagar AM, Submission 22, pp. 2–3.

[24]OPAN, Submission 28, p. 5.

[25]Bolton Clarke, Submission 35, p. 2.

[26]Anglicare Australia, Submission 36, p. 2.

[27]Bolton Clarke, Submission 35, p. 2.

[28]Department of Health, Disability and Ageing, Submission 31, p. 4. Note, this submission was provided prior to the Australian Government’s announcement of 20,000 new packages being released on 3 September 2025.

[29]Department of Health, Disability and Ageing, Submission 31, p. 4.

[30]Mr Greg Pugh, First Assistant Secretary, Department of Health, Disability and Ageing, Proof Committee Hansard, 29 August 2025, p. 72.

[31]Mr Ian Yates AM, private capacity, Proof Committee Hansard, 29 August 2025, p. 47.

[32]Department of Health, Disability and Ageing, answers to questions taken on notice, 29 August 2025 (received 2 September 2025), [p. 1].

[33]See for example, Melton City Council, Submission 124, [p. 1]; Community Options, Submission 121, p. 4; Professor Kathy Eagar AM, Submission 22, p. 2; Inspector-General of Aged Care, Submission 20, p. 3; Mount Alexander Shire Council, Submission 12, p. 3; City of Greater Geelong, Submission 25, p. 5.

[34]Department of Health, Disability and Ageing, Submission 31, p. 4.

[35]Department of Health, Disability and Ageing, Submission 31, p. 4.

[36]Department of Health, Disability and Ageing, Submission 31, p. 5.

[37]Professor Kathy Eagar AM, Submission 22, p. 2.

[38]Inspector-General of Aged Care, Submission 20, p. 3. See also Mount Alexander Shire Council, Submission 12, p. 3.

[39]Margaret, Proof Committee Hansard, Canberra, 29 August 2025, pp. 28–29.

[40]Dietitians Australia, Submission 47, p. 1.

[41]City of Greater Geelong, Submission 25, p. 5.

[42]Inspector-General of Aged Care, Submission 20, p. 4.

[43]Department of Health, Disability and Ageing, Documents tabled at public hearing – Canberra 29 August 2025, p. 13.

[44]Mr Ian Yates AM, Submission 101, p. 4.

[45]Inspector-General of Aged Care, Submission 20, pp. 3–4.

[46]Illawarra Retirement Trust, Submission 49, [p. 1].

[47]City of Greater Geelong, Submission 25, p. 4.

[48]Mr Ian Yates AM, Submission 101, p. 4.

[49]Aged Care Reform Now, Submission 29, [p. 5].

[50]Older Women’s Network, Submission 26, [p. 2].

[51]Older Women’s Network, Submission 26, [p. 2].

[52]Aunty Grace, Submission 37, p. 4.

[53]Aunty Grace, Submission 37, p. 4.

[54]Aunty Grace, Submission 37, p. 5.

[55]Aunty Grace, Submission 37, p. 5. See also, Aged Care Reform Now, Submission 29, [p. 5].

[56]Aged Care Reform Now, Submission 29, [p. 1].

[57]Aged Care Reform Now, Submission 29, [p. 5].

[58]Whiddon, Submission 23, p. 3. See also Meals on Wheels NSW and Meals on Wheels Victoria, Submission 24, [pp. 1–2].

[59]Aunty Grace, Submission 37, p. 10.

[60]Aunty Grace, Submission 37, p. 10. See also National Seniors Australia, Submission 45, p. 4.

[61]Professor Kathy Eagar AM, Submission 22, p. 4.

[62]City of Greater Geelong, Submission 25, p. 4.

[63]Aged Care Reform Now, Submission 29, [p. 4]. See also Western Australian Government, Submission 141, [p. 1].

[64]City of Greater Geelong, Submission 25, p. 5. See also Older Women’s Network, Submission 26, [pp. 4–5].

[65]Aunty Grace, Submission 37, p. 10.

[66]OPAN, Submission 28, p. 15.

[67]Centre for Ageing and Research Translation, Submission 40, p. 4.

[68]OPAN, Submission 28, pp. 14–15.

[69]Council of Elders, Submission 32, p. 2.

[70]Centre for Ageing and Research Translation, Submission 40, p. 4.

[71]Department of Health, Disability and Ageing, Submission 31, p. 7.

[72]Department of Health, Disability and Ageing, Submission 31, p. 7.

[73]Department of Health, Disability and Ageing, Submission 31, p. 7.

[74]Department of Health, Disability and Ageing, Submission 31, p. 6.

[75]Department of Health, Disability and Ageing, Submission 31, p. 7.

[76]Aged Care Reform Now, Submission 29, [p. 4].

[77]Aged Care Reform Now, Submission 29, [p. 4].

[78]Aged Care Reform Now, Submission 29, [p. 4].

[79]Aged Care Reform Now, Submission 29, [p. 4].

[80]Inspector-General of Aged Care, Submission 20, pp. 5–6.

[81]UnitingCare Australia, Submission 28, p. 6.

[82]Whiddon, Submission 22, pp. 1–2.

[83]Whiddon, Submission 22, pp. 1–2.

[84]Whiddon, Submission 22, p. 4.

[85]Walpole Community Resource Centre, Submission 38, [p. 1].

[86]Walpole Community Resource Centre, Submission 38, [p. 1].

[87]Darwin Community Legal Service, Submission 122, p. 2.

[88]Mr Tom Venning MP, Submission 120, [pp. 1–2].

[89]The Hon Mark Butler MP and the Hon Sam Rae MP, Press conference with Minister Butler and Minister Rae, Canberra – 3 September 2025 | Health, Disability and Ageing Ministers | Australian Government Department of Health, Disability and Ageing, 3 September 2025, (accessed 4 September 2025).

[90]See for example Ageing Australia, Submission 30, p. 1; Mr Hayden Shaw, Submission 119, [p. 3].

[91]See for example Inspector-General of Aged Care, Submission 20, p. 5.

[92]Inspector-General of Aged Care, Submission 20, p. 2.

[93]Inspector-General of Aged Care, Submission 20, p. 5.

[94]Bolton Clarke, Submission 35, p. 4.

[95]Bolton Clarke, Submission 35, p. 1.

[96]UnitingCare Australia, Submission 27, pp. 3–4.

[97]Anglicare Australia, Submission 36, p. 5.

[98]City of Greater Geelong, Submission 25, p. 5.

[99]Mr Tim Hicks, General Manager, Policy and Advocacy, Bolton Clarke, Proof Committee Hansard, Canberra 29 August 2025, p. 12.

[100]Older Women’s Network, Submission 26, [p. 6].

[101]OPAN, Submission 28, p. 6.

[102]National Aboriginal and Torres Strait Islander Ageing and Aged Care Council, Submission 43, p. 4.