For months, providers across the sector have been told to stay calm, keep adapting and trust that the wrinkles in Support at Home would eventually be ironed out. That line has not aged well.
What is unfolding is no longer a minor implementation wobble, nor the usual turbulence that comes with a major reform package. It is a policy mess on a national scale, and older Australians are paying for it in delayed care, reduced support, growing confusion and a level of distress that should have pushed this issue onto the national agenda long ago.
Providers are seeing the fallout every day in angry phone calls, anxious families, exhausted staff and consumers receiving far less than they were led to expect. None of this has come out of nowhere.
Back in late 2024, when many of our leaders were busy applauding the reform package, some of us were looking at the less glamorous part, the fine print. Strip away the rhetoric and the warning signs were already there. The package looked underfunded, overly complex and dangerously difficult to implement. What was flagged then is now playing out in plain view.
The difference now is that this has moved well beyond provider frustration. More than 100 parliamentarians from across the political spectrum have raised the alarm, and the media is finally starting to catch up to what providers, consumers and families have been living with for months. That matters, not because political attention is a solution in itself, but because it makes this much harder to dismiss as isolated grumbling from a sector reluctant to adapt.
We have also written to the minister on two previous occasions and received the standard response that the sector has somehow misunderstood the reform and that everything is, apparently, fine.
And the numbers alone should have settled the matter by now. Around 350,000 older Australians are either waiting to be assessed or waiting for the level of home care they have already been found to need. Many of those who eventually receive support are getting only a fraction of what they actually require.
If thousands of older Australians dying while waiting for approved care does not qualify as a public emergency, then the bar for public failure is set absurdly low. So how did it get this far off track?
Funding was never enough
Part of the answer is funding and part of it is execution. And part of it is the familiar habit of governments announcing reform with confidence long before the operational machinery is ready to carry the weight.
The sector was always willing to have a serious conversation about increasing consumer contributions. The real issue was that even with higher participant contributions, the program was not funded at anything like the level needed to meet demand. Providers can see it in service delivery and consumers can feel it in the support they are not receiving. Families are now living with the consequences in real time.
The implementation itself has only made things worse. Delays, patchwork announcements, late guidance, shifting rules and policy reversals have left providers redesigning systems, explaining changes to worried clients and trying to remain financially viable while the policy ground keeps moving underneath them. That would be difficult even in a well funded system and this is not a well funded system.
Providers are wearing the anger
The earlier warning about cuts to care management and administration funding now looks especially important. At the time, concern was raised that slashing the dollars needed to coordinate care and keep services running would leave providers carrying a serious shortfall. That was not alarmism, it was arithmetic.
Reduce the funding that supports coordination, compliance and continuity and it should surprise nobody when prices rise, service hours tighten and delivery becomes harder.
Then there is the promise that nobody would be worse off. It was always a neat political line. It now sounds increasingly detached from the reality providers and consumers are actually dealing with. In the real world, no worse off means very little if someone ends up with fewer hours of support, more confusion and a much longer wait.
Providers, as usual, are left to absorb the frustration. They are blamed for price increases after funding support is cut. They are blamed for reduced service hours in a system that does not come close to funding real demand. They are blamed for poor communication while trying to explain a government designed scheme that too often appears to have been announced before it was properly thought through.
That is the part policymakers still seem not to fully grasp. It is the coordinator trying to explain a budget to a distressed family. It is the frontline worker standing in someone’s kitchen, forced to defend decisions they had no part in making.
What needs to happen now
The assessment process has only deepened the damage. Automated or algorithm driven processes producing funding outcomes below actual need should concern everyone. Providers do not need a technical briefing to know something is wrong. They can already see the mismatch between assessed needs and funded supports and consumers can see it too.
What is needed now is not another burst of tidy language, another promise or another round of political reassurance. What is needed is correction.
That means more packages, released much faster. It means restoring care management and administration funding to levels that reflect the real cost of delivering safe, compliant and responsive support. It means recognising complexity, rural delivery pressures and failed markets instead of pretending a neat universal formula will somehow cover them. It means reinvesting unspent funds into additional packages. And it means admitting, plainly, that if Support at Home is not properly funded, many older Australians will be held in hospitals and pushed earlier into residential care.
Most of the sector saw this coming. Now more than 100 parliamentarians can see it too, and the media is finally starting to catch up. At this point, nobody gets to pretend the problem is hidden.
It is not the careful modernisation of home care that was promised.
It is a national disgrace.
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