Eight months after the Support at Home program and the new Aged Care Act came into effect on 1 November 2025, a stark verdict has emerged from those on the front line of delivering care.
At the Ageing Australia Queensland Conference, an anonymous poll of about 150 aged care managers and professionals revealed that 94 per cent believed the new system had made outcomes worse for older people compared with the Home Care Packages program it replaced. Of those, 57 per cent described it as “much worse”. Only 4 per cent saw it as a positive change.
Adrian Morgan, General Manager of home care provider Flexi Care Inc., who led an expert panel at the conference, described the results as confronting.
“This was not a scientific study, nor was it intended to be,” he posted on LinkedIn. “But it was a snapshot of the views of people who deal with the realities of delivering care to people in their homes on a daily basis. They had no incentive to do anything other than tell it like they honestly saw it.”
In a subsequent interview, Morgan said he was not entirely surprised by the strength of the response.
“I’m personally not surprised that people are finding the program is not delivering what it was promised,” he explained.
He pointed to a long list of fundamental problems that providers and older Australians had raised for months before implementation.
One major issue is the sheer complexity of Support at Home, which burdens both older people and providers. Many can no longer afford the services they previously received, largely because the package management fee was banned, pushing hourly rates higher. Some consumers now pay up to 80 per cent of the total cost of certain services from their own pocket.
Services once available under Home Care Packages have also disappeared or become inaccessible. Morgan gave the example of cottage respite, non-institutional overnight respite to support carers.
“You are not allowed to spend Support at Home money on cottage respite,” he said, noting the distress this has caused for some families.
Commonwealth Home Support Programme (CHSP) options remain severely underfunded and have not kept pace with the growing older population.
Another significant grievance is the government’s practice of initially funding only about 60 per cent of assessed needs for many new Support at Home packages.
“It’s never been properly explained,” Morgan said.
While some move to full funding within weeks, others wait up to five months.
“They’d be on 60 per cent of what they need for five months until their full funding came in.”
Waiting lists for assessments and funding allocation have also worsened, adding to the sense that the system is failing.
These problems were not unexpected. Providers, experts and advocates flagged major design flaws for months leading up to 1 November 2025. The government appeared not to listen. Critics argue this was intentional, driven by cost-cutting priorities over practical outcomes.
A particularly harsh focus of criticism has been the Integrated Assessment Tool (IAT), which relies heavily on an algorithm to determine funding levels. Despite months of warnings and pressure during Senate estimates, the government initially denied serious issues with the lack of meaningful human override. Assessors reportedly resigned rather than endorse outputs they believed were wrong.
Only after sustained public and political pressure has the government begun to discuss changes, such as escalation pathways for complex cases. Many in the sector view these as belated, limited concessions rather than genuine fixes.
The government has made some adjustments since launch, including the reclassification of personal care services, such as showering, to remove consumer contributions from October 2026. While welcome, these changes address problems that should never have existed in the original design.
Morgan described many of the changes as minor tweaks that leave core issues unresolved.
“At the heart of it, it’s still very problematic,” he said.
The reforms were promoted as “once in a generation changes for the better”. Eight months on, Morgan is clear on whether or not things have improved.
“Definitely not,” he said emphatically.
He noted that the overwhelming feedback from professionals, and likely an even higher percentage from consumers, shows the system has gone backwards.
The 94 per cent verdict from experienced aged care professionals at the Queensland conference is difficult to dismiss. It reflects daily realities: higher costs forcing reduced services, lost flexibility for changing needs, administrative complexity, and an assessment system that many believe prioritises consistency and savings over individual circumstances.
Older Australians and their families, along with providers, continue to press for the original promise to be met. Warnings ignored before implementation have now become lived experience. As the population ages, the risks of further hospitalisations, premature residential care admissions, and preventable decline grow.
The question remains: have the government’s aged care reforms made things better or worse?
For the vast majority of those closest to the work, the answer is clear and deeply concerning. Meaningful structural change, rather than incremental tweaks, is urgently needed to restore dignity and effectiveness to home care support.
I have worked in residential aged care for many years in a senior role, and I have witnessed many changes over the years, particularly in the past five. We have experienced two rounds of changes to the aged care standards because the government did not get it right the first time, with no compensation for the providers. Implementing a new set of standards is a significant financial burden for us.
Additionally, we have seen the introduction of the new Aged Care Act. Currently, there is substantial funding allocated to the 5-star rating system, which is not fit for purpose, alongside considerable money spent on surveillance. There is a profound lack of trust in providers from the commission; we often face abuse from difficult family members, and the commission seems indifferent, frequently siding with them. The resources available on the commission’s website is their only assistance. You can’t even get a person on the phone for assistance.
Moreover, no additional funding is directed towards the care that truly makes a difference. We continue to do this work because we are passionate about aged care, but I have lost faith in the system.
Things are more harder for the customers and the providers. Weren’t the changes based on what the older people were calling for?
I find, when this fed gov is not interested in charging the mining industry royalties & proper taxes (like norway). Due to personal interest in this industry. This economy, of which we are very much part off. Will never be able to properly work. Especially when we are 1 trillion $$$ in debt. While norway has saved 3 trillion $$$$$. & in the meantime has a very healthy economy moving forwards. Norway charges approx 76% royalties & their minerals are still selling. Get the base right, & everything falls into place.