In a decision that has sparked alarm among advocates and providers, Prime Minister Anthony Albanese’s post-election cabinet reshuffle has demoted aged care from a cabinet-level portfolio to an out-of-ministry role, just seven weeks before transformative reforms are set to reshape the sector.
Victorian MP Sam Rae’s appointment as Minister for Aged Care and Seniors, operating under the renamed Minister for Health and Ageing, Mark Butler, signals a troubling deprioritisation of a sector at a critical crossroads.
With the new Aged Care Act and the deeply flawed Support at Home program due to commence on 1 July 2025, this downgrade risks plunging Australia’s 4.2 million seniors into a crisis of neglect, financial hardship, and systemic failure.
A Sector Sidelined at a Pivotal Moment
The demotion of aged care from cabinet comes when the sector desperately needs strong leadership. The Aged Care Bill, passed on 25 November 2024, promises a rights-based framework, replacing outdated legislation with a focus on person-centred care.
Yet, its cornerstone initiative, Support at Home, is a “ticking time bomb,” according to industry experts, threatening to undermine the independence it claims to champion.
Anika Wells, the former Minister for Aged Care, has been reassigned to Communications and Sport, leaving a void in cabinet-level advocacy. While Albanese insists aged care remains integral to health, stakeholders like the Older Persons Advocacy Network (OPAN) are dismayed.
“It is disappointing to see that aged care is no longer the responsibility of a cabinet minister,” said OPAN’s CEO, Craig Gear, urging the government not to deprioritise reforms critical to older Australians’ rights.
Tom Symondson, CEO of Ageing Australia, warns, “We’re running out of runway for the July 1 deadline, yet aged care providers still don’t have all the necessary information to prepare.”
Without a dedicated cabinet minister, the sector lacks the high-level influence needed to address these gaps, leaving providers and seniors in limbo.
Support at Home: A Flawed Reform Package
The Support at Home program, replacing Home Care Packages and Short-Term Restorative Care, aims to help 1.4 million Australians live independently by 2035. Yet, its design is a bureaucratic nightmare, poised to burden pensioners and self-funded retirees with crippling costs.
From 1 July, the program introduces eight funding levels, ranging from $11,000 to $78,000 annually, with means-tested co-contributions for “Independence” services (e.g., personal care, up to 50%) and “Everyday Living” services (e.g., cleaning, up to 80%).
Clinical care remains government-funded, but the high costs of essential services like showering ($100 per hour at 50% contribution) or shopping ($95 per hour at 80%) could force seniors to forgo care.
Adrian Morgan, General Manager of Flexi Care Inc., is scathing: “Parts of the design will have the exact opposite effect” of enabling independent living. He cites cases where seniors, priced out of personal care, risk infections, falls, or social isolation.
A harrowing example involves an elderly woman whose carer was hospitalised; under Support at Home’s rigid reassessment process, she could face months without support, risking malnutrition or worse.
Professor Kathy Eagar, an expert in aged care financing, calls the funding model “deceitful,” noting that the $78,000 top package includes consumer contributions, potentially costing individuals $30,000 annually.
She predicts a rise in unregulated “black market” care as desperate seniors seek affordable alternatives, compromising safety.
Financial hardship for the vulnerable
The financial burden is particularly acute for pensioners, surviving on less than $30,000 a year, and self-funded retirees near the poverty line. Morgan warns that high users of personal care “stand to lose the most,” facing thousands in annual costs for basic hygiene.
Accompanied shopping, vital for social connection, becomes a luxury at $76 per hour after contributions.
Public reaction reflects the distress. One commenter lamented, “I self-manage my 92-year-old husband’s Level 2 package… it appears that under the SAH scheme [costs] will be prohibitive.”
Another warned, “People will be injured—or even die—attempting tasks they can no longer safely perform.”
The program’s inflexibility exacerbates the crisis. Reassessments for new services can take six months to a year, leaving seniors vulnerable during sudden changes in need.
A 10% cap on unspent funds and a 10% limit on care management starve providers of resources to adapt care plans, risking neglect for those with complex needs.
Palliative care funding, cruelly capped at four months, could abandon families at their most vulnerable.
Morgan calls this “heartless,” advocating for ongoing support to honour seniors’ dignity in their final days.
A government ignoring warnings
The government’s refusal to heed these warnings is infuriating. Morgan notes, “I can’t see evidence they’re listening,” a sentiment echoed by providers like Nick McDonald and public commenters decrying the lack of clear communication.
The 2023 Aged Care Taskforce, led by Anika Wells, relied on a $396,000 survey claiming public support for co-contributions, yet only 9% of respondents understood the changes.
The “no-worse-off” principle, touted by Minister Mark Butler, rings hollow. When pressed on ABC Adelaide about pensioners facing $100 weekly costs, Butler dodged, admitting the system’s complexity.
With aged care now outside cabinet, the sector lacks a powerful voice to challenge such evasions or push for urgent fixes.
A Preventable Catastrophe
The demotion of aged care from cabinet, coupled with the flawed Support at Home program, sets the stage for a preventable catastrophe. Eagar disputes the government’s $18.8 billion savings projection, warning that increased hospitalisations and residential care, far costlier than home support, will erase any fiscal gains.
Public hospitals, already strained with 20% of beds occupied by those awaiting care, brace for a surge.
Morgan’s proposals reclassifying personal care as clinical, capping contributions at 30% and 50%, pre-approving common services, and delaying implementation to 2026, offer a lifeline. Yet, without cabinet-level advocacy, these solutions risk being ignored.
As Anglicare Australia’s Kasy Chambers notes, ageing with dignity extends beyond care to housing, income, and mental health. The government’s reshuffle, sidelining aged care, undermines this holistic vision, leaving seniors to bear the brunt of a system that prioritises cost-cutting over compassion.
With only seven weeks until the reforms take effect, the Albanese government must act swiftly. Delaying Support at Home, engaging providers and consumers, and restoring aged care’s cabinet status are critical to averting a crisis that will betray Australia’s seniors. The clock is ticking, and the silence from Canberra is deafening.
Will the Department of Health and Aged Care be restructured to accommodate the change in Ministers appointments