Australia’s aged care reforms were sold as a long-overdue reset: safer, fairer and centred on dignity and choice. But beneath the policy slogans lies an uncomfortable reality. For many older Australians, particularly those ageing at home, the reforms are already undermining access to something far more basic than choice or flexibility: adequate food and nutrition.
The shift towards keeping people in their homes for longer is not inherently flawed. Most older Australians want to remain independent for as long as possible. The problem is that the system designed to support this ambition has been restructured without the funding, planning or capacity to sustain it. Nowhere is this failure more visible than in community meal services.
For decades, programs like Meals on Wheels have quietly filled a gap that policy rarely acknowledges. They do not just deliver food. They prevent malnutrition, reduce hospital admissions, support medication adherence and provide vital social contact for people who might otherwise go unseen. Yet these services operate under funding models that have barely changed despite dramatic population ageing.
Under the Commonwealth Home Support Program, demand has steadily outpaced supply. Allocations are capped, demographic growth is ignored and providers are expected to absorb shortfalls as community need rises. In many areas, that quiet strain has now tipped into crisis. Meal services that once prided themselves on universal access are being forced to ration support, introduce waiting lists or turn people away entirely.
This is not a marginal issue. Hundreds of thousands of older Australians rely on entry-level home support each year. As aged care reforms funnel even more people into the home-based system, pressure on food services will intensify sharply. Without increased capacity, the result is predictable: older people missing meals, relying on poor-quality alternatives or skipping food altogether.
The consequences are serious. Malnutrition among older Australians is already widespread, particularly for those living alone, managing chronic illness or experiencing cognitive decline. Poor nutrition accelerates frailty, increases falls risk and drives avoidable hospital admissions, placing additional strain on the health system. What appears as a “meal service issue” quickly becomes a hospital bed issue, a residential care issue and a budget blowout.
Regional and smaller providers are especially exposed. Unlike large organisations, they lack reserves to subsidise unmet demand. When funding does not match reality, they face impossible choices: run at a loss, reduce service quality or deny access to people who need help. None of these outcomes align with the stated goals of aged care reform.
The rhetoric of consumer choice rings hollow when there is no meal to choose from. A system cannot claim to promote independence while quietly eroding the supports that make independence possible. Food is not an optional extra. It is foundational care.
What makes the situation worse is the absence of transparency. Providers remain uncertain about how existing programs will transition into new frameworks, how funding will be indexed to population growth, or whether nutrition will be treated as a core outcome rather than a line item to be squeezed. Uncertainty paralyses planning, discourages workforce investment and ultimately harms older people.
Your paragraph ‘For decades, programs like Meals on Wheels have quietly filled a gap that policy rarely acknowledges. They do not just deliver food. They prevent malnutrition, reduce hospital admissions, support medication adherence and provide vital social contact for people who might otherwise go unseen. Yet these services operate under funding models that have barely changed despite dramatic population ageing.’ is so accurate.
Our city council (Shepparton) abandoned over 100 Meals On Wheels clients in 2023, with the explanation that there wasn’t enough funding from the Commonwealth government.
One would have thought that aged care in the community would be a priority, but sadly, it isn’t, as we’ve all seen from the debacle that has ensued with the home support scheme.
I don’t know how many MOW services are still operating around the state, since Shepparton was abandoned.
Greater Shepparton City Council believed it was enough for a provider to be the coordinator of Lite ‘n Easy meals, delivered fortnightly to your door (whether you’re home or not – good luck with porch pirates), in styrene boxes.
Some people don’t have freezer capacity for so many meals at once.
Some people don’t have the ability to heat the meals without help.
Most people miss the welfare check when the hot meal arrives each day.
Everyone misses the smiling faces of the volunteers who deliver the meals each day.
Once more, or should I say, still, the ageing population is being patronised or ignored and dying waiting for the promised help.
Who is going to fix this problem?
I think the problem lies in the function of using Volunteers to distribute meals.
The demographic of the population who used to volunteer, came from a place where a single income was enough for a household and those people just cannot anymore. This is due to a variety of reasons, some of those being that they are involved with their own work as people are working longer, or caring for grandchildren due to the cost of living putting pressures on working parents, caring for a partner, or even themselves now requiring the MOW service.
Most working people these days, are unable to add additional volunteer hours as they have no more hours left to add after you consider paid work, child raising, or other commitments, or distance/time to commute. Some young people don’t even have their own vehicle to make the deliveries.
I think it is unfair to expect this service to continue to be run by Volunteers, however it is disappointing for all of the reasons you have mentioned, that vulnerable people miss that personal and connected touch by being shoved onto the Lite and Easy option.
I feel Councils need to be adequately funded to support MOW and perhaps it needs to become a paid service with adequate renumeration to retain workers. Perhaps Government needs to consider adding this in as part of a Support at Home service?
I forgot to say, in my comment earlier, well done Jakob Neeland for keeping Meals on Wheels topical.
Thank you.
Good article Jakob and all you say is true. MoW services across NSW and indeed in parts of Australia are finding they need to waitlist clients to manage.
And, as people move from CHSP to the planned introduction of Support at Home (800K+ extra people) the system will further remove much needed nutrition services.