Accelerating acquisitions and fearful futures – documentary looks back to question where aged care is headed

The delicacy of aged care goes beyond a fine line. Vulnerable but vivacious seniors, business models, government policy, front-line staff and loved ones makes a heady mix of need, influence, impact and ethics. Careless, an Australian documentary tackles this head on, hearing the stories of these seniors with no holds barred. Hearing from complicated and courageous seniors is an invaluable opportunity to conduct a temperature check on the sector. Far from a pile-on of the industry, the trailer runs head-first into the tension so many sincere and highly-performing providers have wrestled with, “there’s gotta be some good aged care providers out there, and there are”. The look into past government decisions to lean into “industry, industry, industry” questions the course that’s been set and challenges that a course correct can and must happen.

Family first

Central to filmmaker Sue Thomson’s documentary is her mother Margaret. She is observed to be a humorous straight-talker, when being mic’d up she incredulously asks, “why do you need to listen to me?” It is as the documentary unfolds, the answer to that, for provider leadership, loved ones, future seniors and the nation at large, becomes unavoidably evident. To steer the aged care sector-ship, those at its heart have searing insight into the current failures and hopes of the system.

Margaret’s resistance to entering into aged care is an important exploration mechanism, a spirited, outrageous, go-getter former nurse who says what so many seniors experience without having a voice. Noting the resistance markers for every-day Australians is an opportunity that leadership and government can use to leverage change.

Pin-pointing change is made human with the cast of eccentric and crack-up cast of senior Aussies, when faced with the heart-wrenching change of leaving their cherished homes, they can no longer be a number on a waitlist, this is irrefutably happening; A reminder that proximity to the lead up to entering RAC is a tender and layered time that must be a part of the aged care story, and policy debate.

Home is where the heart is

Affirmed by Margaret, is what seniors have been saying since the dawn of time, they want to age at home. With Support at Home wobbling at best, a shambles at worst, providers and advocates both have now raised the call for in-home care reform to ‘trumpet’ levels.

And yet even billions have been poured into in-home schemes, advocates and experts are increasingly calling on the government for transparency on where the money is going. Many of those in provider leadership and loved ones question the impact of the billions, that while abundantly increasing, why do waitlists continue to stagnate, and approved packages come out the door at 60% interim funding?

The documentary further explores the loss of intergenerational living. With single family homes prioritised from centuries back, the runaway cart of house prices (another Australian crisis) has not only missed its moment to be entrenched in the psyche of society but in the ability to be made reality.

In other parts of the world, homes have long been set up to accommodate as many generations as possible. Advocates, particularly who’ve come to Australia from these other parts have been making in-roads into highlighting that meeting the needs of aged care in the future may require a full re-evaluation of how we do life as families, as society, and how government policy can support intergenerational living.  

ACCC

A core message in the documentary is squarely examining the move of former governments to move aged care into the business model. Examining John Howard’s successive policies that underpinned the shift to privatisation, most subsequent governments are argued to have done little to safeguard the ‘true’ business of caring for Australia’s elderly.

In speaking to the ABC, Director Thompson says, “In 1997, the government very clearly saw it as a way of making lots of money, without thinking clearly about the long-term effects of monetising aging”.

Frustration is evident, “[Government] they all talk a lot, we had a royal commission, and very little has changed.”

In what can be seen as a timely update alongside the release of the documentary is the announcement from the ACCC. Come 1 July 2026, acquisitions laws, they are a-changin’. The tolerance for the velocity of market change the sector has been undergoing may not be sitting well with Canberra.

The ACCC announced, “under the new regime, businesses contemplating acquisitions which meet certain thresholds must notify the ACCC and wait for approval before their proposed acquisition can proceed. The ACCC will be the first decision maker on each notified acquisition.”

“The new merger control regime will be a major change for the ACCC, business and consumers.”

The polarising reactions highlight a fault-line in the industry, with business-centric voices denouncing the move, and yet others saying it doesn’t go far enough.

The new law shows a definitive move to safeguard at least an attempt at competition. And in the face of robust mergers and acquisitions, some are wondering if this move will be enough to calm the trend.

Lack of competition

There is a growing concern, backed by local and internal economists, that Australia’s lack of competition in the provider pool, and the seemingly ever shrinking pool, is set to assuredly deliver negative trends, most profoundly prices invariably going up; A headache to seniors, loved ones and notably, the government.

Economists have repeatedly urged government to entrench in policy protections to resist monopoly and encourage entrants into the aged care space. The latest move of the ACCC has many wondering if the calls have finally been heeded.

As the sustained headache of the Colworths duopoly has seen government attempt to tango with price fixing and supplier treatment, some analysts hedge that the government is showing signs of attempting to try and get ahead of the problem in aged care.

The ACCC notes, “some acquisitions can substantially lessen competition by reducing the number of competitors and changing the way the remaining competitors behave.”

“When competition is reduced, consumers can face:

·   higher prices

·   reduced product or service quality

·   less choice and innovation.”

Awareness is seemingly present. 

With countless seniors and loved ones reaching out to Hello Leaders about the already sizable jump in in-home costs in the interim ‘free market’ for services, the government may be taking another look at unimpeded capitalism.  

At the heart is already a crowd, seniors hoping for RACs that can be homes, with adult children hoping to entrust care to professionals to prevent their own burnout, front-line staff, worried about being lost in the system. Advocates are adamant, human voices are calling out and deserve to be heard alongside the march for GDP growth and the latest vision of the productivity commission.

Great providers tainted by the not

Even more so, providers of heart, conviction and perseverance need to be acknowledged. Working on shoe-string budgets to support countless seniors on supplement daily rates, and with the government’s supplement vs RAD rate pricing structure meaning no gradation between dipping below the 40% supplement funding and a race to zero, frustration is growing.

Provider leadership has warned that current policy undercuts encouraging all providers to share the load of those with less means.

In the documentary’s trailer, the tension of providers who are pouring themselves into making homes for seniors, and being painted by the same brush as poor performers is acknowledged.

“There’s gotta be some good aged care providers out there, and there are.”

“And isn’t it a shame they get a bad name based on the others”.

Navigating my aged care

Director Thompson also sheds light on the confusing complexity of the current digital supports to navigating aged care. The inspector-general too handed down her searing findings last month.

Thompson, in talking to the ABC, shares that her parents were smart, academic and involved in medical care. She initially thought they’d be fine navigating My Aged Care, they weren’t.

“They’ll say, ‘my computer’s really bad, it’s not working’. But they’re not using it properly. Or they’ve got arthritis in their fingers.”

From countless sources, Hello Leaders has heard the “maze-like” condition, as the Inspector-General called it, has heads spinning, wondering if a PHD is required to get basic answers. This from seniors and aged care leaders alike.

For the tech savvy, the labyrinthine challenge of My Aged Care can best the most astute, and when it comes to phoning, the line seems to invariably drop-out. Both providers and loved ones have bemoaned the sheer difficulty for what is posed as the focused point of entry for aged care navigation.

Thompson calls a spade a spade, “it’s brutal”.

Sustainable future

As AI starts to rapidly concern younger generations entering the workforce, with predictions of significant job loss, the government must strategically seek to entrench sustainable practices into aged care.

The sector must work for those currently needing its services, and those who will need it in fifty years. As current working generations are priced out of the market, the concern about seniors of low means entering aged care will only continue.

Significant overhaul of tax revenue has also been a call for many advocates and economists who see writing on the wall. These experts frame the lack of appropriate taxation of gargantuan multinationals as set to steamroll into budgets in the coming decades.

Quality homes and paying for them

Thompson shares with the ABC that, “governments should take more control, paying for wonderful, beautiful, diverse, inclusive communities where people can age in place, supported.” And so with that must come a plan to sustainably pay for it. And potentially safeguarding, or even supporting, competition in aged care may have a part to play in keeping costs down for all. 

Thompson notes, “tt was really important that this film was angry at the system, but I wanted to show that they’re not just maudlin, bemoaning their lives.”

“They’re out there doing great things, trying to make the best of it, and often they’re hilarious.”

For both providers who seek to champion the pursuit of excellence in person-centred care, in the routine without fanfare, and the seniors and advocates who are seeking change, guiding government reform remains critical. Through submissions to parliament, through supporting artistic examinations of the system, the opportunities are there. 

And for government, it is incumbent of the best and brightest in reform decision roles to take note and pivot in humility, strategy, sustainability.