The queue has become the system: Australia’s home care crisis laid bare

Older Australians now have to queue to join the queue for care.
The system built to help people stay at home is keeping them waiting instead.

It’s the new irony in aged care.

Before older Australians can even get on the waiting list for home care, they must now wait just to be assessed for eligibility.

This week’s ABC investigation laid bare a reality that many in the sector have quietly known for months: the system designed to help people stay independent at home is buckling under its own weight.

Assessment backlogs have blown out so far that some older people are now waiting up to nine months just to be told what level of support they might receive. By that time, many will have already declined, been hospitalised, or given up.

For a reform agenda that promised “simpler, faster, and fairer” access to care, this is the very definition of regression.

A queue for the queue

At the heart of the issue is the national assessment process, the gateway into all government-funded aged care.

The ABC reports that more than 116,000 Australians are currently waiting for an assessment, and 121,000 more are waiting for a Home Care Package once approved. In other words, before an older person can even join the queue for care, they must first join the queue to join the queue.

In some areas, the wait can stretch to almost a year. The consequences are devastating but predictable: increased hospital admissions, family exhaustion, and preventable deterioration.

The problem is not just a backlog; it is a breakdown. As one former assessor told the ABC, the process has become so transactional that people who miss a phone call risk being dropped from the list altogether.

A failure of system design, not bad luck

It would be easy to blame the pandemic, workforce shortages, or an ageing population. But this crisis did not emerge overnight. It is the result of policy architecture that has not kept pace with demand or accountability.

Outsourced assessment contracts, shifting eligibility rules, and fragmented local delivery models have created a bottleneck of bureaucratic complexity. The $1.2 billion invested in assessment reforms over the past decade has produced an outcome no one intended: a slower, more confusing system than before.

Executives and boards across the sector should see this for what it is: not a temporary traffic jam, but a structural failure of design and delivery.

The human cost behind the numbers

It is tempting to view assessment delays as data points in a government dashboard. But for families on the ground, they represent months of limbo.

Older people recovering from hospital stays or managing new disabilities are left without equipment, without care workers, and often without hope.

Providers meanwhile face unpredictable referrals, disrupted workforce planning, and financial strain as pipeline certainty collapses.

Every delay ripples outward, from emergency departments to residential facilities, from exhausted carers to providers trying to do the right thing. This is not inefficiency; it is harm, measured in real human time.

Leadership must break the cycle

If we have learned anything from the Royal Commission, it is that no amount of new legislation can rescue a system that fails at execution. The Support at Home reforms coming in 2026 will only succeed if the infrastructure beneath them can actually deliver timely access.

Leaders across the sector must demand transparency on assessment performance, push for co-designed triage models, and challenge the idea that “more funding” alone is the fix.

Accountability, data visibility and workforce redesign, not another taskforce, are what is needed now.

Because right now, the message to older Australians is painfully clear: you will get help, eventually. Just wait your turn to wait.

The front door to failure

In the private sector, no executive would tolerate a nine-month onboarding delay for a paying customer. Yet in aged care, we have normalised it as process.

That is the truth facing Australia’s aged care leadership today: the queue has become the system.

Until we rebuild the front door of assessment, access and equity, every promise of “care at home” remains just that: a promise.