An older Australian can be clinically ready to leave hospital but spend months, even years, waiting for aged care. Instead of receiving residential aged care, they remain in an acute hospital ward, where prolonged stays can increase the risk of functional and cognitive decline.
In Queensland, more than 1,100 older people are waiting in hospital for residential aged care. Across all long-stay patient groups, 15 have waited more than 700 days for discharge.
Whiddon CEO Chris Mamarelis says hospital staff are not the problem.
“The issue is not the people. It is the setting,” he explains.
“An acute ward is built to diagnose, treat and discharge. It cannot offer the independence, choice, community and sense of home that aged care is designed to provide, however hard the hospitals try.”
Where do aged care rights and responsibilities sit?
The Aged Care Act’s Statement of Rights sets out entitlements including independence, choice and safe care for people accessing or seeking funded aged care. Registered aged care providers must act compatibly with these rights when delivering funded services – but public hospitals operate under different healthcare laws and standards.
Mamarelis argues this creates an accountability gap for older Australians awaiting aged care in hospital, where the same provider-specific obligations don’t apply.
“These senior Australians have been assessed as ready to leave hospital. The system has simply not delivered the next step.”
“Yet the people we call stranded patients are living without the rights, the dignity and the care journey they are entitled to expect.”
Stranded patients expose divided responsibility
According to Mamarelis, figures presented to health ministers in September identified more than 3,600 older Australians awaiting discharge nationally, compared with more than 2,700 in mid-2025. Capacity remains a major barrier, with a shortage of residential aged care places, complex care requirements and fragmented discharge processes contributing to delays.
A NSW Productivity and Equality Commission report, released on 14 October, found around 1,100 older patients were stranded in NSW public hospitals. It estimated that the annual fiscal, economic and wellbeing costs exceed $1 billion in NSW and recommended a separate funding and accountability framework for stranded patients.
Mamarelis argues the problem lies in how responsibility is divided between state hospitals and federally funded aged care. “Each government is doing what its framework asks of it. The problem is that the framework was built in silos, and no one is accountable for the person who falls between them.”
“The person has crossed the line. The system has not.”
He advocates for shared governance, integrated care pathways and funding arrangements that consider the entire care journey rather than individual jurisdictions.
Whiddon’s Collaborative Health Project highlighted the need to bring government stakeholders and community partners together to address gaps between services.
Where do aged care providers come in?
While calling for greater coordination, Mamarelis acknowledges the limits of what individual aged care providers can achieve. With occupancy above 95% and staffing and funding tightly controlled by the Commonwealth, he says providers are “very limited in their ability to address this on their own.”
“Providers did not create this problem.”
Boards can, however, document the barriers preventing older Australians from accessing care. “What we can do is keep capturing the data: admissions, referrals, declined admissions and complex health requirements,” he said.
“Boards should be asking for it and using it to keep building the case.”
Mamarelis also wants boards to use their influence to advocate for greater coordination between governments and providers. “Throwing more money at it is not the answer. Spending it differently, through a single lens, is.”
He urged boards to consider the consequences of prolonged hospital stays for the people they eventually admit.
“When we admit a senior Australian who has spent months in hospital, what has that stay cost them?”
For Mamarelis, reducing those delays will require more than additional aged care places. It will take state and federal governments working together, with clearer accountability for what happens between hospital and aged care.
