“You do get what you pay for”: Fiona Somerville on why families are ditching government home care

Australia’s home care system was meant to give older people choice and control. Instead, many families say it now delivers delays, paperwork and a shrinking number of care hours. As the 1 November aged care reforms take effect, frustration is spilling over, and some families are simply walking away.

It’s a shift that Fiona Somerville, Managing Director of Melbourne-based provider Acquaint, has watched gather pace long before this latest round of reform.

At the highest level, a government home care package delivers an average of just 11 hours of direct support per week, barely enough to meet daily needs, let alone sustain independence or wellbeing.

The real cost of “subsidised” care

The new cap on administration fees, limited to 10 per cent of a package, was intended to protect consumers. Somerville says it has instead prompted many government-funded providers to lift their hourly rates to around $90 to $100 to offset lost revenue.

“We’ve been at the higher end of the market, but I note that many government providers are now charging around the same and some a lot more per hour than Acquaint,” she says. “You do get what you pay for, and most people are happy with the price once they understand our service offer.”

She says self-funded retirees and part-pensioners are questioning the benefit of subsidised care once they see income-tested fees and how few hours they receive in return.

“Frustrated rather than misled is probably a better reflection of how people we talk to feel about the government programs,” Somerville says. “They realise how little the subsidy actually buys, especially once contributions are added in.”

A growing gap

Somerville believes the waiting list remains a critical pressure point, with “a massive backlog and no sign of that dissipating any day soon.” Until supply improves, she says, there will always be people who miss out.

She also warns that middle-income Australians may end up caught in the middle, not eligible for full subsidies yet unable to afford enough private care to fill the gap.

“For those with some level of wealth, they’ll be contributing exorbitant amounts for basic services like cleaning and gardening when what they really need is some help around the house to start,” she says.

“That’s where the unfairness will come in, as these costs far outweigh the market value of the services. People may well start to ask what’s worth having through their package, and what is best managed outside of the package.”

Value and expectations

As more families weigh those choices, expectations are also changing. Somerville says many people now want flexibility, responsiveness and consistent staffing that the system often cannot provide.

“The main drivers are things like an excellent, responsive service and great, reliable staff that they get along with,” she says. “We take great pains to ensure we match people up well because when you’re looking at the higher number of hours a week we have staff in the home, you really want to make sure that once you’ve got the skill set right, you need to make sure that everyone gets along beautifully. After all, it’s an honour to be invited into someone’s home.”

Beyond the reforms

Somerville says the system is “designed for everybody” but argues that until more hours and staff are available, many people will continue to turn elsewhere for help.

“Private care is helping take pressure off government-funded services,” she says. “Every private client we support frees up a subsidised package for someone who truly needs it.”

She believes the new fee structure may unintentionally widen the gap between policy and practice, leaving families to choose between long waits and higher bills. “Private options will keep growing simply because families can’t wait,” she says. “The system is designed for everybody, but right now it’s not reaching everybody.”