Reform

As she prepares to leave the role, Natalie Siegel-Brown has delivered her strongest criticism yet of aged care reform, warning that good intentions are being undermined by poor implementation and a system that may be increasing pressure on residential care.

A survey of older Australians has highlighted growing frustration with Support at Home, revealing challenges around waiting times, complexity, provider availability and out-of-pocket costs.

IDDSI standardised texture-modified food and thickened fluids across aged care, changing how risk is described. But safety language alone hasn’t fixed rosters, training or communication pathways – and Standard 6 now demands the operating model catch up.

Aged care providers ask where the money will come from before asking whether their kitchen system is already wasting it. Poor design costs more than budgets do – through waste, rework, complaints and burnt-out chefs carrying risk no one else sees.

This new cross-setting framework gives aged care leaders an evidence-based blueprint to measure quality across the entire continuum of care, helping organisations bridge the gap between health services and residential settings to deliver truly integrated, person-centred outcomes.

A CEO’s line – aged care can survive, but not run like it’s 1985 – sent Lindsay O’Grady back to 1986: the year he started as a chef. Forty years on, the kitchen has changed. But has the model around it changed enough?

While the headlines have focused on allegations surrounding additional service fees via HELF, the more important question for boards and executives is whether the sector has fully understood what the new Aged Care Act is asking providers to become.

RFBI has spent four years and significant capital building housing for 285 overseas nurses and carers. The program’s entire foundation rests on one federal mechanism. This raises questions about policy risk, sourcing ethics, and board-level contingency planning that other providers haven’t yet answered.

The Senate has delayed a policy decision for the Commonwealth Home Support Programme, but it hasn’t delayed demographic reality. Demand continues to grow, and organisational capability needs to grow with it.

Outgoing Inspector-General Natalie Siegel-Brown tells a Senate inquiry that Support at Home’s assessment algorithm, means-testing design and co-payment structure are driving older Australians into costlier residential care. And warns the budget isn’t the problem – the administration is.