We introduced readers to the New Aged Care Act, rolled out nationally on 01 November 2025. From a policy standpoint, the reforms were intended to future-proof the aged care system against Australia’s ageing population, while addressing long-standing challenges exposed by the 2021 royal commission. Central to the changes are a strengthened charter of rights for older Australians, a new code of conduct for providers, and updated quality standards aimed at improving safety and accountability.
Yet for many older Australians, the reality has been far from reassuring. Rather than improving access to care, the new system has triggered widespread confusion, delays and distress — affecting both those seeking support for the first time and those already reliant on home care services. To understand the depth of this upheaval, it’s necessary to look beyond the policy intent and examine how the system now operates in practice.
The Assessment Backlog
One of the most consequential changes has been the partial privatisation of aged care assessments. Late last year, contracts worth around $1.2 billion were awarded to private providers, replacing the state and territory public health clinicians who had conducted assessments for decades.
The impact of this has been significant. More than 116,000 people are currently waiting for a home care assessment. While the government advises the median wait time is 23 days, families, carers and aged care workers describe a vastly different experience.
Following a recent 7.30 report, the ABC was inundated with emails. One couple in their 70s said they were told it would take “nine to 10 months” just to be assessed. Another woman described waiting eight months for her father’s reassessment — only to be contacted two months after he had died. An elderly man said he had simply given up.
Even after approval, individuals are placed on a separate waiting list for a home care package — a list now exceeding 120,000 people. Complaints to My Aged Care often lead families back to the same assessment agencies, while the health and independence of those needing support continue to decline. According to families and industry insiders alike, the assessment system is in crisis.
Decisions by Algorithm
Compounding these delays is the introduction of the Integrated Assessment Tool — an algorithm that determines how much care an individual receives. While a clinician still conducts a home visit, assessors say they are unable to override the algorithm’s outcome, even when it clearly fails to reflect a person’s needs.
One assessor told the ABC the tool frequently assigns low levels of care to people with complex or high needs, leaving clinicians powerless. “I am forced to sign off on decisions I don’t agree with,” he said.
When support proves inadequate, individuals must apply for reassessment, further clogging an already overwhelmed system.
Waiting for Care
Approval, however, does not mean help arrives. More than 107,000 people are currently waiting to receive a home care package, with standard wait times stretching to 10 or 11 months. Although the government has promised an additional 80,000 packages by the end of the financial year, this is unlikely to eliminate the backlog or ease mounting frustration.
One woman said her father was discharged from hospital while waiting for a package and was told the delay could be up to nine months. She resigned from her job to care for him full-time. Another wrote that her 92-year-old neighbour with Alzheimer’s disease had been told she would wait at least a year.
Taken together — assessment delays and package shortages — it is estimated that around 200,000 people need home care and are not receiving it.
Commonwealth Home Support Co-Payments
Alongside access issues, the reforms have also reshaped how care is paid for. The introduction of Non-Clinical Care Contributions (NCCC) means many essential in-home services — including showering, dressing, cleaning and shopping — now attract co-payments. These are not discretionary extras, but fundamental supports that underpin health, dignity and quality of life.
‘No Worse Off’ Promises
A core aim of Labor’s reforms is to make aged care financially sustainable. From 01 November, all people receiving home or residential care are required to contribute to its cost. To quell concern, the government assured the 250,000 people already in the system that they were “grandfathered” and would be “no worse off”.
While providers are now capped on management fees, some have responded by sharply increasing hourly service rates — in some cases by 30 to 40 per cent. The result is fewer hours of care each week, even though funding levels have not increased.
At Senate Estimates, Senator David Pocock questioned how an 84-year-old whose respite costs rose from $132 to $447 per hour could be considered “no worse off”.
While the government states that those who can afford to contribute should do so in order to protect fully funded clinical care, advocacy groups and providers warn the line between clinical and personal care is dangerously blurred. “We need to make sure that poor access to showering services doesn’t actually create more hospital admissions,” said National Seniors Australia’s Ian Grice. Australian Unity’s Rohan Mead Bowden echoed the concern, describing personal care as “deeply personal” and closer to clinical support — and warning against forcing older Australians to choose between essentials like heating, food and basic hygiene.
This original article published ABC News 13th December 2025. To read the full article: https://www.abc.net.au/news/2025-12-13/aged-care-package-reform-worse-off-confusion-despair-waitlist/106136364
