By all appearances, Australia is reforming aged care and the NDIS to make them more “sustainable,” “efficient,” and “person-centred.” But if you look beyond the government’s budget gloss, a far more concerning picture emerges — one of rising compliance burdens, systemic underfunding, centralised control, and an accelerating squeeze on both providers and the people they serve.
Aged Care: A Home-Care Revolution That’s Underfunded?
The 2024–25 Federal Budget loudly proclaims a $531 million investment into 24,100 new Home Care Packages. It’s a win — on paper. But dig into the details and you’ll find this comes hand-in-hand with a cut to residential care places, from 78 to just 60.1 per 1,000 people over 70. That’s not reform — that’s rationing.
Providers are expected to deliver more community care, with fewer resources and mounting compliance pressures. In fact, the same budget provides $174.5 million for the ICT systems behind the new Single Assessment System, designed to centralise and standardise who gets care, what care they receive, and from whom.
Sounds efficient? Sure. But it also:
- Reduces flexibility for personalised care,
- Threatens to cap services like allied health, and
- Risks locking out vulnerable pensioners through increasingly rigid eligibility gates.
NDIS: Growth, Reform — and Quiet Austerity?
The NDIS is growing. That’s the good news. But the government has committed to $14.4 billion in savings over five years through “legislative reforms.” Translation? Cuts. Controls. Caps.
These changes aim to rein in spending — yet without a real plan to invest in foundational supports, like allied health and community infrastructure, the result could be devastating. Providers already report squeezed margins, uncertainty around pricing, and an ongoing lack of clarity about what the reforms actually mean.
The consequence? A wave of provider exits or forced mergers, especially among smaller, community-based organisations who don’t have the corporate muscle to survive in this increasingly complex, compliance-heavy environment.
Compliance Overload and Forced Consolidation
Both sectors — aged care and the NDIS — are being hit with massive regulatory overhauls. The government is pumping over $110 million into expanding regulatory bodies like the Aged Care Quality and Safety Commission in anticipation of the new Aged Care Act (due 1 July 2025).
And while robust oversight is crucial, the practical outcome for many providers is:
- Increased red tape,
- Constant audits and data reporting,
- Rising back-office costs, and
- More time spent on compliance than on care.
Smaller operators, already battling tight cash flows, are being pushed to the brink — triggering rapid industry consolidation. If this continues, we risk trading a diverse ecosystem of care for a handful of large players, with all the dangers that come from centralisation: higher costs, less innovation, and more distance from the people these services were built for.
Reform Without a Heart?
The government has made it clear: it wants systems that are “sustainable.” But sustainability can’t just mean cutting costs and increasing control. If people on pensions are being asked to pay more out-of-pocket, if access to services like physio or speech therapy becomes a bureaucratic battle, and if providers are forced to either merge or die — what exactly are we sustaining?
These reforms risk becoming less about delivering better care, and more about managing spreadsheets.
It’s time to ask: Are we reforming for people, or for politics?
