Clear the Home Care backlog

National Seniors Australia (NSA) is urging the Department of Health, Disability, and Ageing to immediately increase the number of Home Care Packages (HCPs) to help clear the waitlist and ensure timely access to essential support for older people.

This recommendation is made in a submission to the Senate Standing Committees on Community Affairs, before which NSA chief executive officer, Chris Grice, gave evidence on Friday, 29 August.

Our submission to the inquiry focuses on the impact on older people, noting that delays are impacting the well-being of seniors and their carers across Australia.

The Royal Commission into Aged Care Quality and Safety identified significant shortfalls in meeting the needs of older people, particularly regarding waiting times for aged care.

Despite a commendable increase in HCP availability over the past 5-10 years, demand, especially for higher-level care, remains largely unmet – a problem exacerbated for Australians living outside major cities.

The Commission’s final report, now approaching its fifth anniversary, specifically recommended that HCPs be made available within one month of assessment, to eliminate waitlists.

However, the reality falls far short of this. As of 31 March 2025, 87,597 older Australians were on the National Priority List awaiting HCPs at their approved level. While 99% of these people are receiving a lower-level HCP or have been approved for services via the Commonwealth Home Support Programme.

While the government announced the release of 31,715 packages for 2024/25, comprising 24,100 from the budget and 7,615 from the Mid-Year Economic and Fiscal Outlook, the actual impact on the waiting list and whether these packages were released on time remains unclear due to a lack of publicly available data.

This situation is compounded by the delayed launch of the new Support at Home Program until 1 November 2025.

While this delay offers older people more time to understand system changes, it postpones access to vital protections and improved services. The current system struggles with significant wait times, where people assessed as having an “urgent” need may still wait at least one month for in-home care.

Recent service disruptions have also led to delays in conducting home care assessments, with some assessment organisations resorting to phone evaluations.

These delays come at a cost, and NSA members gratefully told us of their experiences. One 95-year-old man waited eight months for an assessment for a Level 3 package, only for his family to be told it could be another year before the package is applied.

Members of another family spoke of unacceptable delays for their chronically ill mother and father with dementia, highlighting how the system fails to truly support the evidence-based strategy of enabling older people to remain at home for increased well-being.

Crucially, published wait times for HCPs only reflect the period from assessment to package allocation, failing to capture the entire duration people wait for support.

NSA warns that if the supply of packages continues to lag demand, it will inevitably lead to a growing waitlist and inadequate care, ultimately increasing the demand for more expensive hospital and residential care.

Limiting the availability of HCPs is a “false economy”; it merely shifts the need for care and support to other, often higher-cost, areas. Older people are increasingly stranded in hospital settings due to difficulties accessing appropriate home or residential care.

This systemic failure has severe repercussions for Australia’s broader health system. Older Australians, who constitute 17.1% of the population, accounted for 49.7% of total patient days in public hospitals in 2023.

The delayed implementation of the new Aged Care Act is already placing immense strain on hospitals, with older people being admitted for conditions that could be managed at home.

Hospitals are seeing a higher percentage of older patients occupying acute-care beds, often staying longer due to discharge delays when safe aged care services are unavailable.

This exacerbates bed shortages, lengthens emergency department wait times, and increases pressure on health professionals, putting further strain on an already overstretched system.

“Exit block” – where patients ready for discharge cannot be moved due to a lack of available aged care – is a persistent problem that is compounded by delays in the Support at Home program.

The continued delays in accessing HCPs fundamentally undermine the objectives of the Aged Care Act 2024, which enshrines the right of older Australians to timely and equitable access to care.

The current backlog has resulted in significant adverse outcomes, including premature admission to residential aged care and avoidable hospital presentations.

Failure to address the waitlist not only compromises consumer choice and dignity but also risks non-compliance with the core principles of safety, accountability, and quality of life embedded in the new rights-based aged care framework.

Clearing the aged care waitlist is an urgent priority. It is essential to ensure that the intent of the Aged Care Act is realised in practice and that older people receive the care and support they are entitled to without undue delay.