This discussion paper examines the state of play in aged care reform in Australia. The paper outlines the background and context; what has been achieved to date and what challenges have emerged; reform measures still in progress; and key strategic observations, questions and issues for ongoing reform.

The paper identifies where measures have had positive effects or outcomes, and whether there are also issues arising from those measures that may have been negative, or require additional review, consideration or action. In addition to recognising positive improvements, the focus is on issues that have arisen because of reform measures whether already implemented or currently underway.

The recommendations in the discussion paper aim to generate further consideration of the relevant issues. The paper was written prior to and published after the implementation of the new Aged Care Act on 1 Nov 2025.

Key findings

• There is broad agreement that the significant increases in Award wages has produced positive (some say very positive) effects on staff attraction and retention, and on staff morale.
• Direct increased funding by government; the introduction of the Australian National Aged Care Classification (AN-ACC); and the creation of Independent Health and Aged Care Pricing Authority (IHACPA) are all measures that have led overall to both increased resources in residential aged care and home care.
• 24/7 nursing is widely regarded as being as close to universally achieved as possible.
• There is widespread sector agreement that workforce development is the current major challenge, the next strategic phase of the reform process.
• The assumption that older people in aged care can be properly cared for by an untrained workforce has its roots in ageism and must change.