# 2026 Australian Comparison Brief — Aged Care Reform and Lessons for NZ | Field | Detail | | ------------------ | ------------------------------------------------------------------------------------- | | **Type** | Australian comparison brief — Aged Care Act 2024, rights-based reform, lessons for NZ | | **Status** | Reference | | **Date** | June 2026 | | **Classification** | Neutral business/campaign intelligence | --- ## Why This Matters for NZ Australia's aged care system has undergone the most significant reform in a generation. The **Aged Care Act 2024** creates a rights-based framework with a legislated Statement of Rights, an independent complaints commissioner, mandatory star ratings, home care packages as an entitlement, caps on administrative costs, and worker registration. These reforms follow the devastating Royal Commission into Aged Care Quality and Safety (2018-2021), which found systemic failures in quality, safety, and governance. For NZ, where the aged care system faces similar challenges — a 12,000-bed shortfall projected by 2032, workforce shortages, quality concerns, and fragmented governance — Australia's reform experience offers both lessons and a benchmark. NZ's current legislative framework (Health and Disability Services (Safety) Act 2001) has not had a comparable overhaul. --- ## Key NZ-Relevant Data and Findings ### Australia's Aged Care Act 2024 — Key Reforms | Reform Element | Detail | NZ Comparison | | --------------------------------- | ------------------------------------------------------------------------------ | -------------------------------------------------------------------------------------------------------------- | | **Statement of Rights** | Legislated rights for older people receiving aged care | NZ's Code of Health and Disability Services Consumers' Rights (1996) is broader but less specific to aged care | | **Complaints Commissioner** | Independent Aged Care Complaints Commissioner | NZ has Health and Disability Commissioner (broad) plus Aged Care Commissioner (advisory, not complaints role) | | **Star Ratings** | Mandatory 1-5 star ratings for every facility on compliance, quality, staffing | NZ has no public ratings system — only certification periods (1-4 years) | | **Home Care Packages** | 4 levels of entitlement-based packages | NZ has no home care entitlement — capped, rationed hours | | **Administrative cost cap** | 15% cap on admin costs for Home Care Providers | No equivalent regulation in NZ | | **Worker registration** | Mandatory registration for aged care workers | No mandatory registration for NZ care workers | | **Provider governance standards** | New governance, financial, and prudential standards | Limited financial oversight of providers | | **Annual quality statements** | Mandatory public quality reporting | No equivalent requirement | Source: Australian Government, _Aged Care Act 2024_ (https://www.legislation.gov.au); Australian Government Department of Health and Aged Care, _Summary of Aged Care Reforms_ (2024). ### The Royal Commission Catalyst The Royal Commission into Aged Care Quality and Safety (2018-2021) was the most comprehensive investigation of aged care in any country. Its findings echo many issues in NZ: | Royal Commission Finding | Parallel in NZ | | -------------------------------------------------------------------- | -------------------------------------------------------------------------------------- | | "Aged care is in a state of crisis" | Health NZ briefing (2024) describes system "under significant and growing pressure" | | "Older people's rights are not adequately protected" | Aged Care Commissioner's report (2024) found "lack of dedicated strategy and planning" | | "Workforce is undervalued and underpaid" | NZNO, E tū, and union reports highlight chronic understaffing | | "Home care is underfunded and inaccessible" | Home care waitlists growing; no entitlement model | | "Quality information is not transparent or comparable" | NZ has no public rating system; audit reports are technical and hard to interpret | | "There is no independent complaints mechanism specific to aged care" | NZ's Aged Care Commissioner role is advisory only (as of 2026) | Sources: Royal Commission into Aged Care Quality and Safety (Australia), _Final Report: Care, Dignity and Respect_ (2021); HDC, _Amplifying the Voices of Older People_ (2024). ### Specific Reform Areas with NZ Relevance #### 1. Statement of Rights (Part 2 of the Act) Australia's legislated Statement of Rights includes: - Right to **safe and high-quality care** - Right to **dignity and respect** - Right to **make informed choices** - Right to **live free from abuse and neglect** - Right to **access advocates and complaints mechanisms** - Right to **exercise control over personal affairs** **NZ relevance:** NZ's Code of Health and Disability Services Consumers' Rights is broad (10 rights covering all health/disability services) but has no aged care-specific articulation. Advocates argue a dedicated Aged Care Charter of Rights would strengthen protections and increase public awareness. #### 2. Star Ratings System Australia introduced mandatory **1-5 star ratings** for all residential aged care facilities from December 2023. Star ratings combine: - **Compliance rating** (from quality audits) - **Quality measures** (pressure injuries, falls, medication management, etc.) - **Staffing minutes** (registered nurse, enrolled nurse, personal care worker minutes per resident per day) - **Resident experience** (survey results) **NZ relevance:** NZ's certification system (1-4 year periods) provides a rough quality proxy but no comparable public transparency. Consumer NZ and advocacy groups have called for a public ratings system. #### 3. Worker Registration From 2024, Australia is introducing **mandatory registration of aged care workers** (personal care workers, nursing assistants, support workers) through the Aged Care Workforce Registration Scheme. **NZ relevance:** NZ has no mandatory registration for care workers (other than regulated health professionals like RNs). Union and advocacy groups have called for mandatory care worker registration as a quality and safety measure. #### 4. Home Care Packages as an Entitlement Australia's Home Care Packages are **legally an entitlement** once assessed — the government must fund the package. There are four levels: - Level 1: Basic support (up to ~$9,000/year) - Level 2: Low-level support (up to ~$16,000/year) - Level 3: Intermediate support (up to ~$35,000/year) - Level 4: High-level support (up to ~$55,000/year) **NZ relevance:** NZ has no home care entitlement. Hours are capped and vary by region. The gap between Australia's Home Care Package model and NZ's rationed system is a major advocacy focus. #### 5. Administrative Cost Cap The Act caps administrative costs of Home Care Package providers at **15%** of package funds. This is designed to ensure the majority of funding goes to direct care. **NZ relevance:** No equivalent regulation exists in NZ. The E tū/CICTAR report (2025) raised concerns about transparency of aged care spending and provider corporate structures. --- ## Political Relevance ### Australian Political Context - The **Aged Care Act 2024** passed with bipartisan support in Australia — reflecting the strength of the Royal Commission's findings - The reforms add ~$5.6 billion in additional government spending over 4 years - Implementation is phased through 2025-2027 - **Worker registration** was a Labour government priority; opposed by some provider groups on cost grounds - **Star ratings** have been broadly supported by consumer groups but created compliance burden concerns for providers ### Implications for NZ Politics - Australia's reform trajectory creates **natural pressure on NZ to respond** — journalists and advocates regularly compare the two systems - The **2026 NZ election** may see parties asked to commit to specific reforms (star ratings, home care entitlement, worker registration) - NZ's **Aged Care Commissioner** role (established 2023) is an advisory-only position — Australia's model of a statutory complaints commissioner is a stronger model - **Cross-Tasman comparisons** are powerful media and campaign tools — the two countries share similar demographics, culture, and health systems, making Australia the most natural comparator for NZ ### Party Positions (NZ) | Party | Stance on Aged Care Reform | | ----------------- | ---------------------------------------------------------------------------- | | **National** | Incremental; case-mix funding focus; no major legislative overhaul signalled | | **Labour** | Supports home care expansion; committed to reviewing staffing ratios | | **NZ First** | Supports increased aged care funding; defender of NZ Super | | **ACT** | Favours private sector solutions; less regulatory approach | | **Green** | Supports rights-based framework; worker registration; home care entitlement | | **Te Pāti Māori** | Focus on culturally appropriate care; kaumātua-centred reform | --- ## Business Implications ### For Aged Care Providers - **Australia's reforms are a benchmark** — NZ providers should anticipate similar expectations for transparency, quality reporting, and worker standards - **Star ratings** create competitive pressure — providers with good ratings benefit from increased demand. NZ providers should consider voluntary quality transparency ahead of any mandated system - **Worker registration** would increase costs for NZ providers (training, compliance) but could improve workforce professionalisation and retention - **Administrative cost caps** (like Australia's 15% cap) could impact business models if adopted in NZ — particularly for large corporate providers ### For Investors and Financial Institutions - **Australia's reform process demonstrates** that aged care is a politically exposed sector — regulatory risk is real - **The spending trajectory** in Australia (~$5.6B additional over 4 years) shows government is willing to increase aged care funding significantly when political pressure builds - **NZ's lower spending base** (~0.45% GDP vs Australia's ~1.1% GDP) suggests significant potential for market growth if NZ follows Australia's path - **Home care growth** in Australia has been rapid — NZ home care providers and investors should monitor Australian market dynamics ### For Workforce and Training Organisations - **Australia's worker registration** creates a new market for training and assessment services - **Mandated staffing minutes** (Australia: 200 minutes per resident per day, including 40 RN minutes by 2025) directly impacts workforce planning - **NZ workforce shortages** are more acute than Australia's — any move towards Australian standards would require significant workforce investment --- ## Campaign Relevance ### Key Messages 1. **"Australia passed a landmark Aged Care Act in 2024. NZ's aged care law hasn't had a comparable update in 25 years"** — the legislative gap 2. **"Australia has mandatory star ratings for every aged care facility. NZ has no public ratings system"** — transparency gap 3. **"Australia has a statutory Aged Care Complaints Commissioner. NZ's Aged Care Commissioner has no complaints or enforcement powers"** — accountability gap 4. **"Australia's Home Care Packages are an entitlement. NZ home care is rationed and capped"** — home care gap 5. **"Australia is registering aged care workers to improve quality. NZ has no such system"** — workforce gap 6. **"The Royal Commission into Aged Care started with a problem definition that sounds exactly like NZ today"** — pre-emptive framing ### Campaign Strategy | NZ Campaign Ask | Australian Precedent | Political Viability | | ---------------------------------------- | ---------------------------------------- | --------------------------------------------- | | Public star ratings for residential care | Existing since Dec 2023 | Moderate — provider resistance expected | | Home care entitlement | Home Care Packages (2007, expanded 2024) | High cost — requires fiscal commitment | | Worker registration | Phased 2024-2027 | Moderate — union support, provider resistance | | Independent complaints commissioner | Aged Care Act 2024 | Moderate — institutional resistance | | Statement of Rights for older people | Aged Care Act 2024 | High — legislative change needed | ### Vulnerability Points for NZ Government - **"Australia is acting, NZ is consulting"** — timing gap makes government appear slow - **Cross-Tasman media comparisons** are frequent and politically damaging - **The 2026 election** creates a reform window — parties may compete on aged care commitments - **Provider resistance** to Australian-style reforms is lower in NZ because the sector is less consolidated and more reliant on government subsidies --- ## Latest Developments: April–June 2026 This section captures the most recent Australian aged care developments since the main brief above was compiled. These developments are now part of the operational Australian system and are relevant for NZ policy comparison. ### 1. Aged Care Act 2024 — Now Operational (Since 1 November 2025) The new Act commenced on 1 November 2025. The **Support at Home program** replaced the Home Care Packages Program and Short-Term Restorative Care Programme. Key operational elements: - **2,127 providers** registered on day one (ACQSC Provider Registration Snapshot) - **Statement of Rights** and **Registered Supporter** role in effect - **Code of Conduct for Aged Care** workers enforceable - **Single assessment process** from age 65 - **Whistleblower protections** operational The **Commonwealth Home Support Programme (CHSP)** is yet to transition — scheduled after 1 July 2027. ### 2. $3 Billion Budget 2026 Package (Announced 22 April 2026) The Albanese Government committed **$3 billion in the 2026-27 Budget** for aged care: | Measure | Detail | | ---------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------- | | **Personal care made free** | $1B to reclassify personal care (showering, dressing, continence) as clinical care under Support at Home — no out-of-pocket from 1 Oct 2026 | | **5,000 new beds/year** | Targeted capital subsidies, restructuring of accommodation supplement, loading for homes with >60% supported residents | | **Dementia care boost** | $200M+ for 20 Specialist Dementia Care Program units + Hospital to Aged Care Dementia Support Program expansion | | **Accommodation supplement** | New tiers introduced, additional payment for high-supported-resident homes | **Funding source:** Partially offset by reducing the Private Health Insurance rebate for seniors to under-65 levels — may increase annual policy costs by hundreds of dollars. **Minister Mark Butler:** "At the heart of the Labor Government's reforms has always stood a commitment to provide dignified, quality care to every older Australian, no matter their means." **Minister for Aged Care Sam Rae:** "Showering, dressing, continence care — these aren't optional extras. They're the basics of ageing with dignity, and no older Australian should miss out because of cost." **National Seniors Australia response:** Welcomed the package but noted risk of seniors dropping health insurance. Maintains six ongoing advocacy priorities: fair pricing, end to waitlist rationing, assessment integrity, stranded patients, provider transparency, CHSP retention. ### 3. Independent Review of Residential Aged Care Accommodation Pricing (Released 22 April 2026) 83-page independent review by **Nigel Ray PSM** and **Assoc. Prof. Nicole Sutton** — **18 recommendations**. **The supply crisis, in numbers:** - Demand projected to more than double: **198,302 (2024) → 409,677 (2044)** - Australia needs **~10,600 new places every year for 20 years** - But only **802 places added in 2024-25** — growth slowed to ~1,470/year since 2020 - "Opening a new aged care home every three days" just to keep pace **Key recommendations:** | Area | Recommendation | | ------------------ | ----------------------------------------------------------------------------------------------------------------------------------------------------- | | Capital investment | **$2B/year interest-free loan scheme** (10 years); **$30/day per supported resident** for new homes (25 yrs); **$15/day** for refurbishments (15 yrs) | | Rural/remote | Expand **ACCAP** to **$600M+/year** | | Pricing reform | Remove MPIR linking RADs to DAPs; let providers set own conversion rates; shift price caps to DAP basis | | Equity | **$5/day** base supplement increase; three-tier higher supplement ($59.23/$66/$77.30); **$20/day loading** for ≥60% supported residents | | Transparency | Standardised consumer information; expanded advisory services; national infrastructure census | **Government response:** $3B package targets 5,000 beds/year — roughly half the 10,600 needed. Full sector consultation on capital assistance recommendations to follow. **NZ relevance:** The RAD/DAP model mirrors NZ's occupation right agreement (ORA) structure. NZ faces a similar supply challenge (projected 12,000-bed shortfall by 2032). This review is the most comprehensive analysis of aged care accommodation economics conducted in either country — essential reference for NZ policy. ### 4. Aged Care Wait Times Report (First Report, 12 May 2026) First quarterly report under the new Act (covering 1 Nov 2025 – 31 Mar 2026): | Metric | Days | Months | | ----------------------------------------- | ------ | ------ | | **National median** | 294 | ~10 | | **National average** | 360 | ~12 | | **Support at Home median** | 347 | ~12 | | **Residential care (median)** | 167 | ~6 | | **Residential care (average)** | 396 | ~13 | | **Best state (Victoria median)** | 273 | ~9 | | **Worst state (Queensland median)** | 322 | ~11 | | **Backlog awaiting triage (31 Mar 2026)** | 48,592 | — | ### 5. Star Ratings Redesign (Effective Oct/Nov 2025 — Reflected in May 2026) Two significant changes to the Star Ratings system: **Compliance rating (1 Nov 2025):** Redesigned to incorporate graded assessment against the strengthened Aged Care Quality Standards. Now uses a 5-level matrix combining regulatory decisions with conformance/non-conformance grades. **Staffing rating (1 Oct 2025, reflected in May 2026 quarterly update):** Homes must meet **both** total care minutes AND RN care minutes targets to score 3+ stars. Uses dual-threshold matrix. _See separate source brief: `2026 Australian Source Brief - Star Ratings and Quality Regulation.md` for full details._ ### 6. KPMG Aged Care Market Analysis 2026 Ninth annual report — data for FY25: | Metric | Value | Change | | ---------------------------- | ------ | ------ | | Government investment | $39.2B | +9.6% | | Residential expenditure | $24B | +12.8% | | People waiting for home care | 96,709 | +41% | | Residential occupancy | 89.9% | ↑ | | Residential providers | 636 | −0.9% | | HCP providers | 873 | +2.1% | **Key insight:** No new residential providers entered the market in FY25 due to high capital/construction costs. The Support at Home program expected to reshape the home care market in 2026. ### 7. ACQSC 2026 Activity - **Five Quality Bulletins** published in 2026 (through #5-2026) - **Public Information Program** "Choice, dignity, respect – your rights in aged care" launched - **New Monitoring Policy** and **Registrar Service Charter** published - **Research** on barriers to speaking up (WhereToResearch, 2,300 surveyed) — fear of reprisal remains key barrier - **National Aged Care Provider Conference 2026** (Brisbane, 13-14 October): "Rights and choice, every day: one year in" - **Falls Awareness Month** — falls leading cause of injury hospital admissions for over-65s - **Council of Elders** met April 2026 — communique published **Sources for this section:** - Australian Government Department of Health, Disability and Ageing — https://www.health.gov.au/our-work/aged-care-act (accessed 9 Jun 2026) - Minister Butler media release, 22 Apr 2026 — https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/more-beds-more-packages-and-better-care-for-older-australians - Personal care fully funded — https://www.health.gov.au/news/personal-care-to-be-fully-funded-under-support-at-home-from-october - Independent Review of Residential Aged Care Accommodation Pricing — https://www.health.gov.au/committees-and-groups/residential-aged-care-accommodation-pricing-review (accessed 9 Jun 2026) — full PDF: https://www.health.gov.au/sites/default/files/2026-04/independent-review-of-residential-aged-care-accommodation-pricing.pdf - Aged Care Act 2024 Wait Times Report (PDF) — https://www.health.gov.au/sites/default/files/2026-05/aged-care-act-2024-wait-times-report.pdf - Star Ratings changes — https://www.health.gov.au/our-work/star-ratings-for-residential-aged-care/changes (accessed 9 Jun 2026) - ACQSC Quality Bulletins — https://www.agedcarequality.gov.au/news-publications/quality-bulletin (accessed 9 Jun 2026) - National Seniors Australia — https://nationalseniors.com.au/news/featured-news/nsa-welcomes-important-aged-care-changes (accessed 9 Jun 2026) - KPMG Aged Care Market Analysis 2026 — https://kpmg.com/au/en/insights/industry/aged-care-market-analysis.html (accessed 9 Jun 2026) - The Weekly SOURCE analysis — https://www.theweeklysource.com.au/accommodation-review-lays-bare-aged-cares-supply-failure/ (accessed 9 Jun 2026) - Mirus Australia analysis — https://www.mirusaustralia.com/blog/the-independent-accommodation-pricing-review (accessed 9 Jun 2026) - Australian Ageing Agenda — https://www.australianageingagenda.com.au/ (accessed 9 Jun 2026) --- ## Source List ### Australian Government Sources 1. Australian Government, _Aged Care Act 2024_ — https://www.legislation.gov.au 2. Royal Commission into Aged Care Quality and Safety (2021), _Final Report: Care, Dignity and Respect_ — https://agedcare.royalcommission.gov.au 3. Australian Government Department of Health and Aged Care, _Summary of 2024 Aged Care Reforms_ — https://www.health.gov.au/topics/aged-care 4. Australian Government, _Intergenerational Report 2023_ — https://treasury.gov.au/publication/2023-intergenerational-report 5. Aged Care Quality and Safety Commission (Australia), _Star Ratings_ — https://www.agedcarequality.gov.au/star-ratings 6. My Aged Care — https://www.myagedcare.gov.au 7. Productivity Commission (Australia), _Report on Government Services 2024_ — https://www.pc.gov.au/ongoing/report-on-government-services ### NZ Government and Official Sources 8. HDC (2024), _Amplifying the Voices of Older People_ (Aged Care Commissioner's Report) — https://www.hdc.org.nz 9. Sapere Research Group / Health NZ (2024), _Aged Care Service Model and Funding Review_ — https://www.healthnz.govt.nz 10. Health NZ (2024), _The Health of Older People and Aged Care in New Zealand_ — https://www.health.govt.nz 11. NZIER (2022), _Assessing the Equity Issues Facing Aged Residential Care Over the Coming Decade_ — https://img.scoop.co.nz 12. NZNO (2025), _Care in Crisis_ — https://www.nzno.org.nz 13. E tū / CICTAR (2025), _Transparency and Corporate Tax in ARC Funding_ — https://etu.nz 14. Treasury NZ (2024), _Case Study: Aged Residential Care_ — https://www.treasury.govt.nz 15. Office for Seniors, _Better Later Life Strategy_ — https://www.officeforseniors.govt.nz --- _Part of the NZ Seniors Knowledge Base — Aged Residential Care layer_ _Location: `02 Aged Residential Care/`_ _Last updated: June 2026_