The Queensland Aboriginal and Islander Health Council (QAIHC) is urging governments to take immediate action to address major gaps in Australia’s aged care reforms, warning the current system is failing Aboriginal and Torres Strait Islander Elders and placing community-controlled health providers under increasing pressure.
Aboriginal and Torres Strait Islander Elders continue to face significant disadvantage under a new Support at Home co-payment model, which fails to recognise long-standing inequities including limited access to superannuation, lower rates of home ownership, and greater reliance on government payments.
These concerns were highlighted during QAIHC’s two-day Elder Care Workshop, where Interim First Nations Aged Care Commissioner Andrea Kelly spoke about the widening gap between what communities need and what the aged care system is currently designed to deliver.
QAIHC Acting CEO Paula Arnol said the November 2025 reforms will worsen inequities unless governments involve communities in designing solutions.
“The current reforms are not addressing the realities faced by many Aboriginal and Torres Strait Islander Elders,” she said.
QAIHC General Manager, Sector Development, Gregory Richards said: “Elders face financial barriers and services that don’t meet their cultural needs. Without real collaboration and support for community-controlled providers, these reforms could make the gap worse instead of closing it.”
Five years after the Royal Commission into Aged Care Quality and Safety, and two years after her appointment, Ms Kelly continues to serve in an interim capacity – a situation she said sends a troubling signal about the level of government commitment to reform.
Ms Kelly rejected the idea that Aboriginal and Torres Strait Islander Elders are choosing to leave aged care programs, pointing out that many are forced out by barriers in the system.
Matthew Cooke, QAIHC Board Director for Central Queensland, said the situation highlighted a broader lack of government commitment and understanding to addressing the needs of First Nations Elders.
He said it was unjust that the First Nations Aged Care Commissioner role remained on an interim basis, rather than being established as a permanent and empowered statutory position.
Community-controlled aged care providers – often the most trusted and culturally safe services for Elders – are also facing growing administrative, regulatory and financial pressures under the reform agenda. Many lack the resources to absorb these burdens, placing their long-term viability at risk.
In contrast, large for-profit providers are better positioned to adapt, raising concerns about widening gaps in service quality, cultural safety and accessibility.
The transition from the Commonwealth Home Support Programme (CHSP) to the new Support at Home model is also reducing flexibility and removing low-barrier, preventative supports that many Elders rely on to remain independent.
IUIH Executive Director Aged Care, Matt Moore, said: “The government has been advised since October 2023 - and again in October 2024, before the new Aged Care Act passed the Parliament - what service program design and funding model was appropriate for First Nations elderly”.
Goolburri Deputy CEO, Trent Adams, said whilst Goolburri was working towards adapting the new modelling, it was inherently placing larger risks on organisations with compliance and liability.
“In the short, it is affecting corporate governance models and requiring companies’ board of directors to be involved operationally,” he said.
“The Commonwealth Home Support Programs have a foundation and good track record and needs to continue. Support At Home is not a mature enough system to meet the needs of such a vulnerable cohort with such a growing demographic population.
“With an ageing Australian population, I have great fears for our Elders that they will fall through the cracks or be forced out of the system as it’s not designed for our people.”
QAIHC and sector partners are urging governments to take immediate steps to prevent further harm:
“Without urgent change, these reforms intended to strengthen aged care risk will cause lasting harm to the very people they are meant to support,” Ms Arnol said.
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