New aged care report centres voices of older First Nations people

A new report from the Department of Health and Aged Care on transforming the nation's aged care system for First Nations communities has highlighted the need for urgent reform.

Transforming Aged Care for Aboriginal and Torres Strait Islander people, authored by Interim First Nations Aged Care Commissioner Andrea Kelly, discusses the significant challenges experienced by Aboriginal and Torres Strait Islander people in accessing high quality, responsive and culturally safe aged care.

Ms Kelly has undertaken extensive public consultation since her appointment to the position in January 2024, addressing Recommendation 49 of the Royal Commission into Aged Care Quality and Safety:

“To establish a statutory Aboriginal and Torres Strait Islander Aged Care Commissioner (Commissioner) to ensure culturally safe, tailored and flexible aged
care services for older Aboriginal and Torres Strait Islander people.”

The report details four key recommendations for the improvement of aged care in First Nations communities, including a commitment from the federal government to developing a 10-year transformation plan, co-designed with Aboriginal and Torres Strait Islander people.

“Without significant change including an equity-based approach, the aged care system will not meet the current or projected growth in demand of aged care services for older Aboriginal and Torres Strait Islander people. I have outlined a plan to achieve this, which starts with genuine partnership with Aboriginal and Torres Strait Islander people,” Ms Kelly said.

“I am hopeful the reforms underway will incorporate Aboriginal and Torres Strait Islander experiences and perspectives to meet their needs.”

Key findings

Despite having a lower life expectancy and a higher chance of requiring aged care at a younger age than other Australians, the report reveals Aboriginal and Torres Strait Islander people face heightened barriers when attempting to secure aged care, including a lack of cultural flexibility and understanding, communicational challenges and disconnection from country.

The report speaks to the traumatic legacy of colonisation and dispossession, the Stolen Generation and a national health system with foundations in institutionalised racism.

Ms Kelly recommends an equity-based, person-centred approach; one that makes culturally aware, trauma-informed and flexible care the norm.

“We must ensure that policies and programs are designed with and targeted at older Aboriginal and Torres Strait Islander people, as the most vulnerable and disadvantaged people in our country. An intersectional approach to this work is important,” she said.

Sector response

Minister for Aged Care Anika Wells has welcomed the report's findings, affirming that “the government is actively considering the recommendations and how they can be taken forward.”

“I am pleased to extend Ms Kelly in the role of Interim First Nations Aged Care Commissioner until June 2026. Ms Kelly will continue to ensure Aboriginal and Torres Strait Islander voices and perspectives are incorporated in the reforms currently underway,” Ms Wells said.

Sector peak bodies have taken the opportunity to call for urgent action from the government.

The Older Persons Advocacy Network (OPAN) chief Craig Gear OAM said the Network is “pleased to see the recommendation for a permanent Commissioner.”

“OPAN endorses the recommendations, particularly the development of a 10-year transformation plan co-designed in genuine partnership with Aboriginal and Torres Strait Islander people,” Mr Gear said.

“All older people deserve access to safe, high quality and, above all, culturally appropriate aged care services.

“We need to keep moving on aged care reform, and the key to this is ensuring the new Aged Care Act takes effect on 1 July 2025, we cannot afford any further delays.”