Close the gap: 10-year plan for First Nations aged care

The Department of Health and Aged Care has released a 10-year plan to strengthen the nation's aged care system for Aboriginal and Torres Strait Islander communities.

The Aboriginal and Torres Strait Islander Aged Care Framework is an important step towards longer and healthier lives for indigenous people but also a key element of the government's wider commitment to Closing the Gap.

Prime Minister Anthony Albanese last month addressed the National Agreement on Closing the Gap in Canberra after the release of the Commonwealth’s Closing the Gap 2024 Annual Report and 2025 Implementation Plan. 

“We are working in partnership with States, Territories and peak organisations to Close the Gap,” he said.

“We are delivering record funding in health, education and housing, as well as $842 million to fund essential services in remote communities.

“Australians want to close the gap between indigenous and non-indigenous Australians. Australians believe in the fair go.

“The task before us is to build a future in which all Australians have access to the same opportunities.”

The Framework's foreword, penned by Aged Care Minister Anika Wells, said “now is the time to make aged care work for Aboriginal and Torres Strait Islander people and communities.”

“Aged care should embrace the strength that lies in the heart of Aboriginal and Torres Strait Islander people while supporting them to lead enriched lives as they age.

“The Royal Commission into Aged Care Quality and Safety recognised that the aged care system has not adequately supported older Aboriginal and Torres Strait Islander people in the past and that they remain underrepresented among aged care recipients and the aged care workforce.”

Guiding Principles

The Framework's Guiding Principles are designed to ensure that while the focus may be on aged care, the outcomes extend to benefit whole communities, contributing to the government's larger goals of Closing the Gap. They are:

1. Genuine partnership and shared decision-making with Aboriginal and Torres Strait Islander stakeholders and communities on aged care reforms.

2. Prioritise Aboriginal Community-Controlled Organisations and increase their participation in the aged care sector.

3. All mainstream institutions, government agencies and stakeholders in the aged care system are accountable to deliver better aged care outcomes for Aboriginal and Torres Strait Islander people.

4. Evidence based on the lived experience of Aboriginal and Torres Strait Islander people will be used to drive aged care reform for Aboriginal and Torres Strait Islander people.

A vision for the future

Despite efforts to improve aged care services through recommendations from the Royal Commission and initiatives like the Aged Care Act and the Elder Care Support Program, Aboriginal and Torres Strait Islander people continue to be underrepresented in the aged care system.

The Framework aims to achieve “significant improvements to the aged care experience for older Aboriginal and Torres Strait Islander people” over the next decade and has developed five outcomes to drive measurable reform.

Outcome One - Culturally safe and responsive access to aged care
Several targets have been set to ensure older Aboriginal and Torres Strait Islander people can access culturally safe aged care services. These include increasing the representation of Indigenous people in aged care services, ensuring 100 per cent completion rates in cultural safety training for aged care workers, and increasing overall satisfaction with the aged care system.

The Framework emphasises simplifying the system, improving service navigation, and empowering community-controlled organisations to provide culturally appropriate support and education, ultimately building trust and improving engagement.

Outcome Two - Culturally safe, accurate and prioritised assessment
Current assessments for home and community care, as well as residential care, are often reported as lacking cultural safety and sensitivity. These processes have typically been designed through a non-Indigenous lens, which does not adequately consider the unique needs of the community.

Key goals for this outcome include ensuring assessments begin within 10 calendar days for high-priority cases, increasing the number of assessments conducted by Aboriginal and Torres Strait Islander assessors, and increasing the involvement of the Elder Care Support workforce.

The government also aims to increase cultural safety training for the assessment workforce and ensuring that mainstream assessment organisations have a Reconciliation Action Plan (RAP) in place by 2028.

Outcome Three - Culturally safe aged care services in community
Place-based care is crucial to the delivery of culturally safe care.

A lack of service availability has meant that many older Aboriginal and Torres Strait Islander people have been forced to leave their community in order to receive care.

The Framework targets an increase in Aboriginal and Torres Strait Islander care providers (Outcome Four) but also building on the number of mainstream care organisations engaging in training that promotes culturally safe, trauma aware and healing informed care, and holistic health and wellbeing.

Outcome Four - More Aboriginal and Torres Strait Islander aged care providers
Outcome Four is about empowering choice. As many Aboriginal and Torres Strait Islander people prefer to receive services such as aged care from people in their community, the government has committed to increasing the number of Aboriginal and Torres Strait Islander organisations that provide aged care.

Currently, around two per cent of aged care services are delivered by Aboriginal and Torres Strait Islander organisations, the government has committed to increasing this by 10 per cent each year until they reach four per cent.

Outcome Five - A larger Aboriginal and Torres Strait workforce
The 2023 Aged Care Provider Workforce Survey shows Aboriginal and Torres Strait Islander people represent just 1.2 per cent of directly employed workers in the aged care sector.

The Framework is aiming to increase this to 3.4 per cent by 2025, meaning Aboriginal and Torres Strait Islander people will not only need to be recruited but actively trained and supported.

For more information download the Framework here.