A major blueprint to overhaul aged care in Aotearoa is winning support from home-care providers and unions, but pressure is already mounting on the Government to make sure the people delivering the care are not left behind.
The independent Aged Care Ministerial Advisory Group has released its final report, A Place to Grow Old: Securing the Future of Aged Care, laying out 40 recommendations for a more integrated and sustainable system.
The report warns the current system is fragmented, difficult to navigate and facing growing financial pressure as New Zealand’s population ages. It proposes stronger home and community care, better support for carers and whānau, changes to residential care funding and a new approach to how the costs of aged care are shared.
The Home and Community Health Association has strongly welcomed the direction of the report, particularly its focus on helping older people remain independent and living in their own homes for longer.
That shift could become increasingly important for kaumātua Māori, where ageing well can be closely connected with remaining near whānau, whenua and community rather than entering residential care.
The advisory group recommends expanding in-home services so people can receive more intensive and clinical support without automatically having to move into residential facilities. It also calls for better support for carers and whānau and improved navigation of what can be a complicated aged-care system.
But while the direction of travel is receiving support, the Public Service Association says reform must also address the workforce crisis sitting underneath the system.
The PSA has welcomed proposals for a cross-sector aged-care workforce strategy and stronger employment protections when service contracts change providers. However, it says reform also needs to resolve pay equity for care and support workers.
The advisory group itself acknowledges that a sustainable aged-care system depends on a stable and properly trained workforce capable of working across both home and residential settings.
It recommends the Government work with unions, providers, consumers and community organisations on a national workforce strategy, although key issues around employment terms and conditions were outside the formal scope of the review.
The financial challenge is substantial.
Government spending on in-home and residential aged care reached about $2.5 billion in 2024/25, while people receiving residential care contributed roughly another $1.26 billion, excluding additional premium charges.
The advisory group estimates its wider reform package could improve health outcomes while avoiding more than $830 million a year in unnecessary growth in taxpayer costs by 2037/38.
Associate Health Minister Casey Costello has welcomed the report but has stopped short of committing the Government to its recommendations.
The Ministry of Health and other agencies have been directed to examine the proposals and develop advice for future policy and funding decisions. Costello says funding for the sector has increased by $446 million over the past three years, while this year’s funding uplift for home care remains under negotiation.
For Māori, the decisions that follow could be particularly significant.
The advisory group’s work recognises the importance of culturally appropriate care and includes Māori expertise, while its wider push toward ageing at home has the potential to give more kaumātua the choice to remain connected with whānau and community.
The report has now put a comprehensive reform plan in front of the Government.
The next test will be whether ministers are prepared to fund it — and whether investment in buildings, beds and home-care services is matched by investment in the workers who provide care every day.
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