A landmark global study into aged care reform is right: simply throwing more money in won’t fix the system as populations age. We need to redesign how the whole system works.
However, any attempt to break down rigid workplace silos will fail unless governments build safety nets for workers during the transition.
The international research, recently published in a special issue of Health Care Management Review, argues that decades of reform have focused on isolated fixes rather than structural integration (Pulse IT, July 14). Lead editor Dr Madhan Balasubramanian and a global team of researchers highlight that workforce models, digital tools, and funding mechanisms must operate as one interconnected system – what they term a “transdisciplinary” overhaul.
Without the “connective tissue” to link clinicians, managers, and policymakers into shared workflows, reform efforts will continue to address symptoms rather than root causes.
Across Australia and New Zealand, recent policy experience shows the size of the challenge.
First, we need digital buffers – smart software tools that connect care teams automatically. Right now, frontline workers in Australia know that information sharing between doctor surgeries and aged care homes often means little more than dropping a static PDF attachment into an email or fax. The Australian Digital Health Agency’s National Healthcare Interoperability Plan and the Sparked data program show the Federal Government wants to fix this. But the real test is whether software companies turn these official standards into simple, two-way tools that workers use every day on the floor.
Second, we need micro-credentials – short, accredited courses that protect staff as their roles evolve. As a workplace software developer in the healthcare sector, I see this daily. Initiatives like Australia’s Aged Care Transition to Practice (ACTTP) program and state TAFE courses give personal care workers stackable, formal qualifications in areas like dementia and palliative care. Expanding these short courses nationally will be vital. When Health New Zealand (Te Whatu Ora) tried to expand Healthcare Assistant duties without a clear, nationally recognised training safety net, the rollout stalled due to severe pushback from unions.
Finally, we need hybrid-funding safeguards to protect providers while they adjust. When Australia introduced the Australian National Aged Care Classification (AN-ACC), the government rightly set up a transition fund and shadow assessment period so providers wouldn’t go under while retraining staff. What is the government’s appetite to expand this kind of protection across the sector at the scale researchers envisage?
Getting these three safety nets right is critical to easing the intense pushback from unions and medical associations whenever job boundaries shift.
Whenever governments expand what health workers are allowed to do, protectionist battles ignite. In Australia, the Federal Government’s Scope of Practice Review and state pharmacist prescribing trials – such as Queensland’s pilot covered by Pulse+IT – drew fierce opposition from the Australian Medical Association (AMA) and RACGP over patient safety concerns. When aged care homes pass routine mobility tasks to Allied Health Assistants, physio and occupational therapist unions worry about quality being watered down.
Across the Tasman in my home country, the New Zealand Nurses Organisation (NZNO) consistently resists delegating clinical tasks to Healthcare Assistants, citing unsafe workloads and blurred responsibilities. Meanwhile, Australian unions like the ANMF and HSU raise concerns whenever job descriptions expand without proper training, pay adjustments, or legal protections.
This pushback isn’t just stubbornness. Workers and unions are reacting to a system that asks employees to take on new tasks before legal, digital, and financial protections are actually in place. When a care assistant handles clinical checks without a formal micro-credential, they take on liability without recognition. When a pharmacist collaborates without shared digital tools, they take on extra paperwork without a full view of the patient. And when an operator shifts roles without funding support, workers end up squeezed by cost-cutting targets.
As Pulse+IT recently noted from the ITAC Conference, providers don’t just need more tech – they need connected systems that simplify daily work and remove friction. We cannot simply tell care teams to “work together better” and expect unions to step aside.
If policymakers and tech leaders want to modernise aged care, they must deliver these core foundations: digital tools that make teamwork seamless, short qualifications that protect workers, and flexible funding that gives providers room to adapt. Only then can we build a care system that truly supports the people delivering it.
