State of the Nation: Global Perspectives
Series 3 / Episode 5
Episode 5: Australia's Aging System: Insights and Lessons
“Positivity, planning and purpose are the silver bullets for ageing well.”
In Episode 5 of State of the Nation: Global Perspectives, Kari Gerstheimer speaks with Marcus Riley, Executive Chairman of BallyCara, about Australia’s evolving aged care system and what the UK can learn from it.
Marcus reflects on a 25 year career shaped by relationships with older people and communities, and shares his belief that successful ageing rests on positivity, planning and purpose.
A career grounded in relationships
Marcus started working in aged care at just 17, helping in the gardens of a retirement community. He later returned in a leadership role and has remained in the sector ever since. When asked what he is most proud of, he does not cite structural reform or professional recognition.
“It’s the relationships I’ve formed over 20 or 25 years,” he says. “Through those relationships, hopefully I’ve been able to have a positive influence.”
Those years of listening to older people shaped his thinking about what enables some to thrive in later life while others struggle.
From that reflection, he distilled three essentials for ageing well.
“Positivity, planning and purpose,” he explains. “They are the silver bullets.”
They counter what he sees as the greatest threats to ageing successfully: isolation, loss of control and negativity.
A fragmented system with strong safety nets
Australia’s social care landscape is divided between aged care, health and disability services, including the National Disability Insurance Scheme.
There is universal access in principle and reasonably strong financial safety nets. However, the system is highly fragmented. The federal government funds and regulates aged care, while state governments run hospitals and health systems.
“There’s so much alignment and potential for integration,” Marcus notes. “We just haven’t seen that materialise.”
The result is duplication, inefficiency and frequent tension between levels of government, particularly when hospital discharge delays highlight gaps in community provision.
Reform driven by public scrutiny
The turning point came with the Royal Commission into Aged Care Quality and Safety, established in 2018 following sustained media coverage of serious failures in parts of the system.
The Commission exposed poor administration, inadequate oversight and funding pressures. It ultimately led to the most significant legislative reform since the Aged Care Act 1997, with new legislation coming into force in November 2025.
Looking back on the years preceding reform, Marcus reflects:
“There was a high degree of reactive policy. A lot of drift in terms of policy settings.”
While the Royal Commission created momentum, he believes it missed a crucial opportunity by failing to deliver a united recommendation on long term funding.
“That really reduced the political pressure for prompt, significant response.”
Funding, fairness and difficult choices
Under the new framework, aged care remains primarily taxpayer funded, but means testing has strengthened. Those with financial capacity are expected to contribute more towards their care and accommodation.
Marcus accepts the principle of fairness but raises concerns about unintended consequences.
“There are going to be very difficult choices for people,” he says.
With clinical care more heavily subsidised than other supports, there is a risk that individuals may forgo essential daily living assistance because of cost.
He is also candid about rigidity.
“People are constantly having to conform to the system, as opposed to the other way around.”
Episode 5 of State of Our Nation: Global Perspectives is out now.
Blooming by Marcus Riley
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