Chapter twelve: The marketisation of aged care: The impact of aged care reform in Australia

Australia, in common with a number of Western countries, is opening the provision of aged care to market forces. The marketisation of aged care has been associated with increased service provision by private, (often) for-profit service providers, consumer choice and greater financial contribution by users. Older people are constructed as the consumers of these services. Underpinning this strategy is the belief that the creation of a market for aged care will ensure quality care through consumer choice between competing services and greater consumer control of these services. This chapter critically examines recent changes in policy and legislation which have enabled greater private for-profit ownership of residential aged care facilities, and consumer contributions to the cost of residential aged care through interest from a refundable accommodation deposit. It examines the impact of these changes on the ownership of residential aged care facilities, identifying increasing private for-profit ownership. These changes are rationalised by consumer-directed care (CDC). We critically examine CDC through exploring the assumptions underpinning it and evidence for capacity for consumer choice. The chapter concludes with a discussion of regulatory changes, noting that current standards provide limited capacity to address poor quality care arising from poor staffing of facilities. © The Author(s) 2020.