Care and support are activities that develop and maintain people’s capabilities, independence or quality of life. Across a person’s lifetime, these activities may span many areas, such as health, education or social care.
The care and support economy—the provision of paid care and support—is one of Australia’s fastest expanding economic sectors. Responsibility across these sectors is divided between the Australian Government and state and territory governments.
While there are many services connected to care and support, this Strategy focuses on aged care, disability support, veteran’s care and ECEC.3
These sectors are connected by a range of similarities.
Labour in these sectors is split between unpaid and paid care and support. Before the emergence of a formalised, paid market, the care and support provided to children, people with disability or people frail due to old age was done informally within households, primarily by women.
These segments of the care and support economy are projected to experience significant growth in demand in the coming years. This is due to demographic changes that include our ageing population and the increase in women’s workforce participation.
They share similar workforce demographics, with a predominantly female workforce and a high proportion of workers from migrant and refugee backgrounds. Most entry‑level jobs have no or low qualification requirements.
Workers in care and support sectors experience wage penalties when compared to other occupations with similar characteristics in adjacent sectors. Registered nurses working in aged care earn less than nurses in working health care. Teachers who deliver preschool programs in centre-based day care earn less than those teaching in primary schools.
Government plays a major role in funding and regulating the four sectors, and sometimes directly provides services within them.
Each of these sectors provides vital social infrastructure and supports the workforce participation of those using the services, their families or carers.4 Yet, work in the care and support economy has often been undervalued and workforce development has fallen short. This threatens the sustainability of the care and support workforce and exacerbates the risk that Australians will be unable to access affordable and high quality care and support.
The primary focus in the care and support economy is on the physical and emotional needs of the people accessing care and support. These needs include connectedness to others, the ability to exert influence over their environment, and safety — all within the expressed life choices of each individual. In ECEC the primary focus is on the education and development of children.
As policy makers, governments also need to consider the wellbeing of the family members, friends and neighbours who provide informal or unpaid care, and the workers who provide formal care and support. Government also has a responsibility to consider impacts on current and future taxpayers (who fund the majority of contributions to care and support services) to ensure spending is effective, sustainable and supports intergenerational equity.
A key aim of this Strategy is to provide a holistic view across the care and support economy. This will help facilitate comprehensive solutions addressing the shared needs of care and support workers, providers and the communities they serve. A holistic approach will also help improve the overall quality, accessibility, and sustainability of care and support, and ultimately contribute to building a more equitable and inclusive care and support economy.
Governments have often sought to address the challenges in many of the care and support sectors individually, but when policies are made in silos there can be unintended consequences for the service user and other sectors. This often occurs when different government departments are responsible for administering different programs or when there is a division of responsibilities between the Australian Government and state and territory governments.
ECEC Snapshot
1.4 million children from 1 million families attend a Child Care Subsidy (CCS) approved ECEC service.
CCS is based on family income and activity test.
Centre-based Day Care (CBDC) is the most commonly used service type:
- 8,827 CBDC services
- Employing 146,726 staff
Other types of care:
- Family Day Care
- In home care
- Outside school hours
There are also 334,440 four- and five-year-old children enrolled in a preschool program.
Major policy milestones:
- 2000 and 2004 – Child Care Benefit (2000) and Rebate (2004) introduced to assist families with the cost of raising children.
- 2018 - CCS replaces the former Child Care Benefit and Rebate arrangements.
- 2012 - The National Quality Framework is introduced to improve quality and transparency.
- 2023 - Cheaper Child Care package increases CCS for most families.
Disability Support Snapshot
One in six Australians with disability, including the one in four First Nations people with disability and 2.2 million women with disability.
National Disability Insurance Scheme (NDIS)
- 573,342 participants
- 325,000 NDIS workers
- Around 20,000 registered providers and 130,000 unregistered providers
Individualised budgets based on what’s reasonable and necessary.
Non-NDIS
Funded by the Australian Government and state and territory governments: either directly provided or through grant arrangements.
Major policy milestones:
- 2013 – The NDIS Act 2013 was created, beginning with a trial phase followed by a staggered roll out across Australia.
- 2016 – Commenced rollout of the NDIS; WA will have fully adopted the scheme by 2023.
- 2019 – Disability Royal Commission established, expected to report by September 2023.
- 2023 – The NDIS Review examines the design, operations and sustainability of the NDIS.
Veterans’ Care Snapshot
Community Nursing Program
- 11,111 clients
- 292 providers
Veterans’ Home Care Program
- 31,105 clients
- 161 providers
Fee-for-service contracts directly with providers.
Major policy milestones:
- 2001 - Veterans’ Home Care created to deliver home care services to the veteran community.
Aged Care Snapshot
Commonwealth Home Support Programme
- 840,000 consumers
- 1400 providers
- 76,096 total staff
Grant funding agreements with providers.
Home Care
- 216,000 consumers
- 906 providers
- 80,340 total staff
Individualised funding assigned to the consumer.
Residential aged care
- 245,000 residents
- 735 providers
- 277,671 total staff
Funding to providers based on residents’ assessed need.
Major policy milestones:
- 2012 - Living Longer Living Better reform package.
- 2021 - Royal Commission into Aged Care Quality and Safety spurs major reforms to aged care.
- From here on, the term care and support economy is intended to refer to these four sectors. Return to footnote 3 ↩
- Social infrastructure refers to the facilities, spaces, networks and services that support quality of life and wellbeing in our communities, and it includes care, education, and health provision.Return to footnote 4 ↩