It's not hyperbole to suggest we Western Australians think we’re a bit special.
Obviously we are, geographically, temperamentally and, let’s be honest, economically.
As Liz Behjat, state manager WA and the Northern Territory for peak body Ageing Australia, likes to remind anyone within earshot, “We’re 10 per cent of the population and 40 per cent of the GDP”.
I can imagine the eyerolls from those reading this on the east coast, but that’s fine, we’re used to it.
Nowhere more so than in our care sectors, where providers 3,000 kilometres from Canberra are running services across 2.5 million square kilometres.
WA’s strength has always been turning isolation into innovation; and it’s something that has been proved again during the past few years.
When hospital ramping prevented people getting the care they needed, aged- and home-care providers here worked with WA Health to build practical discharge pathways.
Shared data systems now link hospitals directly with aged-care and home-care providers, reducing delays and freeing beds (a uniquely WA fix born from cooperation, rather than blame).
In disability, providers and the state government were running foundational supports and place-based services for years, long before the NDIS Review gave them a name.
Trials in Katanning and neighbouring towns now bring the WA Department of Communities, the National Disability Insurance Agency and local providers together to design new commissioning models for thin markets in rural and First Nations communities.
There’s also the Inklings program – a collaboration between The Kids Research Institute, the WA Country Health Service and NDIS providers – which began as a small early intervention pilot for babies showing developmental differences and is now being studied nationally.
And through the state’s Disability Innovation Fund, provider-run projects such as Huntington’s Australia’s mobile neuro-clinics in the Kimberley are taking specialist supports to places that would otherwise go without.
What’s different about WA is that providers and state and local governments are recognising that ageing and disability are shared responsibilities. They are whole-of-government challenges, not just Commonwealth funding problems.
That recognition creates the opportunity to link health, workforce, housing, infrastructure and community services in a single, connected system.
The vision behind initiatives such as the Older Adult Integrated Care Hubs reflects exactly that: aligning health and care planning, population data and future infrastructure so services grow where people live and age.
It’s the same principle now being reinforced by the Productivity Commission’s recommendations on co-commissioning: designing care around people, not programs.
However, the coming Support at Home reforms and the NDIS overhaul are testing every provider’s patience and viability. Support at Home, due this month, promises a simpler, more flexible home-care model.
The NDIS reforms will tighten registration, funding and compliance. While these reforms are broadly welcomed, they have been long-running and exhausting.
Nationally, KPMG’s Aged Care Market Analysis 2025 shows the sector contracting. In the NDIS, NDIA data shows a growing concentration of payments to the largest providers, and our experience is certainly that smaller providers are exiting in droves.
Every part of the care system is under strain at the moment including governance, capital, data, workforce and cash flow. Hopefully, though, these reforms are also pushing an evolution that might finally reward capability over compliance. The providers investing in technology, workforce design and genuine partnerships will likely be the ones still standing when the dust settles.
So, the next 18 months will be messy. There’ll be pain, unintended consequences, and it will become even clearer that the department wasn’t ready for the new Aged Care Act. Some providers will call time. The challenge now is to stay steady, keep perspective and lead from the front.
Based on their past history, we’ll see WA providers and state and local government come to the fore. They will collaborate because distance demands it. They will innovate because no-one’s coming over the border to fix it for us.
Some might call it luck, but we’ll call it what it is here in WA: leadership.
So yes, maybe we are a bit special.
• Amber Crosthwaite is a commercial lawyer specialising in seniors living, aged care and disability
