A new analysis of 2,684 Australian homecare providers by StewartBrown should give UK policymakers – and commissioners – serious pause. In November 2025, Australia introduced its new Support at Home programme. One of the most significant changes was financial transparency. Providers must now publish prices reflecting the full cost of delivery.
Package management fees – previously up to 15% of a package’s value – were removed and folded into hourly rates. This ended the practice of cross-subsidising care management through opaque percentage charges and required providers to price every element of delivery openly. When hidden costs were exposed, prices rose by an average of 39%.
By February, median published rates were:
- Personal care: $112 AUD p/h (c. £57).
- Registered nursing: $180 AUD p/h (c. £92).
- Allied health: $185-228 AUD p/h (c. £94-£116).
- Care management: $140 AUD p/h (c. £71).
Even allowing for higher living costs, these rates are more than double the UK’s weighted average of £24.36 per hour. The immediate reaction may be that Australian homecare is expensive. A better interpretation is that transparent pricing reveals the true cost of regulated, employment-compliant care.
Australia’s cost of living is around 14-18% higher than the UK’s and net salaries are about 30% higher. Homecare wages reflect that reality, supported by a structured wage ladder linked to qualifications and experience.
Crucially, average provider margins are just 5.3%. The sector is estimated to need around 9.5% to become investible. Smaller providers operate at negative margins; even at scale, margins remain modest. There is no evidence of systemic overpricing. Transparency has not inflated the market – it has clarified it.
Now compare that with the UK. The weighted average hourly rate paid by councils and NHS bodies in 2025 was £24.36. The NHS pays slightly less – £23.96 per hour – despite funding the most complex packages.
Homecare Association analysis shows a £3.25bn funding gap if care workers are to receive pay equivalent to NHS Band 3 healthcare assistants and providers operate sustainably. When it comes to councils, 29% are paying below the direct employment costs of care workers at the National Living Wage. No UK region funds homecare at or above the Minimum Price for sustainable delivery.
Unlike Australia, the UK does not operate transparent, cost-reflective commissioning. Competitive procurement and price-driven frameworks obscure the real economics of care. Constrained local authority budgets shape rates rather than consistent cost modelling. For providers, this means absorbing inflationary pressures, employment reform and increasing clinical expectations without uplifts in fee rates.
Yet Government policy is moving in the opposite direction. The Employment Rights Act proposes guaranteed hours, enhanced sick pay and stronger protections, alongside Fair Pay Agreements negotiated through collective bargaining. Expectations around delegated healthcare tasks continue to grow. These reforms are welcome in principle. But legislating for stronger employment rights while commissioning below the cost of employment creates an economic contradiction.
Australia’s reforms show something uncomfortable but important – fair wages, workforce progression and regulatory compliance have a visible price. Removing hidden cross-subsidies forced that price into the open.
The UK has not yet had that moment of honesty. Social care is not discretionary. It is essential infrastructure underpinning community health, workforce participation and NHS performance. Infrastructure that is persistently underfunded does not become efficient – it becomes fragile.
If we want stronger workforce rights, clearer progression and professional parity with health colleagues, we must commission transparently and fund accordingly. Australia has exposed the true cost of homecare. The question is whether the UK is prepared to face the same reality.
Dr Jane Townson OBE is Chief Executive Officer at the Homecare Association.
Email: [email protected] X: @homecareassn