An empty chair set aside for federal aged care minister Sam Rae at a South Australian health summit highlighted tensions between state and federal governments over the national shortage of aged care beds, as SA Health Minister Blair Boyer presented modelling that the state government said showed ambulance ramping hours would have been cut by two-thirds in August had aged care beds been available.
SA Health Minister Blair Boyer presented the modelling at a meeting of state government, health and union officials in Adelaide this morning, convened under the title “federal aged care crisis”. The meeting was intended to increase pressure from the state government on Canberra over a shortage of aged care beds, which the state has blamed for consistently high ambulance ramping.
In August, SA ambulance ramping hours hit 5,891, the highest on record and more than double the highest monthly figure reached under the previous Liberal government. Prior to the 2022 state election, Labor had prominently promised to "fix the ramping crisis".
Mr Boyer told the meeting that the number of patients in public hospital beds unable to transfer to aged care was around 500 and could rise to almost 700 during next year's winter peak. The state government said that had those beds been available, ramping hours during the winter peak would have fallen from nearly 6,000 to below 2,000.
“What if we had, magically, all that capacity back? What if today the system had the 500 beds, that are out of action, available to us again?” Mr Boyer asked rhetorically.
The federal government cited short notice and a scheduling conflict for Minister Rae's absence. The ABC understands Mr Rae was given only a few days' notice and that a counteroffer was made to meet with Mr Boyer in Canberra.
A federal spokesperson defended the government's spending record, saying it was "not wasting a moment" to bring new residential aged care beds online. "Earlier this year, we announced the outcomes of an Expression of Interest process which will unlock $134.5 million to deliver 268 new residential aged care beds across five Adelaide sites, improving access to care and helping ease hospital discharge pressures," the spokesperson said. "We're supporting the construction of around 5,000 additional residential aged care beds each year."
The state government said double that number was needed.
The federal government also said the states had rejected opportunities to contribute. "When states told us delayed discharge was their biggest pressure point, we listened and put $2 billion on the table ringfenced for aged care services, through the National Health Reform Agreement. The states rejected it and took the money for hospitals instead," the federal spokesperson said.
Asked whether he was doing political damage to his federal Labor colleagues by being outspoken, Mr Boyer replied, “I doubt it's winning me any fans. Do I sit back because I'm afraid of being a bit unpopular with some of my colleagues and pull my punches? I'm not going to do that.”
State opposition health spokesperson Jack Batty welcomed the meeting provided it did not turn "into another talkfest. We really need more than summits, we need commitments, we need deadlines, we need actual results."
Premier Peter Malinauskas likened the high demand on aged care beds to a freight train that had been in motion for "decades" and had "now arrived at the station. The country's not ready for it." He told Radio National that decisions made "during the course of the Abbott years" had unwound policy measures designed to prevent the situation, and the consequences were now playing out.
Analysis
Why This Matters
- The dispute reveals a growing political rift between state and federal Labor governments over who is responsible for resolving the aged care bed shortage, which directly affects hospital capacity and patient safety.
- Record ambulance ramping hours place South Australian patients at risk and strain the state's health system, making the issue a key electoral vulnerability for the Malinauskas government.
- The outcome of this standoff could set a precedent for how other states negotiate with Canberra on shared health funding and aged care provision.
Background
South Australia's ambulance ramping crisis has been a persistent political challenge since Labor won the 2022 state election on a promise to "fix the ramping crisis". The state government has consistently argued that the shortage of federal-funded aged care beds prevents the transfer of patients out of hospital, clogging emergency departments and causing ambulance crews to wait longer to offload patients. The federal government has emphasised its own spending commitments while noting that states rejected a $2 billion offer ringfenced for aged care under the National Health Reform Agreement.
Key Perspectives
SA Health Minister Blair Boyer: Argues the aged care bed shortage is the primary driver of record ramping and that providing the beds would have cut ramping hours by two thirds during the last winter peak. He says he is prepared to be unpopular with federal colleagues to press the issue.
Federal government spokesperson: Defends the government's record, pointing to $134.5 million unlocked for 268 new residential aged care beds across five Adelaide sites and supporting construction of around 5,000 additional beds each year. Accuses states of rejecting a $2 billion ringfenced offer for aged care services.
SA opposition health spokesperson Jack Batty: Welcomes the summit but demands commitments, deadlines and results rather than another "talkfest".
SA Premier Peter Malinauskas: Describes the aged care bed shortage as a long-term problem that has arrived, blaming decisions made during the Abbott years for unwinding preventive measures.
What to Watch
- Whether federal Minister Sam Rae meets with SA Health Minister Blair Boyer in Canberra as a counteroffer was made.
- The next round of National Health Reform Agreement negotiations, which will determine how much funding flows to aged care versus hospitals.
- The impact of the 268 new Adelaide aged care beds announced for five sites, whether they come online in time for the next winter peak.
Checked
12 claims in this story checked against 1 source: 12 supported.
Show each claim
- SupportedAn empty chair for federal aged care minister Sam Rae at the bed-shortage summit highlighted state-federal tensions.Just In: “Those tensions were on full display in the form of an empty chair set aside for federal aged care minister Sam Rae”
- SupportedThe state government said the modelling showed ramping hours in August would have been cut by two-thirds if aged care beds had been available.Just In: “South Australia's worst-ever ambulance ramping hours in August would have been reduced by two thirds had there been no aged care bed block, the state government has claimed”
- SupportedFederal aged care minister Sam Rae was unable to attend the meeting.Just In: “federal aged care minister Sam Rae, who was unable to attend”
- SupportedBoyer presented the modelling at a meeting of state government, health and union officials in Adelaide that morning.Just In: “SA Health Minister Blair Boyer presented the modelling at a meeting of state government, health and union officials in Adelaide this morning”
- SupportedSouth Australian ambulance ramping hours reached 5,891 in August, a record and more than double the previous Liberal government's highest monthly figure.Just In: “In August, ambulance ramping hours in South Australia hit 5,891 — the highest on record, and more than double the highest monthly figure reached under the Liberal government”
- SupportedBoyer said around 500 public-hospital patients could not transfer to aged care, and the number could rise to almost 700 during the following year's winter peak.Just In: “the number of patients in public hospital beds who were unable to transfer to aged care beds was currently around 500 and could further increase to almost 700 during next year's winter peak”
- SupportedBoyer said ramping in the winter demand period just passed would have been below 2,000 hours instead of almost 6,000 if all the capacity had been available.Just In: “the winter demand period we've just had, where it almost peaked at 6,000 hours — and would have been below 2,000 hours had we had all the capacity available to us.”
- SupportedBoyer asked: “What if we had, magically, all that capacity back? What if today the system had the 500 beds, that are out of action, available to us again?”Just In: ““What if we had, magically, all that capacity back? What if today the system had the 500 beds, that are out of action, available to us again?,” he asked rhetorically.”
- SupportedThe federal government cited short notice and a scheduling conflict for Rae's absence.Just In: “Short notice and a scheduling conflict were cited by the federal government for Minister Sam Rae's inattendance”
- SupportedA federal spokesperson said $134.5 million would deliver 268 new aged-care beds across five Adelaide sites.Just In: “we announced the outcomes of an Expression of Interest process which will unlock $134.5 million to deliver 268 new residential aged care beds across five Adelaide sites”
- SupportedA federal spokesperson said the government was supporting construction of around 5,000 additional residential aged-care beds each year.Just In: ““We're supporting the construction of around 5,000 additional residential aged care beds each year.””
- SupportedA federal spokesperson said the states rejected a $2 billion offer for aged-care services and took the money for hospitals instead.Just In: ““When states told us delayed discharge was their biggest pressure point, we listened and put $2 billion on the table ringfenced for aged care services, through the National Health Reform Agreement. The states rejected it and took the money for hospitals instead,” the federal spokesperson said.”