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Children in care need a streamlined, consistent health system regardless of where they live or how frequently their circumstances change.
Every child deserves access to timely, consistent and tailored health care. But for the thousands of children and young people growing up in Australia’s foster care system, that’s not always the case.
Too many are falling through the cracks, facing a lifetime of preventable health issues because the systems designed to protect them fail to support their long term health and wellbeing. Many of these are children who have experienced significant trauma, and they are being let down by fragmented and often complicated services that don’t respond to their complex needs.
With the 2025 federal Budget recently announced and a federal election now complete, there is a real opportunity for policy makers to show national leadership and make meaningful change for children in care. While the Budget provides some welcome relief through tax cuts and energy rebates aimed at alleviating cost-of-living pressures for middle and low-income families, it fails to deliver targeted support for children in care.
Budget health care measures such as the expansion of Medicare bulk-billing, the establishment of 50 additional urgent care clinics, and increased investment in public hospitals are all positive steps towards enhancing Australia’s health care system. For children to access good health care, they need consistency and advocacy on their behalf to guarantee that they receive their regular health check-ups, that developmental milestones are being met and recorded, and that learning and developmental delays are investigated and diagnosed.
Alarming statistics
Data from the Centre for Community Child Health in 2022 revealed alarming disparities in the health care experiences of children and young people in care. Among young people with care experience, 33% reported having a long term physical health condition, with over half stating that their symptoms worsened during COVID-19 lockdowns. Nearly half of the children surveyed had a long term mental health condition, with 83% reporting a deterioration in their condition during the pandemic.
Far too many children and young people in care are missing out on vital health assessments and specialist services. A recent study of over 6000 children in foster or kinship care found that only 41 children had attended all their recommended health check-ups. These statistics are unacceptable and tell us that there is an urgent need for reform.
Growing inequalities and increasing demand for services
Children come into care for many different reasons; often, it’s just that parents and families are unable to cope and need support. The end goal of any out-of-home care service is to bring families back together and ensure that children are safe at home.
However, economic and structural inequalities continue to leave more than one child out of six and one adult out of eight living in poverty. More than 3.3 million Australians, including 761 000 children, are experiencing poverty and financial hardship, with many families on social security support struggling to meet their basic needs.
We see this data, and yet social security payments remain well below all measures of adequacy — at just $56 a day for JobSeeker and $47 a day for Youth Allowance. This is not enough for people to meet their basic needs. Young people living independently don’t have the skills or means to pay rent, feed themselves, attend school or education, or find work to support themselves with $47 a day.
The centre’s member organisations have told us about the overwhelming demand for family services in recent years. More than 94% of our members indicate that most of the children and families they work with are living in poverty or at significant risk. Services are stretched beyond capacity, forced to turn away families seeking early intervention support because they are overwhelmed by the need for critical response.
The housing and homelessness crisis facing young people was similarly absent from the Budget’s provisions. Nearly 40 000 children and young people across Australia find themselves without a place to call home each year. Research shows that around one in three young people leaving out-of-home care will experience homelessness within their first year.
A Gold Card for children in care
The Centre for Excellence in Child and Family Welfare has been asking for the introduction of a health care Gold Card system that establishes children and young people in care as an equity group and supports them with priority access and services that will identify previous gaps in their health care, and ensures their needs are properly investigated and met.
Like the Veteran Gold Card, this system would provide priority health care access for children in care from the moment they enter the system until they are at least 21 and ideally 25. It recognises that children in care face significantly higher rates of physical, mental, and developmental health challenges than their peers and require a consistent and intentional approach to meeting those needs.
The Veterans’ Gold Card is an example of the positive impact of prioritised health care, and we want a similar model for children in care. This sets them up as they become young adults with the information and support they need to manage and advocate for their own needs. It could help them access the National Disability Insurance Scheme and other specialist supports, and relieve pressure on carers who often struggle to navigate complex health care systems.
A Gold Card is about more than just ensuring access to GPs or emergency care. It could support continuity of care, which is often lacking for children who may move between temporary accommodation, extended family and foster care homes and lose access to medical records or specialists along the way. Without targeted policy responses, these children will continue to be underserved by even the best-funded systems.
Streamlined health system needed
While the Budget contains health care measures aimed at improving access for Australians broadly, it overlooks those most in need of prioritised support. Children in care need a streamlined, consistent system regardless of where they live or how frequently their circumstances change.
Current initiatives, such as Victoria’s $37.8 million investment in expanding the Pathway to Good Health program and the state’s HomeStretch and Better Futures initiatives, offer valuable support for young people until age 25. Tasmania’s Kids Care Clinics have also been launched to address shortages in paediatric care for vulnerable children. These state-based efforts are commendable but are inconsistent across Australia, leaving too many children behind.
As an identified equity group, programs designed to support children in care could be scaled and delivered across all jurisdictions. This would prioritise access to timely health assessments, specialist services, and ongoing support, giving children in care the opportunity for better health results regardless of where they live.
For our foster carers, it could make getting medical and developmental assessments for a child in their care much easier. Foster carers have told us they are sometimes left out of pocket for doctor or specialist visits because of lengthy processes to apply for and access reimbursement.
Foster carers are incredible people who advocate for the support needed by the children in their care like any parent. Too often, the systems they work in make this more complicated than needed. Attaching a health care card to the child means costs are met, and medical and therapeutic support can be accessed without delays or additional stress.
Conclusion
A Gold Card-style system represents a practical, compassionate way to give children and young people in care a supportive hand and show them that we care about their physical, mental and developmental needs. This will help them navigate the myriad of other challenges of poverty and homelessness that they may face.
The recent federal election provides a unique opportunity for leaders to step up for children in care and make this a priority and will be a clear demonstration of commitment to improving the lives of vulnerable children.
Australia needs to make this the year that we finally deliver on the promise to care for every child — not just in theory, but in practice.
Deb Tsorbaris is the CEO of the Centre for Excellence in Child and Family Welfare
The Centre for Excellence in Child and Family Welfareis Tasmania and Victoria’s peak body for child and family services. For over 100 years, the centre has advocated for the rights and wellbeing of children, young people and families, ensuring their right to be heard, to be safe, to access education and to remain connected to family, community and culture. For more information visit www.cfecfw.org.au.
The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the MJA or InSight+ unless so stated.
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