A consistent theme in many of the foregoing chapters is the impact of health reforms on community services and families, and particularly on women’s paid and unpaid caring roles. This chapter argues that contemporary approaches to aged and community care policy disadvantage carers. The structure of the Australian welfare state increasingly depends on women as carers in the private sphere, as for example in health care provision and programs such as Home and Community Care. The Aged Care Reform Strategy has shaped changes in the aged care system over the last 10 years. One of the most important policy developments in aged and community care has been the planned reduction in nursing home beds and a shift in emphasis to hostel- and community-based home care services. Much of the aged care industry is operated as private, profit-making business, as is increasingly occurring with privatisation of the health and community care sector.