Many Australians want to grow old at home with family and friends. Yet most have homes that are inaccessible. Without intervention now, taxpayers will be asked to deal with the unintended consequences for the health, aged care and disability budgets.

We all know people who go to hospital and do not return home because they can no longer climb the stairs, get down the hall, or use the bathroom. The alternative is an extended hospital stay while they wait for expensive modifications, or placement in some distant residential facility.

The fix?

Community and housing industry leaders agreed with the federal government a voluntary national guideline and a plan to provide basic access features in all new housing by 2020. Governments at all levels endorsed this agreement through their housing, aged and disability policies. This includes COAG’s 2010-2020 National Disability Strategy.

Adding these features at the design stage is cheap and easy to do. One cost estimate is A$200-$1,000 per dwelling. This would provide:

1. An accessible path of travel from the street or parking area to and within the entry level of a dwelling;

2. Doorways, corridors and living spaces on the entry level which most people can use;

3. One bathroom, shower and toilet that most people can use, with reinforcement in the walls for easy installation of grab-rails if required.

The agreement does not solve the housing needs of people with significant long-term disability. This requires more thought. But it does allow most people to manage unexpected disability, illness or frailty until more substantial changes can be made.

Just as importantly, it allows friends and family who have mobility difficulties to visit and be part of family life.

Voluntary approach isn’t working

A 2015 review of the agreement indicated that the voluntary approach has failed. It estimated that, without intervention, less than 5% of the agreed 2020 target would be achieved.

There are good reasons for this failure. The housing industry is highly competitive and risk-averse.

Most housing is designed and built long before the buyer comes along. Builders build what has sold in the past and what they think buyers might aspire to in the future. Their experience is that most buyers do not aspire to be old, disabled or frail, so access is not high on their agenda – but it should be.

These maps demonstrate the speed at which populations are ageing. They show the proportion in each country of people aged 60 or over in 2014 and 2050.UNDESA Population division, World population prospects: the 2015 revision

Although the features are easy and cheap to install, a change to new practices has its risks and can be expensive. Contrary to the notion that a single builder builds a home, housing construction constitutes a complex web of subcontractors and suppliers. Each is dependent on the other to avoid delays or unexpected costs.

A simple change, such as wider doorways, can throw out the preceding and following trades, and both time and money are lost.

From the housing industry’s point of view, the estimated cost of voluntarily providing these features is much greater. It is simpler to keep doing the same – there will always be a buyer at the end.

The housing industry acknowledges that when change is necessary for the common good, regulation is required. The industry first resists, then makes the change. The “conveyor belt” of housing construction adjusts, and business continues as usual.

A home’s design affects people’s lives throughout its lifetime, so many others bear the secondary costs of inaccessible design. Providing access in a home after it is built is 19 times more expensive than if it was included from the start. But it is the tertiary costs to health, ageing and disability programs that are of real concern.

The National Disability Insurance Scheme and the aged care reforms – Australia’s most ambitious and costly social programs in a generation – are based on the premise that it is both socially and economically responsible to keep people connected. This includes participating in community and family life for as long as possible.

What now?

Australia needs only to look to other countries to understand what needs to be done. The UK has legislated for minimum access in all housing since 1999. For three decades, Japan has provided financial incentives for the housing industry to build accessible housing.

Although these strategies are not without their problems, they have clearly changed the housing industry for the better.

The federal government must let go of the voluntary approach, to think long-term and regulate for minimum access features in the National Construction Code for all new housing. The agreed 2020 target can then be achieved.

As a nation that prides itself on embracing difference, a national accessible housing code is a good place to start.

Margaret Ward is affiliated with Australian Network for Universal Housing Design. She is currently co-convenor. This network is sponsored by People with Disability Australia. It is calling for minimum access features in all new and extensively modified housing to be provided in the National Construction Code.