PRIVATE MEMBERS' BUSINESS

Dr RYAN (Kooyong) (13:22): I thank the member for Cowper for moving this important private member's motion. Graham Crossan is a member of the Kooyong community. Graham is 80 years old, and he has motor neurone disease.

Graham requires 24-hour-a-day care. He is ventilator dependent, and he can't stand. But the integrated assessment tool found that, despite Graham's condition, he's not eligible for the highest level of aged-care support in the community.

Graham's story is only one of a swathe of recent concerning stories I've heard in my electorate about the aged-care sector. The integrated assessment tool is now under investigation by the Commonwealth Ombudsman, and I commend my colleagues in the Senate for their scrutiny of the IAT at Senate estimates on 2 June. What emerged from estimates on that date was deeply disturbing.

We now know that aged-care assessors had the ability to override the algorithm used by the Integrated Assessment Tool until as recently as May 2025. In March 2026, I wrote to the minister asking a straightforward question: was there consultation before that human override capability was removed? It took more than three months for the minister to respond, and, when he did, his answer provided no certainty.

Questioning at estimates confirmed that the capability for assessors to override the IAT algorithm was stripped out without consultation, without engagement with the aged-care workforce, which would be using the tool, and without due consideration of what that change might mean for the people who are being assessed. That raises a serious question. Why was the minister unable or unwilling to provide that information when I asked about it earlier this year?

Senate estimates also confirmed that the algorithm was developed internally and that it wasn't independently tested as part of the 2023 IAT trial. That was the same trial that the minister has repeatedly pointed to as evidence that the algorithm was tested. That is an extraordinary admission.

The department also admitted that, under the previous system, people were overclassified, up to as many as 50 per cent. There has been no equivalent acknowledgement that the IAT might now be underclassifying people. I would argue that Graham Crossin's case demonstrates that this is happening.

The numbers speak for themselves. During the 2024-25 financial year, there were 170 requests for reviews of IAT outcomes. By 31 March 2026, that number was 989.

Just remember, reviews aren't easy to get. They require a written application sent by mail. Older Australians, many of whom are vulnerable, many of whom have cognitive loss, have to submit a physical letter to Adelaide to request a review.

So I'm worried that we don't know the true scale of cases like Graham Crossin's. But you know it's bad when the outgoing Inspector-General of Aged Care, Natalie Siegel-Brown, has said that she is 'struggling to understand how some of the results that are coming out are coming out'. That's on page 102 of the transcript.

I suggest that the minister look that one up. I acknowledge the government's recent changes to the priority pathway for motor neurone disease. These were pointed to by the minister in the House when I asked him about Graham's case.

But they do nothing for somebody like him, who is already in a system which is actively denying him the support that he needs and which, on review, comes back again to the same cruel answer—because its settings are intrinsically wrong. That's something that the minister knew but failed to acknowledge when I asked him about this in the House. I support the private member's bill introduced in the Senate last week by the shadow minister for health, Senator Anne Ruston, and by crossbench senators Penny Allman-Payne and David Pocock.

That bill would restore assessor discretion. It would enable qualified professionals to adjust or override the algorithm when their clinical judgement demands that they do so. It would also improve transparency by requiring decision notices to explain how both the tool and human judgement are applied, and it would allow anyone assessed since November 2025 to request a fresh assessment.

We have to restore professional judgement, clinical knowledge, fairness, common sense and generosity to the aged-care assessment system. Older Australians deserve nothing less.