QUESTIONS WITHOUT NOTICE: TAKE NOTE OF ANSWERS

Senator ANANDA-RAJAH (Victoria) (15:20): I was going to talk about housing, but in fact I think I'm going to switch to aged care. We seem to think that, as humans, we are perfect decision-makers. In fact, we are far from perfect.

We are riven with internal biases, the most dangerous of which are unconscious ones—the ones we don't even recognise. We have our own blind spots, and we are highly subjective. I know this well because of my career in medicine.

In medicine, we have multiple scoring tools, clinical decision support tools, or what are called, in this House, algorithms—so many. We have the APACHE score for critically ill people. We have the Apgar scores for newborns.

There is the Glasgow coma score for people who might be losing consciousness. There is the Framingham Risk Score for people with cardiovascular risks, when you're trying to weigh up whether you need to give them certain meds or not. There's the RIFLE score for people with chronic kidney disease.

There are so many that are incorporated in medicine, because, in medicine, we appreciate that unconscious biases can kill people, and that is exactly what happens. And that's why so much research has gone into developing clinically validated scores. This morning, I heard a lot of rhetoric in this chamber around the integrated assessment tool that has been developed for aged care.

Some senators from the coalition said that this has not been clinically validated. They questioned why we are using an algorithm on older Australians: how dare we do this! In fact, the integrated assessment tool was developed over a four- to five-year period, starting back in 2020 or thereabouts, because we found that, in the old system, when people were being dispensed home-care packages, there were people with very similar clinical, social, cognitive and physical characteristics who were getting widely different packages—widely different packages.

In other words, it was highly variable, and there was inbuilt inequity in the old system, meaning that we were creating a country of haves and have-nots, by design, because we were relying on subjective assessments by flawed humans. This is why the IAT was developed. It was originally prototyped in 2020.

There were advisory groups—clinical, technical and statistical. In 2022, Flinders University ran a living lab trial—mock scenarios, with actors and clients. This is what we do in medical school, by the way; this is how we train doctors to become better doctors: we use mock scenarios.

In 2023, there was a live trial in over 22,000 people, and it was clinically validated on them. Then the IAT was further clinically validated on a dataset of over 100,000 people. It turned out, from that, there's a classification tool, which determines your level of funding, and a prioritisation tool, which determines which level you get.

And we have launched this. We had a hearing where we found that, of the 180,000 assessments that had been done, 834—or 0.5 per cent—are now undergoing review, and only one, as of April of this year, has gone to the Administrative Review Tribunal. In other words, it's not perfect, but it's not bad at all.

It's not bad at all, and it means that we are delivering more equitable aged care to more Australians without creating, by design, a series of haves and have-nots. We know there's more to do, and we are introducing further escalation protocols to improve this tool. (Time expired)