Aged Care Legislation Amendment (Aboriginal and Torres Strait Islander Aged Care Commissioner and Other Measures) Bill 2026

Ms SHARKIE (Mayo) (10:24): While I recognise what the government's trying to do here with this amendment—to enable escalation of home support assessment decisions in extenuating circumstances where the needs of the older person are not fully captured by the existing assessment process—I think we need to recognise that the system we have fails to address the systemic and structural flaws that the aged-care integrated assessment tool, the IAT, has created, and we need to see and detail and monitor its outcomes closely.

In April 2026, the Australian and New Zealand Society for Geriatric Medicine wrote to and advised both portfolio ministers, identifying multiple clinical risks resulting from the IAT's design. Then, we had Professor Kathy Eagar, in her evidence to the Senate Community Affairs References Committee's inquiry into Support at Home, saying that there is 'absolutely no justification for replacing expert clinical assessors with an algorithm'.

Surely we've learnt in this place how fatal algorithms can be. Professor Eagar said that the 62-page IAT is 'massively overengineered', a 'huge waste of taxpayer money', 'not fit for purpose', 'fatally flawed' and its continued use 'cannot be justified'; that 80 per cent of the IAT's 622 questions are not used in the algorithm and issues such as 'frailty and elder abuse are not really even mentioned'; that small differences in functional IAT scores produce very different funding outcomes for people with identical needs; that no other country uses an algorithm so extensively to assess care needs, and those who have tried to do so all but 'abandoned it' because 'it does not work'; and that 'this system is not at all consistent with the vision that the royal commission had in mind'.

The minister surely knows this. Professor Eagar said that the rules regarding IAT are 'not consistent with the act', as they redefined Support at Home as a financial entitlement scheme rather than a care and support scheme, which was the purpose that was set out in the act. She said that people who don't get their needs met end up malnourished, dehydrated and with pressure injuries and that they have falls, break their hips and fill up our emergency departments—which I'm seeing in South Australia and we're seeing right across the nation.

This is not a saving of taxpayer money. The Guardian newspaper reported documents released under FOI in which multiple state and territory health ministers have documented systemic errors since the IAT commenced in November last year. The director-general of health in WA, Dr Shirley Bowen, stated that the absence of a pathway for clinical discretion in exceptional circumstances poses significant risks.

She said: Without a pathway for discretion, a small but vulnerable group of older people might experience catastrophic outcomes while waiting for algorithmically determined access to services. Expert evidence was also provided by former inspector-general of aged care, Ian Yates, AM, to the Senate inquiry. He agreed with Professor Eagar.

He said that assigning funding levels before the care services are worked out is 'contrary to person-centred care' and that the assessment methodology is 'fatally flawed'. So I would urge the government and urge the minister to admit that the IAT is fatally flawed. This is a bandaid patch-up.

I don't even think it's going to work. Most older Australians don't think it's going to work, and their families are deeply concerned. Why are you not properly listening to the experts, whether that's Professor Eagar, Ian Yates, COTA, OPAN or National Seniors?

We have seen a litany of failures by this minister and this act already, and older people are dying because of it.