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

Senator McALLISTER (New South Wales—Minister for the National Disability Insurance Scheme) (11:34): As I was indicating before the debate was interrupted, the government will be opposing this motion. We have heard from the parliament and from the community a desire to ensure that there is the ability for a human to review decisions made for Support at Home. The government has listened to that feedback.

We are proposing a mechanism to do exactly that. That legislation has been considered by the House of Representatives. The rules under underpinning that process have been developed, and an exposure draft for those rules has been published.

The legislation that is before this chamber could be supported today. We could support it today and enact that escalation process into law, and that would ensure that there is a process for a human to review decisions made for Support at Home. The motion before us, which proposes splitting the escalation pathway out of the bill before us, would only the delay the commencement of this measure.

As I noted earlier, the effect of schedule 4 of this bill will be to amend the Aged Care Act to allow certain aged-care assessment decisions to be reviewed through an escalation pathway, and that pathway would apply to certain classification decisions for home support and priority category decisions for home support, assistive technology and home modifications.

As noted by Minister Rae during consideration in the other place, the escalation path will make a real difference to older people who have complex, extenuating circumstances that don't fit neatly into existing assessment processes. During the hearing on the escalation pathway amendments by the Community Affairs Legislation Committee, there were many stakeholders that welcomed the government's decision to legislate an escalation pathway, the legislation that is before us today.

Tom Symondson, the chief executive officer for Ageing Australia, said that many older people had contacted his organisation about their assessment outcomes, demonstrating that the escalation pathway was, and I quote, 'very much needed'. And he went on to say this: We see this review pathway as a useful interim safeguard, and we welcome the ability for those assessments that are found to not meet the needs of the older person to be reviewed relatively quickly.

The Australian College of Nurse Practitioners also made a submission, and they said the pathway, and I quote, 'has the potential to improve fairness, responsiveness and confidence in the aged-care assessment system'. Mr Craig Gear of the Older Persons Advocacy Network told the committee this: OPAN welcomes the proposed escalation pathway. It's an important interim reform to enable human correction of outcomes informed by the integrated assessment tool.

Mr Gear also said this: We have called for this sort of escalation pathway since the commencement of the Aged Care Act in 2024. Older people need an accessible correction mechanism while this longer-term reform goes on to address other concerns around the IT, including how it picks up dementia. Major stakeholders in this policy area are asking for the legislation that is before this parliament now to be endorsed by this Senate.

Under the escalation pathway, where an older person's needs are not fully captured by the integrated assessment tool in extenuating circumstances, the assessment organisation can refer the case to the department and if the case meets the criteria, the department can substitute the outcome of the original assessment, so a person is not left with an outcome that doesn't reflect what they need.

It adds a further safeguard and strengthens assurance and human oversight of the assessment process. This is what stakeholders, including some in this chamber, have been calling for. In addition to the motion before us, I understand that the Greens political party intend to move another amendment that would change the way the escalation pathway would work.

Under the escalation pathway, as the government proposes, older people's assessments will be escalated to the system governor, the secretary of the department or his delegates in the cases where the assessment tool doesn't fully capture the complexity of their circumstances. If necessary, the outcome can be adjusted to ensure the older person gets appropriate care.

The secretary of the department is—should it need to be said—a human. His delegates are human—the human override that senators have been calling for. What the Greens are instead proposing with their amendment is an assessor led override.

I want to be clear about the deficiencies of this approach, because it mirrors the old assessment system, and the old assessment system saw inconsistent and unfair assessment outcomes being delivered because it was so dependent on who the assessor was making that determination. And the Greens amendment seeks to take us backwards to that unfair system. A broad discretion to override the classification of priority assigned under the rules, as they propose, risks undermining fairness and, importantly, slowing access to care for many of those who need it most.

It also risks the sustainability of the aged-care system itself. Costings by the department show that the fiscal implications of this model will be up to $16 billion. I'll repeat that number: $16 billion in additional cost.

Every senator in this place should care about the sustainability of our aged-care system. The government's proposed escalation pathway is the practical, responsible protection that the system needs without compromising the needs and the care of older people. So I return to the motion that is before the chair, which essentially seeks to delay this important reform, and it does nothing to improve the pathway for a single older person; it does nothing to deliver solutions for older people.

Our government has been consistent. We are willing to work across the chamber and beyond this building to deliver an aged-care system that older people deserve, and that is what we have been doing since we came to government. Targeted consultations were undertaken by the department as part of the review of the Support at Home prioritisation mechanism.

Stakeholders broadly supported the principles underpinning the assessment system and acknowledged the role of standardised decision-making in promoting consistency, transparency and equity. They also acknowledged that there may be exceptional circumstances where an individual's needs are not adequately reflected in the assessment outcome. Consultation highlighted concerns regarding circumstances involving complexity, deterioration, cognitive impairment, carer arrangements and social vulnerability.

That stakeholder feedback has informed the development of the escalation pathway, together with analysis case studies provided by assessment organisations. The government is willing to continue to work with stakeholders across the parliament to further improve our aged-care system, but that should not hold up this important measure. It's important to note that at no point does the escalation pathway, as we propose, remove or diminish an individual's existing rights to seek reconsideration of an aged-care assessment decision under the act.

The legislation manages the interaction between the escalation pathway and existing reconsideration processes by pausing reconsideration timeframes while an additional review is under way. This preserves an individual's access to merits review, and it assures a person is not disadvantaged where both processes are engaged. The government's proposal, which is before this chamber right now, is practical and responsible.

It does not compromise the care of older people, and it builds on the change we made earlier this year to the prioritisation systems queue rate, which brought the average wait for someone assessed as high priority, down from just over two months to just over one. It builds also on our change to make sure that people with MND are automatically treated as urgent.

But the motion before the chamber seeks to delay consideration of that practical, responsible protection. It seeks to split the bill and, by the stated intentions of Senator Allman-Payne, it seeks to prevent the establishment of the escalation pathway as proposed by the government. It's hard to see how that meets the calls of the stakeholders that I alluded to earlier in my remarks.

It's hard to see how delay meets the calls made by other parliamentarians here and in the other place for increasing oversight. It is hard to see how it advances the interests of older Australians. It looks like a political stunt designed to draw attention to the Greens political party at a time when they wish to be more visible in the public domain.

It doesn't look like a responsible reaction to a serious policy process to set the aged-care system up for the future. We have been working on this issue since we came to government, making sure the aged-care system, which had been characterised by neglect under the previous government, can deal with the challenges it faces now and deal with the challenges it will face in the future.

The proposal to split this bill in half doesn't assist with that. The proposal to return to the old system of total discretion by assessor organisations also doesn't assist with that and potentially adds billions of dollars of cost into the system. That's what the department analysis says, and that's what senators will need to weigh in considering the motion before the chamber.