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

Senator ANANDA-RAJAH (Victoria) (10:48): I wish to make some comments regarding the process that has followed the Greens political party and the coalition thwarting passage of an improvement to our generational aged-care reforms. As you know, this government is committed to improving standards, quality, accessibility and affordability of aged care, and we had to do it, because when we came to office in 2022 we inherited an aged-care system that was in crisis.

It was the royal commission that demanded we draw a line under a coalition era that they titled as 'neglect'. With that, we began the hard work of generational reform. It was in November of last year that the new Aged Care Act kicked off.

This was a complete overhaul of the system. It was recommendation 28 of the royal commission that demanded we introduce a more streamlined assessment system for older Australians. Until then, there had been way too much duplication, inefficiency and undue complexity.

In other words, it was onerous and burdensome on Australians, and, frankly, it was expensive for taxpayers. That's what happens when you have inefficiencies and duplication. And so, over a number of years, starting in 2020, the department started to craft an assessment tool that is now called the IAT, the integrated assessment tool, which has received a lot of press, not all positive, and there has also been a lot of mischaracterisation of this tool and the rationale behind having it.

We introduced this tool because we realised that there was imperfect decision-making happening by humans. Some people were getting too much in their home packages; others were not getting enough. If you were a man and you spoke perfect English, the chances are you were going to get a pretty good package, maybe overcompensated for your needs.

If, on the other hand, you were a non-English-speaking migrant—a bit like my family, my dad—the chances are you were probably going to miss out and not have your needs met. In fact, that's what the data showed. We had $4 billion in unallocated funds that were sitting in accounts not being used.

So something had to be done to deliver consistency and standardisation. The IAT was developed over a number of years using very large datasets, using expert input. I won't go through all of that.

It is in the Hansard from 1 April 2026, which lays out very clearly how this was developed. It basically then used about 13 different sections, including social supports, health issues and the home environment, to classify an older Australian into one of eight categories, No. 8 being the most severe category. With that, we also applied a prioritisation mechanism.

We know the process is not perfect, and that was recognised by this minister very early on. And so we instigated what was called a rapid review into the prioritisation mechanism. I'm going through this because the detail matters.

It was a prioritisation mechanism that underwent a rapid review. The report is currently being considered by the government, but changes were made, and you have to be agile when you're introducing generational reform. Things never go smoothly.

There are always roadblocks. There are always points of friction. We have tried to be adaptive as a government.

And so it became clear very early on that patients with, for example, motor neurone disease needed to be escalated up in the categories. So they now have a categorisation of 'urgent', which means they get their care packages, their Support at Home care packages, within a month, as do other people in that urgent category. But we know that the prioritisation mechanism does need to be adjusted, and that is being considered right now.

What is disappointing, after weeks and weeks and weeks of testimony and hearings that I've sat through in the committee with my colleagues from the Greens political party and the coalition, is that, now, five minutes to midnight, as we are trying to fix this system and make it more responsive to the needs of older Australians, they basically have banded together to completely thwart this.

They are throwing the baby out with the bathwater. The point of contention is the escalation pathway. They are blocking passage of an escalation pathway that we want to introduce so that older Australians get the care that they need, the packages that they need, in a much faster, more streamlined fashion.

Why? They want us to go back to the drawing board and tear up the IAT, the integrated assessment tool, because they say that it is an algorithm. God forbid we use an algorithm to deliver efficiency, consistency and standardisation!

Humans are the best decision-makers! That is absolutely false. In medicine, humans are not the best decision-makers.

Humans are assisted by similar clinical decision tools. We have a plethora of them in health care because we recognise that humans are biased decision-makers. And so, when we're dealing with thousands upon thousands of older Australians who need aged care, we must deliver consistency across what is a very diverse population terms of income status, ethnicity, language and values, as well.

But we have to deliver equity and standardisation. And so it is beyond disappointing that this has been blocked by the coalition and the Greens political party. In addition, I want to also mention that this goes contrary to several peak groups who provided testimony.

Mr Craig Gear of OPAN described this escalation pathway as, I quote, 'an important interim reform' and argued: Older people need an accessible correction mechanism while longer-term reform goes on. And that's what they're blocking. They're not happy.

They want to throw the baby out with the bathwater. 'Get rid of the IAT,' they say, but in doing so they are stopping us from actually improving the system, stopping government the from being agile and responsive to the needs of older Australians. They're going contrary to these peak bodies, who are actually saying: 'Get on with it. We know that it's not perfect, but get on with it.' Then we have Mr Irlam of COTA Australia, who said that further work on the assessment process, quote, 'should not delay fixing the immediate problem affecting older people'.

Ageing Australia similarly supported the escalation pathway proceeding while broader work on the process continued. Mr Symondson from Ageing Australia said: If we go right back to the drawing board now, how many people are going to fall through the already gaping cracks that we have in the system while we get that right? Which is why we do support the amendment … We have a range of stakeholders—peak groups—urging this parliament to get on with it and deliver on this significant reform, which is an escalation pathway, which does put in the human so that we have a practical safeguard that is designed to improve the prioritisation mechanism for Australians who feel like they haven't been heard or haven't been properly assessed by the IAT.

We think that number, based on data from earlier this year during estimates, is about 0.5 per cent. But, over a large number of people, that's a lot of people. We recognise that it's not perfect, and we are trying to fix it by introducing an escalation pathway with a qualified assessor.

They're making that judgement, responding to the issues raised by older Australians and their families. But the Greens, in their wisdom, and the coalition have said, 'No can do.' Start again, government. To all those years of work in trying to come up with a more efficient, standardised, better process in response to recommendation 28 of the royal commission, they say: 'It's not good enough for us.

We want to go back to the old system—' because the old system was perfect. What nonsense. It was not perfect; $4 billion tells us of unallocated funds—unallocated meaning not being used—because the assessments were wrong.

It tells us that the old system was not perfect. We are trying to improve this system, and you are standing in the way as usual. The Greens political party put the perfect in front of the good.

They are not pragmatists. They do not have the interests of older Australians in mind. This reform also introduces the Aboriginal aged care commissioner.

This is not a point of contention, but it is urgent that we deliver on this reform, because older Australians, particularly those of Indigenous background, have woeful health outcomes. ABS data from 2022 put the life expectancy gap at nine years for men and eight years for women. However, if you live in a remote or very remote community, life expectancy is 67 years for men and 71 for women.

It is much, much worse. We know that older Indigenous Australians have a much harder time gaining access to aged care, for a range of reasons. Of course, the tyranny of distance is one of them, but they find the system hostile.

They lack trust in the system. This is the legacy of colonisation. So recommendation 49 from the royal commission said that we should consider appointing an Aboriginal aged-care commissioner in order to be responsive to the cultural needs of Indigenous Australians right around this country, because they don't feel like they have cultural safety in the current system.

They need an advocate. They lack the self-efficacy and the ability to advocate for themselves. So an interim commissioner was installed by us in 2024, and we now want this enshrined in legislation going forward.

Senator ANANDA-RAJAH: I'm glad you support it, Senator Ruston. I do accept that. Senator ANANDA-RAJAH: And so do you, Senator Allman-Payne.

However, I am disappointed that we are being thwarted in delivering what are much-needed and urgent improvements to the assessment system. We know that generational reform is never easy. We're going through it right now with the NDIS.

That's going to be a bumpy road. No-one's pretending that delivering generational reform in aged care is going to be simple. We all accept that there are going to be bumps on the road.

But what we don't need, as a government and on behalf of the Australian people, are parliamentarians turning the needs of older Australians into a political football. We've got to rise above this, folks. There's too much at stake.

There are people out there suffering. I have some lived experience with that, with my 86-year-old father, who didn't actually wait that long to get his IAT done—but it was on us. We as a family probably did not make that decision to actually seek help early enough.

So to older Australians out there: I urge you to not leave it too late. If you think you need an assessment, get the assessment done, while we bat it out in here and try to deliver on this escalation pathway so that we can, in those instances where you feel like you have not received a satisfactory assessment, escalate it, get it amended and ensure that you are heard through a proper process.

Instead, we sit here wasting time instead of serving the nation, playing politics with the needs of older Australians. It's disgraceful. The Greens political party should hang its head in shame.

There is no point crying tears on committees. Get in here and actually act. (Time expired)