The government has inspired ‘profound distrust’ by ignoring evidence of the integrated assessment tool’s flawed design and implementation, say dissenting voices, sparking hopes the amendment will be defeated in Parliament.
A Labor-led Senate committee has recommended a bill containing a new rapid review pathway for disputed integrated assessment tool decisions pass without amendment, but Greens and Coalition senators say the government is ignoring evidence and could fix the controversial algorithm with the “stroke of a pen”.
The committee investigating amendments to the Aged Care Legislation Amendment (Aboriginal and Torres Strait Islander Aged Care Commissioner and Other Measures) Bill 2026, tabled its report this afternoon, recommending that the bill be passed as amended.
Schedule 4 of the bill concerns the introduction of a rapid review pathway for IAT decisions which will enable an assessor who believes an IAT outcome is incorrect in exceptional circumstances to refer the decision for review by the Department of Health, Disability and Ageing.
In their comments, Coalition and Greens senators were critical of the lack of transparency of the rules regarding the escalation pathway for disputed decisions, which the government has not yet released.
Greens Senator Penny Allman-Payne accused the government of “inspiring profound distrust” by insisting that incorrect aged care assessments were unusual, and repeated accusations that the escalation pathway simply allows the government to mark its own homework.
Coalition senators branded Schedule 4 as “a band aid on a symptom, not a fix for the cause”.
“The evidence shows that the fundamental problem in the assessment system under the Support at Home program lies in the Integrated Assessment Tool’s classification algorithm,” Senator Anne Ruston and Senator Chris Gatenby wrote in the report.
“Schedule 4 leaves that algorithm untouched. Despite the weight of evidence, the Department told the committee it does not agree the tool is flawed.”
Aged care assessment expert Professor Kathy Eagar said she agreed with the serious concerns raised by the Coalition and Greens in the report, and said she expected to see the Bill pass but the escalation pathway amendment to be defeated in the Senate.
Professor Eagar noted that the inquiry members voted along party lines and because the government has majority membership, the inquiry recommended that the whole Bill, including the escalation amendment, be supported.
“That is to be expected,” she told Health Services Daily.
“However, both the Coalition and the Greens raised serious concerns in their statements in the final report and I agree with them.
“The government does not need an amendment to the Act to introduce an escalation pathway. It can do it via the Aged Care Rules.
“My expectation now is that the Bill will be passed but the amendment dealing with the escalation pathway will be defeated in the Senate.
“We will know that the government is serious about an escalation pathway if Minister Rae changes the rules to allow it.”
The Coalition senators also noted that rules around the eligibility criteria, decision-making requirements and safeguards that would determine whether the pathway worked in practice had not been released by the government.
“Parliament should not be asked to repeat the lack of transparency that created this problem in the first place,” they wrote.
“In addition, officials were also unable to explain whether anything in the Act prevents the existing rules being amended to restore clinical discretion at the point of assessment, which is the very discretion assessors were told they would have.
“It appears the Minister could reinstate human override as part of the original decision-making process with the stroke of a pen.”
Meanwhile, Senator Allman-Payne said the amendment did not address the scale of the problem with the IAT.
“As demonstrated in evidence from Professor Kathy Eagar, the IAT systematically under-assesses those with cognitive issues, frailty and mental health conditions,” she said.
“It is disheartening, and inspires profound distrust, to see this compelling evidence ignored by the government and Department that continues to insist that mistakes merely occur in limited or outlier cases.”
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Senator Allman-Payne was also critical of the lack of transparency regarding the rules around restoring clinical discretion.
The amendment did not address the aged care assessment system’s refusal to acknowledge the professional expertise of clinicians, she said.
“Instead of restoring clinical human override to assessments, the amendment asserts the primacy of the Department in making decisions about older people’s care.
“The criteria on which these cases are to be judged have been almost entirely reserved for the rules, which the Senate is unable to see before being asked to consider this pathway.
“As given in evidence to this inquiry, the escalation pathway amounts to the Department being given power to mark its own homework following mistakes it is making.”
Senator Allman-Payne said any reforms to the aged care assessment system were inadequate if they did not abolish the IAT, fully rework the algorithm and restore human override by clinicians.
“The Greens will not give cover to the continuation of this broken algorithm, the bypassing of clinical assessors and the systematic under-assessment of older Australians’ needs.
“We remain committed to a total reform of the aged care assessment system.”
Two weeks ago, Professor Eagar and former acting aged care Inspector-General Ian Yates were invited to give evidence to the inquiry in relation to the amendments.
Professor Eagar told that hearing that the amendment was a “statutory safety valve for a system that is continuing to fail”.
The government’s argument that the new system gave a pathway to human override “misses the point”, she said.
“The system requires expert clinician decision making, not a human override.”
Professor Eagar said the other problem was that a review by a departmental assessor would not be independent and would constitute a conflict of interest.
“The assessment amendment, as it is now, allows the department to mark its own homework.”
Mr Yates told the hearing in September that his advice to the Senate would be to remove that schedule from the bill.
“Two wrongs do not make a right, and it seeks to divert and distract from fundamental flaws in the assessment process, and it does not address them,” Mr Yates said.