I present a supplementary explanatory memorandum to the bill, and I ask leave of the House to move government amendments (1) and (2) as circulated together.

Leave granted.

I move government amendments (1) and (2) as circulated together:

(1) Clause 2, page 2 (at the end of the table), add:

(2) Page 60 (after line 22), at the end of the Bill, add:

Schedule 4 — Additional review for prescribed entry decisions

Aged Care Act 2024

1 Section 7

Insert:

entry decision reviewer: see subsection 90D(4).

prescribed entry decision: see section 90A.

2 Section 55 (after the paragraph beginning "For the service groups")

Insert:

A classification decision or a decision about an individual's priority category may be reviewed and changed in certain circumstances, at the request of certain approved needs assessors connected with the decision, and with the consent of the individual.

3 Subsection 78(1) (note)

Omit "Note:", substitute "Note 1:".

4 At the end of subsection 78(1)

Add:

Note 2: Certain decisions under this subsection can be subject to additional review under Part 4A.

5 At the end of subsection 83(1)

Add:

Note: A classification decision can be subject to additional review under Part 4A.

6 At the end of subsection 86(1)

Add:

Note: Certain decisions under this subsection can be subject to additional review under Part 4A.

7 At the end of subsection 90(1)

Add:

Note: A decision under subsection 86(1) about an individual's priority category can be subject to additional review under Part 4A.

8 After Part 4 of Chapter 2

Insert:

Part 4A — Additional review process for certain classification decisions and priority category decisions

90A Decisions subject to additional review

(1) A decision by the System Governor for an individual for a classification type for a service group is a prescribed entry decision if subsections (2) and (3) apply to the decision.

(2) This subsection applies to the following:

(a) a classification decision under section 78 for the individual for the classification type ongoing for the service group home support;

(b) a decision under subsection 86(1) about the individual's priority category for:

(i) the classification type ongoing for the service group home support; or

(ii) the classification type short-term or ongoing for the service group assistive technology; or

(iii) the classification type short-term for the service group home modifications.

(3) This subsection applies to a decision that meets the conditions (if any) prescribed by the rules.

90B Requesting additional review

(1) A person may request the System Governor to review, under this Part, a prescribed entry decision for an individual if the person:

(a) is an approved needs assessor; and

(b) is authorised to make the decision; and

(c) is employed or otherwise engaged (however described) by the entity that employed or engaged (however described) the approved needs assessor who provided the classification assessment report or prioritisation report for the decision.

Note: The request is taken to not have been made in certain circumstances: see section 90C.

(2) The request may be made only if:

(a) the individual consents to the request; and

(b) the circumstances (if any) prescribed by the rules apply.

Note: If a request for review of a prescribed entry decision is made under this Part, requests (including by the individual) for reconsideration of the decision under Division 2 of Part 2 of Chapter 8 are affected by section 90G (additional reviews—interaction with reconsiderations).

(3) The request must:

(a) be made in writing and in the approved form; and

(b) comply with the requirements (if any) prescribed by the rules.

Timeframe for requests

(4) The request must be given to the System Governor within the following period after the day the prescribed entry decision was made:

(a) 7 days;

(b) if the System Governor determines a longer period for the request than would otherwise apply under paragraph (a)—that period.

(5) The System Governor may, at the request of the person who requested the review, extend the period under subsection (4).

90C When request taken not to be made

(1) A request under subsection 90B(1) is taken, for the purposes of this Act (other than paragraph 90G(2)(b) (days to be disregarded for reconsideration and review provisions)) to not have been made if:

(a) the System Governor is satisfied that a requirement in this Part has not been met in relation to the request; or

(b) the person who requested the review withdraws the request before it is decided under subsection 90E(2).

Note: For paragraph (a), examples of requirements that may not be met include the following:

(a) the decision is not listed in subsection 90A(2);

(b) the decision does not meet the conditions prescribed by the rules for the purposes of subsection 90A(3);

(c) the person requesting the review does not meet the requirements in subsection 90B(1);

(d) the circumstances prescribed by the rules for the purposes of paragraph 90B(2)(b) do not apply;

(e) the request does not comply with the requirements prescribed by the rules for the purposes of paragraph 90B(3)(b).

(2) The System Governor must give the person who requested the review written notice that the request is taken to not have been made:

(a) if paragraph (1)(a) applies—as soon as practicable after receiving the request; or

(b) if paragraph (1)(b) applies—as soon as practicable after receiving the withdrawal.

90D Dealing with a request for additional review

(1) This section applies if a request is made under subsection 90B(1) to the System Governor to review, under this Part, a prescribed entry decision for an individual.

(2) The System Governor must, as soon as practicable after receiving the request, give the person who requested the review written notice that:

(a) states that the request has been received; and

(b) specifies the day the request was received.

Reviewing the prescribed entry decision

(3) The System Governor must:

(a) personally review the prescribed entry decision under section 90E; or

(b) cause the prescribed entry decision to be reviewed under section 90E by a delegate of the System Governor who:

(i) was not involved in making the decision; and

(ii) occupies a position in the Department.

(4) The person who reviews the prescribed entry decision under section 90E is the entry decision reviewer.

90E Additional review — decision

(1) This section applies if a request is made under subsection 90B(1) to the System Governor to review, under this Part, a prescribed entry decision for an individual.

(2) The entry decision reviewer for the review must review the prescribed entry decision and decide to:

(a) affirm the prescribed entry decision; or

(b) vary the prescribed entry decision; or

(c) set aside the prescribed entry decision and substitute a new decision.

Note: For the effect of the decision, see section 90G.

Requirements for review and decision

(3) In reviewing the prescribed entry decision and making a decision under subsection (2), the entry decision reviewer:

(a) must have due regard to procedural fairness; and

(b) must have regard to any material on which the prescribed entry decision was based that the entry decision reviewer considers relevant; and

(c) may have regard to any matters prescribed by the rules as matters to which the entry decision reviewer may have regard; and

(d) must act in accordance with the rules.

(4) Without limiting paragraph (3)(d), rules made for the purposes of that paragraph may prescribe criteria, methods or procedures relating to classification levels or priority categories.

(5) If the entry decision reviewer decides under subsection (2) to vary or substitute the prescribed entry decision, that decision (as varied or substituted) must:

(a) if that decision is a classification decision under section 78—be a classification level set out in the rules for the purposes of paragraph 81(2)(a); or

(b) if that decision is a decision under subsection 86(1) about the individual's priority category—be a priority category prescribed by the rules for the purposes of paragraph 87(1)(a).

(6) To avoid doubt, in reviewing the prescribed entry decision and making a decision under subsection (2):

(a) the entry decision reviewer does not need to follow the criteria, methods or procedures prescribed by the rules as mentioned in subsection 78(1) or 86(1) (as the case may be); and

(b) if the entry decision reviewer decides under subsection (2) to vary or substitute the prescribed entry decision, that decision (as varied or substituted) does not need to meet the criteria:

(i) if paragraph (5)(a) applies—set out for a classification level by the rules for the purposes of paragraph 81(2)(b); or

(ii) if paragraph (5)(b) applies—prescribed for a priority category by the rules for the purposes of paragraph 87(1)(b).

Guidelines

(7) The System Governor may, by notifiable instrument, make guidelines relating to any of the matters mentioned in this section.

90F Additional review — notice and date of effect

Notice of decision

(1) After an entry decision reviewer reviews a prescribed entry decision for an individual and makes a decision under subsection 90E(2), the entry decision reviewer must, within 14 days of making the decision, give written notice to:

(a) the person who requested the review; and

(b) the individual.

(2) The notice must set out the following:

(a) the decision;

(b) the day the decision was made;

(c) the reasons for the decision.

When decision takes effect

(3) The decision takes effect:

(a) unless paragraph (b) applies—on the day the decision was made; or

(b) if the notice specifies a day as the day the decision takes effect (which must be a day on or after the day the prescribed entry decision took effect)—on that day.

90G Additional reviews — effect and interaction with reconsiderations

Additional review decision has effect as if made under original provision

(1) A decision under subsection 90E(2) on review of a prescribed entry decision has effect as if it had been made under the provision under which the prescribed entry decision was made.

Note 1: The decision (the additional review decision) under subsection 90E(2) is disregarded for the purposes of Part 2 of Chapter 8 (reconsideration and review): see paragraph (2)(a) of this section.

Note 2: For the date of effect of the additional review decision, see subsection 90F(3).

Note 3: The additional review decision does not have effect if (see subsection (5)):

(a) the decision (the reconsideration decision) on a reconsideration of the prescribed entry decision under Part 2 of Chapter 8 is as favourable as, or more favourable than, the additional review decision (see subsections 564(4) and (6) (effect of reconsideration decision), and subsection (4) of this section); or

(b) the Administrative Review Tribunal makes a decision on review of the reconsideration decision (see section 107 and subsections 108(2) and (4) of the Administrative Review Tribunal Act 2024 (operation and effect of Administrative Review Tribunal's decision)).

Interaction with reconsideration provisions

(2) In applying Part 2 of Chapter 8 (reconsideration and review of decisions) in relation to a prescribed entry decision:

(a) disregard a decision (if any) under subsection 90E(2) on review of the prescribed entry decision (despite subsection (1) of this section); and

(b) disregard a day during a period (if any) (the additional review period):

(i) starting the day a request is made under subsection 90B(1) to review the prescribed entry decision; and

(ii) ending the day notice of a decision on the request is given under subsection 90F(1), or notice that the request is taken to not have been made is given under subsection 90C(2).

Note: Paragraph (a) has the effect that a reconsideration of the prescribed entry decision under Part 2 of Chapter 8 is of the decision as made, and not of the decision as varied or substituted under subsection 90E(2).

(3) A request under subsection 559(1) to reconsider the prescribed entry decision, that is made during the additional review period, is taken to have been made after that period.

Additional review decision prevails over decision on reconsideration if more favourable

(4) If:

(a) a decision (the additional review decision) under subsection 90E(2) is made on review of a prescribed entry decision for an individual; and

(b) the prescribed entry decision is subsequently affirmed, varied or substituted (the reconsideration decision) on a reconsideration of the prescribed entry decision under Division 2 of Part 2 of Chapter 8; and

(c) the additional review decision is more favourable for the individual than the reconsideration decision;

despite subsections 564(4) and (6) (effect of reconsideration decision), the reconsideration decision does not have effect for the purposes of this Act (other than section 566 (review by the Administrative Review Tribunal)).

Note: If this subsection does not apply (for example, because the reconsideration decision is as favourable as, or more favourable than, the additional review decision for the individual), the reconsideration decision has effect instead of the additional review decision and the prescribed entry decision (see subsection 564(6) and subsection (5) of this section) on and from the time mentioned in subsection 564(4).

Additional review decisions otherwise subject to decisions on reconsideration or ART review

(5) To avoid doubt, subsection (1) operates subject to:

(a) subsections 564(4) and (6) (effect of reconsideration decision); and

(b) section 107 and subsections 108(2) and (4) of the Administrative Review Tribunal Act 2024 (operation and effect of Administrative Review Tribunal's decision).

9 At the end of subsection 559(1)

Add:

Note: If the reviewable decision is a prescribed entry decision, and a request is made under subsection 90B(1) to review the prescribed entry decision:

(a) days in the additional review period mentioned in paragraph 90G(2)(b) are disregarded in applying this Part in relation to the prescribed entry decision; and

(b) a request for reconsideration under this subsection of the prescribed entry decision made during the additional review period is taken to have been made after that period: see subsection 90G(3).

10 At the end of subsections 559(3), 560(5) and 562(5)

Add:

Note: In applying this Division in relation to a prescribed entry decision, days in the additional review period mentioned in paragraph 90G(2)(b) are disregarded if a request is made under subsection 90B(1) to review the prescribed entry decision.

11 Application

The amendments made by this Schedule apply in relation to a prescribed entry decision made on or after the commencement of this item.

This Labor government is committed to building an aged-care system that delivers the care that older Australians need. This amendment establishes the capacity for an escalation pathway for home support assessment decisions. It will make a real difference to older people who have complex extenuating circumstances that don't fit neatly into existing assessment processes.

The integrated assessment tool is a critical component of the Single Assessment System, which was a key recommendation of the Royal Commission into Aged Care Quality and Safety. This amendment further improves that system. Where an older person's needs cannot be fully captured by the assessment, assessment organisations will be able to refer that assessment to the Department of Health, Disability and Ageing. The system governor will then be able to substitute a different outcome where the case meets the criteria. The circumstances in which this applies will be set out in the Aged Care Rules. We'll take the time to consult on exactly what those criteria need to be to ensure that we're delivering a sustainable, workable pathway. This sits alongside other work to strengthen our assessment system based on the experiences we've heard about from older Australians and those who care for them.

Earlier this year, we made changes to the prioritisation system, Curate, which brought the average wait for someone assessed as 'high priority' down from just over two months to just over one. We made sure that people with MND are automatically treated as urgent. We're enabling assessors to correct input errors in the tool, and the rapid review into the Support at Home prioritisation mechanism will tell us what else needs adjusting.

At this stage, I acknowledge the constructive conversations I've had with the shadow minister, on behalf of the opposition. There are contributions in terms of how we further improve this system. We have the member for Mayo, the member for Kooyong and the member for Curtin in the House, all of whom I have met with and discussed different elements of this system; I thank them for their constructive engagement as well.

Consistent national rules are an essential feature of a fair, sustainable system. Assessment organisations, peak bodies, advisory group members and representative groups told us the system needed a way to deal with the exceptions to the rules. This amendment continues the government's work of delivering a system that provides safe, dignified and high-quality aged care for every older Australian.

I want to speak very briefly about the government's proposed changes to the integrated assessment tool. The Greens fully support the establishment of a permanent Aboriginal and Torres Strait Islander aged-care commissioner. The government's amendments show that Labor are slowly starting to recognise that they've built a system that is untenable. The government says it will provide an escalation pathway for those underassessed by their aged-care assessment tool.

We know, though, that the integrated assessment tool is broken. It systematically underassesses older Australians with cognitive issues, mental health conditions and frailty. This is the same tool that was giving older people with MND 10 times less funding than was necessary. This is not a tool that can be fixed with an escalation pathway to tape over everything it gets wrong. Older people don't need another escalation pathway to the department; they need human override by clinicians and the new assessment tool.

Older Australians expect to be treated with dignity, respect and care. They expect and deserve to have decisions about their care made by human beings. The integrated assessment tool is a symptom of the aged-care system that Labor has created—one where real people, in the later stages of their lives, are subject to the whims of an algorithm. I've received many emails, phone calls and letters from older Australians and their adult children in my electorate. Without exception, they're absolutely horrified by the lack of transparency and the callous disregard that Labor's aged-care system is putting them through. Securing aged care is really hard, and it should not be this way. The fact that Labor is proposing these amendments shows that pressure is working. This bill and these amendments regarding the IAT will go to a Senate inquiry, where the Greens will continue to work across the whole parliament to fix this broken system.

Among other things, the government's amendments to the Aged Care Act introduce an additional human review process for decisions made by the integrated assessment tool, and I support these amendments. They're overdue and they're welcome. For close to a year, an automated tool has had the final say on aged-care support packages for older Australians. Assessors with decades of clinical experience have been unable to override a result that they believed to be wrong. Older Australians have seen their supports cut despite deteriorating health, with no clear explanation and no way for a human to step in and fix it. I've heard directly from individuals affected and from aged-care assessors and providers in Curtin who describe watching this system produce outcomes they knew to be incorrect and being powerless to change them. That's older Australians carrying the cost of a process that nobody can properly explain or correct. So, when the government brings forward a schedule that restores a form of human override, I welcome it.

The new part 4A allows a human assessor to request an additional review of a decision made by the automated integrated assessment tool. The substance of this reform sits in the rules that will be made under it. The bill leaves crucial matters to those rules, including what requirements must be satisfied for this human review process to be used. Those rules are not before the House today. They will be made by the executive, and they deserve the same scrutiny as the legislation itself. I'll be looking closely at them when they're tabled, and I expect the government to consult properly with the sector first. A human override with narrow rules and short windows would not fix this.

I also want to place these amendments in a wider context, because it should not have taken this long, and it should not happen again the way it's happened this time. This morning, the Guardian revealed that, before the rollout of the automated aged-care tool, assessors had been told by government many times that they would maintain the ability to override the assessment tool. Only at the last moment did these assessors, many of whom had been working to assess and support older Australians for decades, realise that the government had actually failed them and failed older Australians by taking away any ability to override the automated tool. Despite frantic warnings made by the assessors that this would cause real problems, the government ignored them and ploughed ahead.

These types of safeguards should not be an afterthought, and they should not be at the whim of each minister. Last week, I introduced the Automated Decision-Making (Safeguards and Transparency) Bill into this House. That bill does for all automated government decisions what these amendments do for one small corner of the aged-care system. It requires any department or agency automating a decision to meet a set of safeguards and transparency requirements before that automation goes live. It prohibits automation where a decision requires genuine human discretion, where an outcome cannot be properly explained or where it would produce an unlawful result. Where automation is used for high-risk decisions, it requires a human to be able to override the outcome, requires the system to be tested for accuracy before use and requires review pathways and independent oversight.

The story of the integrated assessment tool shows why this framework is needed. This was not unique to aged care. It was a symptom of a larger gap. We have no general rule that a human must be able to correct an automated government decision. So, when something goes wrong, the fix has to be legislated, department by department, after the harm has already been done. Older Australians should not have to be the ones who discover the gap in the system by living through it. Neither should people relying on the NDIS or social security or on the growing number of government processes where automation is being introduced. That's the case for a single mandatory framework that applies across government, rather than a patchwork of amendments introduced after each failure has already occurred.

I support these amendments. I'll be scrutinising the rules that follow them closely, and I urge the government to look at what happened here and support a broader framework governing the use of automated decision-making so the next robodebt, no matter which department it's in, is stopped before it starts.

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.

I rise to speak to an amendment that adds human oversight through a new review process on certain aged-care assessment decisions made by the integrated assessment tool. I've been raising concerns about the integrated assessment tool, the algorithm currently being used to determine aged-care supports, since the legislation for it was passed by the House—22 times this year in parliament. Since 1 November last year, there has been no mechanism for skilled clinicians to be able to override the final assessments of this tool.

I've heard repeatedly from Kooyong constituents whose needs have been grossly underestimated by the integrated assessment tool, which has left them with aged care packages that have been manifestly inadequate. I repeatedly raised concerns about community members like Graham Crossan, an older member of the Kooyong community with motor neurone disease, and how he was underserved and undersupported by the aged-care system as a result of this tool. I've repeatedly raised the concern that we have been creating robo-aged-care.

That's why I'm really happy to see the government listening to reason and listening to the concerns of aged care experts and older Australians from around the country for the need to restore human oversight to aged-care decision-making. I'm really pleased that the government has recognised an amendment that the minister is to refer to the Senate Standing Committee on Community Affairs. I hope that this inquiry will be open to public submissions so that older Australians, like those I've heard from in Kooyong, and the experts from the sector can continue to voice their concerns about how the aged-care system is treating them in this country.

On my initial reading of the amendments, the proposed review framework is a positive and constructive step, but there are details that will need to be resolved. It's important that older Australians have the opportunity to discuss the algorithm's outcome with a skilled clinician that undertakes their assessment and that, if they're unhappy with that assessment, they can apply to the system governor for a review of its decision. The amendment is providing that a request for review must occur within seven days of the algorithm's original decision. Urgency is good, but this is a very small window. I look forward to further detail from the minister on how the department plans to equip assessors with the knowledge to encourage applicants to pursue this pathway within that timeframe.

The amendment states that a review will be undertaken if the circumstances prescribed by the aged-care rules apply, and I note that the minister has promised further consultation with the sector and older Australians on those rules. I hope that he will—as my colleague the member for Curtin has suggested and as I've already spoken to in the main legislation that we're addressing today—consider the need for and press his colleagues to urgently legislate a system-wide framework for the use of automated decision-making in government. We've already in this House this week spoken to the ills, the harm and the gross damage undertaken and inflicted on Australians by robodebt. We have to make sure that that doesn't happen again.

I'd also like more detail on who's going to be undertaking the reviews under this amendment. It specifies that the system governor or their delegate, who has to occupy a position within the Department of Health, will be responsible for that decision. It's absolutely crucial that those delegates have clinical experience. They cannot be public servants without the ability and the expertise to undertake that sort of review. I'm really pleased to see that the reviewer can vary decisions about both the classification and the priority of older Australians undertaking these assessments. In other words, the review will be able to determine how much funding those individuals receive and how quickly. It's good that the reviewer is going to have to provide reasons for that decision-making within two weeks of the decision.

I'd like to commend the Minister for Aged Care and Seniors for taking this step. He has been pushed very hard by the crossbench on this issue, with good reason. We commend him for acting now. We would have liked him to act sooner, but you take what you can get in this place.

These amendments provide an opportunity for correct decisions under a system that may otherwise leave, and has been leaving, older Australians without the support that they need and deserve.

Question agreed to.

Bill, as amended, agreed to.