Penny Allman-Payne (Queensland, Australian Greens) | Link to this | Hansard source

I seek leave to move a motion relating to the integrated assessment tool, as circulated in my name.

Leave not granted.

Pursuant to contingent notice standing in the name of Senator Waters, I move:

That so much of the standing orders be suspended as would prevent me moving a motion to provide for the consideration of a matter, namely a motion to give precedence to a motion relating to the integrated assessment tool.

This suspension is urgent because the Four Corners program last night revealed the shocking impact of the government's flawed and untested Integrated Assessment Tool on older Australians. It is urgent that we suspend to consider this issue because the answers given by the minister in last night's Four Corners program indicated that the minister showed himself to be utterly ignorant of the severe and ongoing impacts that this flawed tool is having on older Australians.

It is urgent that we suspend standing orders because the answers given by Senator Wong to the questions raised by Senator Colbeck further indicate that the government does not understand the incredible hardship that is being placed on older people and their families who cannot get the care that they need in a timely way. This matter is urgent, and we should suspend standing orders because we know that the Integrated Assessment Tool algorithm is flawed. We know that the Integrated Assessment Tool is consistently underassessing older people's care needs, and we know, from the answers that the minister continues to give, that the government is not fully alive to this issue.

It is urgent that we suspend standing orders to debate this motion because we know that tiny differences in this flawed algorithm are seeing some people having their care support halved. We know that it is urgent, and we should suspend standing orders to debate this because people like Sean Dorney—who's had motor neurone disease for a decade, who has sought a reassessment and who is not eligible for the fast-track mechanism that the minister says has been implemented, because he already has a care package—is still waiting eight months later for an assessment when he has a neurodegenerative disease.

It is urgent that we discuss the need for the government to scrap the flawed Integrated Assessment Tool because we heard clearly in evidence given by the department that it was never tested and verified externally and independently by clinicians. We know that this is urgent and, therefore, warrants a suspension of standing orders to debate because we know that the minister's view that there are a tolerable number of requests for review is flawed. We know that hundreds of people are not bothering to challenge the algorithm, because they are worried that they will be worse off. We know that the burden to challenge an algorithm that is flawed and to fix a problem that the government was told was foreseeable should not be placed on older people and their families. It is urgent that we debate this because people like 96-year-old Audrey don't have time to wait for the government to scrap a tool that is saying that, despite her last assessment being 12 years ago, her care needs have not increased.

It is urgent that we suspend standing orders to debate this issue because we know that the minister is out of his depth, does not understand his brief and has failed categorically to listen to the concerns that have been raised in the hearings that we have had in the Support at Home inquiry and in the questions that we have raised at estimates. When clinicians, when providers, when older people, when their families and when the people who work in the sector are all telling the government that this tool is flawed and is underassessing the care needs of older people, it is urgent that the government acts. That is why it is urgent that this motion be put before the Senate. I urge every senator to support the government scrapping this integrated assessment tool, going back to the beginning, consulting with clinicians and restoring human override so that no older person in this country is subject to a computer program deciding their care.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) | Link to this | Hansard source

I stand also to support the urgency of the issue that has been put forward by Senator Allman-Payne because the evidence before us is absolutely damning. The integrated assessment tool is not working, and there is not one piece of evidence to suggest that it is. This is no longer about a few teething problems. This is a systematic structural flaw in the algorithm that is put in charge of making decisions about the care needs and the urgency of those care needs of older Australians—older Australians like Audrey.

For any of you who saw the Four Corners program—

Sue Lines (President) | Link to this | Hansard source

Senator Ruston, I remind you this is a suspension debate, not a debate about the substantive motion.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) | Link to this | Hansard source

Thank you very much, President. I can't think of anything that is more urgent than older Australians dying because they're being misassessed by an algorithm that's been put in place by this government. People are dying. There is nothing more urgent than putting in place in this chamber and in this parliament measures to prevent people from dying. So I don't think anybody in here would disagree that there is nothing more urgent than making sure that people are not dying unnecessarily, because legislation and, quite frankly, a computer are making decisions that leave their care needs so underfunded and under-resourced that they're dying while they're waiting for the care that they have been assessed as needing.

I don't believe I need to stress the urgency of this motion any more, but, quite frankly, the fact that the government, since the introduction of the new reforms into aged care in November last year, have failed—

Sue Lines (President) | Link to this | Hansard source

Senator Ruston, I remind you once again that your comments need to focus on why this suspension order ought to be agreed to.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) | Link to this | Hansard source

I'd ask the people of Australia: do you think it is urgent that we should make changes to a computer algorithm that is making decisions about older Australians that is causing them to die while they wait for the care that they need? I don't believe that there is any more urgent thing that we should be doing in this place or the other place. The fact is that this place has already passed legislation. The will of this chamber is that the algorithm requires human override. What we're seeing today, though, is the urgency has been escalated because of the Four Corners program last night—

Sue Lines (President) | Link to this | Hansard source

Senator Ruston, I'm going to remind you once again you need to focus on the debate at hand, which is whether or not a suspension ought to be agreed to.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) | Link to this | Hansard source

I believe the suspension needs to be agreed to, and the reason for its urgency is that unless something is done about the failed computer algorithm that this government has in place and its continued refusal to address the fundamental and structural flaws older Australians will die. I don't know if anybody in this chamber would like to disagree with me and argue that older Australians dying unnecessarily because of a piece of legislation and an algorithm that has been legislated through this place is not urgent. I would be pleased for you to come forward and make that case, because I believe my case is very strong. As I said, please come forward if you disagree with me.

It's not just me. I absolutely agree about the urgency of this and the fact that older Australians are dying, but the experts also agree about the urgency of this motion. The experts are people like the former inspector-general of aged care Ian Yates, the recently resigned inspector-general of aged care Natalie Siegel-Brown and one of the most pre-eminent experts when it comes to making assessments about the care needs of older Australians Professor Kathy Eagar, the architect of the AN-ACC system.    Nobody in Australia knows better than Professor Eagar about how you go about assessing the needs of older Australians. This government—

Sue Lines (President) | Link to this | Hansard source

Senator Ruston, I'm going to remind you once again that we are debating a suspension motion.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) | Link to this | Hansard source

The suspension motion, President, is about a piece of legislation that this government refuses to address and is causing Australians—older, vulnerable Australians like Audrey—to die. I don't believe that there is anything more urgent than trying to remedy a situation where people are dying as a result of a decision of the government that has been put through this chamber, through rules that were not made evident or obvious when the legislation was put through. They were subsequently revealed in a series of rules that were opaquely put through this chamber. I can't think of anything that's more important than the will of this chamber being recognised, such as the will of this chamber when the aged-care assessment tool private senators' bill was put through this place. I commend Senator Allman-Payne for raising attention on the urgency of the fact that a cruel tool this government refuses to acknowledge is causing older Australians to die unnecessarily.

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) | Link to this | Hansard source

The government will not be supporting this suspension motion today. I imagine it's not going to be the last one for the week. There is a range of urgent matters before the Senate. I accept that there are so many things this chamber could be debating this week, but there are also a number of very critical pieces of legislation—including the NDIS, our reforms to gambling law, implementing new arrangements for the news media bargaining incentive and dealing with the Treasury laws amendment bills—that this chamber has sought to debate as well.

On the point of urgency, there is no shortage of urgent matters before the Senate this week. Indeed, the Senate has just resolved, earlier today, to put in place arrangements to have those matters dealt with. Notwithstanding the important issue that's being raised by the motion and the fact that the government has already been clear about work that is being done around the integrated assessment tool, we should be allowed to get on to the program that the Senate resolved earlier today to deal with. I note there have been people raising concerns about the amount of time for debate on certain pieces of legislation. These suspension motions will eat into that time. So, again, the government doesn't support this.

I know the chamber has had a lot of debate in relation to the aged-care reforms—important reforms that were supported, I should say, by this chamber last year—to make the aged-care system more sustainable. As the Leader of the Government in the Senate said during question time, we have invested billions of dollars into aged care since coming to government to make sure that we are able to deal with the demand that we're seeing in aged care in both in-home care and residential care, and also in the workers who provide care to elderly Australians. Our commitment is very clear, but we do need to make sure it's on a sustainable footing. The Minister for Aged Care and Seniors is working through a whole range of issues, some of which have been raised in this chamber, and will continue to do so.

But we need the Senate to get on with what is before it this week, which is the other pieces of legislation that are equally urgent and require the attention of the Senate. Those have been listed in the program today. Last week, the Senate did not pass a single bill—

Opposition Senators:

Opposition senators interjecting—

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) | Link to this | Hansard source

Well, those opposite have woken up. I wasn't going to point the finger, but I would say a lot of time was spent last week not debating legislation. People send us here to debate legislation. I accept that there's a whole range of other forms and customs and practice of this place.

Opposition senators interjecting—

It would be great if we didn't need to put in place time management motions if the Senate actually got through legislation in a way that was manageable, but it doesn't seem to be able to do that. That's the problem that time management has to deal with. Because, ultimately, if you waste an entire week not passing a single piece of legislation—and it wasn't government senators who were chewing up the time; let's be clear about that—then pressure will build, and you will have to put time management motions in place.

On the suspension that Senator Allman-Payne seeks to move today, notwithstanding the very real issues facing aged care in this country, the reform work that's underway and the investment that we're making, the demand for aged care continues to grow. It is an important issue that this chamber should debate. But there have been debates specifically on this issue in this chamber in recent weeks, and this week we have important reforms that the Australian people would like us to act on. The gambling and NDIS reforms are two of them, and I think our media friends are very keen on settling the news media bargaining incentive. (Time expired)

Sue Lines (President) | Link to this | Hansard source

I remind the chamber that Senator Allman-Payne was heard in silence. Senator Ruston was heard in silence. For some reason, people seem to think that the disrespect shown when Minister Gallagher got up is okay. It is not okay. Every senator in this place deserves to be heard in silence whether they are agreed with or not.

Larissa Waters (Queensland, Australian Greens) | Link to this | Hansard source

It is urgent that we get a better deal for older Australians and work to bring some humanity back into our aged-care system. I thank my colleague Senator Allman-Payne for seeking to suspend standing orders today to deal with this issue. Labor's continued use of the untested and structurally flawed integrated assessment tool is failing older Australians, and it is urgent because they are running out of time. The integrated assessment tool was developed to assist practitioners to make clinical judgements about the level of support that aged-care recipients needed. It was supposed to support human decision-making. It was never supposed to become a tick and flick that would let a computer decide whether someone like Audrey Staniland, who we all saw and loved last night on telly, requires no increased support despite being blind and living alone. On last night's Four Corners we learned how—

Sue Lines (President) | Link to this | Hansard source

Senator Waters, I'm going to draw you back to the suspension motion. It's not for substantive debate.

Larissa Waters (Queensland, Australian Greens) | Link to this | Hansard source

This matter is urgent, because, as Four Corners revealed last night, this is exactly how this tool is used, and it's the outcomes for older Australians like Audrey that are both devastating and urgent. This is precisely the sort of issue that this chamber should be fixing on an urgent basis. With no additional support, Audrey and her family are worried that she'll have to leave her home and move into residential aged care instead. And we know how that ends: tragically. Even getting an assessment from this terrible tool comes with a wait time—

Sue Lines (President) | Link to this | Hansard source

Once again, Senator Waters, you are talking about the substantive motion and not the reason that we need to suspend.

Larissa Waters (Queensland, Australian Greens) | Link to this | Hansard source

I think that people's lives matter and that this is urgent for older Australians. It is urgent for us and it should be a matter that this chamber is debating. Instead, they've got a median wait time of 36 days to even get an assessment from this terrible tool. This is urgent because there are 98,606 Australians waiting to be assessed and hoping for support that will allow them to stay at home longer, with or close to their loved ones, rather than being forced into residential aged care. What's particularly galling and what also makes this matter urgent is that at-home care is not only what most older Australians prefer; it costs less. On average, the cost to subsidise a person in resi aged care is more than $117,000 while care at home is about $30,000. I'm sure, President, you would agree that judicious use of public money to support people is a question that is both important and urgent.

In its drive to save money off the backs of everyday Australians, rather than making big corporations pay their fair share, Labor has streamlined decisions—

Sue Lines (President) | Link to this | Hansard source

Senator Waters, you are well off topic. It is about why you need to suspend standing orders.

Larissa Waters (Queensland, Australian Greens) | Link to this | Hansard source

We should suspend standing orders, because algorithms and machines should not be in charge of the fate of older Australians. Human beings should be. I've just laid out that it's actually cheaper and more humane to do that. Instead, we've seen Labor partly privatise the assessment system, as well as employing the robots to make decisions, which they were never designed to do. They handed contracts for more than $1½ billion—

Sue Lines (President) | Link to this | Hansard source

Senator Waters—on the suspension motion.

Larissa Waters (Queensland, Australian Greens) | Link to this | Hansard source

I think older Australians think this matter is urgent, and I think it will not reflect well on this chamber that the government of the day is asserting that it is not, and I will continue to assert that this is both urgent and important. This could be fixed today. It's exactly why my colleague Senator Allman-Payne has put this motion. It is exactly why it is urgent to debate this motion. These are people's lives that are at stake, and this chamber could fix this today, and, instead, the government is choosing not to. It's likely about to vote against this motion to provide older people with the dignity and support that the Greens think that they urgently need. Have you learnt nothing from robodebt and from the devastating human toll of that inhumane policy?

The urgency goes to what the values of this place are, and it's about whether we value human beings and whether we're prepared to invest in the security and the dignity of older Australians or whether this government will continue to do favours for the likes of Donald Trump and fossil fuel companies and the gambling companies and leave Australians tossed aside—

Sue Lines (President) | Link to this | Hansard source

Senator Waters, the suspension motion is what you need to be talking about.

Larissa Waters (Queensland, Australian Greens) | Link to this | Hansard source

saying that they are not urgent. It's more urgent for this government to do favours to the gambling companies. It's more urgent for them to do favours to Donald Trump. Where is your sense of priority here? Imagine if we actually properly funded at-home-care packages. Imagine if we actually treated older Australians with the dignity that they deserve. Imagine if this chamber didn't have to debate whether that was urgent and important and if we just got on with doing the job of working for Australians. Imagine that! That's what the Greens are working for. I'm proud my colleague has pushed for this, and I strongly support this.

Michelle Ananda-Rajah (Victoria, Australian Labor Party) | Link to this | Hansard source

Thank you to Senator Ruston and Senator Allman-Payne. I've worked with both of these colleagues on the community affairs committee and on the Support at Home program, and all three of us are committed to improving the care and dignity of older Australians, particularly those Australians—and there are many of them, thousands and thousands—who want to age at home. This motion is important, but it is not urgent. It is not urgent for the reason that the government is aware of the problems with the Integrated Assessment Tool, which is at the heart of the controversy with regard to Support at Home, and is working methodically through these issues.

As you know, Minister Rae has announced a rapid review into the Support at Home prioritisation mechanism—

Sue Lines (President) | Link to this | Hansard source

Senator Ananda-Rajah, I'm also going to remind you that you need to focus on the motion at hand, which is to suspend the business of the Senate.

Michelle Ananda-Rajah (Victoria, Australian Labor Party) | Link to this | Hansard source

As you know, we are methodically working in the background on the issues that have been raised by the Greens political party and the coalition with regard to this urgency motion. We do not believe that an urgency is required, mainly because we are working to amend and rectify the issues with the Integrated Assessment Tool, which have been ventilated in many fora in this place, both in hearings at the committee level and in this very chamber today.

Minister Rae has instigated a rapid review into—

Sue Lines (President) | Link to this | Hansard source

Senator Ananda-Rajah, once again, you are getting on to the substantive motion and not speaking to the reason to oppose or agree to the motion to suspend.

Michelle Ananda-Rajah (Victoria, Australian Labor Party) | Link to this | Hansard source

President, I'm trying to just relay the fact that it is not urgent, because we are working in the background to rectify the problems. I speak to those steps that we are actually taking to try and address the concerns that have been raised by my colleagues as well as members of the community with respect to the Integrated Assessment Tool. This tool was initially developed many years ago, about six years ago, and it has been clinically validated. It had a lot of clinical and technical and statistical input. We know it's been rolled out now, mainly because the previous system, when we first came to government—

Sue Lines (President) | Link to this | Hansard source

Senator Ananda-Rajah, you were again going to the substance of the motion and not the reason to suspend.

Michelle Ananda-Rajah (Victoria, Australian Labor Party) | Link to this | Hansard source

We are attempting to iron out the problems with this tool in consultation with the sector. We do not believe that it requires an urgency motion, because the work is currently going on in the background methodically, carefully and in consultation with the sector and with stakeholders and with aged-care providers and, indeed, with families. We also know that the care of older Australians is at the heart of this government, and this is why we brought in generational reform with the Aged Care Act.

Sue Lines (President) | Link to this | Hansard source

Senator Ananda-Rajah, I'm going to remind you once again to confine your remarks to the suspension before the Senate.

Michelle Ananda-Rajah (Victoria, Australian Labor Party) | Link to this | Hansard source

I accept that those opposite feel that an emergency motion is required. I don't accept that at all because I have been part of the process trying to delve into the issues raised by the coalition and the Greens political party with respect to this act and the integrated assessment tool. We know that the parliament is working through these issues in a hearing, and the minister is also working through these issues. This is why I don't believe it requires an urgency motion.

We know that the care of Australians is an issue close to the heart of families all around this country. Does it require an urgency motion to elevate it? It has already been elevated in the national consciousness and in the national debate over many, many months since the rollout of the new Aged Care Act in November last year. We know that the rollout, while it is generational reform, has had some issues, and they have been brought to light by families and by members of parliament, the coalition and the Greens political party. Does it warrant an urgency motion? I don't believe it does because we are working methodically through these issues in the background. When those issues are done in a careful, consultive way, I'm confident that we will have resolution of this and do not require taking this further in this chamber through an urgency motion. I don't see how it's going to, in any way, advance improvement to the fundamental problems that have been raised by families, cited by those in the coalition and the Greens and aired in the ABC Four Corners report last night.

I do believe that the only way to resolve these problems is to do it in a consultive, careful, methodical way, which is how we are approaching this problem. That's why I am not in support of this urgency motion; I do not believe it is required.

Richard Colbeck (Tasmania, Liberal Party) | Link to this | Hansard source

I rise to support the motion and the urgency of the motion moved by Senator Allman-Payne. I thank her for bringing this to the chamber. It is urgent that this government gets the message about what's happening to senior Australians. It is urgent that this government actually acts rather than talks about the problem.

It is urgent. The situation for senior Australians waiting for a home-care package and the number of people waiting for a home-care package is the worst that it has ever been. It is urgent that this chamber delivers that message to this government so that they act rather than just talk about the problem. It's clearly urgent, when you have people like Professor Kathy Eagar AM saying that the algorithm is fundamentally and completely flawed, that the government actually acts.

I think it's quite reasonable that this chamber reinforces the message urgently that it sent to the government when they passed legislation to allow a qualified assessor to override the algorithm. It's urgent that this chamber actually has the opportunity to reinforce that. It's urgent that they actually get on with doing the job that they promised to do before the 2022 election.

Because of the fact that the situation for people waiting for a home-care package and the number of people on the waiting list is worse than its ever been, it's urgent that this chamber has the opportunity to send that message. The more than 5,000 families of people who died in the last 12 months alone waiting for a home care package would think that it's urgent too. The more than 5,000 families who lost a loved one while they were waiting for a home-care package just in the last year, I think, would think it's urgent that this chamber deal with this as well. It's extraordinary that the minister gets up and says that this is not as urgent as the media bargaining code, and it says a lot about the government's priorities that it thinks that the media bargaining code is more important than the 5,000 people who died while they were waiting for a home-care package in the last 12 months. It's disgraceful.

Interestingly, if we go back to the 1979 IBM training manual, it says:

A computer can never be held accountable, therefore a computer must never make a management decision.

And I think we should urgently apply that principle to this issue in the context of this debate. (Time expired)

Sue Lines (President) | Link to this | Hansard source

The question is that the motion to suspend standing orders be agreed to.

Penny Allman-Payne (Queensland, Australian Greens) | Link to this | Hansard source

I move:

That a motion relating to the integrated assessment tool may be moved immediately, have precedence over all other business and be determined without amendment or debate.

Question agreed to.

I move:

That—the Senate:

(a) notes that the Integrated Assessment Tool (IAT) is untested, structurally flawed and systematically under-assessing the care needs of older Australians, especially those living with mental health conditions, cognitive issues and frailty; and

(b) calls on the Government to:

(i) take immediate action to abolish the IAT,

(ii) replace the IAT with a tested assessment system that is designed with clinical experts,

(iii) ensure this new assessment system has guaranteeing the rights of older people as its first priority, and

(iv) restore the role of clinical professionals in the assessment process and reinstate the ability for human override.

Question agreed to.