The Commonwealth Ombudsman investigation has found that the actions of the Department of Health, Disability and Ageing in running aged care assessments, “including the implementation of the IAT, have been unreasonable”.
His verdict on Labor’s Integrated Assessment Tool (IAT) is blunt: “a reasonable person would … lack confidence that the system is in fact fair and consistent.”
Under Labor’s own laws, an algorithm decides whether an older person is eligible for home support, how much funding they get and how urgently. “Currently, under the law, these automated decisions cannot be overridden and changed, even if they are clinically inappropriate,” the report states. Families, assessors and geriatricians have been saying this for a year.
The Department “did not, and may still not, understand key components of the legal framework it created”. In October 2025, one of its own executives warned that “no advice has been given to government on the implications and risks” of removing assessors’ discretion. Ministers were briefed days before the rollout and pressed ahead. Professor Kathy Eagar has since called the design fatally flawed.
The Department’s response to the Ombudsman reveals what the algorithm is really for. “Aged care funding is limited,” Secretary Blair Comley wrote, blaming human assessors for approving 20 to 25 per cent of people at the top level of the old system against a forecast of 15 per cent.
Then the giveaway: “Introducing additional subjectivity would undermine these objectives, in favour of subjective assessments of ‘fairness’.”
Clinical judgement is treated as a budget risk to be engineered out. The Ombudsman called the Department’s claim that the algorithm is objective “mistaken”, because every input still depends on an assessor’s judgement.
One woman with a rapidly progressing, incurable neurological condition was given a 10 to 11 month wait. Her family told the Ombudsman the Department “relied on an algorithmic decision-making process to refuse escalation of priority despite acknowledging that the outcome is inappropriate”.
Another, who needed vital medication at home, was rated medium priority. She was hospitalised after almost dying from the delay.
HelloCare has reported on a Melbourne man with motor neurone disease denied critical funding, and on Neil Raymond, whose funding came through two days after he died. In 2025-26, about 17 people a day left the Support at Home priority system because they died. Families absorb the rest, in what one provider called an invisible second care system.
Within hours of the report’s release, Health Minister Mark Butler and Aged Care Minister Sam Rae responded with a familiar line: “The Albanese Government inherited a broken aged care system and we are working to turn it around.”
Bluntly stated, is a pathetic deflection. The Ombudsman examined the system Labor built. The Aged Care Act 2024, the Rules that switched off human override and the November 2025 rollout all happened on Labor’s watch. And most importantly, as recently as March, the Aged Care Minister Sam Rae was still defending it despite mounting concern.
The ministers’ answer is yet another review that is due to report “in the first half of 2027”. There is no commitment to act on it. Any decisions or changes to legislation or IT that may follow would probably not occur until late 2027 at best. At 17 deaths a day in the queue, every month of delay means roughly 500 more people who will never see it.
The new escalation pathway, starting in January, sends hard cases to the Department, not back to the assessor who saw the person. Eagar has called it little more than a fast-track appeals system.
The ministers also claim to accept “all remaining recommendations”. Yet the Department’s 2 October response only “noted” the two that matter most: restoring the power to override the algorithm.
“Having no mechanism to resort to human judgement in the appropriate circumstances is not, in our view, satisfactory,” the Ombudsman concluded.
The fix is simple: let assessment delegates override the algorithm when its decision is “perverse, clinically inappropriate or otherwise not in the best interests of the older person”. The Senate has already voted for it.
On the day Rae announced his review, Labor voted down an amendment to do exactly that.
Older Australians are dying while they wait. They cannot wait until 2027.
