In a heated exchange on the floor of Parliament, Aged Care Minister Sam Rae faced pointed questions about the Integrated Assessment Tool (IAT) from Independent MP Dr Monique Ryan who challenged the government’s reforms, asking, “Minister, are these once-in-a-generation reforms just ‘robo aged care’?”
She added, “Experienced clinicians are unable to override algorithmic decision-making. The government’s new single assessment scheme is failing older Australians.”
Minister Rae’s response aimed to reassure, but a closer look reveals carefully crafted language that skirts direct accountability. He stated, “Let me be clear: the IAT classification algorithm does not replace assessor input; it relies on assessors documenting their advice in the IAT first.”
He continued, “I assure the member that assessors still play a critical role in achieving high quality assessment outcomes by using their clinical judgement and strong communication and engagement skills to complete the IAT during the assessment.”
The minister emphasised that the IAT ensures “accuracy and consistency” in decision-making, with particular stress on “consistency”. He also noted that the Department of Health, Disability and Ageing plans to refine the tool regularly and is monitoring its operation.
These statements are classic examples of carefully worded political rhetoric, loaded with semantic wiggle room. By saying the algorithm “does not replace” assessor input but “relies” on it, Rae implies a collaborative process without committing to how much weight human judgement actually carries in the final outcome.
Terms like “critical role” and “clinical judgement” sound empowering, yet they mask the reality that assessors are now barred from overriding the algorithm’s decisions in most cases.
This pivot from earlier promises, where overrides were allowed, leaves the government room to claim technical adherence to rules while ignoring frontline chaos. It prioritises “consistency” over compassion, as if uniformity in assessments excuses mismatched care for vulnerable seniors.
This ministerial framing stands in stark contrast to the raw frustrations voiced by aged care workers in the Facebook group Aged Care at Home Forum Australia, a community hub for Australian home care staff. Here, assessors, providers and carers share experiences that paint a picture of a system weighted against human insight, where algorithms dictate outcomes with little regard for real-world needs.
One assessor and delegate described manipulating inputs to game the system for better client results, focusing solely on what the individual can or cannot do without considering informal supports.
They lamented, “As a delegate I see some assessors not being clinically accurate in their information and you can see it affects the outcome. Assessors are not to blame, AI is not to blame. The fact is that as a clinician I cannot simply override an outcome, when the training we did before Nov 1 back in May said we would have the option.”
This highlights the betrayal felt after overrides were promised in training but abruptly removed, stripping away clinical discretion and even the ability to adjust priority levels based on judgement.
Echoing this, another worker called the minister’s claims outright “BS”, asserting, “They have no control. All info is input into software and a level is allocated. It takes all empathy away from the decision, now all based on an algorithm.” A colleague agreed, recalling an assessor who admitted outcomes were determined by “some algorithm” with no input from them.
The human toll is evident in stories of mismatched assessments. One carer shared how their parents, both stroke survivors with similar impairments, received wildly different levels: one a Level 2 via phone assessment, the other Level 7. They questioned, “You can’t assess someone without looking at them.”
Another described a client with high needs denied priority changes, now limited to cases of homelessness or domestic violence, leaving others to “just have to wait”.
Frustration boils over into broader critiques of government priorities. A participant described the system as a “fiasco”, accusing politicians of neglecting seniors while funding overseas aid and perks, demanding, “Vote them out. They are a disgrace.” Others highlighted wait times stretching for months, with one 102-year-old waiting seven months for reassessment, risking death before funding arrives.
Carer burnout was a recurring theme, with one anonymous member hospitalised from exhaustion, fearing reassessment under the new rules.
Political disillusionment runs deep, even among Labor supporters. One admitted disappointment, while another urged abandoning party loyalty, stating, “Voting for them is condoning this.”
Calls for transparency included demands for a whistleblower to expose the inner workings of the system, with scepticism about Rae’s claim that wait times are decreasing. As one quipped, “Did Sam Rae say that ‘wait times are coming down’ with a straight face?”
Providers like Adrian Morgan from Flexi Care have publicly noted a 37 per cent rejection rate for upgrades since the changes, a sharp rise from near zero pre-November 2025. This data underscores how the algorithm’s rigidity is downgrading care, forcing providers to navigate appeals while clients suffer.
The government’s handling of the IAT raises serious concerns about its regard for clinical expertise. Born from the Aged Care Royal Commission’s push for better assessments, the tool was meant to unify and humanise the process. Instead, by locking out overrides and hiding behind “rule-based” processes, it has created a dehumanised bureaucracy that values fiscal restraint over lived realities.
Assessors are reduced to data entry operators, entering information into an opaque system that produces decisions which may ignore nuances such as cognitive risks or family strain.
This is not reform but regression. The department’s vague promises of “refinements” do little to address the ethical crisis driving workers away or the risks facing seniors. With Australia’s ageing population growing to 4.9 million people aged over 65, ignoring these voices is politically risky and socially dangerous.
The minister’s semantics may buy time, but they will not mend broken trust or prevent avoidable harm. Real accountability would require publishing the algorithm, restoring clinical overrides and prioritising people over processes. Anything less is a damning indictment of a government failing its elders.
