Ombudsman investigating complaints about aged care tool – but not the tool itself

The federal ombudsman has begun investigating complaints about Australia’s new aged care assessment system, but not the system itself, a distinction critics say borders on the absurd.

At issue is the Integrated Assessment Tool, the algorithm-driven framework now used to determine how much government-funded home support older Australians receive. Since its rollout in November, it has attracted hundreds of complaints from families, assessors and advocacy groups.

Yet while the Office of the Commonwealth Ombudsman is examining those complaints, it is not conducting a direct investigation into the algorithm that sits at the heart of the decisions.

For many in the sector, that raises a fundamental question: what exactly is being investigated?

Investigating outcomes, not causes

The ombudsman’s role is to scrutinise government administration, and its inquiry will focus on how decisions are made, communicated and reviewed. But critics argue that approach risks missing the central issue.

If an automated system is producing contested or harmful outcomes, they say, examining complaints without interrogating the system itself is like auditing a series of wrong answers without checking the formula that produced them.

The Integrated Assessment Tool works by collecting detailed information about an older person’s health, mobility and circumstances. That information is then processed through an algorithm that assigns a funding classification.

In most cases, assessors cannot override that classification.

It is this rigidity that has triggered alarm across the sector.

“Reduced to data entry”

Assessors have reported feeling sidelined, with their professional judgement effectively constrained by a system that delivers a fixed outcome regardless of nuance.

Families have shared stories of reduced support following reassessments, even as needs increase. Some say they are reluctant to seek a review at all, fearing the risk of being downgraded.

At the same time, internal review processes can take up to 90 days, leaving vulnerable people in limbo.

Critics argue these are not isolated administrative issues but predictable consequences of a system that prioritises consistency over flexibility.

A design that cannot be questioned

The controversy is sharpened by the fact that earlier versions of the tool were intended to include room for assessor discretion.

Those involved in its development say the final implementation removed that flexibility, effectively locking in the algorithm’s authority over human judgement.

Aged care consultant Lynda Henderson, who helped design the original framework and now relies on the system herself, has described the outcome as a betrayal of its original intent.

Her experience reflects a broader concern that the system is less about tailoring care and more about controlling costs.

Government defends approach

The government has consistently defended the tool, arguing it delivers fairer and more consistent outcomes.

Aged Care Minister Sam Rae has said the system improves efficiency and reduces wait times, while maintaining that human assessors remain central to the process.

But critics say that misses the point. While humans collect the data, they argue, the decisive step, determining funding, has effectively been handed to an automated system that cannot be meaningfully challenged.

Echoes of past failures

The situation has drawn uncomfortable comparisons to the Robodebt scandal, where automated decision making caused widespread harm before being reined in.

In that case, scrutiny eventually extended to the system itself, not just the complaints it generated.

Advocates warn that failing to take a similar approach now risks repeating the same mistake: trusting a system’s outputs without adequately testing its assumptions.

A partial investigation

The ombudsman’s investigation may still lead to improvements in how complaints are handled or how decisions are communicated.

But without examining the algorithm driving those decisions, critics say any findings risk being incomplete.

Greens senator Penny Allman-Payne has been among those calling for deeper scrutiny, warning that automated decision making in aged care cannot be allowed to operate without transparency or accountability.

For many older Australians and their families, the distinction between investigating complaints and investigating the system behind them is not just technical, it is deeply practical.

If the tool is producing outcomes people experience as unfair or harmful, they argue, then examining everything except the tool itself is not just insufficient.