APA welcomes Senate commitment to end automated decision-making in aged care

The Australian Physiotherapy Association (APA) welcomes the Senate’s commitment to ending automated decision-making in aged care and calls on the Federal Government to immediately consult with expert clinicians, such as physiotherapists, to repair its broken assessment and package allocation system.   

The APA thanks the Senate for its strong recognition that algorithms cannot replace clinical decision making by qualified healthcare professionals, such as physiotherapists, by backing a Greens motion demanding that the government abolish its Integrated Assessment Tool (IAT).  

APA President Dr Rik Dawson said comprehensive clinical assessment by a clinical assessor, not an algorithm, is the only mechanism that will accurately determine the level of care older people need to remain independent at home.   

‘Good aged care starts with the right clinical assessment. Older people’s care needs are complex and an assessment must be based on understanding the whole person and their clinical needs,” Dr Dawson said. 

‘The fundamentally flawed assessment tool – designed to disregard the views of clinicians in favour of automated decision-making – was always a recipe for disaster. 

‘We now know that hundreds of thousands of older Australians are missing out on the essential care that will keep them mobile, prevent falls, hospitalisation and early entry into residential aged care – a false economy that ends up costing the taxpayer far more.  

‘The sad reality is that delayed access to the right care often results in preventable deterioration and permanent loss of independence for older Australians.’  

Dr Dawson warned that a rapid review IAT would not provide the depth of examination required to resolve the complex systemic shortcomings of the tool.  

‘The algorithm does not take into account critical indicators or clinical assessor notes, often producing inadequate assessments and Support at Home package allocations, putting the person at risk of functional decline. 

‘The Senate motion brings even more exposure to the fact that urgent action must be taken to reduce further harm to older people. 

‘The government must work closely with expert clinicians as a matter of urgency to ensure improved needs-based access to care for older Australians,’ he said.   

This work must include:   

• timely access to physiotherapy to maintain strength and mobility, prevent falls, reduce hospitalisation and early entry into residential aged care;   

• genuine clinical oversight of assessment and funding decisions;    

• clear pathways to escalate cases where an outcome does not match identified need;    

• faster access to approved funding and services;    

• timely access to assistive technology and home modifications;    

• clear identification of the needs of those near end of life; and    

• funding classifications that reflect the actual cost of delivering the care people have been assessed as requiring.  

The APA has also lodged a submission with the Senate Community Affairs References Committee inquiry into the Support at Home program, currently with the inquiry secretariat, outlining recommendations to improve service delivery, aged care assessment processes and access to timely care for older Australians.  

The APA submission makes clear the challenge facing aged care reform is not simply one of program implementation, but of system design. Current settings remain weighted towards managing deterioration rather than preventing it.