SALLY SARA, HOST: Sam Rae is the Minister for Aged Care and Seniors and joins me in our studio this morning. Minister, welcome back.
SAM RAE, MINISTER FOR AGED CARE AND SENIORS: Good morning, Sally.
HOST: How did this happen, that human intervention was left out in this important assessment process?
RAE: I think we just need to clarify there. It's not so much that it was left out. We previously had an assessment process that was not fit for purpose. We had people waiting very long periods of time. At the worst-case scenario, people were waiting 10 months just to get their aged care assessment. And what we ended up with was an aged care system where there was essentially $4 billion of unspent funds that could have been better distributed to older people in need of care. The case for having a much improved assessment system was very clear. The Integrated Assessment Tool to which this discussion pertains, it's the updated system, is a much improved system. It deals with both the classification of people's care needs as well as the prioritisation of care needs.
But I want to make a couple of points. The clinical component of the assessment is always done by a person. One hundred per cent of aged care assessments are done by a person, most of them in the person's home itself. That is about making sure that the highly trained assessors can engage with the older person, engage with their families and engage with the environment that they're living in to enter the very best clinical data into the system.
The automated component that you're talking about is the application of the Aged Care Rules, and the rules have to be the same for everyone. This ensures that across our country, across all of the diverse communities, and indeed across the diverse assessment organisations that actually do the assessments, we get an equitable outcome, we get a fair outcome, we also get an efficient outcome for older people. Now, median wait times are down under a month consistently, so people aren't waiting as long, and we're getting much fairer outcomes.
HOST: So there's speed there, but if we're talking about the quality of the decision that's being made, there’s not human override there. Humans put in the data, the algorithm makes the decision, but there’s not a way to override that?
RAE: The human being does the assessment. They're a highly trained assessor. After that happens, the data goes into the Integrated Assessment Tool. There's then a second human being, that's the assessor delegate, who then reviews the data against the notes that have been taken through the assessment process, makes sure that that the input data is right so that the …
HOST: So that's reviewing the data, but they don't have override to override the decision?
RAE: Well, again, I think we need to understand the clinical data is collected by the clinicians. The laws are made by essentially the Parliament of Australia. The rules that govern the system, have to be applied equitably to everybody. Of course we need to make …
HOST: So there's no room for humans there to understand some of the nuance or if there are any issues there. So that is an algorithm, computer-derived decision, correct?
RAE: Again, what there are is a set of rules. The rules have to be the same for everyone Sally, that's how we get an equitable outcome for every older person across our country. The bit that varies in this process, the subjective piece, if you like, is the assessment piece. That's the piece that captures the needs of the older person. And then the objective piece is the application of the rules. That's the part that's standardised.
HOST: That's done by an algorithm.
RAE: It's done in a standardised way, that's right. There's an application of the aged care rules. The rules have to apply to everybody equally. There is a mathematical component, that's the nature of a process. An algorithm is just a process. There is a process by which the aged care rules are applied. That's an automated process.
HOST: So there's no way for a human to override that decision?
RAE: Well, as I said, there's the first person who does the assessment …
HOST: I understand that part. So if we're just getting to the question, there's no way to override the decision?
RAE: Well, I think you need to understand the flow of the process, there's a review process as well, and that's …
HOST: After the decision?
RAE: After the decision, that's right. The person can seek a review of the decision and that then comes back into a separate process. Another human being, a third human being, is part of the review process. I think that's the number that you were referring to that came out of Senate Estimates there.
We've seen about half of one per cent of the total number of assessments go to the review process. In the March quarter, we did over 130,000 assessments, so it's a very large number of assessments that are being completed nationally.
HOST: So hundreds of people are appealing their reviews. Could there be more mistakes or cases we don't know about here?
RAE: The system can always be better, Sally, and that's what this reform program is all about, making the system better for older people. And Minister Butler and I made an announcement yesterday about another improvement.
As I said, we think the Integrated Assessment Tool is a significant improvement on the previous assessment system, but I'm not satisfied with the prioritisation mechanism that's a component of that tool. So I've asked the Department to conduct a rapid review and give us their findings within three months so that we can continue to make the changes to this system that get the very best outcomes for older people.
HOST: What were the financial savings from using this algorithm?
RAE: This has not been based on any financial savings. This is based on getting the best outcomes. This is a generational reform program The Government's investments in aged care are the greatest that our country has ever seen. We've seen investment in the aged care system rise by more than 40 per cent since we were elected just in the last four years.
HOST: So in terms of improving this system or streamlining it, there were no savings here. Was it worth your while? What advantage does it produce?
RAE: This is getting much better outcomes than the old system. We're getting fairer outcomes for older people. We're getting more efficient outcomes for older people. We're making sure that there's an equitable distribution of our aged care services and that care gets to the people who need it most.
HOST: On a separate issue, we're talking about the issue of MND. On a separate issue you'll be amending the Aged Care Rules to give urgent priority access for at home care to support older Australians with MND. The Opposition says the creation of a special priority assessment pathway is a clear admission that the Government's tool is failing. Is that fair?
RAE: Everyone wants to play politics, Sally. I can't stress this enough. Our focus, relentlessly, is on getting better outcomes for older people. And I have said all throughout this reform process that I would monitor the reforms as they roll out and that we would of course need to make continuous improvements, and that's what this is about. It's the latest step in a long line of continuous improvements in the system to get the best outcomes for older people.
Now MND, it's a rare but incurable disease and it's characterised by a very rapid deterioration in people's condition, and that's why we want to make sure that those people get the priority access that they need. That's why we're making these changes.
HOST: How long has the Government been concerned that the new aged care system has not been responding urgently enough to deliver care to older Australians with MND?
RAE: Well, as I said, we've been monitoring the system very closely. But over the last weeks, my concerns around this have been elevated and we've been watching it very closely and doing some policy development about how we can respond. We're making this temporary priority pathway so that people who are living with MND are prioritised appropriately within the aged care assessment system. And at the same time, we're doing this rapid review of the prioritisation mechanism overall so we can continue to improve the system on an ongoing basis.
HOST: Sam Rae, thank you very much for coming in this morning.
RAE: Thank you.