Senate Community Affairs Legislation Committee

Senate Estimates hearing, 28 Oct 2026

Searchable transcript of the Senate Community Affairs Legislation Committee, 28 Oct 2026 Senate Estimates hearing, with chapters: Opening Statement and Procedural Matters, Bulk Billing Rates and Data Reporting, Stem Cell Register Procurement Inquiry, Departmental Restructuring and Downsizing…

Chapters

Opening Statement and Procedural Matters (18:13)
The committee opens the supplementary budget estimates hearing for the Health, Disability, and Ageing portfolio, welcoming the Minister and Department Secretary.
Bulk Billing Rates and Data Reporting (20:50)
Senator Ruston questions the department regarding the availability of bulk billing rates by electorate following a previous question on notice and data publication delays.
Stem Cell Register Procurement Inquiry (22:40)
Discussion regarding a delayed tender for the stem cell register and a debate on whether procurement-related questioning belongs in corporate or specific outcome sessions.
Departmental Restructuring and Downsizing Efforts (24:52)
Secretary Comley explains structural changes within the department, including the consolidation of the health resourcing group and efforts to meet budget targets through downsizing.
Artificial Intelligence Policy and Implementation (29:38)
Officials outline the department's policy on artificial intelligence, the use of Microsoft Copilot by staff, and the risk assessment processes for new AI use cases.
Cybersecurity Patches and IT System Security (33:26)
The department discusses recent cybersecurity patches for web applications following global vulnerabilities and coordination with Services Australia regarding data security.
Aged Care Communication and Merchandise Contracts (35:14)
Senators inquire about contracts for an aged care image library, My Aged Care promotional magnets, and the development of an upcoming public relations campaign.
National Health Reform Agreement Funding (40:16)
Discussion on the National Health Reform Agreement, including $25 billion in additional hospital funding, state-by-state breakdowns, and NDIS growth targets.
Health Reform and Data Digitalization Strategy (44:26)
Examination of NHRA reforms including First Nations outcomes, workforce strategies, and the progress of health data sharing and digital transformation.
Aged Care Procurement and Promotional Materials (48:28)
Inquiry into the costs of My Aged Care promotional products and the department's compliance with procurement rules for office furniture.
Budget Anomalies in Health Service Expenditure (51:25)
Senators question a $16 billion anomaly in health services budget outcomes, which officials suggest may relate to Department of Veterans' Affairs spending.
Ombudsman Report on Aged Care Automation (56:58)
Discussion regarding the timeline and receipt of the Ombudsman's draft report on automation and oversight in the aged care sector.
Residential Aged Care Bed Growth and Funding (1:01:37)
Analysis of net growth in operational aged care beds and the $1.7 billion funding package designed to deliver 5,000 additional places.
Integrated Assessment Tool Legal Framework Errors (1:16:34)
Investigation into miscommunications regarding human overrides in the Integrated Assessment Tool and the department's failure to understand the legal framework.
Freedom of Information Handling for Assessment Documents (1:26:59)
Senator Allman-Payne questions the department on delays and handling inconsistencies regarding Freedom of Information requests related to the Integrated Assessment Tool.
Rapid Review of Aged Care Prioritization Algorithms (1:28:16)
The department provides an update on the rapid review of prioritization and classification algorithms used in the integrated assessment process, currently under government consideration.
Policy Decisions on Clinical Overrides in Assessments (1:30:44)
Senator Pocock questions the government's decision to prohibit clinical overrides in aged care assessments, contrasting the policy with previous promises made to assessors.
Funding Allocation for ACT Respite Infrastructure Upgrades (1:39:07)
Discussion regarding the $10 million election commitment for the Barangiri respite site in the ACT, including questions on costings, scope of works, and asset management.
Hospital Discharge Delays and Regional Capital Grants (1:48:11)
Officials discuss data collection for older people waiting in hospital beds for aged care places and provide details on capital grants issued to Western Australian providers.
Funding for Dose Administration Aids in Home Care (1:54:49)
Senator Gatingby inquires about the funding of Dose Administration Aids (Webster Packs) under the Support at Home program and potential cost shifts to pharmacies or individuals.
Residential Care Subsidies and Bed Supply Projections (2:01:11)
Senator Ruston seeks clarification on accommodation supplements and subsidies for new aged care homes, requesting projections for bed supply over the next four years.
Ombudsman Report on Priority Algorithm (2:05:40)
Review of the Ombudsman's report concerning the priority algorithm used in aged care assessments and the timing of ministerial advice.
Escalation Pathway and Human Override (2:11:17)
Debate over the implementation of a human override mechanism within the aged care escalation pathway and the drafting of legislative amendments.
Support at Home Personal Care Reforms (2:16:18)
Overview of the removal of co-contributions for personal care services under the Support at Home program to improve dignity and access for older Australians.
Impact on Carers and Community Choice (2:20:00)
Analysis of how aged care reforms benefit family carers and support the principle of aging in place within the community.
First Nations Aged Care and Cultural Safety (2:26:05)
Discussion on cultural safety, First Nations aged care needs, and the role of the First Nations Commissioner in ensuring appropriate care delivery.
Outcome 3: Aging and Aged Care (2:47:29)
The committee recommences with Outcome 3, focusing on aging and aged care, and introduces witnesses from the Aged Care Quality and Safety Commission and other regulatory bodies.
Integrated Assessment Tool and Human Oversight (2:48:11)
Senators question the department on the Integrated Assessment Tool (IAT) and the necessity of human oversight in automated decision-making processes to ensure consistency and subjectivity.
Ombudsman Findings on Assessment Governance (2:53:51)
Discussion centers on the Ombudsman's report regarding the governance and oversight of aged care assessments, specifically addressing the role of private versus public providers.
Testing and Validation of the IAT (2:58:55)
The department responds to criticisms about the IAT's implementation, detailing the live trials and validation processes used to ensure the tool's accuracy before its final rollout.
Review of Aged Care Algorithms (3:03:45)
Officials discuss the upcoming independent review of aged care classification and prioritization algorithms, which will incorporate clinical expertise and dementia care feedback.
Transparency and the Ombudsman's Draft Report (3:09:40)
Debate arises over whether the government should have shared the Ombudsman's draft report with the Senate during legislative negotiations to ensure transparency in deliberations.
Timing of Legislative Amendments (3:14:12)
The committee examines the decision to proceed with legislative amendments before the final Ombudsman report was publicly released, questioning the impact on parliamentary oversight.
Consultation on Escalation Pathway Rules (3:20:00)
Officials discuss targeted stakeholder engagement regarding the design of the escalation pathway and the development of draft rules.
Technical Capacity for Human Override (3:25:55)
Discussion on the technical ability to override assessment outcomes and the legal constraints surrounding its use within the system.
Assessment Wait Times and Telehealth (3:29:37)
Officials provide data on assessment referrals, median wait times, and the prevalence of telehealth assessments for older Australians.
MND Classification and Algorithm Review (3:37:05)
Concerns regarding incoherent results for Motor Neurone Disease assessments and the planned review of the classification algorithm.
Modelling the New Escalation Pathway (3:41:17)
Discussion on anticipated volumes for the escalation pathway, staffing requirements, and the 28-day decision target for reviews.
Minimum Service Offers and Care Rationing (3:45:09)
Debate on whether Minimum Service Offers (MSOs) constitute a structural form of care rationing in the aged care system.
Improving Communication for Older Australians (3:52:31)
Addressing feedback on the complexity of aged care terminology and efforts to provide plain-language resources and better website navigation.
Data on Interim Aged Care Packages (4:02:20)
Statistical breakdown of interim places and Minimum Service Offers allocated to older Australians since the program's commencement.
Mortality Data for MSO Recipients (4:06:20)
The committee discusses the availability of data regarding individuals who pass away while receiving a Minimum Service Offer (MSO) rather than a full service package.
Criteria for Full Service Packages (4:06:56)
Officials explain the criteria for bypassing the Minimum Service Offer to receive a full package immediately, including urgent priority, end-of-life care, and restorative care pathways.
High-Level Package Assessment Priorities (4:08:29)
Senator Ruston seeks data on the percentage of individuals assessed for Level 7 or 8 packages who are categorized as urgent or high priority under the single assessment model.
Recent Home Care Package Releases (4:10:46)
Discussion regarding the number of new home care packages released and reallocated since July 2026, referencing the latest quarterly report for the Support at Home program.
Three-Month Wait Time Target Projections (4:12:22)
The department outlines the release of 32,000 new places to reach a total of 420,000 by June 2027, aiming to achieve a three-month average wait time by November 2027.
Roadmap to Legislative Wait Time Requirements (4:14:30)
Officials discuss the inclusion of MSOs in wait time calculations and the legislative requirement to meet the three-month target, detailing the long-term plan to support additional places by 2035.
Review Application Statistics and Finalisation Rates (5:20:03)
Officials provide data on the 2,208 review applications received between November and June, noting that over 1,500 have been finalised.
Review of Aged Care Assessment Decisions (5:20:03)
Officials discuss the volume of assessment reviews, the 90-day statutory timeframe, and the "deemed finalised" status for cases exceeding the clock.
Support Plan Reviews and Legal Standing (5:30:56)
Examination of the 15-day KPI for support plan reviews and the legal criteria for appealing decisions, including statutory timeframes.
Wait Times for Full Service Offers (5:35:09)
Discussion regarding the 10-week average wait time for full service offers and reports of delays extending to 17 weeks for some providers.
Deaths While Awaiting Home Support Packages (5:37:12)
Officials provide data on the number of individuals who died while on the home support waitlist and discuss expedited end-of-life pathways.
Assistive Technology and Bureaucratic Burdens (5:40:01)
Inquiry into the costs and administrative hurdles for assistive technology and the registration process for allied health associate providers.
Inspector of Aged Care Program Evaluation (5:46:10)
The Inspector of Aged Care discusses the "Before the Fall" report and the value of preventive investment to delay residential care entry.
Management of Unspent Home Care Funds (5:50:35)
Discussion on the $3.6 billion in unspent funds and the new rules allowing participants to carry over 10% or $1,000 of their package.
Analysis of Support at Home Utilization (5:58:09)
Officials analyze the $727 million underspend in the Support at Home program, citing workforce availability and service delivery constraints.
Minimum Service Offerings and Funding Policy (6:06:03)
The committee examines whether releasing packages at a 60% minimum service offering contributes to under-utilisation and if 100% funding should be provided from day one.
Average Package Costs and Data Analysis (6:10:55)
Discussion regarding the average cost of home care packages, comparing department estimates of $28,000 against industry reports suggesting higher figures.
Provider Viability and Service Price Increases (6:14:34)
Inquiry into the 38% average increase in service type costs and the financial sustainability of home care providers operating on thin margins.
Algorithms and Quality Assurance in Care (6:20:44)
Senator Roberts raises concerns about classification algorithms and provider overcharging, leading to a discussion on the Quality and Safety Commission's audit processes.
Pensioner Co-contributions and Hardship Provisions (6:28:41)
An explanation of co-contribution rates for full pensioners across clinical, independence, and everyday living categories, including available hardship support.
Hospital Bed Block and Transition Care (6:32:12)
Discussion on "bed block" where patients remain in hospital due to lack of aged care availability, and the role of transition care (step-down) facilities.
Workforce Growth and Dementia Support Programs (6:37:19)
Officials outline workforce improvements, including 24/7 nursing requirements and the expansion of the hospital-to-aged-care dementia support program.
Residential Aged Care Bed Availability in Tasmania (6:43:50)
The committee examines the shortage of residential aged care beds in Tasmania and the resulting impact on the state's public hospital system. Officials provide data on Commonwealth-funded beds and discuss funding negotiations with state governments.
Defining and Tracking Delayed Hospital Discharges (6:48:45)
Senators question the department on the lack of a uniform national definition for 'stranded patients' or delayed discharges. The department explains ongoing work with states and territories to verify data and track patients awaiting aged care assessments.
Wait Times and Mortality for Aged Care Places (6:52:31)
Inquiry into the average wait times for permanent residential aged care places and the number of individuals who pass away while waiting for a bed. The department takes several specific data requests on notice regarding mortality in hospital settings.
ANAC Pricing and Wage Increase Impacts (6:54:00)
The department addresses concerns regarding the 2.55% ANAC price increase and whether it sufficiently covers the 4.75% wage increase for aged care workers. Officials discuss stakeholder feedback and the methodology used to index costs forward.
Financial Viability and Sector Profitability Data (6:57:51)
A comparison of profitability data between the department and external reports like Stuart Brown. Officials clarify that roughly 62% of residential providers are profitable, noting differences in data sets and the weighting of not-for-profit providers.
Care Minute Penalties and Compliance Trends (7:01:05)
Discussion on the financial penalties applied to homes failing to meet mandatory care minute targets. Officials provide statistics on funding reductions in MMM1 regions and the upward trend of facilities meeting both care minute and registered nurse targets.
Administrative Costs and IHACPA Pricing Methodology (7:11:15)
Professor Michael Pervan from IHACPA explains the complex methodology for setting aged care prices. The discussion covers the reduction in expensive agency staff usage, the use of ABS and RBA indices, and the rising administrative costs per resident.
Methodology for AN-ACC Price Recommendations (7:35:50)
Senator Ruston questions the 2.55% price increase recommendation for AN-ACC, noting it appears low compared to the Fair Work Commission's wage increases. IHACPA explains their cost-based methodology and the exclusion of profit margins from their advice.
Indexation Factors and Cost Transparency (7:40:00)
The committee discusses the specific indexation factors used to reach the 2.55% recommendation, including wages, superannuation, and CPI. IHACPA addresses the complexity of disaggregating non-care administration costs from provider data.
Legislative Requirements for Price Advice (7:43:42)
IHACPA clarifies that under current legislation and government direction, they must provide a single recommended price rather than alternative scenarios. They confirm the use of independent quality assurance for their mathematical modeling.
Impact of Data Lag on Pricing (7:45:27)
Discussion turns to the challenge of using historical data (2023-24) to set current prices. IHACPA acknowledges the pressure this puts on indexation accuracy and compares the process to established hospital sector pricing models.
Administration Cost Shortfalls and Benchmarking (7:49:04)
Senator Ruston highlights reports of significant administration cost shortfalls per resident. IHACPA discusses their engagement with Stuart Brown's benchmarking data and the difficulties of applying a uniform cost allocation method across the sector.
Sector Viability and Provider Diversity (7:51:56)
The hearing examines how pricing affects diverse providers, from large corporate entities to small regional facilities. IHACPA notes the model is designed to put downward pressure on spending, described as a 'shoe designed to pinch.'
Allocation of Corporate Administration Costs (7:58:24)
Witnesses explain how corporate and home-level administration costs are allocated across care, accommodation, and everyday living. IHACPA clarifies that administration of care is included in their calculations rather than being split solely between other categories.
Hospital Stranded Patients and Compliance (8:01:04)
The segment concludes with a discussion on the costs of 'stranded' older patients in hospitals and the administrative burden of compliance for aged care providers, specifically regarding the My Aged Care system.
Administrative Burden on Care Managers (8:04:18)
Inquiry into the time spent by care managers navigating My Aged Care and the department's efforts to gather data to quantify the sector's administrative compliance overhead.
IHACPA Pricing Framework and Hoteling Supplement (8:07:21)
Examination of the IHACPA pricing methodology, the frozen hoteling supplement, and a joint review with the department to tier pricing for rural and remote facilities.
Residential Care Occupancy and Funding Underspend (8:10:37)
Analysis of the $1.4 billion underspend in aged care, attributed to lower-than-forecast occupancy rates and the significant growth of home care packages over the last decade.
Budget Discrepancies and Accounting Treatments (8:23:32)
Officials clarify differences between the Final Budget Outcome and the annual report, explaining the impact of accrual vs. cash accounting and interagency transfers on reported underspends.
Inspector-General of Aged Care Oversight (8:28:12)
The acting Inspector-General discusses the office's independence, the upcoming statutory review of Royal Commission recommendations, and concerns regarding the Integrated Assessment Tool.
Access to Biologics for Pediatric Crohn's (8:42:55)
Discussion on PBS requirements for children with Crohn's disease to trial steroids before accessing biologic treatments, and ongoing PBAC work to improve access for serious inflammatory conditions.
PBAC Review of Pediatric Clinical Guidelines (8:48:07)
Professor Joe Watson explains the complexities of updating PBS criteria for pediatric use and the historical lack of commercial interest in pediatric drug submissions.
Bulk Billing Disparities in the ACT (8:56:24)
Discussion on why the ACT has significantly lower bulk billing rates compared to surrounding regions and the effectiveness of the triple bulk billing incentive.
Modified Monash Model and Canberra Healthcare (8:59:30)
Officials discuss how statistical definitions in the Modified Monash Model (MMM) affect healthcare business models and bulk billing incentives in the ACT.
Bulk Billing for Children and Local Clinics (9:02:45)
Examination of bulk billing rates for children under 16 in the ACT and updates on the staffing of government-funded bulk billing clinics in Tuggeranong.
Ultrasound Bulk Billing and Women's Imaging Review (9:06:44)
Senator Pocock highlights the low bulk billing rate for ultrasounds in the ACT and the department provides an update on the Women's Imaging Review.
National and Western Australia Bulk Billing Trends (9:12:47)
The department presents updated national bulk billing data showing a 5% increase over the last year, with specific focus on rising rates in Western Australia.
Private Health Insurance Rebate and Hospital Demand (9:16:07)
Senator Ruston questions the modelling behind proposed changes to the private health insurance rebate for over 65s and the projected impact on public hospital demand.
FOI Redactions and Hospital Strategy Correspondence (9:24:20)
Officials are questioned about redacted correspondence from the public hospital strategy branch concerning the impact of policy changes on hospital demand and whether advice was sought before or after the announcement.