The Coalition government abandoned plans to privatise aged care assessments in 2021 following an outcry from key stakeholders, amid warnings of risks to the health of older Australians and conflicts of interest.
Three years later, the Albanese Labor government has stealthily done what the Coalition government recognised as a step too far. Labor has largely privatised the aged care assessments under the guise of a Single Assessment System.
What’s worse, aged care assessments are being conducted by organisations that also deliver aged care support, a clear conflict of interest. Catholic Healthcare, for example, operates 42 residential aged care homes and provides home care services to about 4,000 older Australians. It was awarded nearly $136 million to undertake aged care assessments until 2029.
The Royal Commission expressly warned against this being allowed: it recommended that all assessments be undertaken by an assessor who was not involved in providing aged care, so that a person’s level of funding would be determined independently.
Nearly $1.5 billion has been handed out to private operators under the Single Assessment System to conduct aged care assessments, according to contract details released last December by the Department of Health and Aged Care.
A Single Assessment System was a recommendation of the Royal Commission into Aged Care Quality and Safety, which the Coalition accepted.
However, its plans to privatise aged care assessments was met with fierce resistance from stakeholders, including state and territory health ministers, the Australian Medical Association and the Australian and New Zealand Society for Geriatric Medicine.
The AMA, for example, warned that privatisation “would risk the health of older Australians and open the system up to conflicts of interest”.
Despite these warnings, the federal Labor government has now proceeded down the privatisation path. In early 2024, there was an open tender process for organisations with the capacity and capability to deliver aged care assessments for the Single Assessment System. Since December 2024, the private sector (both for-profit and not-for-profit) has been undertaking aged care assessments. State and territory governments continue to deliver hospital-based assessments.
Since December, concerns have been growing about the quality of assessments under this privatised system.
I was recently asked to advocate for Susan* following an aged care assessment undertaken by APM – a private company that was awarded $226 million to undertake assessments. Susan lives alone on the Mornington Peninsula with no family on hand to offer support.
In July 2024, Susan’s GP requested a comprehensive assessment via My Aged Care. In December 2024, Susan mistakenly received a regional assessment. According to those working in the sector, this is a common mistake.
Comprehensive assessments need to be undertaken by staff who are clinically qualified. These assessors not only ask questions but also probe the answers. They know that older people with cognitive failure can present very well, so it is critical to dig deeper.
Regional assessments, on the other hand, do not require staff with a tertiary degree. According to a number of senior staff in aged care, new assessors working for some private companies may only receive eight hours of online training to conduct regional assessments. These aged care staff are also concerned that some assessments are conducted over the phone if the assessor does not have time to do a face-to-face interview.
Susan’s regional assessment was riddled with errors, some quite serious. These errors have been highlighted in pink. (insert pic)
When I raised concerns about the inaccuracies in Susan’s assessment with the Minister for Aged Care, I received the following response from the Department of Health and Ageing: “I would like to assure you that the Australian Government is committed to creating a better experience for older people in Australia seeking aged care services.
“The department has developed a new Single Assessment System, to simplify and improve the experience of older individuals undergoing aged care assessments. As part of this system, one workforce will be empowered and trained to conduct the necessary assessments across both home and residential care. This important reform is an opportunity to improve the delivery of aged care assessments, including assessment wait times.”
In the past, our taxes funded councils to undertake regional assessments and provide aged care services under the Commonwealth Home Support Program. Council services were in the main excellent and much appreciated by recipients. Older residents and their families appreciated having a highly trained and fairly remunerated Council employee provide aged care services. They also knew they were not being ripped off by a private provider that prioritised profits over care.
However, councils have exited aged care in droves because of changes in the way the Federal Government funds aged care. According to the Australian Services Union, just 26 of Victoria’s 79 councils currently provide aged care home services.
So now our taxes are given to large private companies to undertake the private assessments and then private companies to deliver the services.
In some cases, the company that undertakes the assessment is the same company that delivers the home care. What could possibly go wrong?
* Not her real name
With Elizabeth Minter
First published in Michael West Media on 1 March 2025