HEALTH PRIORITIES – WHO GETS WHAT?
Stone the crows! Ever-more medical research is just what doctors order, but which doctors?
Despite the Senate knocking back the GP co-payment supposed to fund the $20bn Medical Research Future Fund, the government came good, starting the scheme last week, kicking in $1bn and promising to allocate $10m for new research in the next financial year.[i] Granted getting to $20bn may take time, “never” strikes the Crows as a likely target date. Still, the feds are doing what they have promised, establishing a new funding stream, on top (for now) of the $800m National Health and Medical Research Council research budget.
But who will do the handling? Warwick Anderson, the recently departed chair of the NHMRC (he’s off to a policy job in Strasbourg), told the National Press Club the NHMRC should get the job and he quoted the Prime Minister as saying it should allocate “the vast majority of money.” But, he added, “vested interests are already circling like sharks.” [ii]
And they appear to have attacked. Health Minister Sussan Ley says the Future Fund Board of Guardians will administer the MRFF, with research allocations recommended by “an expert advisory board”. [iii] But who will be on it? If anybody the Crows asked knows, they aren’t telling. The NHMRC says it will not comment on a government announcement and the minister’s office asked for questions in writing and then ignored them, twice. [iv]
If the Crows were birds of a speculating feather they would suggest Anne Kelso, the new chair of the ARC will be a member plus the more vocal of the research lobbies which formed up as the MRFF Action Group, when it looked like the fund was fritzed last year – including the Association of Independent Medical Research Institutes.
If so the MRFF advisory board meetings will be frank affairs – because the IMRI sector was not the strongest admirer of the NHMRC’s under Anderson. Last year, IMRI chair Doug Hilton, from the Walter and Eliza Hall Institute, complained that the NHMRC was inefficient and should leave researchers not administrators to manage the grants system:
As researchers, we are used to applying our problem-solving skills to our research. We are confident and optimistic that together we can put some of those skills towards fixing the broken system that rules our working lives and impinges on our personal lives.[v]
According to Doug Hilton, from the Walter and Eliza Hall Institute, there are “countless examples of local research that had stagnated due to a lack of funding.” [vi]
Professor Anderson was never having any of this; suggesting that calls for higher grant rates ignored overall funding and the growth in research scientists bidding for money.[vii]
Anderson attacked calls for senior researchers to decide who gets how much for which research, adding, “It’s a wish to return to the old days when the NHMRC gave institute directors a large amount of funding and then left them to decide how it should be spend internally.” [viii]
A review of the IMRIs, commissioned by former health minister Peter Dutton, chaired by Graeme Samuel (Anderson is a member), also suggests that IMRIs “must be able to demonstrate that they are financially stable in the long term as a precursor to receiving government funding.” [ix]
But what unsettles the Crows is the idea of giving specific interest groups control over funding. IMRIs work on curing a disease and, as such, do not have the whole policy picture necessarily. In contrast, the NHMRC assesses proposals on their quality and impact, rather than the profile of the disease. [x]
Which single-disease advocates by definition don’t. As Anderson explains:
Pretty much weekly, somebody calls in the press or wants to see the minister or wants to see us about how their particular area of research needs to be a priority, and usually with the tagline that the NHMRC doesn’t understand and doesn’t fund in this area. … It goes along with “NHMRC should…” – fill in what you want there, support more young researchers, support more leading researchers, support more nursing researchers, support more clinical research, health services research, complimentary medicine, genomics and so on. Priorities are a big issue for NHMRC, and if you give more support for one area, by definition there’s less support for somewhere else. And so, consistent with what I said earlier, we need to fund across the spectrum. We need people who are research savvy and trained in every area of research in Australia.[xi]
Which means the people who hand out the MRFF can’t be passionately committed to curing one disease. Passion isn’t the same as policy.
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[iii] [iii] Ley, ibid
[v] Brendan Crabb and Doug Hilton, “If its broke, fix it,” The Australian April 2
[vi] Rebecca Urban, “Budget 2015: NHMRC funding ‘needs complete overhaul,’ ” The Australian, May
[vii] Review to
[viii] Anderson, ibid