House debates

Thursday, 4 June 2015

Bills

Medical Research Future Fund Bill 2015, Medical Research Future Fund (Consequential Amendments) Bill 2015; Second Reading

11:37 am

Photo of Andrew GilesAndrew Giles (Scullin, Australian Labor Party) Share this | Hansard source

I also rise to make a contribution to the debate on the Medical Research Future Fund Bill 2015 and the Medical Research Future Fund (Consequential Amendments) Bill 2015. I follow a very interesting contribution from the previous speaker, the member for Lyne. He spoke very effectively about some of the challenges Australia faces in the context of medical research within which this debate takes place; but, unfortunately, the issues that he addressed are not matters that are resolved by the legislation before this House, which is very disappointing.

These bills give effect, belatedly, to the government's commitment last year to set up a medical research fund. We on this side of the House have some significant concerns about supporting such a fund. The amendment moved by the shadow minister, the member for Ballarat, is intended to ensure that the fund meets its stated purpose. Presently, this cannot be said to be the case. There is more to be done if we are to ensure that Australia's world-class researchers have the support they need to secure our future health needs and to enable us to take full advantage of their discoveries through translation.

Over the last six months, I have been meeting and consulting with medical researchers around Australia, with my colleague and friend the member for Chisholm, to develop Labor's response to the challenges of supporting medical research. We have visited universities and medical research institutes and met concerned eminent people in the science and medical research community. I take this opportunity to thank all of those who engaged with the member for Chisholm and me. I recognise the extraordinary interest the sector showed in contributing to the debate on this issue and to informing our policy response on the challenges of securing Australia's medical research future. It is disappointing, of course, that the legislation before us evidences no such consultation—that the government has not availed itself of the extraordinary insight to be found across that profession.

As a Melburnian I take great pride in the work that is done in the Parkville precinct, around the Alfred and around the Monash Medical Centre. But it was striking to see the extraordinary, innovative and life-altering work that is taking place, as we speak, right around Australia in extraordinary facilities like the TRI in Brisbane, the Garvan Institute of Medical Research in Sydney and the SAHMRI in South Australia; and to see the important work that is being done in South Australia, in Adelaide, bringing together clinical practice, research and higher education to see the benefits that can be derived from those sorts of synergies—matters that are critical to advancing our medical research future, matters not touched on by this government as yet.

It was also very interesting to me to hear from medical researchers. It is one thing to hear from bodies engaged in medical research about the concerns they have about workforce development—concerns that would be alleviated by a future Labor government, which would address the deep concerns we have about science, technology, engineering and maths education—but it is quite another, and indeed affecting, to hear from researchers themselves, young researchers and midcareer researchers, who have an obvious passion and enormous capacity for their work but see great disincentives put in their path.

The previous speaker spoke about Australia's lamentable position compared to the OECD average in terms of funding medical research; and, to the extent that this fund goes some way towards turning that around, that is to be commended. But there is so much more to be done if we are to ensure that our best and brightest are applying their talents to securing Australia's future health needs.

These conversations I had over the last six months, these dozens of meetings, were a pleasure and a privilege, and they have shown me clearly what is at stake in this debate: the range of challenges in supporting medical research effectively in clinical practice, in universities and in our world-leading medical research institutes; the exciting opportunities that are there for us to harness to transform lives; and the ability to create good jobs of the future. This debate has also demonstrated once again the gulf between the rhetoric of the Abbott government and the reality when it comes to medical research.

In the more than a year since the Medical Research Future Fund was announced—to the surprise of just about everyone, including the sector—not much has happened. We recognise now that this fund was supposed to be up and running by 1 January of this year. That did not happen, of course. I do acknowledge one significant bit of progress, although not one that resulted from consultation on the part of the government: it is very pleasing to see the abandonment of the link between the GP tax and medical research. Labor and the community made the case, beyond argument, that the sick today should not pay for the health advances of the future. That is something that should be acknowledged in the course of this debate. But what can explain the delay in bringing this legislation forward? It certainly is not exhaustive engagement with the sector, as the bill and, indeed, the Treasurer's second reading speech demonstrate.

More generally, while it is one thing to provide a mechanism to deliver more money to medical research, it is quite another, clearly, to adequately support this critical sector. By way of contrast, let us think about the approach that Labor took in government. It commissioned the McKeon review, an exhaustive process of engagement which provided a 10-year plan for the sector, deeply anchored in first principles, which did not see medical research as something good in and of itself but tied investments in medical research to the health needs of Australians. Let us not forget about that work and let us keep working to that template, which continues to be very highly regarded in the sector.

I think it is worth mentioning, before touching on the details of the bill, the broader context of this debate. On the one hand we see a government that is engaged in the most savage cuts to the health budget, and on the other we look narrowly at the prism of medical research, where the NHMRC grants program is under extraordinary pressure. Something needs to be done. I touched, earlier, on the clear anxiety shown by young and mid-career researchers and the real fear that our best and brightest will be pushed away from this field, either into clinical practice or overseas.

Let's pause for a moment as we consider the legislation before the House, and consider the opportunity that is before us and that is open to the government. This fund is about two things—it is about putting more money into medical research but seemingly, unfortunately, not solely into research. More money for research, though, is a good thing. Equally importantly, we have an opportunity to try to do things differently. We cannot forget this. The challenge is not simply about providing more money to do the same things.

I want to talk briefly about three matters: what is in these bills; the concerns; and what is not in the legislation that is critical to supporting medical research in Australia's future. The substantive bill that is before us establishes the fund and special account for the purpose of distributing grants to states and territories, medical research institutes, universities and corporate Commonwealth entities or corporations. The breadth of this is the first concern we have. It also allocates some funding from the Health and Hospitals Fund to the Medical Research Future Fund—another concern. It provides some mechanisms for credits and debits from the fund and sets out the main purposes. These, like many elements of the bill, mirror our other nation-building funds. This is clearly an off-the-shelf product, not one that has been designed to be fit for its special purpose. The bill also sets out the investment policies for the fund and goes on to provide a mandate for the fund that includes the need to enhance the Commonwealth's ability to provide grants of financial assistance that support medical research and medical innovation. This definitional issue is another significant concern.

The consequential amendment bill provides for some amendments to a number of acts to facilitate the fact that the Future Fund will exist in the context of other funds being managed by the Future Fund, and makes amendments to reflect the abolition of the Health and Hospital Fund and certain other transitional amendments.

In terms of the substantive bill, we have to be very clear in recognising that one thing the bill does not do is fulfil the promise of the fund to direct fund earnings to medical research, primarily by boosting funding to the NHMRC. But there are wider issues of governance before us. The mechanisms for disbursements are drawn very broadly. This is not how we were led to believe the fund would work, and it is not consistent with those claims. The definition of medical research and medical innovation is very broad and goes way beyond the expectations of the sector and the wider Australian community. While there is a capacity within the bill for the effective delegation of responsibility for providing funding, this is completely discretionary, and that goes to the real risk that funding can be applied regardless of merit. This is an extraordinary thing to do when we think about the sorts of investments we are supposed to be supporting and the sort of rigor that the community—the scientific community, the medical community and the Australian community—are entitled to expect. This is the sort of rigor that we should be requiring through peer review processes. This is compounded by the absence of any mechanisms for independent oversight. The governance issues in this bill are shocking, and clearly demonstrate a failure to consult with the community and to consider how we can best provide for medical research. It is really concerning that, in the past year and a bit, the government has not constructed a fund model that is fit for purpose, even on the government's own terms. Let's leave aside these broader questions about the first principles we should be trying to fulfil through the legislation before us—it fails the test government set itself.

When we come to this debate about health and medical research, it is critical to acknowledge Labor's support for health and medical research through the funding commitments we made in government, and also through the work we did in commissioning the landmark McKeon review, which did provide and continues provide an effective long-term vision. The review is something that the minister, and indeed the government, should have regard for because it contains something that this government seems to be incapable of, and that is a clear and clearly articulated vision for the future of medical research—a vision for future wellbeing in Australia, and also a vision for the jobs of the future. It displays an appreciation of the need to break down the silos that continue to exist between clinical practice and research.

What is absent from the government is an understanding of policymaking in a considered and effective way that involves consultation, and the need to take on board the views of experts and all those affected. What is missing is an appreciation of the critical importance in dealing with the question of robust independent peer review in determining allocations. What is missing is any appreciation of striking a balance between supporting high-quality basic research, which is so important and something that we do very well, and building on our translational capacities. There is also no consideration of funding innovation and no consideration of the critical questions around workforce—these are questions that are compounded by the uncertainty caused by the government's radical higher education deregulatory agenda.

We have here an opportunity to offer certainty to young researchers. I read with interest an article in the Sydney Morning Herald by Louis Wang, one such young researcher, and someone excited by the announcement of this legislation and the establishment of the fund, but someone who I fear will be gravely disappointed when he sees what is actually before the parliament.

Supporting medical research is vital for all of us in this place. I have heard effective contributions from government members, and that is pleasing to hear; but mouthing these words is not enough. Engaging with the sector and taking on board their views is critical. The legislation before us is really an object lesson in how not to develop innovative and effective public policy. There is an opportunity for the government to get it right by supporting the amendments moved by the member for Ballarat.

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