On 23 April 1999, the Academy made the following comment on the recommendations of the Wills Committee.
The Academy congratulates the Wills Committee on the thoroughness and comprehensiveness of the Strategic Review of Health and Medical Research. It is particularly insightful and paints an exciting vision for Australia's health and medical research future. It is strongly endorsed by the Academy and Government is encouraged to act swiftly to grasp the momentum and unity of purpose generated by the Committee's recommendations. While the bench-marking against international development in this sector is very comprehensive and the spectrum of recommendations from the Review is very broad, there are several major points which are of fundamental importance to achieving the vision articulated by the Committee. These are:
Two of the core recommendations under this heading (fully funding projects and paying true salary costs) are unexceptionable and should not be controversial given the proposed increase in NH&MRC funding. It should be stressed, however, that salaries for more junior research staff come from one-line grants and adjustments for real salary costs for such staff are also necessary if the value of each individual one-line grant is to be maintained. The proposed portability of grants between institutions and into and out of block-funded institutes, when taken together with the proposed break-up of block funding into a core facility grant (a Director's grant) and multiple project and program grants, will lead to the development of a real market for research groups such as that which developed in the UK with the introduction of the Research Assessment Exercise. It will become possible for institutions to recruit high profile groups but whether Institutions benefit from this will depend on their capacity and willingness to enter the market place.
The proposal to shift from small three-year grants to larger five-year grants is sensible given the proposed increase in NH&MRC funding which it is hoped will maintain grant success rates in the range 25-30%. The Review's strong support of the Network grant system needs to be tempered by the knowledge that the NH&MRC has yet to run a single round of these. The guidelines for Network grants (published in 1998) require financial input from Government, industry and research institutions. The conditions may suggest that the objects of encouraging collaboration and of supporting applied R&D have been confused.
The aim of this recommendation, namely to create real career structures for high quality research workers, is laudable and is strongly supported by the Academy. Nevertheless the proposal to increase the number of research workers entering the career stream at junior levels and to reduce their promotional opportunities by placing quotas on the number of available senior positions is probably unworkable and certainly will not encourage talented research workers to enter and stay in research careers. It should be noted that such a pyramidal staffing structure does not exist in research-active University Departments - the concept of a fixed established quota of Professorial and Associate Professorial positions in Departments in which Senior Lecturer positions are the career grade does not and could not operate in research-active departments. As a particular example, a research-active Department (unnamed) at one of the G8 Universities (unnamed) employs 15 Academic staff: these include 7 full Professors, 3 Associate Professors, 3 Senior Lecturers, and 2 Associate Lecturers. While the Department concerned would like to appoint more younger staff, it has no wish to dispense with the services of its very productive senior staff. For the same reason, no Department would wish to lose the services of an NH&MRC-funded Principal Research Fellow merely because there was no quota place available for their promotion to Senior Principal Research Fellow. The Academy believes strongly that promotion on merit must continue to be available for all productive research staff funded by the NH&MRC and that the problem of senior staff who become unproductive should be dealt with directly by use of appropriate performance management procedures.
The Academy believes that means need to be explored whereby research staff can follow dual careers in partnership either with a University or with industry. This would require the University or the industrial partner to join with the NH&MRC in making conjoint appointments at relatively junior levels and allowing such staff to work full-time at research during their most productive years whilst having the opportunity over time to develop other skills of particular value to the partners. Some of these staff would slowly transfer into roles in which research was no longer predominant; others would remain in research and should be able to feel confident that promotion was always possible when merit could be demonstrated.
The Academy does not support the proposal that research findings should be presented to decision-makers prior to their acceptance for publication in peer-reviewed journals although it accepts that the assessment of IP implications have to be dealt with before publication. Whilst acceptance for publication by a high quality, peer-reviewed journal is not a cast-iron guarantee that research findings in a particular study are repeatable or true, the process does filter out papers in which the data are internally inconsistent, are based on poor methodology, or are inconsistent with current knowledge. The Review's proposal would remove even this limited safeguard.
The Academy supports the proposals contained in Section 5.1 (1-5) very strongly, but it wishes to point out that high quality specialist administrators are as difficult to recruit, train and retain as high quality scientists. They are also very expensive. Given that the aim of funding research is to produce good quality science, care will need to be taken to ensure that the administrative structure is appropriate and not larger than is necessary to achieve the laudable aims expressed in this section.
The report suggests that allocations for disease-related or organ-based streams should be influenced by community involvements in the decision making and/or priority setting processes. Whilst community input is valuable and should be sought, the Academy believes, as the report goes on to say, that resource allocation should still be based ultimately on excellence and innovation, as assessed by peer-review. The Academy supports the concept of defining broad research areas that are to be given some priority in funding, but ample scope must always be left to identify and fund high-quality proposals in all areas of medical sciences. Predicting the future will be no easier for those funding medical research than for planners in other walks of life. Would the elimination of gastric ulceration due to Helicobacter have been designated in advance as a priority area for Australian medical research?
The Academy believes that the Australian Society for Medical Research is already fulfilling this role and could be assisted to develop it further, perhaps in collaboration with the Australian Academy of Science and other relevant bodies.
The Academy supports the proposals in principle but is concerned that the funding could suddenly be withdrawn after 5 or 10 years according to whether as yet undefined criteria to do with financial benefits and improved health outcomes have been met or not. The Academy believes that a more broad-ranging review of research funding, such as that embodied in the present Wills Review, should be conducted periodically, say every 7 years. These Reviews would attempt to identify which funding policies had been successful and which had not, and to reshape policy accordingly. Assessing outcomes in terms of financial benefit and improved health should be attempted but these may prove difficult to define and to attribute to particular research programs. Treating gastric ulceration by treating Helicobacter infection improved health outcomes everywhere, not just in Australia. Improvements in health outcomes due to advances in medical research have to be assessed in global terms.
The Academy is concerned that these proposals seem dependent on the willingness of State Health Departments to surrender control of that part of their discretionary budget that they allocate for support of research infrastructure. Since it seems inherently unlikely that all State jurisdictions would agree to such a proposal, the Academy feels that developing an alternative strategy to deal with research infrastructure needs should be developed so as not to hold up implementation of other proposals.
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