Julia Gillard (Lalor, Australian Labor Party, Shadow Minister for Health and Manager of Opposition Business in the House) Share this | Hansard source

Thank you. As the minister has outlined, the purpose of this bill is to amend the National Health and Medical Research Council Act 1992 to introduce new governance arrangements and to clarify accountability and reporting functions for the National Health and Medical Research Council. These new arrangements will establish the NHMRC as a statutory agency. The chief executive officer will be responsible for the primary functions of the agency and will report to the Minister for Health and Ageing. Previously the council of the NHMRC was responsible for both governance matters and expert scientific advice. The new division of responsibility will allow the council to focus on expert scientific advice whilst the chief executive officer will have day-to-day responsibility for the operation of the agency.

As the minister has outlined, the proposed changes also streamline the reporting lines of the chief executive officer and the council. The previous arrangement with the NHMRC having three concurrent lines of reporting obviously added complexity to the arrangements. Those three lines of reporting were to the minister, to the Secretary of the Department of Health and Ageing and to the council itself. This bill provides for the chief executive officer to report directly to the minister while keeping the secretary informed. Those streamlined arrangements have much to recommend them.

The amendments enacted in this bill address the governance issues identified in four major reviews: Sustaining the virtuous cycle for a healthy, competitive Australia: investment review of health and medical research, better known as the Wills report, which was published in December 2004; Governance of the National Health and Medical Research Council, which was an audit report from the Australian National Audit Office in February 2004; Review of corporate governance of statutory authorities and office holders, better known as the Uhrig report, which was published in June 2003; and Investment review of health and medical research, better known as the Grant review, which was published in December 2004. These changes which are incorporated in this bill were outlined in a media release from the Minister for Health and Ageing on 7 September 2005.

It is interesting to note that, given all of these reports have been around for some time—the most recent of them being in December 2004, which, as we would all know, is some time ago—clearly the minister has been no hurry to make the changes. These changes are claimed by the government to—and this statement was made in the second reading speech:

... strengthen the NHMRC’s independence, promote clear lines of responsibility for governance and financial accountability and allow the council to focus on issues relating to medical and biological research and advice.

Given this is the claim made for the bill and these matters are important, it seems that it would have been better if the government, and in particular the minister for health, had brought forward this legislative change far more quickly than leaving it to this stage of 2006.

Indeed, both the second reading speech and the minister’s media release from September last year highlight the need for the NHMRC to build better links with business to improve investment in research and to explore industry joint ventures. So, beyond the governance arrangements, the statements made in support of the bill have included statements about the need for the NHMRC to build better links with business. Labor is very supportive of the need for more industry support for research and development. We are very supportive of the building of better links with business. We certainly need to see better translational research, but we would be concerned if this is a foundation stone for the government at some point in the future—and I acknowledge it would be some point in the future—seeking to withdraw levels of government support which otherwise would have flowed on the basis that private funds have gone in to meet that gap. We obviously want to see the government keeping up effort in this area and private sector involvement being on top of that. I will come to the specific issue of the recent budget and the allocations to health and medical research a little bit later, but I make that comment in the context of the longer term.

At the same time that the bill was introduced, the government also introduced the Australian Research Council Amendment Bill 2006, which takes a very heavy-handed approach to the Australian Research Council, abolishing the board and the council’s ability to conduct inquiries into national research issues and make decisions about the effective use of research funds. There is a concern that this will lead to even more examples than those that are already known of and on the public record, where the Minister for Education, Science and Training has objected to funding for specific projects. So we are very concerned about what is happening to the Australian Research Council and the possibility of even further party political style ministerial intervention into research projects.

We are very strongly supportive of the Australian Research Council’s independence and, given that this bill was introduced at the same time as the bill dealing with the Australian Research Council, we think it is very important to make the point at this stage that Labor would be very deeply concerned about any similar attempt with respect to the National Health and Medical Research Council. We do not contend that this bill about the National Health and Medical Research Council is such an attempt to enable political interference by the minister in the work of the National Health and Medical Research Council but, given the way in which the government is going with the Australian Research Council, we think it is important to indicate our concerns about that direction of government policy at this stage.

Labor will be supporting this bill, but we do have some concerns about it and about the willingness of the Howard government to invest in the incredibly important research efforts that are funded by the National Health and Medical Research Council. Our concerns go to the following areas. First, we have concerns about the membership of the council. We oppose the removal of the requirement that membership of the council must include ‘an eminent scientist who has knowledge of public health research and medical research issues, a person with expertise in the trade union movement, a person with expertise in the needs of users of social welfare services and a person with expertise in environmental issues’. We recommend that the requirement for these various areas of expertise remain and that the legislation make it clear that multiple categories of expertise may be found in individuals on the council.

Put simply, we do not think that there has been sufficient explanation as to why the removal of these particular categories of appointment to the council is warranted. We think these categories are worthwhile ones to make sure that the council has available to it that broad depth of expertise. We note, of course, that given the Howard government’s hatred of the trade union movement and its policy bent of making sure the trade union movement is destroyed in this country—notwithstanding that free trade unions are fundamental to any democracy—we are not surprised to see the removal of the category of a person with expertise in the trade union movement, but all of these categories have been removed. They ought not to have been removed and we would certainly be recommending to the government that they be reincluded.

Whilst we support the inclusion of expertise in ethics, particularly in medical research, we seek clarification from the government as to whether the chair of the Australian Health Ethics Committee is a member of the new council, as is the case at present. The legislation deals with having a person with specific expertise in ethics relating to research involving human beings. We want to know whether the satisfaction of that requirement will be that the chair of the Australian Health Ethics Committee will be a member of the council. So we have concerns about the membership of the council.

Secondly, we have concerns with and are opposed to the removal of the need for the federal health minister to consult with state and territory health ministers before appointing the chair of the Australian Health Ethics Committee. The bill now requires ‘consulting appropriately’—that is a quote from the bill itself—but it does not contain a definition of what this might mean, nor any means of certifying that the consultation has been done. So there is a reference to consulting appropriately but no content as to with whom you need to consult or how you need to evidence that that consultation has been done. In our view, this undermines the principle that the NHMRC should be at arm’s length from government and a body that has broad acceptability and responds to national interests rather than those of the particular federal health minister in question.

Appointments should always be made on the basis of merit and there should be a formal process in place to ensure that this occurs. This is of course a point that would endure without depending on the political complexion of the government at the time. I think Australians have a right to be assured that appointments to bodies like the NHMRC are not being made on a party political basis. One of the ways of ensuring that is to make sure that there is consultation between the federal government and state and territory governments so that a variety of views are put and that you are getting people on the NHMRC who are respected across the board—respected nationally and respected across the levels of government.

Our third concern is in the area of disclosure of interests. We note that the minister is not required to be advised if a member of the council has disclosed an interest. We consider it the responsibility of the minister to know if a member or members disclose an interest. We regard this as a basic accountability issue, not an administrative task as noted in the schedule prepared by the department for the bill. Of course, accountability has not been a strong suit of the Howard government. We certainly do not want to see any repeats of the Robert Gerard appointment, where a responsible minister—in this case the Treasurer—can stand up in this House and say, on a matter that would cause concern about accountability, that he did not believe it was his job to check, which is what he said in this House. He simply did not believe it was his job to check. He does not believe that encompassed in his duties as Treasurer is the need to check on the veracity of qualifications and any issues that might arise when you are making an appointment like the Robert Gerard appointment. We are worried that this bill institutionalises a minister not knowing, not checking and not caring, and that is not good enough on accountability matters.

On the question of accountability, we further believe—and we note in this regard the advice of the Australian Vice-Chancellors Committee—that the altered reporting arrangements raise some accountability issues. We agree with the AVCC recommendation that the bill should be amended to enable expert advice to be provided directly to the minister. So that is a further accountability issue.

We would also raise—particularly I suppose this week, of all weeks, though the issue is of ongoing and deep concern to us each and every day—the question of Indigenous health and, consequently, Indigenous health research. We acknowledge the inappropriateness of defining particular research priorities for the NHMRC, but we indicate that we would be concerned if the proposed restructure has the result of diminishing the capacity of the NHMRC to strategically respond to the serious problems of Indigenous health. As we know, Indigenous Australians in this country still have an average life expectancy of 20 years less than the rest of Australia. That continues to be a source of national tragedy and something that we all need to be focused on. We would be concerned if there was a withdrawal of effort in the area of Indigenous health research.

We note that significant progress has been made in the area of Indigenous health research in recent times through the involvement of members with Indigenous expertise working across the current committee structure. We certainly would not want to see that good work come to an end as a result of restructured arrangements.

That is our list of concerns about these new arrangements. They are not sufficient to stop Labor supporting the bill, but we do think that there is considerable food for thought there for the government. Some of them are matters about which the minister could offer a reassurance in dealing with this bill. Some matters require further legislative change. But we believe they should be seriously considered by the Howard government.

We are all aware of the value of biomedical research to this country. The NHMRC is Australia’s primary funder of biomedical research and development. In 2005-06 the NHMRC provided $447 million for health and medical research. A recent Access Economics report clearly found that support for biomedical research is one of the best investments our nation can make in the wellbeing of our people. The report states:

... the ... returns from health R&D are so extraordinarily high that the payoff from any strategic portfolio of investments is enormous.

And:

Health R&D must be seen as an investment in wellness with exceptional returns.

Historically, Australian health research and development give an annual average return of $5 for every $1 spent on research and development. This can be as high as $8 for cardiovascular research and development and $6 for respiratory research and development.

The Access Economics report found that, despite the additional funding flowing as a consequence of the 1999 Wills review, continued boosts to investment in health research and development relative to GDP are warranted, given Australia’s poor ranking relative to other OECD countries. As this nation ages and the dependency ratio increases and health spending rises, breakthroughs in research and development are seen as the best way to address the challenge inherent in the cost and impact of chronic disease.

The investment review of health and medical research, the Grant review, recommended that the government continue to invest and build on the Wills funding by increasing federal government investment in health and medical research to $1.8 billion by 2008-09, bringing Australia up to the OECD average level of investment of 0.2 per cent of GDP. A key finding of the Grant report was that the government investment through the Wills funding package had already started to deliver results and that further increases in funding for health and medical research will yield similarly considerable health benefits and economic dividends.

We do know that Australian researchers are finding life increasingly difficult. A December 2005 paper in the Medical Journal of Australia highlighted the extent of researcher dissatisfaction with funding and the inadequacy of infrastructure support. It is not surprising, but indeed very disturbing, that so many of our best scientists are attracted overseas and stay there.

We are concerned in this context that, while there is additional investment in medical research, the budget actually represents a lost opportunity. We believe that the Howard government has no real future strategy for health and medical research. Whilst the Treasurer talks about the need to cut health spending to address the ageing population, he does not seem to appreciate the wise words of the Grant report.

Indeed, we have seen in the post-budget period the Prime Minister, the Treasurer and the Minister for Health and Ageing big-noting themselves, in this place and outside, about the funding for the National Health and Medical Research Council that is in the budget. But when you actually work your way through the budget papers you can see that, in contrast to this big-noting, there is a huge opportunity missed here to make a real difference.

The government has announced $905 million in research funding in the budget. But let us look at where this funding comes from and when it will be spent. If you do that, the package is considerably smaller than the $905 million that is being boasted about by this arrogant government. Only $590.7 million in funding is provided in the four years from 2006-07 to 2009-10, the four years normally in the budget papers—$215 million is provided in 2005-06 and $99.3 million is provided for the five years beyond July 2010. Mr Deputy Speaker, you would be familiar with the fact that, when governments want to pump numbers, they engage in these kinds of devices.

Of the total funding package of $900 million, $670 million is provided due to the decision to sell Medibank Private. Labor simply do not agree that $670 million of funding for health and medical research should be made contingent on the sale of Medibank Private. We are opposed to the sale of Medibank Private. The arguments that have been put in support of the sale are completely spurious, particularly the argument that the sale of Medibank Private will increase competition in the private health insurance industry. This does not pass the laugh test. If the government sells Medibank Private as a going concern, at the end of the sale we will have exactly the same number of private health insurers. If the government breaks Medibank Private up into parts, and allows existing private health insurers to buy those parts, then we will have fewer private health insurers available in the market. Either way, there is no way one can assert that competition will be increased by the sale of Medibank Private. We are opposed to the sale of Medibank Private and we are most certainly opposed to anything as important as health and medical research funding being made contingent on the sale of Medibank Private.

While the government is yet to explain where the $215 million to be provided in 2005-06 comes from, we are afraid that this apparent largesse comes at the expense of current health programs that were not delivered. We know across the Health and Ageing portfolio that there are programs that are littered with underspends due to incompetence in delivery by the current government. We do not think that you can claim it as a great advance to collect up that underspent money and rebadge it as money for health and medical research.

In any event, the spend in the budget, which is described as being a response to the Grant review, is dramatically less than that recommended by the review. The review recommended that the NHMRC budget rise to $1.8 billion by 2008-09. We are certainly not going to achieve that. Indeed, the funding in the budget package will mean that by 2009-10 NHMRC research funding will be $664 million—that is, only one-third of what has been recommended by the Grant review.

We are also concerned, as I indicated earlier, that the government may in the long term be seeking to substitute, for government effort, effort from the private sector. We believe in partnering with the private sector but certainly not in private sector money being used to substitute for what ought to properly be government effort in the area.

Generally, the failure to invest in our research capabilities is yet another example of the Howard government squandering our national resources and failing to build our skills base. The Australian community supports increased health and medical research efforts. Research Australia’s annual health and medical research public opinion polls in 2003-04 showed that most Australians wanted to see increased government and industry investment and are prepared to contribute to that investment themselves. In fact, 47 per cent of Australians said they would rather see surplus government funds invested in health and medical research rather than in tax cuts—a rather selfless approach.

Securing a strong, enduring, sustainable economic future for Australia requires a long-term view for building on the valuable investment to date. This will only be achieved by a continued focus and leadership by government in partnership with researchers, industry and the community. Government commitment to the recommendations of the Grant review would be a good first step towards showing this leadership. If the additional needed investments in biomedical research come only as a consequence of the sale of Medibank Private, then that simply is not good enough and it demonstrates only too clearly the cynicism of the Howard government, its lack of commitment to biomedical research and its failure to make real investments in Australia’s future.

The second reading amendment standing in my name raises a number of these areas of concern about the content of the bill. I move:

That all words after “That” be omitted with a view to substituting the following words: “whilst not declining to give the bill a second reading, the House condemns the Government for:

(1)

failing to make the substantial long-term investments in biomedical research needed to keep Australia at the forefront internationally and to keep Australian researchers in this country;

(2)

linking the increases in biomedical research in the Budget to the sale of Medibank Private;

(3)

failing to understand that Australians want to see more of the Budget surplus spent on research to improve health outcomes; and

(4)

failing to address the concerns raised in the Senate Community Affairs Legislation Committee report on the bill that go to:

(a)

the expertise represented in the membership of the Council;

(b)

the requirement for full consultation on the appointment of the Chair of the Australian Health Ethics Committee;

(c)

the need for the Minister to be advised if a member of the Council has disclosed an interest;

(d)

the ability of the Council to provide expert advice directly to the Minister;

(e)

the need to ensure that the Council has a continuing capacity to strategically respond to the problems of Indigenous health; and

(f)

the importance of role of the CEO and the need to ensure that this position is filled by an independent expert’’.

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