Jan McLucas (Queensland, Australian Labor Party, Shadow Minister for Mental Health) Share this | Hansard source

I rise to speak to the provisions of the Medical Research Future Fund Bill 2015 and the Medical Research Future Fund (Consequential Amendments) Bill 2015 on behalf of the opposition. These bills finally give effect to the government's stated intention to establish the Medical Research Future Fund, having announced its intention in the 2014-15 budget some 18 months ago. It is true to say that these bills have had a very long gestation period and now, it would seem, a fairly quick birth. I will leave that to others to explain.

The Senate Community Affairs Legislation Committee only held a hearing on 4 August 2015, just last week, and the report of the committee was only tabled yesterday afternoon. I certainly am hopeful that the speed that we are now proceeding with does not result in any errors, oversights or omissions. The haste with which this process is occurring does warrant an explanation, and I have to say it puts the crossbench in a somewhat difficult position to deal with the bills in the way that we are. However, I do wish to thank the secretariat of the Senate Community Affairs Committee, including staff who were co-opted for their work in conducting the hearing and also for the preparation of the report. I also think those who wrote submissions to the inquiry and the witnesses who appeared.

I now move to the substance of the bills. As I said, these bills finally give effect to the government's intention to set up a Medical Research Future Fund, but they fail to meet the policy objectives the government itself set in announcing this fund. When it was first announced the government promised:

Fund earnings will be directed to medical research, primarily by boosting funding for the National Health and Medical Research Council …

But now it is clear that, instead, there is no formal role for the NHMRC in administering MRFF disbursements. The government has refused to work with Labor to consider how the NHMRC, an 80-year-old institution that has universal respect, could have a role in assessing applications and administering MRFF disbursements. The government has failed to do this, despite significant support from the sector for a formal process of expert review to be reflected in the bill and consistent support for some formal recognition of the role of the NHMRC. I intend to explore that support in some detail.

Labor agrees with some of the principles established in the bill and that a new health and medical research innovation strategy should be developed to set the agenda for the MRFF funding. But these bills allow for the minister of the day to make decisions that are not subject to the same sorts of peer review that are followed by the NHMRC. Indeed, former NHMRC CEO Prof. Warwick Anderson, now the secretary general of the international Human Frontier Science Program organisation, provided answers to questions on notice specifically supporting a greater role for the NHMRC and a process of peer review to identify what is value for money and what is not. Specifically, Professor Anderson said:

I support the concept of the MRFF advisory committee setting the strategy for the MRFF through consultation, and the NHMRC administering the majority of the funding. When judging how to use public money for research only peer review can identify what is favourable and what is not. NHMRC's almost 80 years of effective, ethical and efficient service to the Australian community means that public trust in the MRFF will be maintained if NHMRC plays the major role in administering the earnings of the fund in accord with the advisory board strategy.

He goes on:

NHMRC's current act allows simple and recently established ways to proceed, if the MRFF funds are provided to NHMRC outside the NHMRC's Medical Research Endowment Account (as is the case with the current government dementia research initiative).

He concludes:

Coordination between the MRFF and NHMRC will be essential if the greatest good is be gained from the MRFF for the benefit of Australia.

The government itself promised that fund earnings would be directed to medical research, primarily by boosting funding for the National Health and Medical Research Council. So it is deeply concerning that, having spent more than a year talking about this fund, the government has not done the work to establish a fund that meets those principles the government first announced.

I acknowledge, through the consequential amendments, that the CEO of the NHMRC is to have a role on the Australian Medical Research Advisory Board, but there is not enough clarity to this point about how that will operate.

The Senate is being asked a lot, in dealing with these bills, to take the government at its word. Despite not properly consulting and not establishing a bill that is based on comprehensive consultation and a robust funding mechanism, the Senate is being asked to trust that the government will sort these details out later. But, frankly, this government has proven itself to be comprehensively untrustworthy and to be capable of politicising almost any issue. Particularly in this department, this government has politicised almost every issue that has come in front of us.

So, what reassurances are there that this fund could not be used to support research into the health impact of wind farms or research into chemtrails. The minister of the day gets to make final funding decisions, based on no process of peer review to identify what is valuable and what is not. It seems that the Greens are happy to support this position—to support the minister making funding decisions not based on any independent peer review process, which leaves wide open the possibility of this government directing funding to its own pet projects to fund research into, as I said, the health impact of wind farms, and to fund its own election promises.

The risk in the way the government is seeking to set up this fund is not just that the best research—that is, the most meritorious research—misses out on funding, but that the loudest voice at the table catches the minister's ear and is ultimately awarded funding for this reason alone.

Dr Phoebe Phillips, the President of the Australian Society for Medical Research, and a researcher into pancreatic cancer, at the Lowy Cancer Research Centre, told the Community Affairs Committee's inquiry:

We do a lot of work with the community and I think that taxpayers really want to know that their money is going towards funding the best possible high-quality research that delivers health outcomes. All the evidence based on peer review in this country—and we have done a lot of this work in this space with independent commissioned reports—suggests that NHMRC peer review has actually been very successful in delivering better outcomes.

Again, I think what we do not want to happen is the loudest speaker being able to approach the Minister for Health and say, 'I have this problem, let's get some money here.' It needs to be peer reviewed so that rigorous questions are asked to actually determine whether it is a feasible study, whether it is a clinical trial or whether it is basic research leading to a discovery trial. As pointed out, how is an individual, group or a team going to measure the outcomes and have an accurate time line which can be judged? I think that is the expectation of taxpayers.

In regard to NHMRC's integrity, they have been around for 75 years in this space and that peer review system has improved greatly over time.

We know that investment into health and medical research through the peer review has really put Australia as one of the leaders in health and medical research.

As I said earlier, it is not just Labor senators who have called for greater transparency, for a process of peer or expert review, and for a formal role for the NHMRC in administering disbursements. There were many witnesses at the inquiry who concurred with that view. I point senators to the Australian Clinical Trials Alliance, who told this to the committee, and also the Group of Eight Universities and the innovative university sector.

Returning to the specifics of the bill, and the way the government wants to make disbursements from the MRFF, the bill also allows for the Minister for Finance to direct credits to the MRFF Health Special Account for the purpose of making grants of financial assistance to medical research institutes, non-profit organisations, universities and corporations. This remains very concerning for Labor. Again, this means that without any oversight from an independent advisory panel, without a peer review process, without consulting the NHMRC, or even distributing funding at arm's length through the NHMRC, the government can for all intents and purposes direct credits from the MRFF to any pet project it wants.

We know that the idea for this fund came about just weeks before the last budget, which is something the government has been embarrassed about ever since. So you would have thought the Treasurer and Minister for Health would have actually done some policy work to properly develop this fund, but they have not. What is most concerning about the way the government is seeking to establish this fund is the lack of proper governance surrounding the way its disbursements will be made.

Labor, of course, is the biggest supporter of health and medical research in this place. We demonstrated this in government through a commitment of more than $3.5 billion in health and medical research funding. This included more than $700 million to build and upgrade health and medical research facilities right across the country. We also commissioned the landmark McKeon Strategic Review of Health and Medical Research, to provide a long-term vision for governments and for the sector. The review made it clear that a levy like the Abbott government's GP tax was not the ideal nor preferred method for funding medical research in Australia, and we continue to agree with this. That is also why we do not believe that the government should continue its freeze on Medicare rebates. The inevitable outcome of this will be a GP tax worse than that proposed in last year's budget and a collapse in bulk-billing rates.

The McKeon review provides a 10-year road map as to how health and medical research can be supported for the benefit of all Australians, but these bills in no way reflect that vision. From Labor's perspective it is especially disappointing that the government has not used this legislation as an opportunity to pursue the recommendations in the McKeon review. Specifically, the government has missed the opportunity firstly to embed research into the health system and secondly to implement the review recommendations to establish integrated health research centres, accelerate clinical trial reforms and support health and medical research workforce retention—the training and support recommendations. It has completely missed the opportunity to support co-investment from philanthropic and other sources, and missed any opportunity to identify new funding sources. Mr McKeon recommended identifying 'other possible funding sources such as alternative debt finance, R&D tax incentives and levies, and schemes such as research prizes'. The government completely ignored those recommendations in establishing this fund.

The fund was meant to be operational on 1 January 2015. It is a reflection of the chaotic and dysfunctional two years we have had with this government that it has only now finally got around to introducing another one of its so-called signature policies. It really does beggar belief that, having not done the policy work in announcing this fund, delaying its introduction by more than six months, the government still has not done the work on setting up a fund with proper governance structures.    It is emblematic, though, of how this government politicises every issue and of its chaotic and dysfunctional mismanagement of the health portfolio.

It is worth putting on record the cuts that have been made to support this fund. This is where the money is ostensibly coming from. Billions of dollars have been cut from public hospital funding; more than half a billion dollars cut from public dental programs; $400 million cut from preventive health programs; and hundreds of millions of dollars cut from the health flexible funds that support vital drug and alcohol rehabilitation services and important work undertaken by organisations like the Heart Foundation, the Cancer Council, the Consumer Health Forum and the Public Health Association. There have been cuts to veterans' dental and allied health programs, cuts to the Healthy Kids Check, cuts to the electronic health records program, cuts to the Partners in Recovery mental health program—and the list goes on. So Labor is right to be sceptical about this government's intentions. We have long said that we always support sensible measures to grow and support health and medical research, but not at the expense of sick Australians today.

While all this has been happening, Labor has been undertaking its own policy development process, consulting with health and medical research leaders and researchers across the country to develop the best system we can. We will move amendments to these bills that reflect those principles. Labor's amendments will add integrity to the bills and reflect in many ways how grants are administered by the NHMRC through its act. It beggars belief that, despite first promising that funds from the MRFF would principally be distributed through the NHMRC, the government has included no formal role for the NHMRC. I want to make it clear that while Labor will not oppose this bill, because we do support health and medical research—indeed we are the strongest supporters of health and medical research in this place—we do not support a discretionary funding mechanism that leaves open the possibility that the health minister of the day can just fund the projects of their choosing. In government, Labor would seek to amend the NHMRC Act to ensure that similar processes are followed for MRFF disbursements as we follow for disbursements from the Medical Research Endowment Account.

Labor agree that research different from what the NHMRC has traditionally funded should be funded through the MRFF, so we do support the development of a new Australian Medical Research and Innovation Strategy as the basis on which these priorities can be identified and projects that have a stronger focus on translational research, clinical trials, and commercialisation can be awarded funding. We also agree that this additional investment should be quarantined from the existing allocation through the Medical Research Endowment Account, and we would make sure this is reflected. I will refer during the committee stage to the intention of our amendments.

Labor has always supported, in word and in deed, health and medical research. Our health and medical researchers do amazing work. For a country of our population size, we as Australians can be proud of the research outcomes from our tax dollars. We can also be proud of the results that our dedicated research community achieve. Labor supports building on this success by growing the translational research that many in the community also support. But the way the government has gone about getting to this point has been less than ideal. The time between inquiry and tabling and now dealing with the legislation has been truncated, which has been problematic for many, including some on the crossbench. The funding sources have been divisive in the community, pitting the desirability of increased funding for health and medical research against access to health services for people who are currently sick and need support now. For one of this government's so-called signature policies, this has been a messy process. The Australian research community will watch this government closely. The policy intent must be achieved both now and into the future.