Introduction by Croakey: Readers have until 14 July to make submissions to a Federal Government review that aims “to improve alignment and coordination between the Medical Research Future Fund (MRFF) and Medical Research Endowment Account (MREA)”.
In the foreword to a 36-page discussion paper, Ministers Mark Butler and Ged Kearney write:
“This national consultation is undertaken in the context of a proposed new national strategy for health and medical research that considers the role of the Australian Government, industry and philanthropy in supporting research and innovation to improve health outcomes.
“The national strategy will consider how best to work alongside state and territory approaches, which could include collaboration on matters of common interest.
“This consultation also seeks to identify how funding bodies could best engage and coordinate with other key Australian Government investments, such as the Australian Centre for Disease Control and the National Reconstruction Fund, and broader revitalisation of Australia’s vision for science and research.”
Meanwhile, Croakey columnist Associate Professor Lesley Russell, who has been championing reform of the MRFF for years, raises a raft of questions for the review, which may also be helpful for those making submissions.
Lesley Russell writes:
On June 4 it was revealed that the Albanese Government is to review the operations of the Medical Research Future Fund (MRFF).
The review will also include the functioning of the National Health and Medical Research Council’s Medical Research Endowment Account (MREA). It will be led by Health Minister Mark Butler and Assistant Minister Kearney, supported by the Department of Health and Aged Care and the National Health and Medical Research Council.
The Health Minister’s media release, with details about the consultation process and how to provide input, is available here.
This review follows years of concerns and complaints – including a raft of investigative papers from me – about the governance of the MRFF, the lack of transparency around how the taxpayer-funded medical research grants are approved, and political interference in the allocation of MRFF funds.
Some context
My papers, published in Croakey Health Media, are here:
- Is the Medical Research Future Fund fulfilling its mission as promised? 19 January 2019.
- An investigation of the Medical Research Future Fund produces 24 pressing questions. 25 August, 2021.
- What is needed to deliver on the investment in the Medical Research Future Fund? 31 August, 2021.
- Despite audit findings, many questions remain about the Medical Research Future Fund. 22 September, 2021.
More recently, an audit of the Australian Research Council, delivered last April, found politicians meddling with peer-reviewed science grants was a “widespread source of despair” and should be stamped out.
An article in The Sydney Morning Herald on 3 June described the MRFF as “a particular source of anguish for many researchers, who welcome government support but are concerned by how it is spent”.
It also comes in the wake of growing revelations about how the Morrison Government pork-barrelled taxpayers’ funds for political purposes.
See, for example, these recent articles from my Croakey colleagues in response to the release of the scathing assessment by the Australian National Audit Office (ANAO) of the administration of the Community Health and Hospitals Program:
- Jennifer Doggett in Croakey Health Media: Experts urge an end to pork barrelling with health funding.
- Charles Maskell-Knight in Pearls and Irritations: Audit Office slams Morrison Government mismanagement of health grants.
Transparency matters
The review has been welcomed by scientific and research organisations. Sadly, up until this point, the criticisms of the MRFF from both these organisations and individual scientists have been very muted, presumably due to fears that speaking out will damage the chances of funding.
This even when it was revealed in Senate Estimates in March 2020 that up to 65 percent of MRFF funds were distributed without peer review, with the Federal Health Minister having almost unfettered power to dictate how the MRFF spends its money.
In October 2021, Professor Warwick Anderson, the former CEO of the National Health and Medical Research Council, called for a review of the MRFF, saying its processes lack transparency and scrutiny.
“The lack of transparency [at the MRFF] leads to the suspicion, whether true or not, that there is direct intervention after the scientific review process is finished,” Anderson said. But the pleas of this authoritative figure went unheeded by the Coalition Government.
Similarly, there was little or no public outrage when the Morrison Government introduced legislation to limit the annual outlays of the MRFF to $650 million, considerably less than the $1 billion that was the original commitment.
The Senate report on this legislation is available here.
The most recent financial status report on the MRFF shows that, since its inception, the $20 billion allocated to the MRFF has earned $3.401 billion and only $2.014 billion has been distributed.
Given that the $20 billion (actually now more than $21 billion) capital of the MRFF represents savings made by cutting and abolishing programs in Indigenous Affairs and Health (as part of the disastrous 2014-15 Budget), I would argue that the need to ensure these funds are invested wisely and transparently in peer-reviewed research to improve the health of all Australians is critical.
Questions to raise
Some of the issues that the current review must consider include:
- The need to look at the implementation of the Investment Funds Legislation Amendment Bill 2021 with respect to the MRFF and how investment decisions and outcomes have been affected by the current interest rate increases made by Reserve Bank (the 2023 March quarterly report shows that return on the investment since September 2015 has averaged 4 percent per annum and the return over the quarter to March 2023 was 2.2 percent).
- The extent to which expert advice was followed regarding decisions about broad areas of research to be supported by the MRFF, the levels of funding apportioned to these areas, and their review.
- The extent to which peer review was used in decisions about individual grants.
- Considerable levels of funding have gone to translational research and to industry. These grants, managed through the Business Grants Hub, need particular scrutiny for appropriateness, value and return on investment.
- What are the administration costs of the MRFF, and what has been paid to the NHMRC and the Business Grants Hub for such costs?
- Is there any evidence of political interference and pork barrelling for political purposes in the operations of the MRFF?
- What are the consequences of limiting applications for MRFF grants to clinicians? Should this requirement be re-considered?
- To what extent does the MRFF coordinate and / or integrate with the NHMRC? Do these processes need strengthening?
- What has been / will be the role of the MRFF is addressing the research needs around the coronavirus pandemic and its on-going health consequences?
- The majority of the 24 questions I posed back in August 2021 still demand answers.
Ongoing concerns
Additionally, Butler and Kearney should review the functioning of the MRFF in the light of the supplementary report from Labor senators to the Senate Community Affairs Committee report on the inquiry into Medical Research Future Fund Bill 2015 and Medical Research Future Fund (Consequential Amendments) Bill 2015.
At a time when research funds are increasingly hard to access, even for senior researchers, it is understandable that many in public health and health and biomedical research have found it hard to speak out about their concerns around the operation of the MRFF.
As if to boost my point, last week saw an announcement that $50 million will be provided from the MRFF for primary care research – a research area that has long been severely underfunded. I’m just one of the many who have been pushing for more research in this area.
But how was this decision made, and by whom?
There is no indication as to whether this was a decision made solely by Minister Butler, or whether it came from an expert advisory panel (likely the former because an advisory panel is to be appointed to develop a Primary Health Research Plan to be administered by the MRFF). In any case, it is very needed and very welcome and thus very hard to criticise.
According to reporting by the Medical Republic, the funding will be targeted at models of primary care involving multidisciplinary teams and team-based care and which include voluntary patient registration with primary care practices.
The funding will also cover the “application of research findings in primary care settings, and spreading knowledge to improve person-centred care”, and better use of data and digital technology to “evaluate models of primary care and support health system planning”.
PostScript from Croakey: See who is on the Australian Medical Research Advisory Board, which advises the Minister for Health and Aged Care on prioritising spending from the Medical Research Future Fund.
See Croakey’s #MRFFtransparency series, by Associate Professor Lesley Russell and others
