Flying Blind
The Australian Health Data Series

Flying Blind is a series of three reports dedicated to uncovering the acute levels of data fragmentation existing at all levels of Australia’s health landscape.

in collaboration with

Reviewing the reviews: the changing landscape of health and medical research

Health matters to Australians. Health and medical research (HMR) does too. In 2016, Research Australia polled public opinion on national priorities. Eighty eight percent of respondents highlighted improving hospitals and the health system. Seventy nine percent of respondents favoured increased HMR funding. Indeed, these objectives converge; an effective HMR sector is fundamental to sustaining our world-class health system. To meet the challenges and opportunities of the future, both social and economic, we need to invest in achieving these goals. This is not a new perspective. In fact, it’s the reason HMR has been everything from a political football to a public-good panacea.

The "Virtuous Cycle" - A focus of Australian HMR Reviews 

One symptom of this is government commissioning several major reviews relevant to HMR in the last five years.

These reviews cover areas such as research policy, funding, HMR strategic priorities, data availability and use, research infrastructure, ethics, and governance.

This review culture seeks to improve Australia's ecosystem for creating and translating knowledge. In doing so, the aim is to benefit our future economic and social wellbeing.

What are these reviews recommending and what impact will they have?

We’ve done the legwork to find out. Read on for a snapshot of key reviews and takeaways for the HMR sector. Our forthcoming report will elaborate on this topic. 

McKeon Review – Strategic Review of Health and Medical Research in Australia

Background: The Labour government commissioned this review in September 2011. It set out a 10-year strategy in the form of 21 recommendations. Political circumstances were such that no comprehensive government response was ever provided. The Coalition government later introduced the Biomedical Translation Fund and Medical Research Future Fund (MRFF) in response to Review findings.

Area of Review: Leadership, workforce, governance, funding, quality, evaluation and translation of all health and medical research in an Australian context.

Takeaways:

  • The HMR sector is complex and fragmented. This is also true of its flow of funds.
  • Embedding research in the health system is vital, especially in clinical settings.
  • Better tracking and evaluation is required of HMR investment and results.

Watt Review – Review of Research Policy and Funding Arrangements

Background: The Coalition government commissioned the Review in July 2015. The final report, released in November 2015, made 28 recommendations. The Government accepted all 28 recommendations in May 2016. The announcement of intended actions came with their National Innovation and Science Agenda (NISA).

Area of Review: Reform of research policy and funding arrangements in the Education and Training portfolio. The review concerned all research disciplines.

Takeaways:

  • Research policies and funding arrangements are convoluted and outdated. Particular need to revise the Research Block Grant (RBG) scheme and indirect costs of research. 
  • New measures for evaluating research engagement and impact are required. For example, through translation and commercialisation outcomes.
  • Recommended a new mechanism for annual performance evaluation of entire research system.

Performance Review of the Australian Innovation, Science and Research (ISR) System 2016

Background: This review was a recommendation of the Watt Review. It was undertaken by Innovation and Science Australia (ISA) and released in December 2016. It forms part of the Coalition’s National Innovation and Science Agenda (NISA).

Area of Review: Performance of the whole ~$33b Australian ISR system. This review covers all disciplines and makes international comparisons.

Takeaways:

  • The NISA brings the research sector in closer alignment with innovation and science.
  • The first ISR Review is meant as a baseline for future performance measurement and as a precursor to an ISR Strategic Plan.
  • The review includes a new performance scorecard against which the whole R&D sector will be measured (including HMR).

Structural Review of NHMRC’s Grant Program

Background: Commenced in response to increasing pressures on the NHMRC grant program including high volumes of grant applications and low success rates. The review began in May 2016 and results are due for release in early 2017. An implementation period will follow and the new system is intended to be in effect by 2018.

Area of Review: Structure of NHMRC grant programs. These currently disburse ~$800m per annum under 15 different schemes with 37 sub-types.

Takeaways:

  • NHMRC grants provide critical funding for universities and independent medical research institutes.
  • A simpler structure is needed for NHMRC grant programs. The current model is too complex and cumbersome and creates a high administrative burden.
  • There was a high volume of responses to the consultation process, with stakeholders often presenting cogent but conflicting points of view. The reviewers see this as evidence of the complexity of the issues at stake.
  • Structural changes need to enhance the program’s capacity to serve a wide range of needs.

Productivity Commission Report on Data Availability and Use

Background: This is a public inquiry into the availability and use of public and private sector data. The draft report was released in October 2016 and the final report is due in March 2017.

Area of Review: Improving the use and availability of all kinds of data across all disciplines. Covers health data in detail.

Takeaways:

  • The current data landscape is outdated and requires major reform to policies and processes. In particular, changes are needed to data custodianship and linkage practices.
  • Data is underutilised due to culture of ‘data risk aversion’. A shift to ‘data confidence’ will require moving beyond a narrow, privacy-focused lens.
  • There is a need, and opportunity, to learn from best practice overseas.
  • Publicly-funded research data should be available for use beyond initial researchers.

This snapshot covers a few of the many reviews relevant to the HMR sector. The question remains: what impacts will they have on the sector? And how long before we find out?

Comments

This is a great review of the many reviews floating around.

My question is more around - who is responsible for implementing the appropriate recommendations from these reviews? Is there a single agency/ organisation that is tasked with assessing the reviews, identifying the specific areas that can impact the health sector and most importantly implement the identified areas that can improve effectiveness of the healthcare sector from the point of view of cosnsumers, providers and the funders of healthcare.

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