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Wednesday, 12 August 2015
Page: 5060


Senator XENOPHON (South Australia) (10:45): Unambiguously, unequivocally, I support this Medical Research Future Fund Bill 2015.

There is no question that the future of our health system lies in significant part with the future of medical research and the advancements that come with it. This fund had a false start when the government, in last year's budget, tried to attach its creation to a Medicare co-payment. It was an ill-conceived idea that the government eventually acknowledged was not going to fly, and I congratulate them for doing so.

No matter how good an idea is, such as this fund, it cannot be sustained if the basis of its funding is fundamentally flawed. The fund will now rely on unallocated funding from the Health and Hospitals Fund being redirected to the Medical Research Future Fund. I hope it is not the case of robbing Peter to pay Paul, particularly as medical research has the potential to reduce the number of people ending up in hospital in the first place.

The genesis for this fund was an acknowledgement by the federal government that not enough money has been allocated to medical research and that to date there has not been a guaranteed long-term and secure revenue source for medical research and innovation in our nation, and for that I commend the Treasurer for acknowledging that need and for this fund filling that necessary gap.

We know of the difficulties with the NHMRC, where only a fraction of the projects applying for grants are successful. This is not a criticism per se of the NHMRC, but given the very basis of its funding model and the way that funding applications are assessed, the need for peer reviewed research to support such applications in many cases means there are worthy projects that miss out.

I think the point has been made by Peter Murphy, the academic who wrote a brilliant book for anyone who is interested in higher education reform or research—Universities and Innovation Economies—a must read if you are interested in this field. Peter is an academic at James Cook University. He makes a point about research; he makes the point about how we have got it wrong by pouring a lot of money into research but, because it always requires peer review, it leads to unintended consequences and bad outcomes.

Peter Murphy makes this point:

Small-scale science with tiny numbers of researchers meanwhile is starved even of miniscule funds. Small science is mocked.

He talks about the 'funding-trumps-all mentality' and he quotes the pioneering geneticist, Sydney Brenner:

… the bureaucrats of science, do not wish to take any risks. So in order to get it supported, they want to know from the start that it will work. This means you have to have preliminary information, which means that you are bound to follow the straight and narrow

I think that this particular fund has the potential and a real opportunity to go outside those narrow parameters—the issues that Peter Murphy talks about.

For example: in 2009 the NHMRC funded 25 per cent of 3,857 of applications. By 2013, only 20 per cent of 4,358 applications were. One famous example relates to the pioneering work of Professor Barry Marshall and his colleague Professor Robin Warren on the link between the Helicobacter pylori—I didn't say 'helicopter'!—bacteria and ulcers. They were infamously—in hindsight—rejected for an NHMRC grant before going on to win the Nobel Prize in medicine in 2005 for their innovative and life-changing research. I genuinely hope that this legislation will mean that the future Barry Marshalls and Robin Warrens of this world will have access to the funds for these breakthroughs and innovations to come to fruition so much earlier—to deal with the sorts of issues and concerns that Peter Murphy has had about this.

And I hope the fund will not take the pedantic approach of the NHMRC where, according to a recent report in The Australian newspaper by Andrew Trounson, a grant application to the NHMRC was rejected because its header was—wait for it, Mr Acting Deputy President!—0.2 millimetres different to what it should have been! It was not the right font size! I know that the minister—Senator Cormann—is genuinely and passionately concerned about stupid, bureaucratic, needless red tape. So if he could give me an assurance that the font size—providing it is legible!—will not—

Senator Cormann: I am!

Senator XENOPHON: I have the thumbs up! I do not think we will need an amendment for that! But 0.2 millimetres and it was rejected!

I see this bill, this proposed fund, as being part of a package of necessary measures to ensure a viable, sustainable and innovative health system to deliver the best possible health outcomes to Australians. It must be part of a holistic package of research and innovation, of preventative health measures and the more efficient administration of our health system and our hospitals.

Reports earlier this year, this time from Sean Parnell, the health editor of The Australian, stated:

TEN per cent of all health expenditure — as much as $15 billion a year — could be saved through a concerted effort to reduce wasteful programs, marginal treatments and avoidable errors, …

This is according to senior officials in the strategic policy group of the Department of Health.

So while it seems clear that there could be real savings to be made, it is important not to pursue false economies such as cutting back on preventative health programs. And it is also vitally important, particularly given the Commonwealth's cutbacks in hospital expenditure, that sensible and pragmatic efficiencies be found without compromising the health of patients.

John Micklethwait, a former editor-in-chief of The Economist, and Adrian Wooldridge, a senior contributor to The Economist, in their book, The Fourth Revolution: the global race to reinvent the state, point to Sweden's willingness to apply new thinking to health care. They cite the example of St Goran's Hospital, where doctors and nurses work collaboratively, and where everybody looks for methods of improvement. Technology keeps track of patients' progress in St Goran's Hospital, and the success rate of operations can be checked by both patients and taxpayers.

Micklethwaite and Wooldridge point out:

Sweden has been a pioneer in health registries, which provide statistics on the performance of individual hospitals. Fear of coming out badly in a national league table is a powerful incentive to try harder. A study by the Boston Consulting Group found that Sweden's National Cataract Register not only reduced the severity of astigmatism resulting from eye surgery but also narrowed the variance between the best and worst hospitals by half.

There is literally real vision in the way the Swedes have gone about improving their health system, both in terms of outcomes and savings.

I would like to pay tribute to Professor Stephen Graves—who I saw on a plane not so long ago—who runs the National Joint Replacement Registry, which is terrific work. We need more of that sort of work, work that reduces costs to the health system and leads to better outcomes for patients.

There is one final issue I want to raise, and I want to explore this genuinely—I have raised it very briefly with the minister in passing—that is, the way that the funding would be prioritised for this fund. I know that the Kids' Cancer Project has expressed concern—I hope they do not mind me raising this—that 'the legislation prioritises funding based on burden and impact on Australians, but this overlooks diseases which impact on a smaller number of people regardless of how detrimental they are'. We are of course talking about childhood cancer. And I want to pay tribute again to the wonderful, the beautiful, Erin Griffin, who passed away last year. She was just 11 years old when she was diagnosed in February 2012 with a rare form of brain cancer called DIPG, otherwise known as diffuse intrinsic pontine glioma. Her mother, Amanda, has kept up the fight, kept the crusade going, for a cure for kids' brain cancer. That was the promise she made to Erin; and it is a promise I made to Erin.

I think it is very important that we get clarification from the government because, notwithstanding that very few children are affected by brain cancer, the impact is huge. We are talking about kids being robbed of 70 or 80 years of life. So I would like to ask the government genuinely and seriously to say that there will be fair funding for that. I also want to pay tribute to my good friend Charlie Teo for the work that he does in terms of curing brain cancer—and for his foundation—and the tremendous work he does to save lives and prolong people's lives.

With those comments, I look forward to the passage of this bill. I look forward to a positive exchange in the committee stage. Let's get on with it. And may the Barry Marshalls of this world come forward with this fund.