Minister Plibersek released the eagerly awaited final report of the McKeon Strategic Review of Health and Medical Research Australia on 5thApril 2013 (http://www.mckeonreview.org.au/). The Review presents 21 recommendations for improving health and medical research (HMR) in Australia over the next decade. The 304 page detailed full report presents a strong economic and health improvement case for enhancement; it abounds in fascinating statistics, case studies and insightful exhibits. Time challenged readers can refer to the separate 64 page summary report or for a really quick read to the 5-page Executive Summary.
First and foremost the Review stresses the importance of embedding research into the health system. Health expenditure of just under 10% of Australia’s GDP or about $130 billion per year will, unless we change practice, rise disproportionately faster than the general economy. Australia is strong in health research but not in integrating research into improving the health system. The Review recommends that Australia drives research activity in the health system by committing to invest 3%–4% of total Australian Government and state and territory government health expenditure on HMR over the long term. Sector leadership and governance will be needed to oversee this. Related recommendations are the gradual establishment over ten years of 10-20 Integrated Heath Research Centres and 1000 research-focused health professionals with practitioner fellowships (if they prove successful) and accelerating clinical trial reforms.
The Reviewrecommends supporting priority driven research specifically by allocating 10-15% of NHMRC budget to priority areas and by nominating specific priority topics such as indigenous health, genomics, global health and rural and remote health.
In order to maintain research excellence and recognising the difficulties faced by early and mid-career researchers, the Review recommends improvements to train, support and retain the workforce; streamlining the grant processes; rationalising infrastructure costs; and building and enabling infrastructure and capabilities such as national patient data bases, registries and biobank hubs.
Non-commercial and public health research are crucial for developing efficient and effective services but are relatively underfunded in Australia and should be encouraged with incentives. Related recommendations concern system innovation and informing health policy and practice with research.
Investing in development can reap financial and health rewards. Enhancement of the pathways to impact research commercialisation can be achieved by instituting a Matching Development Grants scheme and a Translational Biotech Fund for early-stage development. Other recommendations include freer interchange between researchers and industry and recognition of commercialisation achievements, protection of valuable intellectual property and implementation of clinical trial reforms.
Australia lags well behind other OECD countries in philanthropy generally and in HMR specifically despite it being a very attractive target for donors. Recommendations to remedy this include formation of strategic alliances and provision of matching funds. Finally but importantly, the Review recommends a leadership body to drive and oversee the implementation of the recommendations.
The McKeon Review is the first major review of HMR in Australia since the 1998 Wills Review. Dramatic changes in health, research and enabling technologies as well as projections of increasing health costs and an ageing population require Australia to act in order to meet the challenges ahead.
Henry Brodaty
