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15 May 2012

Chairman outlines key Health and Medical Research issues at Garvan AGM

Chairman of Garvan, Mr Bill Ferris AC, welcomed The Hon Jillian Skinner (Minister for Health and Minister for Medical Research), as well as incoming Executive Director Professor John Mattick, at this year's Annual General Meeting, held on 1 May, 2012. In his address he outlined what he sees emerging as 10 key issues / questions for resolution in the two Health and Medical Research reviews that are currently taking place - one at State, the other at Federal level.

CHAIRMAN’S ADDRESS TO 2012 GARVAN AGM


Welcome 
The Hon Jillian Skinner (Minister for Health and Minister for Medical Research), Sr Annette Cunliffe (Leader of the Sisters of Charity), Sr Helen Clarke, Professor John Mattick (Executive Director, Garvan Institute), fellow Board members past and present of the Institute and Foundation, St Vincent's Hospital colleagues, valued Garvan supporters and staff.

In each of the past 10 years, when I have enjoyed the privilege of chairing this AGM, I have marvelled at the number and nature of Garvan discoveries.  This year is no exception and I urge you all to read this excellent annual report from cover to cover.

I do want to publicly give a big thank you to two of our directors who retired from the Garvan board during 2011:

 Martin Hoffman
 (initially 96-99 as Chief Operating Officer, and then from 2001 to 2011 as a Director and Treasurer) and 
Nick Curtis, previous Chair of St Vincent's Hospital and Director of Garvan. Both Martin and Nick gave generously of their time and ideas.

Warren Scott takes over the Honorary Treasurer position from Martin so please test him out today with some tricky accounting questions. I am at the same time very pleased to welcome our 2 new board members, Daniel Petre, successful media and IT investor, author, and philanthropist who has endowed 2 cancer research Chairs at Garvan (so far) and Dr Annette Pantle, who among other things is Group General Manager, Clinical Governance and Chief Medical Office for St Vincent's Health Australia.  We are already benefiting from their experience and expertise.

There were many prestigious awards made to our faculty and staff during 2011; too many to speak of today, but given the Minister’s presence, I will mention just a couple.  Cancer Institute NSW presented the 2011 Premier’s Fellow of the Year Award to Dr Alex Swarbrick, and the 2011 Premier’s Scholar of the Year Award to Dr David Chang.



Last year I spoke of John Shine’s extraordinary contributions to world science and in particular to the Garvan.  I am especially thankful that John extended his directorship through the end of calendar 2011 enabling us to complete our comprehensive and successful search for his successor, Professor John Mattick, whom I have asked to make some comments later today under the heading “Looking Ahead”.

To all our faculty and staff I extend our congratulations and thank yous for the continuing excellence that is Garvan.

In my written report I made brief mention of the two current Health and Medical Research reviews, of critical importance to the research sector and to Garvan.  One is the NSW review chaired by Peter Wills, tasked by Minister Skinner earlier this year to advise and recommend re changes/improvements for NSW State funding of research activities. This Review was well timed and welcomed by the sector; Garvan made a strenuous submission and no surprise that Peter and his panel completed a comprehensively professional report for the Minister.

Following on the NSW Review, perhaps even stimulated by it, the Federal Government has called for a national review of Health and Medical Research, tasking a panel to make recommendations how best to fund Health and Medical Research nationally for the next decade.  I am one of 6 panel members appointed by the Feds to complete this report by December.  Being the least qualified of the 6, but having now considered several hundred of the submissions, let me share with you what I see emerging as 10 key issues / questions for resolution:

 

  • A fundamental mind shift is needed to ensure Medical Research is an embedded, fully integrated, and essential component of the national health care system. 

The current Federal and State Government expenditure on Medical Research is around $1 billion p.a., about 1% of total health budgets.  What % should it be?
 A national vision/plan for Health and Medical Research would help frame the answer and should guide the integration and co-ordination among States and Federal governments. Such a plan would establish key priorities given the reality we can’t expect to do cutting edge research on everything. What diseases are we best to focus on?

  • What might be an appropriate allocation between basic research, and other research (e.g.):

 Clinical research; Public health policy; Health service delivery; Prevention, education and clinical practice; 

What are the likely “next gen” research frontiers – genomic medicines and personalised therapeutics?
  • The NHMRC, and the peer review process are respected and valued. However the peer review process is under huge stress and the bureaucracy and time soak for grant submissions, reviews, monitoring and acquittals may now be badly out of whack with actual research time. There were approximately 4000 applications to NHMRC in 2011; only 2000 to the UK equivalent.

 So would a 5 year minimum time for projects, rather than 3 years, be part of the fix? Maybe staggered applications, rather than one huge process p.a.?

  • The need for a significant, step function increase in clinician scientists if translational outcomes are to be achieved. If such health outcomes are not achieved in greater and more obvious numbers, Medical Research’s licence to practice will be curtailed. So increased funding for recruitment, education and training for clinical scientists will be needed – including “protected time” for clinicians wanting to spend time and effort in research. The disconnect here is that Medical Research is funded by the Commonwealth and health care delivery by the States.  Translational work falls between those stools!
  • All this must be done without diminishing the momentum of basic research.  This will require full funding of research i.e. 60 cents for every $1.00 of peer review grants. For every $1 of research grants, it costs Medical Research Institutes and university researchers another 60 cents to keep the lights on. University researchers have been promised full funding by 2014…why not researchers in Medical Research Institutes and hospitals?

  • Translation requires clinical trials capacity.  The Clinical Trials Action Groups’ current recommendations call for contraction in the approval times for trials and the co-ordination / standardising of a myriad of State and Federal protocols.
  • On workforce issues, the big themes appear to be:

    The absence of sufficient mid-career prospects for post docs,
    And gender inequality i.e. insufficient support for careers of female researchers, in particular provision for interruptions (of babies and childcare).
  • Philanthropy


    The terms of reference for the Panel include how can private philanthropy be better expanded to leverage tax payers’ funding/involvement in medical research. In particular, untied private money might stimulate research less “safe” in nature than often required in the peer review process.
  • Closing the Gap 


    What can be done to make a serious improvement for indigenous Australians? Is it via education, access and delivery of health services, rather than basic research per se?
  • We need more D in the R&D if discoveries are to be commercialised; referred to in some submissions as the “valley of death” between public sector research and private sector development. To this valley between early stage development and presentation to venture capitalists and big pharmas there is a funding and skills requirement for proof of concept, IP protection and development, clinical trials and so forth. Could this best be tackled via expansion of the NHMRC’s development grants?

I have taken more time than usual for which I apologise. But given the importance and currency of this Review, I wanted to share these matters with you; indeed anyone in the room who wishes to question, comment or add to this list, please do so in the Q&A today or send me an email.

In closing, let me say that I remain extremely excited about the prospects for Garvan. We are well positioned with the inheritance from John Shine, with the new and passionate leadership of John Mattick, and with the ever strengthening backing of our stakeholders. Ours is an exciting period ahead!

 

Mr Bill Ferris AC

1.5.2012