Championing research in Primary Care

The Primary Health Reform Steering Group has been charged by the Australian Government with assisting the development of a 10 year Plan for Primary Care. Research Australia has used its submission to the Group’s Discussion Paper to make the case for a greater role for research in the new 10 year Plan.

Research Australia welcomes the Plan’s recognition of the key role research can and must play if reforms are to be achieved. Research Australia has argued for research to be integrated onto the system and to be informed by primary care practitioners (including nurses and midwives, allied health and general practitioners) and patients and carers.

As the national peak body for health and medical research, Research Australia has included case studies from its members of relevant primary care research that demonstrates the expertise available in Australia to support implementation of the Steering Group’s Plan.

Research Australia’s submission is available here.

Budget Update 2021

Summary

The economic impact of COVID-19 continues to dominate the Australian Budget, with tonight’s Budget, the second handed down in just seven months. Like the last one, this is a big spending Budget, but the focus has shifted from providing immediate stimulus to longer term recovery and Australia’s future prosperity. In the health sector, policy reform is focused on aged care and mental health.

Apart from COVID, the biggest health issue the Australian Government has had to grapple with in the last 12 months is aged care. The Royal Commission into Aged Care Quality and Safety provided the Government with 148 recommendations earlier this year. Until tonight, the Government had not provided a substantial response to the report.

This Budget outlines an additional $17.7 billion over five years, seeking to address the needs of aged Australians living at home and those in residential care. This equates to around half of what is called for overall in the Royal Commission’s Final Report. The Prime Minister’s press release states the Government has accepted 126 of the 148 recommendations, we are awaiting the Government’s detailed response to the Royal Commission – particularly the recommendations for dedicated funding for aged care and ageing research. The proposals from the Royal Commissioners in relation to funding for innovation and research have not been funded in this Budget.

Mental Health has also been under the spotlight, including the impact of COVID-19 on mental health. The Productivity Commission provided the Government with a report last year on what could be done to improve mental health, and earlier this year the Department of Health and Ageing consulted on what measures from the report should be implemented, and when.

Tonight’s budget provides $2.3 billion over four years from 2021-22 for the National Mental Health and Suicide Prevention Plan, including initiatives to be progressed with states and territories for a new national agreement on mental health and suicide prevention. The Government has indicated that it has accepted all the recommendations of the Productivity Commission Report on Mental Health and that the funding announced tonight is only phase one of its response. The only research specific funding announced as part of this package is establishment of an Eating Disorders Research Centre as part of a $26 million package of funding for eating disorders. Further funding for research-related aspects of the Productivity Commission’s recommendations may follow in future budgets. There is $117.2 million for data collection, in part to establish the evidence base for reforms. We will be seeking the advice of key mental health research experts to understand how this data can inform continuous, evidence-based improvement in mental health care for Australians.

While Preventative Health has gained attention from the Government in the last couple of years, the National Preventive Health Strategy is still very much a work in progress and there is only very limited additional funding for preventive health in tonight’s Budget. There is $1.9 million in 2021-22 for preventive health research and scoping activities, including a national health literacy strategy, to inform the National Preventive Health Strategy. Research Australia has previously advocated the need to improve health literacy (and digital health literacy) as a key measure to address health inequity and enable all Australians to better use technology to manage their health.

One of the key lessons from the COVID-19 pandemic is that we have become overly reliant on global supply chains for vital materials. This drove a new focus in last year’s Budget on manufacturing, with the announcement of $1.3 billion over five years from 2020-21 for the Modern Manufacturing Initiative. While the Government seems satisfied this is enough, Research Australia believes more needs to be done, and has proposed raising annual Government spending on R&D to 0.75% of GDP, setting a target for Australia to become a net exporter of pharmaceuticals by 2035, and using the Government’s influence as a key buyer of products and services to boost Australian innovation.

A key measure in this regard is a patent box; a tax deduction provided to companies that manufacture in Australia using Australian developed IP (patents). The patent box will only apply to income derived from Australian medical and biotechnology patents, with consideration to be given to the clean energy sector. It provides a concessional effective corporate tax rate of 17 per cent, with the concession applying from income years starting on or after 1 July 2022. Such a scheme has operated in the UK for many years and is designed to support high value manufacturing in Australia, complementing the R&D Tax Incentive. Research Australia has been a long-term advocate of patent box tax treatment, along with CSL and others in our sector, and this is a significant win for health and medical research.

Much has been said recently about mRNA manufacture of vaccines and therapeutics, with the Victorian and NSW Governments both announcing support and Victoria proposing to invest $50 million. In the Budget tonight the Government has announced that it, too, is acting. It will provide an undisclosed amount of funding (commercially sensitive) to the Department of Industry, Science, Energy and Resources to work with the Department of Health to develop an onshore mRNA vaccine manufacturing capability in Australia. Research Australia called for such a commitment from the Government in our Pre-Budget Submission and we have been calling for this facility privately and publicly, to encourage this sovereign capability .

While the MRFF funding proceeds as outlined in the Government’s MRFF 10 year Plan, the funding to the NHMRC’s Medical Research Endowment Account continues to decline in real terms.

Medical Research Future Fund

Funding from the MRFF

The MRFF reached the target of $20 billion of capital in August 2020. Tonight’s Budget sees this balance maintained over the forward estimates.

Forecast spending from the MRFF remains largely as expected over the forward estimates. While only $455 million is available from the MRFF to fund research and innovation in 2021/22 due to lower-than-expected investment returns, the Government is maintaining spending this financial year by providing an additional $175 million for MRFF funding from consolidated revenue (announced in the December 2020 mid-year budget). At this stage the Government expects the investment returns to recover this financial year, with $650 million available to fund medical research and innovation in 2022/23.

MRFF expenditure

$m.	20-21	21-22	22-23	23-24	24-25
MRFF Funding 2021 Budget	579.9	455.0	650.0	650.0	650.0

NHMRC and ARC Funding

In Research Australia’s Pre- Budget Submission and our Pre-Election Statement we continue to call for increases in funding for the NHMRC and ARC’s research programs. This Budget sees both schemes continue to decline in real terms, which is of genuine concern to the health and medical research community.

NHMRC Programs

The 2021/22 Budget reveals funding for the NHMRC’s programs continuing to grow very slightly, and only slightly faster than was forecast in last year’s budget. The increase in this financial year is 1,1%, with annual increases of around 1% thereafter. This is lower than the forecast CPI of 3.5%% for 2020-21 and CPI of between 1.75% and 2.5% expected in subsequent years. In effect, NHMRC funding continues to decline in real terms, as it has done for many years now. Research Australia remains concerned about this deficit because research and its outcomes is a long-term commitment.

NHMRC MREA Funding

$m.

20-21

21-22

22-23

23-24

24-25

Funding to MREA

2021 Budget

853,864

863,266

875,362

887,588

899,124

Funding to MREA

2020 Budget

853,864

862,412

872,770

884,960

N/A

ARC Programs

The Australian Research Council’s Funding Programs are critical to Australian publicly funded research including to the life sciences and medical technologies.

Over the forward estimates, the funding to the ARC for the Discovery Program increases slightly each financial year and while higher than in last year’s Budget, the funding is at significantly lower levels than forecast in the 2019 Budget. In real terms funding to the Discovery Program declines over the forward estimates. Again, a cause for concern.

$m.	20-21	21-22	22-23	23-24	24-25
Discovery 2021 Budget	483,272	489,188	494,922	501,162	509,432
Discovery 2020 Budget	483.272	487.016	487.860	490.610
Discovery 2019 Budget	513.542	525.537	538.350	N/A

The ARC Linkage Program has been singled out by the Government as an important component of Australia’s innovation system, and it was announced that from 1 July 2016 the Program would be open to continuous applications and decision making would be fast tracked.

Funding over the forward estimates is higher than forecast in last year’s budget, but future years fail to keep pace with inflation.

$m.	20-21	21-22	22-23	23-24	24-25
Linkage 2021 Budget	323.166	325.454	329.948	334.109	339.622
Linkage 2020 Budget	322.181	323.871	325.240	327.074	N/A
Linkage 2019 Budget	288.788	295.246	301.741	N/A	N/A

While not funding ‘medical and dental research’, the ARC Linkage program remains important to the health and medical research and innovation sectors.

Research Support

In addition to providing funding for the ARC Linkage Program, the Department of Education and Training also provides funding to universities to help cover the indirect costs of research.

In last year’s Budget, the Government used the Research Support Program to provide a vital injection of $1 billion into higher education research in the current financial year. No further injection is provided in this year’s Budget and funding in is actually lower than was forecast in the 2019 Budget.

Research Support Program

$m.	20-21	21-22	22-23	23-24	24-25
2021 Budget	1918.298	930.659	942.775	958.326	974.143
2020 Budget	1918.298	926.490	929.270	938.107	N/A
2019 Budget	920.573	941.748	962.455	N/A	N/A
2018 Budget	1,018.879	1,042.302	N/A	N/A	N/A

Funding for the indirect costs of research funded by the MRFF is now provided from the Research Support Program. With the MRFF providing hundreds of millions of dollars in funding to universities over the next few years, beyond this financial year, a substantial increase in the Research Support Program is needed just to maintain the levels of research support funding for research projects at their current already inadequate level. The cuts to the Research Support Program beyond the one-off boost in 2020-21 represent a real and continued threat to the capacity of our universities to undertake vital health and medical research.

The issue of indirect research costs remains unresolved for the whole health and medical research sector and indeed publicly funded research more broadly. Research Australia continues to call for a whole of government approach to the issue of funding indirect research costs. Research Australia proposes that the Chief Scientist lead a review of the funding of indirect research costs to establish a sustainable and equitable funding program. In the short term, the pool of funding for the Research Support Program must be increased substantially.

Research Training

The Research Training Program (RTP) provides funding to universities to support higher degree by research students (mostly PhDs). Funding for the RTP also declined in absolute terms between the 2019 and 2020 Budgets, and have only partly recovered in this year’s Budget.

Research Training Program

$m.	20-21	21-22	22-23	23-24	24-25
2021 Budget	1054.981	1069.182	1083.160	1100.967	1119.137
2020 Budget	1054.981	1064.392	1067.585	1077.738	N/A
2019 Budget	1057.595	1081.921	1105.710	N/A	N/A

Industry PhDs

The Department of Industry will provide $1.1 million over two years from 2020-21 to create new employment pathways for students and boost financial incentives for universities to enrol students in ‘Industry PhDs’. This measure will introduce an additional weighting in the Research Training Program funding formula for PhD students who undertake an industry placement.

Research Commercialisation

In last year’s Budget the Government committed funding for a scoping study for a University Research Commercialisation Scheme to better translate and commercialise university research outputs. The development of the Scheme is still in train and there is no funding for the Scheme in this year’s Budget. It looks like this might have to wait until next year. Research Australia remains actively engaged in consultation with the Department of Prime Minister and Cabinet on this Scheme.

CRC Program

Funding forecasts for the CRC Program reflect a shift in some funding between 2019-20 and 2020-21. Beyond that, they are slightly lower over the forward estimates.

CRC Program $million

$m.	20-21	21-22	22-23	23-24	24-25
2021 Budget	222,777	189,980	197,815	191,042	193,807
2020 Budget	234,168	189,040	186,378	188,599	N/A
2019 Budget	187,356	192,239	191,223	N/A	N/A

The CRC Program is important to health and medical research and innovation with about one third of the CRCs funded over the life of the program being health related.

Conclusion

Research Australia will continue to provide analysis and comment in the coming days and weeks as well as seek further input from across the membership for your reactions and insight into the policy and funding announced for our sector; and how it affects or enhances your research and related activities as a result.

Ends …..

A Preventive Health Strategy for Australia enabled by research

Following a Discussion Paper released in 2020, the Australian Government released a draft National Preventive Health Strategy for consultation in early 2021.

Research Australia’s response to the consultation emphasises:

- the critical role of research in supporting the evaluation of existing programs and measures and the development and implementation of new programs;
- the importance of the proposal to increase funding for preventive health measures to 5% of health expenditure by 2030; and
- while providing information is an important tool to empower and support people, supporting people to make the best possible decisions also require practical strategies and programs that can support and incentivise behaviour change, and policies that make it easier for people to make healthy choices.

Research Australia’s submission is available here.

Our response to the earlier 2020 Discussion paper is available here.

Critical Technologies Consultation

The Australian Government’s Critical Technologies Policy Coordination Office is identifying critical current and emerging technologies with the capacity to significantly enhance or pose risk to Australia’s national interest, including our economic prosperity, social cohesion and national security. One of the key areas identified is health.

Research Australia’s submission to the consultation on health related technologies has emphasised the opportunity to address supply chain issues in the development and manufacturing of new technologies in Australia. Research Australia’s submission is available here.

2021 Pre Budget submission calls for renewed investment in R&D

Research Australia’s Pre Budget submission to the Treasurer ahead of the 2021 Budget focuses on the vital role of health and medical research and innovation in Australia’s response to the COVID-19 pandemic, and the manufacturing and innovation opportunities that health and medical research presents for Australia’s economic recovery.

It calls for renewed investment in R&D by the Australian Government, continued support for universities and medical research institutes with meeting indirect research costs, and measures to support medical products R&D and manufacture. The case for increasing NHMRC and ARC funding is also made. Funding for Government initiatives in data sharing and preventive health are among other measures sought.

Research Australia’s submission is available here.

Research to improve Aged Care quality

Counsel assisting the Aged Care Royal Commission have made their final submissions to the Commissioners, and the public has been given the opportunity to comment on the recommendations. This was the last chance for public input before the Commissioners provide their report to the Government in early 2021.

Research Australia has followed the progress of the Royal Commission closely. We urged the inclusion of research in the Commission’s original terms of reference and we have liaised with the Commission’s officers to connect them with researchers who were able to assist the Inquiry.

We have been pleased to see the reliance the Commission has placed on research to understand the current system and its failures as well as to explore alternatives. It is clear that research can play a critical part in improving the delivery of aged care services and in helping Australians to age well, and we have welcomed the prominence the final recommendations to the Commissioners give to research.

Research Australia’s response to the final submissions document is limited to two recommendations. Recommendation 55 deals with the creation of an Aged Care Research Council with a dedicated research budget. Recommendation 56 deals with creation of a minimum national aged care dataset and the availability of data to researchers. Finally, we have responded to the request for public response to remarks made by Commissioner Briggs in respect of Research and Data Governance.

Research Australia’s submission is available here.

Medical Products Roadmap Consultation

Research Australia has responded to the consultation being undertaken by the Department of Industry, Science, Energy and Resources to support the development of a Medical Products Manufacturing Roadmap under the Modern Manufacturing Initiative announced in the October 2020 Budget. Medical products is one of six strategic areas being targeted under the MMI for Government spending of $1.3 billion over five years.

The Consultation was undertaken using an electronic survey restricted the length of the response to each question. Research Australia’s response emphasises:

- the opportunity to support the manufacture of products and materials for clinical trials;
- the opportunity this provides to scale to full scale manufacturing, keeping the full scale manufacturing of medical products developed in Australia on shore; and
- the opportunity to support manufacturing in high value medical products.

Research Australia’s submission is available here. These proposals were further developed in Research Australia’s January 2021 Pre Budget submission, available here.

The Government subsequently released the Medical Products National Manufacturing Priority Roadmap in February 2021. Research Australia’s proposal to support manufacturing for clinical trials as part of the Roadmap was adopted, and identified as a pathway to scaling up of manufacturing capability. The Roadmap is available here.

Data Availability and Transparency- Draft Bill and Accreditation Framework

Research Australia has been advocating for many years for improved access to public data for research. We made submissions to the Productivity Commission’s 2016 Inquiry into Data Availability and Use. Strongly supportive of the Commission’s recommendations, we have worked with the Department of Prime Minister and Cabinet on the consultations which have culminated in the release of the Data Availability and Transparency Bill exposure draft and the proposed Accreditation Framework.

The Draft Bill and accompanying Accreditation Framework for researchers are broadly in line with previous consultations and discussions. Research Australia has made some recommendations designed to improve the operation of the legislation and the Framework.

Research Australia’s submission is available here.

The Data Availability and Transparency Bill was introduced into the House of Representatives on 9 December 2020. Research Australia expects the legislation to be passed by the Parliament in 2021.

Improving approval processes for new drugs and medical technologies

Research Australia has responded to the Parliamentary Inquiry into the Approval Processes for New Drugs and Medical Technologies.

Opportunities exist to change our approval processes to benefit patients and better support research and development in Australia. Faster and more effective approval processes mean new medicines and technologies reach patients faster. Improving the environment for clinical trials enables Australian patients to benefit from the latest medicines and technologies developed overseas while also helping Australian health and medical research to flourish in a competitive and lucrative world market. Research Australia’s submission identifies some of these opportunities with the twin objectives of improving Australians’ health and prosperity.

Research Australia’s submission is available here.

The Committee is expected to hold public hearings in early 2021.

Budget Update 2020

Summary

The global economic impact of COVID-19 has been the overwhelming influence on the Budget handed down tonight. This is a big spending Budget, the biggest Australia has seen, focused on providing immediate stimulus to the economy but also laying the foundations for a future Australia, shaped by the lessons of the last nine months.

Most relevant to health and medical research are the following key announcements:

- Last year’s forecast budget spending on health for 2020-21 was $82.5 billion. This forecast has been revised up to $115.5 billion, as we begin to see just how much COVID-19 is driving up healthcare costs. In the coming months and years, Australians will look to health and medical research and innovation to deliver more effective treatments and more efficient pathways of care to curtail these costs. Research Australia will continue to work with Government to ensure support for the crucial role all parts of the health and medical research pipeline have to play in delivering better, more sustainable care.

- An extra $1 billion this financial year through the Research Support Program for our university researchers will be critical to maintaining Australia’s national health and medical research capability. More than half of all Australian health and medical research in Australia is undertaken in the higher education sector. It is clear that Australia can no longer rely so heavily on international student fees to subsidise research. In the long term, we need to look at effective partnerships between higher education, government, industry and philanthropy. The commitment in this Budget to supporting university research jobs is a welcome interim step towards establishing a more sustainable higher education sector.

- The Government will restore an additional $2 billion over 4 years through the Research and Development Tax Incentive to help innovative businesses that invest in research and development. It is doing this by reversing some of the changes to the R&DTI legislation that are currently before the Senate.

- The budgets for the NHMRC and MRFF remain virtually unchanged. At the same time, researchers are dealing with extra costs to their funded project due to the delays and disruptions caused by COVID-19. While the universities benefit from the one-off increase in the Research Support Program, there is no similar support for researchers in Medical Research Institutes. Research Australia remains concerned that NHMRC funding has not increased over the forward estimates to keep pace with inflation, with the net effect that NHMRC funding continues to decline in real terms.

Broader Context:

One of the key lessons from the COVID-19 pandemic is that we have become overly reliant on global supply chains for vital materials. This is driving a new focus on manufacturing and there are new roadmaps being developed which will, hopefully, join the dots between research, product development and manufacturing more successfully than has been done in the past. $1.3 billion over five years from 2020-21 will establish the Modern Manufacturing Initiative to: support manufacturing projects focused on building long-term business collaboration at scale; translating research into commercial outcomes and bringing new products to market; and integrating local firms to deliver products and services into global value chains. New roadmaps to guide the Modern Manufacturing Strategy are due in time for the 2021 Budget, in six months’ time, including for medical products.

Manufacturing accounts for around 6% of Australia’s economic output but is responsible for a quarter of all industry spending on R&D. However, Australia’s business spending on R&D is low by world standards. If Australia is to achieve the objectives of the Modern Manufacturing Strategy this will have to change, and we have to better connect business with Australia’s powerhouses of research, our universities and medical research institutes.

The Government has made several attempts to reform the R&D Tax Incentive in recent years, and tonight’s Budget is no exception. The R&DTI is critical to increasing business expenditure on R&D in Australia, and thus to the Modern Manufacturing Strategy. The Government is reversing several of the measures which are currently sitting before the Senate. For small business, the $4 million cap goes, and the rate is fixed at 18.5% above the company tax rate. For large companies the number of tiers in the intensity threshold will be reduced to two, with the RDTI paid at a rate 8.5% and 18.5% above the company’s tax rate for tiers one and two respectively. This is expected to increase the amount of R&DTI paid to industry by $2 billion over the forward estimates, compared to the amounts that would have been paid if the legislation had been amended in accordance with the Government’s previous plan.

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