I too rise to speak today on the Medical Research Future Fund Bill 2015 and related bill. These bills finally give effect to the government’s intention to set up a Medical Research Future Fund, the MRFF. And I say ‘finally’ because this fund was supposed to be operational by 1 January, some eight months ago.
It is a sad reflection on the chaotic and dysfunctional two years we have had with this government that it has only now managed to introduce another one of its signature policies. Yet they have time to create knights and dames and to protect hate speech—and how many attempts have they had to introduce a GP tax? This government is so inept that it has no control over its own legislative timetable. This government is setting new lows in getting legislation through this place. A recent report by TheSydney Morning Herald demonstrated that this government has been the least effective government in almost five decades—less effective than even the McMahon government. No wonder it has taken so long for these bills to come before us today.
It is deeply concerning that, having spent more than one year talking about this fund, the government has not done the work needed to establish a fund that meets the principles the government itself outlined. Unfortunately, what the bills before us today fail to do is fulfil the government’s promise when the fund was announced: ‘fund earnings will be directed to medical research, primarily by boosting funding for the National Health and Medical Research Council, the NHMRC’. And it is here that it is important that we acknowledge just how well the NHMRC has served our nation.
The NHMRC has established internationally respected and transparent processes over more than 80 years, and Labor believes the existing mechanisms establish the best process through which the highest quality health and medical research can be funded through MRFF disbursements. The bills before us today only reference that the health minister ‘could’ ask for the NHMRC to manage distributions from the Medical Research Future Fund. It is no guarantee that the health minister will ask the NHMRC to manage distributions. And, given the government’s track record of wanting to control such funding, there is the potential that the MRFF will become a slush fund for the health minister, just like Minister Brandis’s arts slush fund.
Labor senators do not agree that decisions regarding the projects and programs awarded funding should sit wholly with the minister of the day. It is obvious that such a practice would be inconsistent with the way existing grants are awarded by the NHMRC, and inconsistent with international best practice in awarding grants to the highest quality projects based on a process of peer review.
Furthermore, the bills also provide that the finance minister can credit funds to the COAG Reform Fund for making payments to the states and territories for expenditure on medical research and medical innovation, including application and commercialisation activities that translate discoveries to new treatments and practice; and corporate Commonwealth entities outside the general government sector, such as the CSIRO. In addition, while the health minister can delegate responsibility for providing funding to institutions such as universities or medical research institutes, the health minister does not have to use this delegation.
Finally, the Minister for Finance can also direct credits to the MRFF Health Special Account for the purpose of making grants of financial assistance to medical research institutes, non-profit organisations, universities and corporations. Given the flexibility the government is allowing itself as to how funds can be allocated, it leaves open the question as to just what exactly this fund will support. Without any oversight from an independent advisory panel, without a peer review process, without consulting the NHMRC or even distributing funding at arm’s length through the NHMRC, the government can, for all intents and purposes, direct credits from the MRFF to any pet project it wants. This all sounds very similar to concerns with Minister Brandis’s arts funding changes. We know that the changes to arts funding are destroying the sector because of an ill-thought-out process which has vague guidelines and fails to provide appropriate criteria for assessment and basically becomes a private arts fund for the minister.
Back to the MRFF. In short, the government can send the funding to pretty much anywhere they choose with no independent advisory panel to oversee. It is very concerning—in fact, it is quite alarming to us on this side—that a large part of future medical research in this country can be at the sole discretion of the government to use for political purposes. It is a pretty ironic move from a government that is ideologically opposed to picking winners. The government is seeking to establish this fund without proper governance surrounding the way its disbursements will be made. So, how is this good for government?
Maybe those opposite can remind this place when good government is meant to begin again. I think it was six months ago that I heard that quote for the second time. ‘Good governance starts today,’ was, I think, the quote, but of course we are still waiting. Labor, of course, is the biggest supporter of health and medical research in this place. We demonstrated this when in government through a commitment of more than $3.5 billion in health and medical research funding. This included more than $700 million to build and upgrade health and medical research facilities across the country. Also, when in government, Labor commissioned the landmark McKeon Strategic Review of Health and Medical Research to provide a long-term vision for governments and the sector because Labor believes that medical research should be guided by a long-term vision, by guidance from experts, and be overseen by good governance. Those were our policies.
The McKeon review provides a 10-year roadmap as to how health and medical research can be supported for the benefit of all Australians. The review also made it clear that a levy, such as the Abbott government’s GP tax, is not the ideal or preferred method for funding medical research in Australia and we agree. This is also why we oppose the government’s freeze on Medicare rebates and call for it to be abandoned. The inevitable outcome of this freeze will be a GP tax worse than that proposed in last year’s budget and a collapse in bulk-billing rates.
It is really saddening to see just how dysfunctional the government’s mismanagement of the health portfolio has been. It is clear that this government does not believe in the principles of universal health care. It opposed universal health care when Whitlam introduced Medibank, which it overturned when Malcolm Fraser became Prime Minister. And this government does everything it can to strip funding away from health programs.
I would like to put on record some of the cuts that have been made to health to support this fund. They include more than half a billion dollars cut from public dental programs; billions of dollars cut from public hospital funding; almost $400 million cut from preventive health programs; hundreds of millions of dollars cut from the Health Flexible Funds, which support vital drug and alcohol rehabilitation services and important work undertaken by organisations like the Heart Foundation, the Cancer Council, the Consumer Health Forum, the Public Health Association and others; cuts to veterans’ dental and allied health programs; cuts to the electronic health record; cuts to the Pharmaceutical Benefits Scheme, including the proposal that is still before the Senate to increase the cost of medicines by $5 for all general patients and 80c for concessional patients, as well as unfair changes to the PBS safety nets; cuts to a number of important health workforce programs; cuts to optometry programs—not to mention cuts to the Healthy Kids Check.
Now, let us just look at the impact of one of those issues. Having worked in early childhood education I am appalled at the axing of the Healthy Kids Check. This is a comprehensive health check for children aged three to five, which has been scrapped by the federal government to save about $144 million over four years, angering GPs and speech pathologists, as well as parents of young children. The Abbott government axed Medicare funding for the Healthy Kids Check, which is a consultation with a nurse or a GP to assess a child’s health and development before they start school. The scheme includes assessments of a child’s height and weight, hearing, eye sight, oral health, toilet habits and known or suspected allergies. Also, it helps parents to understand the risk of anaphylaxis and how to prevent it. In 2014, 154,000 children used the program. Medicare pays between $58 for a Healthy Kids Check consultation with a nurse and $269 for an hour with a GP, depending on the child’s needs. According to a study published in the Medical Journal of Australia in 2014, the check was detecting problems in about one in five children. The most common problems identified related to speech and language, followed by toilet habits, hearing, vision and behavioural issues.
Other organisations concerned include the Royal Australian College of General Practitioners, which stated it was disappointed by the federal government’s decision, which was made without consulting GPs—what a familiar record they have on that side about that. Also Speech Pathology Australia has stated that scrapping a check that facilitated early intervention services for children with problems before school made no sense at all. In fact, I would say, having previously spent 12 years as an early childhood educator, that it is likely to lead to worse educational outcomes for children who go to school with undetected health problems. Economically, you have to think about the costs involved and about how much money could be saved through early detection. Obviously there could be a cost saving through early detection.
None of this makes any sense—it does not make any sense at all to me but that is like so much of what this government does. These are important programs which should be supported and should not have been axed, but, unfortunately, this government just wants to cut health whenever it can.
The bills we are debating today—the Medical Research Future Fund Bill and the Medical Research Future Fund (Consequential Amendments) Bill—were inquired into by the Senate Community Affairs Legislation Committee. Labor senators made additional comments in the final report, and I would just like to mention some of these today. Labor senators commented:
Labor Senators support the establishment of the Medical Research Future Fund as an opportunity to expand Australia’s health and medical research sector, especially in that it provides an opportunity to implement some of the recommendations of the McKeon Review …
Labor Senators however see the MRFF as a missed opportunity to pursue many of these recommendations due to the rushed and poorly developed proposal the Government has developed—
giving no consideration to McKeon’s recommendations to attract philanthropy and new funding sources, or indeed define the recommendations in the original Bill.
… … …
Labor Senators agree that the types of research that should be funded through MRFF disbursements is different from what the NHMRC has traditionally funded, especially when it comes to commercialisation and translational research. Labor Senators also recognise that through the NHMRC’s existing committee structures this capacity is lacking which is why Labor Senators support the development of the Australian Medical Research and Innovation Strategy and the Australian Medical Research and Innovation Priorities.
Labor Senators do not support the transfer of existing funds within the Health and Hospitals Fund transferring to the MRFF…
The Health and Hospitals Fund was ‘established for different purposes’ and should not be raided to fund the MRFF. Labor will:
… seek to make a number of amendments to the Bills to establish a more robust assessment process. Labor’s amendments establish the inclusion of a process of expert review to ensure that the highest quality research is rewarded, rather than—potentially politically motivated and influenced by the ‘loudest voices’—decisions being made by the Minister of the day and subject to no independent oversight and with little transparency.
A Labor Government would seek to amend the NHMRC Act to ensure that, whilst the MRFF Special Account were to remain independent, the role of any MRFF advisory committee would be reflected in the NHMRC Council structure with the same sort of rigour applied to funding assessment as the NHMRC does through its existing grants streams.
This government could have done, and should have done, a whole lot better with these bills, especially given the delay in bringing them before the parliament today. I encourage senators to carefully consider Labor’s amendments and to support Labor’s amendments to the bills.