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Hodgson: Address, Medical Sciences Congress

Thu, 2 Dec 2004

Hon Pete Hodgson: Keynote address, Medical Sciences Congress

Health research in New Zealand


Thank you for the opportunity to make a few remarks this evening. I have something to say about the current status of health research in New Zealand and I am grateful for the chance.

There is one central idea that pervades thinking in this Government. It has done so for the five years we have been in office. It is that we seek to transform, or further transform, our economy and society.

It is a broad idea, and a simple idea. But it conveys a sense that we do not accept the status quo, that we are progressive rather than conservative and that we are active, aspirational and somewhat restless.

Tonight I get the chance to describe why health research in all its myriad forms contributes directly and multiply to that idea.

The PBRF confirmed that biomedical research is one of our strongest disciplines. Citation rates for health research are high. The level of international interactivity appears high, and so on.

Health research underpins our health system. Nearly all health research relevant to New Zealand is undertaken outside New Zealand. Similarly health research undertaken in New Zealand is relevant to wider humanity. But, it is also true that much of our research is relevant primarily in New Zealand.

In other words that $10 billion we spend on health in New Zealand is informed by research carried out here including research that can be carried out only here. To the extent that out research can influence the prevalence or incidence or management or treatment or prevention of conditions that permeate our society, then health research assists social transformation. Sudden Infant Death Syndrome is a good example.

And then, further along the spectrum, is the role of health research in changing the mix of our economy. I'll make that point just by naming a few companies and wishing each of them well. BLIS, Neuren, ProActa, Protemix, PEBL, Antipodean, and so on.

So there, without hyping it, is a synopsis of our health research system. Scoring well, or well enough it seems, on excellence, on relevance to New Zealand, and one day on wealth creation.

This conference is a combined meeting of a number of small discipline-based societies. The fact that you've chosen to join together and hold a combined meeting is reflective of the recent trends in the way global health is organised and undertaken. And funded, as I shall mention later.

Interdisciplinary research is hardly new. My son is a member of Phil Silva's Dunedin Multidisciplinary Study and he is a thirty-two year old. Parenthetically on that note it was great to see Richie Poulton, who can't be much older than my son, pick up the inaugural Sir William Liley award the other week for his work on the link between genetics and violence in males.

But while interdisciplinary research isn't new, it is certainly on the increase. The tidiness of disciplinary borders is evaporating with the passage of the years. Molecular biology is one reason, sequencing the human genome another, and the strength of information technology and bioinformatics a third. In addition, more animal research is becoming relevant and accessible to human health research. This is particularly the case in New Zealand.

An example is the Government's decision last Friday to establish a national biosecurity and emerging infectious disease unit at Wallaceville. This recognises the value of co-location of human and animal research and acknowledges that an apparently growing number of new human diseases have jumped some species barrier or other.

So disciplines are continuing to melt away, or into one another, as evidenced by this congress of four societies.

As I mentioned earlier, this melting of defined disciplinary boundaries is reflected in the way Government funds health research, partly by design and partly by circumstance.

The Health Research Council is the core funding body for health research and also where the core expertise lies. The majority of all health research funding passes through the council and that will be the case in the future. However, some health researchers cling to the idea that that's where all health research funding comes from and they are simply wrong.

If I leave aside PBRF funding, health research defined to include health technology, is also funded by the New Economy Research Fund (NERF), and by the Marsden Fund. These will be familiar to most of you. NERF has grown very rapidly in the past five years, from under $10 million to $70 million and biomedical research now accounts for 40 per cent of its investment. This is a fantastic result.

Less known is the very new and very small International Investment Opportunities Fund. This was established after it became apparent that joint funding of research across nations is on the increase and that our own funding seasons did not necessarily coincide with those of the other nation or nations. I guess the idea was sown with me when the Welcome Foundation decided, not unreasonably, to channel funding away from countries like New Zealand to developing countries. The occasional rapid trip to London was needed to get the funding back and we overcame the resultant timing difficulties more by good luck than good management.

So watch that fund, especially as it increases, as it will need to. Note too that we have started to deploy science counsellors to help you make the international links. The first of started in Brussels in April and the second starts in Washington in about a week.

Note too that the HRC is itself raising the size of its effective portfolio by joint research partnerships with other parties, such as ACC and Justice. This is a smart move, smarter than just the extra funding that flows, because it assures ownership of the research findings by the co-funder.

At the more commercial end, and I don't count this as health research, are things like: the technology for business growth fund, the pre-seed accelerator fund, the venture investment fund, the NZ-Australia biotechnology fund and, for reasons I mentioned earlier, some primary production research funding that has relevance to health funding. Last week's announcements by Lactopharma on the role of one of the lactoferrins on osteoporosis is an example.

So plurality is the name of the game. And if I were to dip into the social sciences it would become even more so. Similarly I could mention the seven centres of Research Excellence, two of which are related to health research, and mention my personal sadness that the public health CoRE didn't get over the line.

Life for researchers is therefore less simple. You may want to declare the system too complex. Or you may prefer to say that there are more opportunities for health research funding than before. Either way the system deserves exploring.

I shall retreat from our wide array of funds and programmes I just mentioned and just explore the three funds with which you are most familiar: HRC, NERF and Marsden.

Since I become Minister five years ago health research funding won in those three funds has doubled - from $39m to more than $80m per annum. I'm pretty pleased about that and I am hopeful that trend can be continued.

Yet health research funding has been in the news lately, on the basis that it is insufficient, and on the basis that New Zealand is falling behind other nations. How can this be, given that funding has doubled?

Well, there is a long list of reasons why people feel the way they do. First, some researchers equate health research funding with the Health Research Council, alone. They shouldn't.

But if one does focus on the HRC alone then several things conspire to give the complaint some validity. First there is a legacy known as full cost funding, which, from my point of view, has seen millions poured into health research funding for no additional health research activity. The gap has been determinedly closed by specific extra funding yet has a propensity to open once again as it is recalculated by this review or other. That issue will be finally resolved, with money, in eighteen months or so.

A related issue is the increased enthusiasm for university managers to serially clip the ticket on research funding as it moves through the university gate en route to the bench. I am not yet satisfied with the level of transparency in that regard.

Add to that inflation, and the HRC's greater use of long-term contracts, which means the money comes back for reinvestment less often, and you can see how some researchers are feeling the pinch. That is not to condone some of the mischief that has attended the debate but overall the Government and the research community find themselves on the same side.

As to international comparisons the devil is in the data and many apples and oranges have been compared, particularly in comment arising from the AEGIS study. An apples and apples comparison shows us roughly in the middle of the pack but actually that isn't quite the point either.

The proper, broader and much harder question is, all things taken into account, what level and what focus of research activity is optimal for New Zealand? Regrettably the wisdom to answer that question with any evidential particularity is not easily divined.

But I think we are entitled to say more is better. This is why there has been a doubling over five years. I also think we are entitled to say, at current levels of funding, that more still is better still, which is why we hope to continue the funding track upwards.

I have one more thing to say about health research funding and the move to full cost funding. We have a policy of full cost funding, so research isn't marginalised. So that researchers see investment in their environment that is up to scratch. So that buildings and equipment is appropriately funded. So that the system has long-term stability.

With the move to full cost funding of health research now well underway, actually nearing completion, I have a question for you.

Are you seeing the changes? Is your environment improving? It should be. If it isn't then you have some questions to ask, but not of me.

We have had health research under the spotlight for much of the past year. MoRST undertook a review, the AEGIS report, which was very useful. The aforementioned funding debate unfolded, the HRC has intensified its attention to funding formulae and has invoked the assistance of the auditor-general. MoRST and the Ministry of Health have sought to implement or further explore the findings of the AEGIS report and of subsequent discussion with the research sector on it.

One issue is that in front of us is what the health research community calls translational research and what other science disciplines describe with a different lexicon.

We think there is a gap. We think that the findings of the research community are sub optimally deployed in a clinical setting or in our delivery structures or in social marketing or whatever. That is something of a challenge for us as we seek to accurately define first the problem then the solution. You may well be hearing more, and you may well be informally consulted further.

A paper on health research, including discussion on translational research made its way to and through Cabinet on Monday.

It is time for me to conclude. As you would expect my concluding remarks are reserved for those who contested or who won the prizes that are being presented tonight.

I am the Member for Dunedin North and have been for fourteen years. There are more students in my electorate than in any other in the country, and my office is one up from the Captain Cook. I see a lot of students and a lot of student life. I'm also out and around the research benches of the University on a regular basis. I just love it and I can never get enough.

The reason is that I get to alight, briefly, on the brilliance of this or that person's work and their thinking. I get to witness passion and commitment and serious intellectual horsepower. I get to see lateral thinking at work and I get to see the future.

To young researchers and to young would be researchers I have just these comments:

First, you are living in a country which values research and innovation increasingly. I can back that assertion with poll data, with anecdote and, if you look at the Government, with much funding and policy activity.

Second, if you leave New Zealand I hope your post-grad or post-doc abroad works well for you. I also hope you return to share your learning. I am confident that New Zealand is, and will increasingly be, a great place to do health research.

And third. Congratulations to you all.


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