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Current and Emerging Issues for- NHMRC Fellowship Schemes submission

Step 1 - This submission reflects the views of
Organisation Name: 
Victor Chang Cardiac Research Institute
Please identify the best term to describe the Organisation: 
Biomedical research institute / organisation
Step 2 - Personal Details
Step 3 - A. Some questions for you
1. Which of the following best explains your interest in NHMRC’s fellowship schemes: (select ONE only): 
I am currently working in the health and medical research sector
Step 3 - B. Consultations questions
Question 1: How should NHMRC’s funding balance between research grants and fellowships be adjusted as the total number of Project Grants available falls progressively over the next few years?: 
The medical research sector is currently in crisis and is in danger of losing a generation of young scientists due to current funding constraints. As the Strategic Review into Health and Medical Research (the McKeon Review) pointed out several times, severe changes to the NHMRC and other research funding schemes should NOT take place without a comprehensive whole-of-government research strategy in place to ensure a sustainable and productive sector into the future. As will be discussed below, low NHMRC Project Grant success rates are placing additional burdens on an already overstretched sector. Several recent changes in NHMRC’s grant allocation and funding strategy has meant that the NHMRC Project Grant success rate has fallen to 14.9%, and is expected to plummet further to 5.5% in 2017. Firstly, there has been an increase in the number of Project Grants of 5 years’ duration, rather than 3 years. Secondly, the funding of more clinical trials has meant that the average grant quantum has soared from $450,000 to almost $750,000 in three years (from discussions with NHMRC secretariat). These changes occurred without any ‘transition funding’ in place as a buffer. As a result, the grant success rate in 2014 was the lowest in the 75-year history of the NHMRC. This grant funding rate is currently the worst in the developed world. This low success rate will inevitably result in the loss of thousands of young scientists from the industry, as well as many established investigators. To avoid Australia becoming a scientific ‘banana republic’ we are asking that the NHMRC implement a moratorium on the strategy to move to a 5-year grant cycle. The duration and quantum of future Project Grants should be restricted back to a maximum of 3 years and $450,000 respectively. Adopting this approach we are likely to revert back to some 700 Project Grants being funded, as was the case in 2012, with an overall success rate of around 20%. The role of the NHMRC in funding expensive clinical trials should be reviewed; any move towards increasing the number of clinical trials should only be undertaken with significant additional government investment. In addition, trials should only take place that make a significant contribution to broader knowledge; trials that demonstrate merely incremental benefit or do not address mechanisms of disease should not be funded by the NHMRC. At the core of these problems is that fact that the ~$800 million provided annually by the NHMRC for biomedical research represents just 1.15% of the annual $70 billion health budget. While this limited NHMRC funding will be addressed to some extent by the development of a Medical Research Future Fund (MRFF) — which we hope will provide a $224 million boost in 2018—research spending will still only be 1.4% of the total healthcare spend. The McKeon Review recommended increasing medical research spending to 3-4% of the total health budget and that the research allocation is pegged to the healthcare expenditure going forward. Until this issue is adequately addressed research in Australia will continue to dwindle and healthcare costs will continue to rise rapidly. From Table 6 in the Discussion Paper it can be seen that currently 7.5% of all people listed on NHMRC grants hold a Senior or Early/Mid Career Fellowship. When only including researchers who receive some form of salary from the NHMRC, in 2014 16.9% (1,371/ 8,108) received a Fellowship, while 83.1% (6,737/ 8,108) were supported by a Project Grant. That is, for every Fellow, 4.9 researchers are supported by a Project Grant (i.e. a Personnel Support Package, PSP). It is a clearly untenable situation that while the number of Project Grants continues to decrease, the number and success rates of Fellowships remain stable. The question that the NHMRC needs to answer is if fewer people receive Project Grant support, should there also be a decrease in the Fellowship scheme to redress this inequity? We believe it would be more equitable to halt the decrease in Project Grant success rates by implementing the actions above. Ideally, fellowships should only be awarded to the top researchers in the workforce. We suggest that the current level of 5.3% senior fellows (Senior Research Fellowships and above) is reasonable and it would not be sensible to change this without undertaking a more detailed comparative analysis of what happens in comparable countries such as the US, UK and Canada. Much more work and consultation needs to be done to develop a sustainable strategy for the industry as a whole before this question can be answered. A much more secure, rewarding and highly-regarded career structure needs to be in place to encourage the high-performing and experienced researchers to remain in the research sector, regardless of what level of NHMRC support they receive, and to attract new graduates to prevent the sector stagnating. Therefore we support the move to longer Project Grant duration in the future, however we stress again that any changes are not tenable until additional funding and a clear science strategy is in place.
Question 2: To increase the turnover of NHMRC Research Fellows, should these schemes be seen as ‘up and out schemes’, whereby Fellows wishing to reapply can only do so at a higher level?: 
The Victor Chang Cardiac Research Institute recognises the difficulties faced by young researchers who have to compete against an ever-expanding pool of senior researchers. Essentially an ‘up and out’ system already exists for early and mid career fellows, whose have a limited time post-PhD to spend at these levels. There are currently 600 Early Career Fellowships granted, however nearly 60% of these researchers will be unable to go on to the next level, with only 256 Career Development Fellowships granted for 2014 (excluding Practitioner Fellowships). The number of senior Fellowships awarded then expands outwards to 433 Fellows. We believe the distribution of fellowships should resemble a ‘pyramid’ rather than the current hourglass distribution. The strength of any fellowship program is that it is awarded on a meritorious basis not an artificial construct of time spent at any one level or due to age. Ensuring successful and productive careers for early-stage scientists will not be solved by destabilising careers at the later stage of the career spectrum. It is already difficult to attract new people into an industry where currently even world-class experts in their field, who are at the height of their productivity and contribution to society, miss out on grants and fellowships. As the Inquiry discussion paper notes, medical research institutes, universities and hospitals already represent the largest proportion of employers of Chief Investigators (CIs) on NHMRC grants (supporting 3,733 CIs in 2014 compared to 2,034 CIs with NHMRC Fellowship or Research Support Grants). It would be unrealistic to rely on this sector to take up more of the employment load in today’s funding environment.
Question 3: Are there too many Fellowship levels? Does this structure impede the career progression of rapidly rising stars in health and medical research?: 
The Victor Chang Cardiac Research Institute does not consider there are too many levels in the current Fellowship Scheme. Moreover, the current scheme does allow accelerated progression for rising stars.
Question 4: Noting the implications outlined in the Issues paper, should NHMRC extend the duration of Early Career Fellowships to more than 4 years and Career Development Fellowships beyond 5 years (to 7 or 10 years)?: 
The view of the Victor Chang Cardiac Research Institute is that Project Grants should be awarded for a lesser duration (3 years) and at a capped value, and no changes should occur until appropriate transition funding and an overarching scientific research strategy has been implemented (see response to Question 1). The duration of Early Career Fellowships (ECFs) is a separate issue and should not be tied to the duration of Project Grants. Both ECF and CDF are currently awarded for 4 years. This is similar to Future Fellowships through ARC. It is possible to argue on the one hand that all NHMRC Fellowships should be awarded for the same duration, however, any increase in the duration of ECF or CDF’s will result in fewer of these fellowships being available overall. In these austere times this may not be a practical solution. Canada has recently significantly restructured its government-funded research schemes, and has linked fellowships directly to the awarding of Project Grants. However, this only occurred with a well-considered plan and time-line and with generous transition funding in place.
Question 5: Should NHMRC identify and support strategic priority areas in order to build capacity for the future? What else should be done to support women and increase participation and success by Aboriginal and Torres Strait Islander researchers?: 
UNDERFUNDING OF CVD Capacity building is necessary for areas of particular need that have emerged (e.g. Dementia and cardiovascular disease) or is difficult to fund under the traditional NHMRC methodology (e.g. Bioinformatics). Cardiovascular disease (CVD) is the leading cause of death in Australia and is projected to markedly increase healthcare costs as baby boomers age, and with the increasing incidence of ‘lifestyle diseases’ in the younger generation. CVD costs Australians $8 billion per year (11% of direct healthcare expenditure in 2012). In women, CVD causes 4 times more deaths than breast cancer. However, the NHMRC funds cancer research at almost double the rate of CVD. In 2013, cancer research attracted $186 m of NHMRC funding - 1.8 times more funding than CVD ($107 m). This trend has been consistent over the past ten years in Australia as well as internationally. It is not due to CVD research being of a lower quality than cancer research – it actually is more highly cited. Rather, it’s due to a capacity problem with far fewer CVD charities than cancer-related charities and less state government support of researchers in this field. This results in researchers moving away from CVD research to where more funding and scholarships are available. To address this issue, as a matter of urgency, CVD research should be made a priority for NHMRC funding. GENDER INEQUITY In 2013, females comprised 60% of the early career level grant applications (scholarships, ECFs & CDFs), however this plummeted to only 33% of applicants at fellowship level. More oversight of the mechanism of review by grant review panels and an inquiry into why women feel discouraged from participating in the grant application process needs to take place to reduce the loss of women from the science workforce at the more senior levels. Flexible work arrangements should also be available to all recipients of NHMRC funding especially for those with primary child-caring responsibility. The NHMRC could consider incentive schemes for those returning to work after a career break for child-caring in order not to lose these highly-trained researchers who would otherwise be at the peak of their careers and productivity. ABORIGINAL AND TORRES STRAIT ISLANDERS Current schemes to assist Aboriginal and Torres Strait Islanders should be maintained and enhanced. Options could include setting a specific number of postgraduate scholarships and ECF/CDF fellowships aside. Last year 16 postgraduate scholarships were offered in the Indigenous health area (but not necessarily for Indigenous students) and 3 Indigenous researchers received grants/fellowships from NHMRC. At the heart of this issue is the lack of well-trained Aboriginal and Torres Strait Islanders to apply for grants and fellowships, an issue that needs to be addressed earlier in their education at the time they are deciding on a particular career path. Incentives to pursue a career in biomedical research at that stage are vitally needed.
Question 6: Is there a better solution to encouraging diversity in careers than those based on years post-PhD?: 
Currently, Australia has no schemes or incentive programs that adequately encourage commercialisation activities, interaction with industry, or even interaction on a substantial basis with the health care system. As the McKeon Review addressed, these issues are much broader than the scope of one funding program and require a whole-of-government, multi-portfolio strategy to resolve.
Question 7: Should employing institutions be expected to provide more certainty to their employees than now? : 
As the Fellowship Inquiry discussion paper notes, medical research institutes, universities, hospitals and other funding bodies already represent the largest proportion of funders of Chief Investigators on NHMRC grants (employing 65% or 3,733 CIs in 2014 compared to only 2,034 CIs (35%) with NHMRC Fellowships or Research Support Grants). It would be unrealistic to ask this sector to shoulder more of the employment load in today’s funding environment. Whilst some institutions have diverse sources of income that could support some increased research activity, none of these institutions have the ability to provide secure tenure - research staff must be able to support themselves - at least partly - through fellowships. Even universities have to divert research staff towards teaching positions if there is insufficient funding to maintain research employment. At the end of the day the NHMRC can’t compel employing institutions to provide this type of certainty.
Question 8: Would this be achieved if NHMRC required institutions to commit to one or more years of ongoing support for researchers exiting from NHMRC Fellowships? : 
Research organisations already provide significant financial commitment to supporting NHMRC Fellows, Chief Investigators (CIs) and other researchers. As well as covering the entire cost of salaries and on-costs for 65% of existing CIs; each MRI or university makes a significant contribution to the salary and on-costs of CIs who hold fellowships. On average, for each of our non-clinical NHMRC Fellows, the NHMRC provides 65% of the salary and on-costs, while 35% of the costs of supporting a Fellow are provided by the Victor Chang Cardiac Research Institute. The salary levels provided by the NHMRC are well below industry benchmarks. Therefore for every three years of a Fellowship; one year is paid for by the Institute. For clinicians, the cost proportion faced by the hospital and Institute would be even higher. Extrapolating this to the entire sector, in total, research organisations (universities, hospital and MRIs) and other funding bodies provide an estimated 77% of salaries and on-costs for CIs; with the NHMRC only providing less than 23% of support for the total body of CIs named on NHMRC grants. Asking research institutions to fund additional years of support for Fellows would lead to significantly less employment of the overall number of researchers. This would not solve the problem of job insecurity, but would merely place additional strain on an overstretched sector. Smaller organisations that focus on niche diseases would be the hardest affected, leading to less diversity in our funding system.
Question 9: Should this be restricted to Early Career and Career Development Fellows?: 
If research organisations are asked to provide more funding to ECF and CDF researchers, the institutions will find themselves in the same predicament as the NHMRC i.e. there will be less discretionary funding available, so a smaller number of researchers can be supported. This will lead to less employment and stability for early career researchers in the long-term. Any solution needs to be capable of working across all levels of the Fellowship scheme. Limiting the time of Project Grants to 3 years and capping the amount awarded, would release funding for and allow a more equitable distribution of fellowships across the scheme.

Page reviewed: 28 January, 2016