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Current and Emerging Issues for- NHMRC Fellowship Schemes submission

ID: 
81
Step 2 - Personal Details
First Name: 
Anne
Last Name: 
Abbott
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
2. If you are a health and medical researcher, which of the following descriptions best classifies your research? (select ONE only): 
Clinical science – please complete the next two questions
3. If you are a health and medical researcher, which of the following best describes the main source of funding that supports your salary? (select ONE only): 
grants from organisations other than NHMRC.
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?: 
Is it fact that the total number of project grants will continue fall over the next few years? If so, shouldn’t we protest systematically anyone involved in this sector (every Australian)? Conditions for medical researchers are dire enough now. Any other sector would not tolerate them. Moreover, health services are ineffective and financially wasteful to the extent that independent research is not done (funded). It is well known that the government spend on health services is growing unsustainably while we are losing, or not even producing, our top medical scientists. The usual government response to unsustainable health service cost is to make indiscriminate cuts in a way that follows from not having done the research required to know what improves patient outcomes and what does not. This just makes the situation worse because there are cuts to services that improve patient health as well as some continued funding of services that are harmful or ineffective. For the sake of people in Australia and elsewhere, why do we (as people in medical research and know about the situation) ‘sit back’ and allow such cuts to research funding continue?
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?: 
It may not be appropriate, or in the best interests of science, for a medical scientist (example, a highly specialised lab or team manager doing research) to work at a ‘higher’ level. Taking on other roles with considerable time spent in ‘administration’ or ‘teaching’ for example, takes away from research time and should be not be paid by research funds. There will be fellows who should stay and reapply for funding at the same level multiple times. They should not be forced to apply at ‘a higher level’. Funding of such fellows should be dependent on their value to science by continuing to work at that level. ‘Turning them over’ prematurely will still mean Australia does not fund the medical scientists this country needs to make our health services more effective and thus financially sustainable (a healthy and productive society has less need for health services).
Question 3: Are there too many Fellowship levels? Does this structure impede the career progression of rapidly rising stars in health and medical research?: 
Of more relevance is the question about if there are enough fellowships at any level? Fact is, the NHMRC is now just able to dish out a few prizes (short-term, part- salaries) for just a few of our ‘best' medical scientists. Further, it is unable to properly fund even these people. It certainly cannot fund all our best medical scientists and obviously not all the scientists we need to make health services more effective and economically sustainable. Meanwhile, Universities and other Research Institutions cannot afford to pay medical scientist salaries, even if you are best in the world and making huge impact to improve patient outcomes and save on health service costs. No one is funding careers for independent Australian medical scientists. The government stands to gain most financially from adequate research investment because it is the lead funder of health services (a healthy society has less need for health services) and healthy people stay in the work force longer and pay more tax to the government. I have just reviewed 35 NHMRC Early Career Fellowship (salary) applications and they were all excellent, about medical questions we need answered. But only about 6 or 7 will be funded. The unfunded scientists will most likely have to leave science soon and will get some message back along the lines that they 'were not competitive' or 'not for further consideration'. This message is misleading and insulting. They should get the message back that they submitted great applications but the Australian governments (on all sides of politics for decades) have not been smart or appreciative enough to invest in the scientists we need, even though medical research (overall) returns significantly more money than that required to pay for the research. From my own experience, I am the world leader in my field (see FACTCATS.org) making a huge impact to improve health services and reduce health service costs worldwide but the NHMRC has not been able to support my salary for me to continue- just when we are getting the best gains from my years of effort and even though an NHMRC salary is miniscule in relation to the savings my work is producing. This under investment is a worldwide problem. This also gives us great opportunity to become better world leaders in new medical knowledge discovery and education- just the kind of sustainable industries we need to support. The consequences of under-funding medical research to work out what helps patients and what does not are disastrous. As mentioned, the government spend on health services will continue to grow unsustainably and the government will continue to make indiscriminate health service cuts. Meanwhile, drug and device companies (especially in the USA) are doing most of the medical research. They bring their own bias and this is a major reason why the field of carotid artery disease and stroke prevention has become so out of touch with what is good for patients and why the Americans have the lowest life expectancy among developed countries yet pay the most for their health services. Do we want to follow this example?
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)?: 
Extension to 5 years would really help the inefficiency of spending so much time writing grants and add some urgently needed financial security for researchers. It would allow more research output. From what I have seen of ECF applications those who get funded already have a great track record and plenty of work planned to fill five years. As always, checks can be put in place to make sure the community is getting value for money from such investment, especially at the time of reapplication. However, the total number of fellowships also needs to be increased, not remain at steady state. Unless more is invested into the NHMRC, changes such as extending fellowship duration, eligibility etc. will just cause problems rather than provide what is really needed.
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?: 
Yes, the health cost savings that flow from researchers’ work should be recognised, translation of the results facilitated and a proportion of the health cost savings used to fund more research by the team. We need to encourage a complete and positive feedback loop. Currently there is a HUGE disconnect between scientists’ work, its value to improve patient outcomes and ongoing support for the scientists who made the initial discovery. Currently the health research sector is far too separate from the health service sector in terms of services and funding. Women remain severely disadvantaged in the current funding scheme to the extent that they go part-time to look after children (the next generation) and other dependents (including the elderly- the current generation in a few years!). Men who go part-time are equally disadvantaged. Until the last 2 years, the NHMRC has not allowed fellowship applications (beyond the early career/’training’ fellowship stage) unless the applicant was in full-time employment! Thankfully, I believe the rules have just changed. However, reviewers still treat full-time and part-time workers the same when ranking grant applications for funding. Part-time scientists should have separate grant application scheme to full-time workers. Part-time researchers should be able to apply for the same total duration of salary funding and then use it part-time on a pro-rata basis. I cannot see how the current funding system would attract any one into medical research, including Aboriginals and Torres Strait Islanders. It actively repels everyone.
Question 6: Is there a better solution to encouraging diversity in careers than those based on years post-PhD?: 
Diversity in careers should not be based on years post-PhD. It should be based on value to the community.
Question 7: Should employing institutions be expected to provide more certainty to their employees than now? : 
There is no certainty (financial security) in a medical research/translation work, even if you are the world leader in your field making a huge impact to improve patient health and save health service costs globally. This is crazy and helps explain the growing health service crises and reducing standards of care we face. As research is more often about saving health services costs and improving quality of life than about making a profit from a drug or device and takes years, the sector (including universities and institutes) can only be properly funded by the government. There is not enough philanthropy. As mentioned, a major change to the funding model is also required- with research results put into practice and part of the health service costs fed back to the responsible research team so they can continue to make more discoveries. It is not good enough to tell our best and brightest that there is no future in medical research when we need them. We need to get the funding sorted so there is a bright future for them and all Australians as well as people overseas who also benefit from discoveries made here.
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? : 
If institutions could support valuable scientists for a year or two or more between grants or fellowships this would make a huge difference to job security, careers, research efforts and efficient research results and utilisation. Unfortunately, Institutes and Universities usually do not have such bridging funds because they have not been provided from government or charities. This just adds the waste and tragedy occurring quite silently in the research sector all the time. And it is getting worse.
Question 9: Should this be restricted to Early Career and Career Development Fellows?: 
No. Such bridging funds should be available to any valuable scientist, no matter their career stage. It is all about value from their work. There should be no discrimination based on age, career level, discipline, total paid hours in employment, or numbers of publications produced in the last few years, for that matter. Breaks in academic work to do different or related things should be allowed.

Page reviewed: 28 January, 2016