Television interview with Minister Butler and Matthew Doran, ABC Afternoon Briefing - 12 October 2022

Read the transcript of the television interview with Minister Butler and Matthew Doran on National Health and Medical Research (NHMRC) Investigator Grants; gender equality in medical research; COVID-19; vaccine uptake.

The Hon Mark Butler MP
Minister for Health and Aged Care

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MATTHEW DORAN, HOST: The Federal Government's peak medical research authority will soon begin setting targets to address gender inequities in research funding. From next year, the National Health and Medical Research Council will commit to awarding equal numbers of its investigator grants to women and men. It's something the chief executive of the council says is particularly close to her heart. 

NHMRC CEO, PROFESSOR ANNE KELSO AO: As a researcher myself for many years, one day I had the experience of looking up from the lab bench and realising that all my female - many of my female peers had disappeared. Where had they gone? And then went I joined NHMRC, I was really shocked to see our own funding data and seeing that continuing the disappearance of female researchers, even today, many years after I went through that process.  

How can we afford to lose so many brilliant women from health and medical research? We as a country, they as individuals, have invested hugely in their training and their development as researchers and we need their unique talents and perspectives if we are going to have them work alongside men to achieve the research goals that we need for a healthy Australia. 

DORAN: The Health Minister was there for that announcement, and he joins me now in the studio. Welcome to Afternoon Briefing. Talk me through what the concerns are in this space. How has it turned into a situation where you are having to address this problem? 

BUTLER: This has been a concern for many, many years. For many years, we've seen a very clear trend that women or female researchers predominate in the health and medical research sector at the early part of career. So PhD, post doc, in the early career parts of the grant programs run by the NHMRC and then about mid-career. When they’re in their thirties or so, their success rate in NHMRC grand rounds falls off a cliff, it really does drop precipitously. 

With these investigator grants, for example, there are five levels from junior to very senior. At the junior levels women account for about 55% of the applications.  At the most senior level, they only account for less than 25%, in spite of the fact we know women have really been a very big part of our health and medical research sector for years now.  

For years we’ve been trying to address this drop off from mid-career. I know I had responsibility health and medical back in the last Labor Government and when we commissioned the 10-yearly review of health and medical research, that was a key part of their job and we been able to improve it at the edges, but what the NHMRC is saying today, what they received very strong report from the sector in saying, is that it’s got to be structural change. If there is not structural change, there will continue forever and ever to be the structural inequality in the health and medical research sector. 

DORAN: Is there anything that is explaining why there has been a drop off? Is it an active bias at play, or is it something that's been festering away in the background that people have not quite cottoned onto until now? 

BUTLER: Well for years we’ve been looking at things like the publication history. So when you put in a grant, you need to indicate what sort of publications you've done over the last five or 10 years. 

Now if you take time off, such as a woman in your 30s might do, to have children, for example, there will obviously be an interruption to your publications history.  We’ve tried to change things at the edges there, but it hasn't really shifted the dial.  We need to think about this not only from the researcher's perspective, although, that's obviously a very primary consideration. There's also an enormous investment the country makes in training. 

These researchers usually stay in PhD and post doc level, and then grants right through early career, to see them walk away from research in the way that Professor Kelso talked about in her own experience, it's a terrible loss, a brain drain from the sector, not just an issue of structural equality. 

DORAN: You had a meeting yesterday with the AMA and medical students looking at this shortage of GPs across the country. It seems like there were a lot of good ideas that came out of that meeting, and goodwill. But in terms of actually putting some of that into action, what would your message be to the community who are struggling to get access to a GP at the moment? They can't get in. What is the short solution? 

BUTLER: I'm working right now with doctors groups, nurses and patient groups, and allied health groups in the Strengthening Medicare Taskforce which is working right through to the end of the year to make recommendations to government about how to best invest the $750 million commitment we made to strengthen Medicare. 

So that is now looking at improving digital health so that digital connections between general practice, the rest of the help system, how to strengthen the relationship between doctors and particularly patients with chronic complex need, and I think most importantly how to boost multidisciplinary care. So nurses, allied health, not just general practitioners who will lead these teams, but team-based care to look after all of the needs of particularly, people with complex diseases.  

There are things we can do in the short-term, I've talked about that, but I’ve tried to be honest as well that it’s not just the immediate pressures on the system that, as you say, patients are telling us has never been hard to see a doctor, GPs are saying their businesses are under real pressure in terms of their financial viability - because of six years of Medicare rebate freeze under the last government – and all of this is placing pressure on our hospitals. 

It's not just the pressure today, it's also what I’ve described as a terrifying trend, which is that only one in eight medical graduates today are choosing general practice as their career. It used to be four in eight. Now it is one in eight. That pipeline of new GPs to replace the baby boomer generation of general practitioners who are considering retirement today just isn’t there for us. 

And that's why I want to talk to medical students themselves. I mean, I am of more mature years, I can only make an informed guess of what is motivating a decision, a life course decision, a career choice decision of a young medical graduate. I talk to the leaders of the professions all the time, obviously, but I wanted to talk to young people themselves and get their sense of what government could do to shift the dial in their decision between being a GP, which we need more of, and being, say, a hospital specialist. 

DORAN: One last question because we are running out of time, and I feel we are going around the world, but when you hold the keys to a portfolio like yours there is a lot to cover off here. We talked about the lack of take-up when it comes to booster shots for COVID-19. How are you going to address that? Because we know there will be a waning immunity and that could particularly lead to another wave of infections. It doesn't seem like there is a whole lot happening out there to prompt people who may have forgotten to get their extra shot. 

BUTLER: We've been running information campaigns. One of the criticisms I had earlier in the year was that there was not any real booster information campaign coming out of the former government, so we lost a really critical period of the first half of 2022, where there was almost a sense that two shots was enough. When we know two shots is not enough, you need that booster to get that really good protection. So, when we came to government, we very quickly rolled out an information campaign about getting that third shot. 

I have to say I'm very disappointed with the results of that. We're still you know, several million people, are more than six months since having their second shot but haven't had the third shot yet. I've said many times publicly we need to do better. I am much more pleased on the performance of the fourth booster dose for older Australians, particularly over 50 or particularly over 65. 

That’s been very successful. We got that right up very dramatically, protecting the people most vulnerable to severe disease, but we got some recommendations from Jane Halton and her review of vaccine treatment procurement, including some recommendations the go to more information campaigns and we are giving thought to that right now.  

DORAN: Mark Butler, we will wait to see what happens there. Thank you for joining us. 

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