Consultation: Improving alignment and coordination between the MRFF and the MREA webinar – 6 June 2023

MASHA SOMI:

Hello, everyone. I'm Masha Somi and I'm the CEO of the Health and Medical Research Office. I'd like to begin by acknowledging, celebrating and paying our respects to the Traditional Owners of the lands we are all joining from today. I join from Ngunnawal and Ngambri country here in the Canberra region and acknowledge all First Nations Australians on whose Traditional Lands we meet and work and whose cultures are among the oldest continuing cultures in human history. Welcome to the webinar today, which is our first event supporting the consultation on strategies for improving alignment and coordination between the Medical Research Future Fund and NHMRC's Medical Research Endowment Account. The consultation is being led by the Minister for Health and Aged Care, Mark Butler, and the Assistant Minister for Health and Aged Care, Ged Kearney. I hope you've all had a chance to review the discussion paper that is available on the Department of Health's Consultation Hub. Today we're very privileged to have time with Professor Anne Kelso, the CEO of the National Health and Medical Research Council, and Dr Phillip Gould, the first Assistant Secretary of the Health Economics and Research Division, which is where my office sits.

Anne and Phillip will do a short presentation on the proposed reforms and how we are consulting on them. And then we'll move to a Q&A session, which will take the majority of time. We have a Slido available so you can type in your questions and also vote on those you want to hear the responses to. You need to scan the QR code from the reminder email for the webinar that you would have received yesterday, and the code will also come up on one of the slides a little bit later. You can also go to Slido.com and enter a code to join as a participant, and the code is 33 11 565. So, I'll just hand over to Anne now to begin the presentation. Thank you.

ANNE KELSO:

Thanks very much, Masha. Good morning, everyone, and thank you very much for joining this first webinar in our consultation. I'm really pleased to be able to be part of this discussion. I think it's a very important one about how to improve the management of the Medical Research Future Fund and the Medical Research Endowment Account of NHMRC and take the operation of both of these very important funds to the next level. Now, collectively, these two funds now deliver more than $1.5 billion per annum to the research sector in Australia. This is a really significant sum, but every dollar matters and it's critical that we use those $1.5 billion as effectively as we can to undertake the research that Australia needs now, as well as in the future, for the improvement of our community's health and wellbeing. Now that includes discovery research, it includes research to improve clinical care and the delivery of health services for patient benefit. It includes research to inform all levels of public policy, to improve population health. It includes support for translational research, whether it's directly into policy and practice or via a commercial pathway. And it includes research that addresses the specific needs of the diverse people in communities around our very large country. To address today's health challenges and to have the capability and flexibility to address whatever challenges the future throws at us. Now, the purpose of this consultation is to discuss models for the governance of the Medical Research Future Fund and the Medical Research Endowment Account that will allow us to make the best strategic use of these funds. We need a really open discussion, with input from many different perspectives on how we can do this. The consultation is being undertaken in the context of a pending review of the Medical Research Future Fund Act and the future development of a National Strategy for Health and Medical Research. Next slide, please.

So, what are the Medical Research Future Fund and the Medical Research Endowment Account? I want to start with the second one first. The MREA is the fund from which NHMRC grants are delivered. It receives funding every year through the federal budget, and currently that's approaching $900 million per annum. And that funding is specifically to support grants for medical research and public health research. Probably most people on this webinar know that NHMRC has been around for very many decades, and it has an established place in the delivery of competitive research grants to the health and medical research sector, especially in universities, medical research institutes and hospitals. NHMRC reports to the Minister for Health and Aged Care and its strategy, priorities, and policies are developed with the advice of its counsel and a range of advisory committees. Critically, most NHMRC grants, most, not all, are investigator-initiated, and that means that the applicants decide what they wish to work on, and then they compete for funding to support the projects, the researchers, the teams, and the collaborative networks, national and international, to undertake the work. The grants can be in any field, provided their ultimate purpose is the improvement of human health. So, in practice, they range across the spectrum from basic research to clinical, public health and health services research. They include discovery research, translational research in the clinic and the community, and early-stage commercial research. This system has contributed to the very well-recognised strength of Australian health and medical research and to our situation overall as one of the healthiest countries in the world. But this model of research funding was underdone when it came to priority-driven research directed at meeting the specific needs of government and the community. An ideal funding system would have a balance between investigator-initiated, bottom-up research and priority-driven, or top-down research. In 2015, the Australian Government established the Medical Research Future Fund, the MRFF, a really innovative approach to redress this imbalance and to establish a perpetual source of funding for medical research and innovation.

So, the $20 billion MRFF was established, and from that the earnings of the fund are drawn down each year to provide research grants, and that's currently $650 million per annum. The critical difference from the MREA that NHMRC runs is that these grants are awarded in priority areas, which are determined by government on the advice of the Australian Medical Research Advisory Board, AMRAB, following a national public consultation that is held every two years. The funds are delivered through a range of missions and innovative schemes, such as the Frontiers program. They also support a very wide range of types of research and research topics, but with an emphasis that's more on translational research and innovation. Delivery of the MRFF is overseen by the Health and Medical Research Office here in the Department of Health and Aged Care, headed by Dr Masha Somi, and using grant services that are provided by NHMRC and the Business Grants Hub. So next slide, please.

What's the problem that needs to be addressed? We have more money for research than ever before, we have both bottom-up and top-down research supported by these two funds. Well, I think with the MRFF now in operation for a bit over seven years alongside NHMRC and MREA, it's a really good time to ask this question. Stakeholders across the sector have identified a number of issues and the major ones are summarised very briefly on this slide, but they're elaborated in the discussion paper. Some of these issues flow from the fact that these two funds are managed separately through different government bodies, NHMRC for MREA, and Health and Medical Research Office for the MRFF, and their strategies are developed separately through different consultative processes, with only limited coordination. There are many overlaps in the type of research funded by the two funds, and that there's a lack of clarity, I think, in the sector's eyes, about their different purposes. Users of the schemes are calling for greater coordination of grant topics and funding cycles, application requirements, and funding policies that would reduce unnecessary workload. And across the board, we can see that there's a need for greater consumer and community involvement in setting priorities and the design and conduct of research. And as a country, we still have a long way to go to integrate and embed research into clinical environments and public policy development and to support the commercial R&D that will strengthen local development and exploitation of Australian innovation. Next slide, please.

So, what's the goal of the reform? Well, that previous slide outlined some of the details, some of the issues that have been raised over the last few years, but really the overarching issue is, how do we make the best use of the MREA and the MRFF collectively to undertake the research we need for the future health and prosperity of the country? We want that research to be informed by the community, effective and efficient for all users, whether they are researchers or institutions or industry, and they need to balance the benefits of investigator-initiated research, working with the frontiers of knowledge, inspired by the problems that researchers see in their professional lives, with priority-driven research that's flexible and responsive to the needs of the community and governments.

So, the ultimate goal is an integrated approach to funding that will deliver the research needed to address the health challenges of today, while also building the capability and flexibility needed to meet the future health challenges. Now, this does not mean that the special features and benefits of each fund will be lost through the process that we're now about to engage in. There would continue to be different schemes for different purposes, with peer review processes and the expertise of reviewers adapted to the goals of each scheme. But they would have a visible place in an integrated National Health and Medical Research Strategy. Next slide, please.

So, there are two stages to this consultation. The first stage is about how to improve the alignment and coordination of the MRFF and the MREA to address the issues that I've already outlined. There are two elements of that. There are the governance arrangements for overseeing the two funds, including the advisory structures that advise them and the accountability, and then the administrative arrangements to deliver grants from the two funds.

The second stage is the development of an overarching national strategy for Australian health and medical research. Now, today in this webinar, and throughout this consultation over the next six weeks, we are only concerned with the first stage. I imagine there are many people who will participate in this consultation who will want to talk about the second. How the government's investment should be distributed across different fields and types of research to address the country's health challenges, how to bridge the gaps in research translation by commercial and non-commercial pathways, how to support and strengthen the research workforce. But those are issues for later, for the second stage of the consultation. What we want to achieve with this consultation is to be able to present advice to Government on a viable model for the integrated governance and administration of the MRFF and the MREA, so that we'll be capable of delivering grant programs consistent with a future national strategy.

So, I'll now hand over to Phillip Gould to talk about three potential models that we want to discuss with you.

PHILLIP GOULD:

Thanks very much, Anne, and thank you, everyone, for logging in today. What I'll do during my part of the presentation is talk about what we're very deliberately calling three potential models, rather than options for governance and administration of the two funds. And the reason why I stress that difference is that, really, these models are designed to inspire thinking and a good conversation around possible avenues for reform. We're certainly not asking people to select from one of the three models. There are opportunities, I believe, to look at, take various elements of the different models, and put them together. So, as I go through this, please bear that in mind that we're very open to discussions around different approaches. That said, I think, as Anne beautifully laid out, where we put these models together as ways that we could explore, we can manage some of the issues that have been raised with the management of the two funds in the past and also really importantly, to continue drawing on the strengths of the two funds in the way they've been managed.

So we certainly don't feel that we're operating from a point of weakness. There's a lot of strength in the system, a lot of fantastic work has been achieved through the current arrangements, but as always, there are opportunities to improve and that's very much the spirit in which we're putting forward these models. As we go through the models as well, I would ask people with different perspectives to think about how they might work across a broad group of stakeholders. We're very aware of the importance of medical researchers as a key stakeholder in this space, but they're certainly not the only stakeholders, consumers who ultimately will benefit from this research absolutely critical throughout, as are businesses that may seek to commercialise this work, and clinicians who will also be putting it into practice. So we take very much a broad view of what our stakeholder base is.

So about these three models, the first one involves better alignment through coordination. So in many senses, this model requires the least change in terms of complexity of implementation. Under this model, the two funds would continue to be managed separately, but we would look at creating new mechanisms to strengthen coordination between the two. Anne went through in previous slides some of the issues that have been raised with the current model, and many of them do cut to that issue of coordination and clarity of purpose. So, essentially, with this model, and there's more detail in the paper, including some potential diagram or some diagrams around potential governance structures. One of the key elements here is that there's a more formal approach to coordinating between the two funds. At present, we do certainly speak a lot and work together, but this would be an opportunity to strengthen those links and formalise them, potentially, for better alignment of policies and other approaches. This would allow for greater collaboration between CEOs, but also between AMRAB and the NHMRC Council, who are absolutely critical to both of those organisations. So this option, I think, would manage a lot of the concerns that we've seen. And as I said, it has lower implementation complexity and I'll leave it there for this particular slide. We'll go to model two. This model involves the management of both funds by the NHMRC. So that would be a significant change to governance and administration of the funds. This would then mean that NHMRC would develop the investment plans for both funds. Now it's absolutely critical at this point to stress that an approach like this would not be seeking to remove the benefits of a priority-driven approach, that's not what's being suggested here. And it really is about putting the administration of the two funds under one roof, rather than setting up a change in the approach that Anne laid out so nicely before, of having a top-down and bottom-up approach to research. We would, through this model, need to have new advisory structures in place to support the NHMRC Council, which would be the ultimate advisory body for under this model. So we would look, and you can see in the paper as well that there are some options there for the way that that may be structured.

In terms of the complexity of implementation, this is clearly more complex than the previous option. It would involve significant organisational change. It's quite likely that there would need to be legislative change to put this into effect. So that's the second model, but going forward again, excuse me for stressing this again, this is just a model for consideration rather than us putting this forward as a specific option. The next option is probably the most extreme, in terms of both the highest complexity of implementation. And that would actually involve merging the two funds with new governance arrangements. So as it stands, the two funds are entirely separate, they're governed by different legislation. As we said, they seek to meet different purposes. Under this model, the funds could be merged into one, so a single bucket. But that would, again, not mean that we are discounting the importance of different types of research, whether it be top-down or bottom-up. So again, want to stress here that this approach in itself does not necessarily, well, it does not mean an end to priority-driven research.

The benefits of this approach is that it would have a single cohesive investment strategy, so it would really simplify things in that way and drive towards that coherence. This would require significant governance changes, so new governance to support a single funding source. So we have some basic models in the paper which explain how this may work. But this is something where, rather than thinking about the current model that we have, it enables us to say, if you were to start again, would you indeed have two different funds? So it's really kind of a clean sheet of paper. People who are listening to the webinar may themselves have different views of what they would do with a clean sheet of paper, and again, that's all part of the consultations that we're going for. So if we go to the next slide, I think that's all I wanted to say about specific models that we're putting forward. But again, I just wanted to come back to this slide to say that we would like any approach that we take to address these issues that have been raised.

And that's one of the things that we'll be testing ourselves on as we go throughout these consultations. How are we working to alleviate pain points in the sector? And again, I use the term sector very broadly. I mean that as our stakeholder set, which is not just the research sector, but also the other groups which I mentioned before, including consumers, who are absolutely critical. This is why we do the work, is ultimately to improve the health of Australians, but also businesses and clinicians. So, as we go through the discussions and as people consider their questions and the way they engage in the consultation process over the next six weeks, please do keep this in mind. And people may also identify other issues that need to be addressed but may also be very keen to point out strengths in the current system that we really need to seek to protect and at times enhance and build on a position of strength.

Okay, we have a set of questions that we'll use throughout the consultations, and really, a lot of these questions you'll see get to people's views on the strengths and weaknesses of the different models.

As I said before, what elements of the existing process and governance should we seek to keep and what should change? But we are not seeking to limit people's responses to those particular questions. So we're also asking people, are there things that we've not considered in the questions that they would like to raise? We will be seeking public submissions on the paper, and based on the consultations, and they will be, I think we're seeking those by the 17th?

MASHA SOMI:

14th.

PHILLIP GOULD:

Sorry, 14th. My apologies, on the 14th of July. So, there's a significant period of time for people to consider how they would choose to respond to those questions.

Go to the next slide, please. So, next steps. We'll be performing targeted consultation over the next few weeks, including Ministerial and Commonwealth roundtables. I think that the three of us will be travelling extensively together, probably getting to know each other very well over the period, but we're really looking forward to hearing the diversity of views. As I said, absolutely critical that we hear all those voices. The team will also be available to take questions. There is a contact email there, and as required, we would be happy to make contact with groups that feel that they would like to be consulted on this. We'll have to manage expectations. We're not sure at this point how much demand there will be for further consultations, but please consider our lines of communication open. We'll have another public webinar like this on the 3rd of July, and that will enable people to consider more deeply the paper, and they may have further questions in that.

So, we encourage people who have dialled into this webinar today to consider also dialling into that one and letting your colleagues know if you think that they would find that useful. As mentioned before, written submissions will be due on the 14th of July. So, we're really looking forward to those. They are always an absolutely essential part of these processes. Lots and lots of reading for us to do but reading them we're really looking forward to. After the consultation period has closed, we will release and publish a report on the work and the findings from this round of consultation.

So, was there anything else, Masha, or Anne?

MASHA SOMI:

I think we can move to questions. Thank you to all those who've already started submitting questions, and I'll start working through them. So just a reminder, please use the QR code that's on the slide at the moment, and that will take you to slido.com. And in that process, you'll be able to submit questions or vote for existing questions that you'd like to hear the answers to. So, I might throw the first one to you, Phillip. Can you elaborate on why this review is preceding the development of the National Strategy for Health and Medical Research? This seems backwards.

PHILLIP GOULD:

Thank you for the question. We had significant discussions around the best approach to staging these two cases. My view is that the setting of the strategy without having the underlying elements in place is a difficult exercise. I think that by knowing who will be responsible for what going ahead and actually leading any longer-term strategy in the future, then we will be able to have more accountability and ownership, ultimately, on what that strategy looks like. So, that's my short answer to that question. But I will say, it was actually a subject of, I would say, vigorous rather than heated debate among a number of us.

MASHA SOMI:

Thank you. I might put this one to you, Anne. How have public representatives or consumers been involved in priority setting for NHMRC and MRFF grant programs in recent years, and how might this change?

ANNE KELSO:

Yeah, I think it's a really great question because it's a changing world and we look back 10 or 20 years, consumer and community involvement in research was much, much lower than it is today. And I think so, for both agencies, there's been a lot of attention to this in recent years. At NHMRC, we have consumer and community representatives on our council and all of our advisory committees and they and some other people, in turn, form our consumer and community advisory group. So, they have a voice in all of our priority setting and in the development of policies for research and the other work that NHMRC does.

And we're also increasingly involving consumer and community representatives in the peer review of our grant applications to some of the schemes. So, I think that's really powerful. It's certainly an influential voice in everything we do these days at NHMRC, and the same has been true from the beginning for the MRFF. The process for the setting of priorities for the MRFF, as I mentioned in my opening remarks, is overseen by the Australian Medical Research Advisory Board, but it involves a national consultation every two years, which invites everybody who's interested to contribute, whether through written submissions or roundtables or open sessions.

And again, those have been very powerful voices in the setting of the strategy and priorities for MRFF. And then the MRFF also has a consumer advisory group that is giving very strong advice and very influential advice to Masha and her team.

MASHA SOMI:

That's great. And I think the question about, how might this change? I think... Do you want to add something?

ANNE KELSO:

Yeah. I mean, I think, obviously, this is something we want to retain and strengthen over time as we all learn how to do it better and better. And it's absolutely a central part of however this arrangement changes in the coming years. And I think what we'll be doing is looking at the strengths of both of the approaches that are currently used by NHMRC and the MRFF, and also learning from what consumers and community representatives tell us is needed to do this work better.

MASHA SOMI:

Thank you. I might move to a question on...

Okay, so, Phillip, I think this one's for you. How, if at all, would the proposed models two and three involve the Department of Health in decision-making and priority setting?

PHILLIP GOULD:

Thanks, Masha. Good question. In terms of the models, as we've laid them out, there's probably scope for different levels of involvement from the Department. I would say that... As taking a really broad view of it as a stakeholder, the Department is uniquely placed in terms of an understanding of a lot of the challenges that we're facing across a range of different issues. So, it certainly has the capacity to offer unique perspectives, and very broad perspectives as well. I would put it back to some of the people who will be engaged in the consultation as to their views on the level of involvement from the Department. We've deliberately not put forward a detailed model there. I understand that for some stakeholders, they would probably see Departmental involvement as being a good thing. There's always a view as well, sometimes, that government should stay out of these processes. So, I think we'd look to see a good balance there. And as I say, interested as we go through the consultation process to hear views.

MASHA SOMI:

Thank you. So, Anne, I might ask you, can you comment on how workforce, including training and career certainty, would be considered in these models, both during implementation and ongoing?

ANNE KELSO:

Yeah. Well, certainly from my perspective, this is a really crucial set of issues, very complex issues. And NHMRC has always paid a lot of attention to workforce, but we know it's critical that both types of fund enable the development and support, and support the resilience of a strong health and medical research workforce, in universities, institutes and hospitals, but also in that part of the workforce that supports commercial development of innovation in Australia. So, we need, as with all of these issues, to take a very broad view of who the workforce is that we are wanting to look after. I certainly hope that in the future, the grant schemes that are developed under whatever arrangements we have in the future, pay a lot of attention to providing stability and long-term support for all the types of researchers that we need at all career stages, recognising the challenges of that.

MASHA SOMI:

Thank you. Phillip, I might hand this one to you. So, how have you ensured diversity on roundtables? Have you invited stakeholders representing marginalised communities and mid-career researchers to the roundtable?

PHILLIP GOULD:

Yes. Thanks, Masha. The short answer to the question is, yes, we have invited representatives from some marginalised communities, and we have invited early to mid-career researchers. We have to recognise, though, that within those marginalised communities, there's a significant amount of diversity. So, it would be folly for anyone to say that all of those groups have been covered off for any kind of roundtable process. For that reason, we are encouraging people to reach out to us. As I mentioned before, we provided an email address there and we really need to engage meaningfully with different groups, offering different perspectives. I think it's really important that we have different community groups and perspectives in the discussions. As I've said, I've really stressed in my part of the presentation that we don't just view medical researchers as the sole stakeholder group here. They're a very important stakeholder group, but there's a broad set. I mentioned consumers, but even within consumer groups, that by its definition is an extremely broad set for people with different requirements and needs.

So, speaking to a single consumer advocate might really be able to give us a strong sense of all of the issues there. Again, I mentioned the business community, who are really important here. This is a significant investment from the government and actually seeing research translated into ideas which help Australian businesses deliver excellent products to Australian and potentially international consumers is absolutely critical. But we recognise even within the business community there might be fairly small operators through to very large operators who can benefit from this work. Likewise, with clinicians, and people who actually deal directly with patients, there can be very different experiences there. So, I guess, in a very longwinded way, I'm saying we're acutely aware of the importance of diverse perspectives as we go through this consultation and very keen to keep engaging with the communities as broadly as possible.

MASHA SOMI:

Thank you. Anne, I might give this one to you. Will fundamental and discovery science be protected, even if it is more difficult for consumer and community groups to understand the importance of this?

ANNE KELSO:

I would have thought that a future national strategy must look after the discovery and the true innovation end of the pipeline of research. So, it won't be determined by the governance structures that we're talking about today, but it has to be a critical part of any national strategy that ensures that we're investing not only in what we need right now and what could be translated into clinical care or public policy right now, but is also thinking about, what are the new frontiers of understanding of how the human body works, how disease happens, and what the future opportunities are going to be to develop new treatments, new policies, new products, based on that investment in early-stage research. So, any national strategy, I hope, will have that full spectrum that we need and support for all of those different pathways that go from discovery through to ultimate impact on human health.

MASHA SOMI:

So, I might do a couple. We've got some interesting commercialisation, so I'll do a couple in a row. First one to you, Phillip. How will industry in the commercial health sector be further involved in priority setting? This is a common recommendation to drive widespread uptake.

PHILLIP GOULD:

So as I've said, I think it is absolutely critical that there is involvement from industry in this work. I think, again, as part of... you know we're in the early stages of what will be a significant consultation process. We want to hear views from different stakeholders. So, I don't want to pre-empt where we land. We're actually conducting this consultation very much with an open mind. We haven't solved these things. We're not putting options forward. We're putting together models, as I said. I think we do need to think about the advisory structures that underpin these different governance models and how best to get opinions from different groups in there. One of the things I'll say, which is not specific to industry, but I think is an important point, is... If we took an approach of saying, well, there's an industry advisory group, there's a consumer advisory group, and there are researcher advisory groups and clinicians operating separately, we've really missed an opportunity to bring people together. So, I think the approach that we want to take is that we actually have, where possible, people with potentially competing interests and different views working together.

So, that will be a feature that we're really keen to draw out from any final governance model.

MASHA SOMI:

And one for you, Anne. It's not clear that NHMRC Research Committee would be able to advise on commercial and non-commercial translation of research. A new innovation committee might be needed.

ANNE KELSO:

Yeah, and I think this follows on from what Phillip was just saying. You need to form the types of advisory structures that enable you, enable this, however these two funds are managed, that enable them to deliver the national strategy. So, of course, the current council of NHMRC, the current research committee of NHMRC, are designed to support the work that NHMRC currently does. But if, for example, a future NHMRC was managing both funds or a merge fund, then we would, of course, need to think differently about who sits on those, on the council and on the committees. And the committees might indeed have different names. Again, to follow Phillip's point, in a sense, we already, to some extent, do this at NHMRC in the sense that we have quite a lot of diversity of types of expertise on council and on some of our advisory committees, but I can imagine that would need to be further expanded and the principal committees might be quite different in the future from the ones that are there now.

So, the models don't predetermine any of that. I think that the advisory structures need to be what is necessary to deliver the national strategy.

MASHA SOMI:

A lot of interest in commercialisation and translation questions, so I might just keep going on those now that we're on a bit of a roll. So, Phillip, a question for you. How would commercialisation and innovation be dealt with under the new proposed models?

PHILLIP GOULD:

Again, probably similar answer to before, is we're interested to understand views from the sector on how this could be best achieved. I think... We've shown, the Commonwealth has shown, a willingness to think really differently about how we can encourage commercialisation. Speaking from the MRFF side, and Anne may wish to speak more about NHMRC, there've been rounds very much designed and geared towards commercialisation and translation. But importantly, the MRFF is not the only avenue that we've explored. The Biomedical Translation Fund has been a really interesting model, actually working with funds managers to invest in research work. So, we'll continue to look as broadly, and as, it's an overused word, but as innovatively as possible, at ways that we can improve translation because there's... There's nothing more satisfying, really, for the timing of research to see an idea go from that foundational, basic, fundamental science through to practical implementation and commercial success and the delivery of quality products and services to consumers.

So again, all I can say is that we're very keen to explore ways of doing this and that the MREA and MRFF are not the only avenues and that we're keen to support such things.

MASHA SOMI:

Thank you, Phillip. And I might just bring to people's attention, there's a box on page eight of the discussion paper, which talks about why government invests in research. And this is really what we're trying to make sure that MREA and MRFF are actually working collectively to deliver on. And one of those is talking about research that will attract investment for downstream R&D and build onshore commercial activity. So, that's really embedded in what the system is trying to design, what we're trying to achieve through these reforms and the work that we're doing. And just one final one on commercialisation, and I'll throw to you, Anne, before we move on to some other topics. How does this improve, how do the reforms improve, the issue that Australia has that we're excellent at research but globally poor at commercialisation?

ANNE KELSO:

Well, I think that the MRFF is already making progress in this respect and it's something that would be integrated and strengthened through this adjusted governance arrangement that we're talking about today. So, I would expect that we'd want to build on what has already been achieved, learn from industry and other expert stakeholders about how to do it better. But that by having an integrated strategy, you can make sure that the funding across that whole spectrum that's needed is delivered in a way that's most efficient to achieve that goal, along with the other goals of health and medical research funding. I hope that answers the question.

MASHA SOMI:

So, I might ask a couple of questions about the construction of the models that are in the paper. The first is... okay. So, Phillip, perhaps if you can take this one. Can you please explain the consultation that has been undertaken to get to these models?

PHILLIP GOULD:

Yeah. Thank you. So, in arriving at these models, we have drawn on our ongoing and extensive consultation with stakeholders. So, there hasn't been a formal consultation process like we're entering into now to arrive at those models. But these were informed by numerous discussions we have with numerous groups, including we have a consumer reference panel for the MRFF. NHMRC has council, we have AMRAB, but we also have other bodies, expert advisory panels and other groups that we engage with across the sector. So, these have been brought together, really, as a way of addressing what we've had through, effectively, years of ongoing consultation with our stakeholders.

ANNE KELSO:

And I would add to that. We also pay attention to the large amount of unsolicited advice that we receive from different parts of the sector.

MASHA SOMI:

And Anne, to you, what international models have been considered?

ANNE KELSO:

Well, we've looked at a number of different models. I mean, a good example is the UK, which has a range of different research funders that have been brought together in various ways. Model one draws on a model that's used in the UK. We know many countries have several different funds to support research overall, or health and medical research. And so, we do keep an eye on what's happening in other countries and learn from both the problems and the benefits of the different approaches that are taken. But I think it's interesting that when it comes down to really deciding what to present, our own system is unique. There's no direct parallel that I'm aware of in other countries. The way research is undertaken in the structures of universities, institutes and industry is somewhat different in different countries. So, we have to take into account our own situation in arriving at different feasible models that could be implemented here.

MASHA SOMI:

Keep the questions coming and voting up, I'm going literally by the questions with the highest number of votes. So, I'm being democratic here. Anne, I might ask you this one. So it's about the role of consumers on grant assessment committees. And I think you talked about it a little bit earlier. So what's the reasoning behind consumer advisers on grant assessment committees not having voting rights? Is there appetite for this to change?

ANNE KELSO:

This is something that we've been talking about a lot at NHMRC. And now for our targeted cause of the research, which is priority driven, so it's a small part of what NHMRC funds, but it is priority driven. We do now have our consumer representatives on the grant assessment committees scoring as well as providing advice. And so they are fully, you know, their voice is just as loud as the technical or research experts who are also on these committees. So, we've just introduced that. So, we're learning how to do it well and we're paying attention to the feedback, of course, that we get from the consumer and community representatives on the panels as we learn how to do it better. I can't speak for the MRFF and exactly how you do it.

MASHA SOMI:

We're piloting as well. So, for the MRFF we're piloting having consumers vote in our consume-lead research grant opportunity. So, we'll test how that goes and we're working very closely with the team in NHMRC to implement that and we'll take some learnings from that and consider how they can be applied more broadly. So, I guess just building on Anne's comments earlier, this has been an area of growing importance and interest across the sector and also within both of our funds that we've been really trying to hear the feedback and really trying to integrate the views of consumers in that selection process. Okay, so Phillip, for you, is the difference between model two and three, the ratio of funding to MRFF versus MREA? Is it that model three would result in the amount allocated to each potentially changing? However, within model two, the amounts allocated to each would stay the same.

PHILLIP GOULD:

Yeah. Thank you. I think that that is certainly a potential feature of the third model and that may be viewed by some as a benefit that depending on the research skills and requirements that we have that we could adjust the apportionment of funding across those two types of research by others that may also be seen as a risk. There's been, I think, a lot of positive feedback that we've had around some of the approaches that have been implemented through the MRFF, and a lot of very positive views on the way the MREA is administered, so if there seemed to be too much freedom, I think people who like either one of those models might be concerned that the strengths of that might be lost and a single fund may end up tending towards a particular position, a stronger bias towards a particular position. So, and again, I would invite people to offer their views on this, if we were to take that approach, what sort of guardrails would need to be put in place to ensure that the value of both types of research is recognised and enshrined in there?

Or it may be seen by some as too much of a risk, while others may see it as a really good opportunity. So again, we're being deliberately open with these ideas at this point in the consultation so that we can elicit feedback.

MASHA SOMI:

Anne, I'll ask this next question to you, and you may need to refer it to the latest strategy. However, it's really important to ask. So, will the new strategy structure consider how to leverage third-party funding opportunities, for example, from charitable partners?

ANNE KELSO:

I think, Masha, you're right. That is a question for future strategy and whether we remain as now or whether we move down the path towards model two or model three, thinking about how to engage with other funders, particularly with philanthropy, how to mutually leverage support. I mean, that's possible now through both approaches, and, what I think, will continue to be possible in the future. We certainly already work collaboratively with some charitable funders to deliver funding. And there's clearly potential for that to happen on a wider scale if more philanthropic funders and foundations wish to be involved, I would hope that there'd be no impediments to that, continuing under any of the models that we're talking about today.

MASHA SOMI:

I might ask this one of you, Phillip. So, what processes will underpin advisory structures to ensure sector representation and high levels of integrity? Model two with single CEO could be vulnerable.

PHILLIP GOULD:

Yeah, I think it's absolutely clear to us, and it appears from the nature of some of the questions that we're getting today, to a lot of people logged in, that that diversity of views and perspectives will be critical in any governance arrangements. So, I think we've been really clear that we're committed to achieving that. In terms of the specifics of a process to achieve it, there are a number of different ways that things can be done and it could be through formal-ish arrangements, like terms of reference for committees, or it could be baked in to other types of instruments. We're not at the point of saying we've decided what that would look like. And again, it sounds like I'm being facetious and I'm not answering the questions properly, but I genuinely say we put those sorts of things back to the people who are logged in today. And we're interested to hear their views through submissions on how best to achieve that. But what I can say is that we're absolutely committed to achieving that, because we don't believe that we can achieve the right outcome without having the right views heard in the right environments.

MASHA SOMI:

And Phillip, I might ask you this next one as well. So 'I', as in the person, not me. I believe that model three is the most futureproof but is the most challenging in time and complexity. What would make the investment in model three worthwhile?

PHILLIP GOULD:

Yeah, if we came up with a model that enables, brings in the flexibility that we all would like to see, but without the risks that I talked about, of a particular approach being priority-driven or investigator-led dominating, there would be a lot of strength in that sort of model being implemented, but it would have to have the right guardrails in place. Ultimately, there are a number of ways that we would judge success, whether it's for model one, two or three, or whatever sort of combination of those we come up with, we would be looking at seeing consumer and patient satisfaction, looking at improved health outcomes for Australians, and, you know, Australia, as Anne pointed out yesterday, we're a very healthy nation, and sometimes it's difficult to draw a direct link between research and that outcome, but we know that it's there. So continued good health outcomes for Australia, I think, improved opportunities for commercialisation -it would be great to see that's something that we can measure well.

So, we'll be looking at a range of different metrics to understand how successful we've been going ahead. Now's a good time for us, through this consultation, to work out the types of things that we do need to be looking at as we design new governance arrangements, what we should be benchmarking ourselves against.

MASHA SOMI:

Thank you, Phillip. And so, a question for you, Anne. So better coordination between the MRFF and MREA will help ensure that research is done better. However, what is being done to ensure research outcomes reach patients?

ANNE KELSO:

I made the comment earlier on about us having a way to go to have really integrated embedding of research within our health system and also in public policy more broadly. So whatever structures we have in the future, I think this is a big area of work. It particularly concerns… some of it will be about commercial pathways, but certainly not all of it. And it's something that we've been concerned about at NHMRC for a long time. I think it's something that the MRFF is specifically hoping to achieve as well. And it's probably not so dependent on the model so much as a strategy and an implementation plan that really puts emphasis on how you do embed research into clinical care, into public policy development, so that the benefits are carried all the way through to the patient and the member of the general community. It's a really complex issue, and I think it has to be an area of focus, regardless of the model we have – end up with.

MASHA SOMI:

Thank you, Anne. And so, for you, Phillip. Do you have an anticipated timeline for a...? Sorry, for a chosen... sorry. Do you have an anticipated timeline for a chosen model to be implemented?

PHILLIP GOULD:

The short and really frank answer is no, we don't have a detailed timeline. We've got some bets among the team as to how many submissions we'll have from the process and we will commit to going through those properly. We will release a report in response to the submissions and the process, which will be really important. In terms of committing to a particular course of action, that is a decision of the government. But, I think, what you can see through the release of this paper, through these webinars and ongoing work, that there is a commitment to get this right and to optimise the really important spend that the government makes in health and medical research. But it would be folly of me to commit to a particular time or month, but it is a priority.

MASHA SOMI:

Anne, have a submission for you. In a combined fund, will the respective pools of funds be allocated at the same level, or would the allocations of basic and translational funding change? So this is, I think, about model three, if you, put it all together.

ANNE KELSO:

Yeah, and I think that does depend very much on the strategy. And I'm sorry to keep sort of pushing it onto the strategy, but I think it's determined more by that than by the structure of the governance arrangements. But there's clearly more potential with a combined fund for there to be a substantial skewing compared with what we do today. I guess some of the questions about combined funds is how is it populated with dollars, do some of the dollars come from the Medical Research Future Fund, which is a perpetual fund, do some of the dollars come through the federal budget annually as the MREA is currently populated with dollars, and whether those sorts of issues would determine how funding is distributed. But these are really unknowns. And clearly model three has the greatest potential for radical change, let's say, compared with what we have today, whether we have model one or model two or something like that.

MASHA SOMI:

So for you, Phillip. So, thanks everybody, for sending through some of these tricky questions in the spirit of democracy we're asking all of them, so Phillip. So, what's the rationale behind removing the Department of Health and Aged Care from the governance structure under options two and three? I think that would be model two and three.

PHILLIP GOULD:

Yeah, I think the idea behind removing the department from those structures is to have simpler governance and administrative arrangements, I think, as we talked about some of the concerns that have been raised with us around the way medical research is funded, have been around coordination and, in the research sector in particular, there's some confusion around the different roles and functions of the two funds and organisations. So, I think having a single approach to managing that is one way of dealing with that. Again, we've been very clear though with the introduction of model one, that that's not the only way of managing those concerns, but it is a way, and that's part of the underlying logic of that approach. Also, there are arguments around efficiencies to be gained by having a single entity operating in this space. Again, that's something that we're interested to hear views on around the risks versus the benefits of that sort of approach.

ANNE KELSO:

Could I add to that too, because clearly, you could imagine a model two or a model three where the management is brought in under the Department of Health and Aged Care rather than NHMRC. And NHMRC has other responsibilities, legislative responsibilities. So then, effectively, you'll probably be saying those are the legislative responsibilities of NHMRC, which are around producing health guidelines and oversight of research using human embryos and ethical frameworks for health and medical research, those would probably also then need to be subsumed into the department, or you'd be leaving something that's, kind of, a greatly depleted nature for NHMRC. So doing it the other way round has other flow on implications to the other activities of the NHMRC. So, I think from that point of view also there's a sort of simplicity, it reduces the implementation burden, if you like, and complexity, by going in that direction instead of moving everything under the Health and Medical Research Office.

MASHA SOMI:

Anne, I might ask you this one. Health services research is not well supported currently, despite its recognised high priority. Will this be given similar focus to other types of research?

ANNE KELSO:

Yeah, it's true. It's a relatively small part of the funding that goes out from the Medical Research Endowment Account. It goes out pretty much in proportion to applications for health services research, that we don't get nearly as many applications at NHMRC for health services research as for other types of research. Medical Research Future Fund has a greater focus on health services research. I'm not quite sure how the various fund schemes that are currently run are classified in that respect, but I would have thought it would continue to be a really important part of the spectrum of funding that whatever new governance arrangements we have, that would really be important to go on having good funding and extend it beyond where it is today. But I think there's a part of that that’s also about developing a stronger, deeper, broader culture of research in health services so that there are more applications coming in, and I think that in itself would already shift the balance.

MASHA SOMI:

So, technical question, or more specific question for you, Anne, potentially. Why Sapphire for all grants? Surely Business Grants Hub is better suited for commercial grants and infrastructure grants where you need more than just the scientific peer review.

ANNE KELSO:

Yeah. So we're really interested, of course, NHMRC doesn't use Business Grants Hub, so I personally don't have as much understanding of what it does that's different from Sapphire. The thing about Sapphire is, in the end, it's an information management system. But the peer review systems we set up are designed to support each grant scheme. And so even within the MREA grant schemes, we have different ways of doing peer review and we have different types of peer reviewers. If you take our development grant scheme, for example, which is very commercial, then we have equal numbers of commercial peer reviewers as we do those with the direct scientific expertise. So even within the Sapphire schemes that are run by NHMRC, there's diversity in how peer review is done and the expertise of peer reviewers involved. So, if at NHMRC, we were to take on all of the Medical Research Future Fund grant schemes, as is proposed, then we'd be wanting to understand what adjustments need to be made to Sapphire for some schemes in order to meet the requirements that are currently provided by Business Grants Hub.

Sapphire is simply a system with the potential for modification as needed.

MASHA SOMI:

So, Phillip, a question for you. How will the new models counter the perception that the MRFF is a ministerial slush fund?

PHILLIP GOULD:

Thank you. It's almost impossible for me to resist in saying, I think that's an extremely unfair perception. And I think that the numbers speak for themselves in terms of the way grants have been awarded through an open, competitive process as administered by the MRFF and the peer review process being managed by the NHMRC. So, I can't resist making that point. I think, though, whether or not I agree with it, there is a perception. And there has been a perception in the past. I would like to think that the record of grants and the approaches to it should speak for itself. But to be honest, I think that there is some merit in models two and three, by having NHMRC having a larger model there that takes the administration, that probably step away from Government and step away from that perception. So, that's really all I have to say on that.

MASHA SOMI:

Anne, perhaps I'll ask a question for you. Have you considered a more staged approach that builds coordination first with a view to merging later? Is this necessary, regardless of which path is chosen?

ANNE KELSO:

I suspect that whatever model, particularly if it's model two or three, there would be a staged approach because there'd be quite a lot of legislative change and other implementation work and change management within NHMRC and with the wider sector and all stakeholders in order for it to be achieved. Probably, you don't need a staged approach for model one because it's really about designing that coordination mechanism and forming the advisory structure that would link the two funds. But for models two and three, I suspect there would be some staging. If people have thoughts about what those stages need to be, the sorts of things that people might be worried about in the transition to model two or three, or something like either of those models, I think that would be really helpful feedback to us.

MASHA SOMI:

Anne, I might ask this question of you. One unforeseen consequence of the combined models is the challenge to sustain funding for the MREA component. Please comment.

ANNE KELSO:

I think that that challenge applies across all three of the models, because the Medical Research Endowment Account is topped up every year through the federal budget. So, it's always open to decrease or increase, according to the fiscal situation and the views of Government at the time. So, maybe model three has a different level of risk there, but I think models one and two both have that level of risk that the size of the MREA account is determined annually. One could also argue for the Medical Research Future Fund, there's a decision to be made every year about how much to draw down from the fund. The $20 billion-plus that's now in that fund is stable. It's there in perpetuity. But it's the interest, the earnings from the fund, that are drawn down each year. We've already seen how they are affected by returns on investment and inflation and interest rates. And so, some years ago, we expected that by now there would be $1 billion a year drawn down. At the moment, it's steady at $650 million because fiscal circumstances have changed and different decisions have been made.

So, in a sense, I think, for both funds, there's always going to be an impact of external circumstances and the overall fiscal situation for the country in how much money is coming into health and medical research. And whether there's much difference between the three models in that respect is a bit hard to say.

MASHA SOMI:

I might ask this one of you, Anne, as well. Will the review address the imbalance between the time and effort expended on grant applications and low overall success rates?

ANNE KELSO:

It's really hard to see how it's going to make any difference if you're working with a steady budget, which is where we're at, at the moment. We're working with a nominally steady budget for the MREA. In reality, its spending power is declining a bit each year. And similarly, I suppose, you could say the same for the Medical Research Future Fund, as long as it's going down a steady 650 million a year. So, as long as you've got, basically, a fixed envelope to work with and a research sector of a certain size that seeks to choose the rate at which it applies, it's very difficult for us to control funded rates except by imposing limits on what people can apply for. And so, that's really a policy decision that's more at the micro level. I would, of course, naturally, as I'm sure most people would, love to see higher success rates across the board.

PHILLIP GOULD:

Can I just add to that? Not specifically on that question of success rates, but rather broadly speaking, around challenges with getting medical research funding and administering medical research funding. The aim of these consultations is to set up governance arrangements that will enable us to respond effectively to those challenges. So, in and of itself, we wouldn't be seeking to address those issues through this process, but it's rather setting up arrangements that are really well-placed to respond to issues. And that's something that, again, we encourage people to think about when they make submissions to the processes. Which of those three models that we've presented do you think best places us, or which model of your own thinking best places us, to respond to these sets of challenges that we face?

MASHA SOMI:

And I might just add a plug for our new report that we only published maybe a month ago, the Financial Assistance Report, which looks at funded rates across all MRFF programs, or recent MRFF programs, there's a whole appendix that covers it. And what I can say there is that the funded rates vary significantly across the different grant opportunities we run, and actually range between about 5% and 100%. Our average is about 25-30% across the MRFF. So, I'd encourage you to have a look at that report to get that information. So, we're back to commercialisation. People have been ticking those questions. Phillip, commercialisation is essential to drive uptake to create genuine patient outcomes. Will the new governance arrangements still be able to support small to medium-enterprise innovators?

PHILLIP GOULD:

Absolutely. We would be looking at ways to create a pipeline of research, which would be suitable for these small to medium players to commercialise. As I've said, this is not the only avenue to support that work. I mentioned the BTF before, and there's also work that the Department of Industry is doing. So, I would sort of view that as part of a suite of measures, which the government is pursuing at the moment to ensure that. But as I said before, I really mean it, that idea of seeing an idea in its infancy travel through the commercialisation pipeline into actually supporting a successful business that produces products that help improve the health of Australians. I mean, that's really ultimately a lot of what we're about.

MASHA SOMI:

And Anne, a question for you. So, recognising commercialisation and industry growth as valuable outcomes of translational research, would any of the new models consider cross-agency involvement? Now, I'm assuming that is between NHMRC and the Department, but potentially also the Department of Industry bringing our colleagues there.

ANNE KELSO:

I think there are plenty of avenues already for that kind of cross-departmental engagement. I mean, certainly, you know, not so much on commercialisation, but at NHMRC, we've delivered grant opportunities on behalf of the Department of Defence and other parts of Government. And so, there's always the potential for collaboration, co-funding or co-design of funding schemes, if that looks like an efficient way to achieve an outcome for the country as a whole. So, maybe we become more of a one-stop shop for that if we have a joined-up system than we do at the moment. But that potential does already exist.

MASHA SOMI:

And Phillip, perhaps a bit of a cheeky question. Is there an estimate on what the cost savings would be if grants admin were combined, i.e. models two and three? And would those savings go towards more grants?

PHILLIP GOULD:

I don't think that that's a cheeky question. It's only cheeky in the sense that I can't answer it with any number. Look, we will be looking at ways that money might be saved through more efficient administrative arrangements. And there are opportunities, again, across all three models to achieve that. That idea of the first model having better coordination might, in fact, have some opportunities there. The final part of the question was whether that will go back to medical researchers. I'll rely on the bureaucrat's response that that's a decision for Government, which it indeed is.

ANNE KELSO:

And there's something I can add to that, which is that we consider NHMRC as it exists today. The funding to support the office of NHMRC and all of the committee processes and Sapphire and all of that does not come from the Medical Research Endowment Account. So, the support for the office comes through a Departmental appropriation in the federal budget. And so, anything we save does not go into the MREA.

PHILLIP GOULD:

Yes. And likewise.

MASHA SOMI:

However, it's an opportunity to be more efficient, to use that funding to do more. So, Anne, a question for you. If you submit through NHMRC and MRFF, real costs are not able to be applied, especially through PSP salaries. This is not in line with MRFF intent and should be considered. And I think what this is saying is the salary costs that are able to be requested through business grants can be higher than through NHMRC. And the question is, what impact might that have?

ANNE KELSO:

Yeah, we're aware of that issue and that's something that we need to work on anyway because we wouldn't be looking... I don't imagine in the future we'd be looking to have two levels of salaries according to the grant, but I think that's something that we need to tackle directly, regardless of the model for co-governance.

MASHA SOMI:

Keep the questions coming. And upvoting. Okay. I'm going to ask a question, it's another difficult one. So, given the challenges NHMRC has faced with operational changes, e.g. RGMS and Sapphire, isn't model three impossibly ambitious?

ANNE KELSO:

Yes, I hope it's not impossibly ambitious. The change from RGMS to Sapphire has been a long project. It is a complex project because Sapphire has a whole lot of capability that RGMS did not have. RGMS was struggling at the end of its day. So, that has been a complex process that's taken several years. But that's a big IT project. That's, I think, different from the question of combined governance or the merging of two funds. And so, I see those as rather different issues, while not wanting to downplay the complexity of any kind of merger of the type envisaged in model three.

MASHA SOMI:

Thank you. Phillip, this is for you. How would any changes build better integration with policy development, implementation, and practice improvement?

PHILLIP GOULD:

Thank you for the question. I can really only speak from detailed experience from the MRFF perspective. But I can say one of the things that I feel is done very well is setting the priorities that meet the health needs of the Australian people. And in that sense, there is a good level of integration with requirements. In terms of deeper sort of policy integration within the Department, again, that's probably something, and maybe I'm misinterpreting the question, forgive me if I am, but we need to be a little bit careful because I think for some people, seeing that stronger involvement and integration with departmental policy setting has been a good thing because it ensures relevance, but at the same time we have to manage a perception of, you know, the Department sort of choosing favourites. So, that can all be handled through good governance, which I do think we have in place at the moment. But it is something that we will want to get the balance right with any of these models. Again, you know, it has been a theme throughout these conversations that we recognise that a priority-driven approach is really important.

And of course, Government has health priorities for the nation. That's to be expected. As it stands at the moment, AMRA has a really important role in doing that. It's not something that the Department just does by itself, but getting that right balance between setting relevant research, relevant research agenda, versus drawing out the strengths from an investigator-led approach. Getting that balance right will be something that we continue to look at across all three models.

MASHA SOMI:

Anne, I might pass this one to you. So, can you elaborate on the five issues that have been identified, and how they are caused by or solved by changes to the administration and/or governance?

ANNE KELSO:

Of course, it depends on which issues we're talking about... (CROSSTALK) But if we start with, I think the top one relates to the lack of integration of the strategies themselves. And so, NHMRC is required under its Act to produce a corporate plan every year where we capture the strategy in a three-year cycle. And we set that strategy on the advice of Council and our various committees with their great diversity of membership. And then we submit that strategy to the Minister for his or her approval. So, there's a formal process for that, and it's articulated then in the corporate plan every year. And it's not required, because NHMRC preceded the MRFF, so, it's not required to engage with the MRFF specifically in determining that strategy, though naturally, we do. On the other hand, the Medical Research Future Fund needs to produce a strategy every five years and priorities every two years, and it is legislated that that must take into account NHMRC strategy as well as being based on a public consultation.

And so, we have two different health and medical research funds developing their own strategies to deliver their funds with their own pathways to acquire the advice needed to develop those strategies. And only the MRFF is required to take NHMRC into account. And so just logically, if you want to have an integrated strategy for the country, and even just for the Commonwealth part of the delivery of health and medical research, then you wouldn't do it that way. And so, any of the models, I think, gives us an opportunity to set up a structure that enables in the future that we make a common strategy across both funds so that there's a proper integration that covers the full range of everything that the two funds need to achieve. So, that's just one example. I think it's just a very striking example. There are operational issues that come up, of course, all the time, because NHMRC and MRFF do things slightly differently. And within each of the funds we do things differently, depending on the grant scheme.

And so, there's the potential if you bring them together to think about what can be harmonised. Not to make everything the same. I think we both tried, Phillip and I both tried to make that point. We're not trying to mash everything into something where it's all the same, but there may be the potential for greater harmonisation so that there are fewer different ways of doing things and less complexity for all the different types of people who are involved in putting in applications and peer reviewing applications for our two funds. So, those are just two examples where I think we can see really easily the potential for greater coordination and a single governance between the two funds really overcoming some pretty fundamental problems.

PHILLIP GOULD:

The other thing I'll add is, again, as presented, all three models have the opportunity to improve avenues for consumer involvement in research and the translation and commercialisation. But all three of the models, if not implemented in the right way, have the potential to miss out on doing so. And again, I think one of the things that we're really interested in as we go through these consultations is views on advisory structures and approaches that can support those two elements being very strong in whatever model is selected. So, again, sort of, the models are really important, but if they're not implemented well, then they won't necessarily achieve everything we want them to.

MASHA SOMI:

I'll just have a... It's not really a question, but a comment, as a follow on from an earlier question. I'll read that before I shift to the next, we'll move to the next question. So, this is related to the question about the perception of the MRFF ministerial slush fund. And so, the comment is regarding the MRFF being perceived as a ministerial slush fund. It isn't that the peer review is in question, but the way grant calls were announced by very short notice. So, I don't think there's a question there, but just wanted to read that out, just to try to close off that part of the discussion. Anne, I might just ask you this question. How do the three models propose to govern and coordinate the multitude of funding rounds to reduce pressure on researchers across the year, burnout? So, I think it's, how would the three models and the proposed mechanisms help to reduce pressure on researchers across the year.

ANNE KELSO:

Yeah, it does depend on how they're implemented, of course. And in the case of NHMRC, we've got a long history of engaging with the ARC in determining our grant calendar to try to ensure that we don't have the big schemes coming at exactly the same time for our concern for research institutions. And we're trying to work, you know, it's complex given the different structure of MRFF grant schemes. We're trying to do the same for the MRFF. I think all of those sorts of processes become simpler under a single governance structure, and to that extent, probably models two and three make that simpler, simply because you've got a single body overseeing both. A lot depends also in, you know, perhaps back to that question of where the grant schemes come from. And so, the many calls that come from MRFF, there are many more, but generally smaller than the NHMRC ones. I think there's a potential to rethink about how those are managed, to cluster them or to streamline or simplify. And to an extent, that might be possible under the current arrangements and might be possible under model one.

But I suspect it's a bit easier under models two or three. But Masha has a lot more insight into how that works, so, you may well see it differently.

MASHA SOMI:

Oh, I mean, I think it will come down to implementation. And I think we are working to coordinate as effectively as possible across agencies. And I think we all recognise the challenge of researchers feeling burnt out through the application process. And we're continuing to make efforts to improve that. And I think that's possible under any of the models that have been proposed. So, we only have four minutes left. I'll ask you, Phillip, a question about implementation, which is, what timeframe are you working towards to finalise the model, and how will this fit in with the time frames for other strategic initiatives such as the ACDC thing?

PHILLIP GOULD:

Yeah. So, there's a lot going on in the health space, including the ACDC. As I said before, we don't have a sort of detailed timeline. There are a number of decisions that will need to be made in terms of the implementation. I think, as indicated through the models, there are varying levels of complexity for implementation, which would require different levels of planning if a particular model was decided upon. And again, I just stress it's not necessarily model one, two or three, it might be something that looks a little bit different too and draws elements out of each of those three. But that will be a decision for Government as to the timing of that. We can say that we will commit to go through the submissions that we receive through this consultation process as quickly as possible, but we will need to do that properly. I'm expecting a lot of submissions, and I'm expecting, certainly, based on the feedback or the questions today, a lot of really valuable input from that. So, it will take us time to properly go through all of that.

We will then make a public response. So, I think what we can commit to do is let people know when we do know these things and keep the lines of communication open.