In acknowledging the Ngunnawal and Ngambri peoples as the traditional owners of Canberra, I also want to acknowledge that we are not on track to close the gap in Indigenous life expectancy by 2030, as we as a nation promised to do.
 
But I also acknowledge the importance of medical research in closing the gap. We won’t close the gap without your work being at the forefront of our efforts.
 
Singling people or groups out for special praise is always a dangerous venture, but in this case, I’m prepared to chance my arm.
 
I’ve witnessed first-hand the good work of the Baker Institute in Alice Springs in researching HTLV-1, which ravages too many indigenous communities.
 
And the Menzies School of Health Research in Darwin is doing very important work tackling rheumatic heart disease, which kills Indigenous Australians at a rate twenty times higher than other Australians.
 
I single these two institutes out for special mention, but equally recognise all the work being done in Indigenous health research across the country - including by your President, Jonathan Carapetis, whom I also acknowledge.
 
Well, it’s good to be with you this morning.
 
I was pleased to join you last night for dinner as well, where we listened to Minister Hunt.
 
But I am glad you saved the most important meal of the day for me!
 
Now, I’m going to cut to the chase.
 
I’m not going to speak to you for half an hour about how good you are.
 
Let’s take that as a given.  The social and economic value of the work of Australia’s medical research community is understood, valued and honoured.
 
You and the proud tradition that comes before you saves and improves lives every day.
 
As the father of two IVF children, I live and enjoy the fruits of the heritage of Australian medical research every day.
 
But I think you deserve more than respect and honour.
 
I think you deserve more than platitudes.
 
I think you deserve some plain talking.  Some frankness.  Some observations from me, as the alternative Minister for Health, as to how our medical research policies and infrastructure could be improved.
 
Not rancorous partisanship. 
 
But not platitudinal bipartisanship either.
 
I want to share with you some of my observations after having been in the portfolio for six months now.
 
Now it probably works best if we take those observations in two parts, just as medical research support in Australia operates in two main parts, the National Health and Medical Research Council and the Medical Research Future Fund. 
 
First, to the long-standing NHMRC.
 
I am going to do something today that I don’t think I’ve ever done before.
 
I doubt I will ever do it again.
 
Pay tribute to Billy Hughes.
 
Yes, he split the Labor Party in two over conscription in the Great War and consigned us to Opposition for more than a decade.
 
I don’t pay tribute to him for that!
 
But Billy Hughes actually had a substantial ministerial career after being Prime Minister.
 
And he was Minister for Health in the Lyons Government in the 1930s.
 
In that role, Hughes made maybe his most enduring contribution: he established the National Health and Medical Research Council.
 
Not many people would realise that the NHMRC is one of the oldest enduring government agencies we have.
 
Speaking in 1936, Hughes said the Council would help achieve “infinite possibilities in human health and happiness”.
 
He wanted it to drive translation, saying “as fast as new knowledge is acquired it must be applied”.
 
And in its annual report that year, the Health Department said the NHMRC would produce “complete cooperation between the Commonwealth and the state governments, [and] the medical … and other professions”.
 
Rapid translation; complete cooperation; infinite health and happiness – Hughes and his Department didn’t believe in under-promising!
 
But for eight decades since, the NHMRC has been the bedrock of medical research funding in this country. Its work over those decades should be celebrated.
 
We do also have to be honest though.
 
More than 80 per cent of grant applications to the NHMRC are rejected. The rejection rate is even higher in the 2019 round, at around 85 per cent.

Not necessarily because the applications were sub-par.
 
Not necessarily because they didn’t stack up.
 
But because the NHMRC does not have a big enough budget to fund many worthy endeavours.
 
And that has real consequences. As AAMRI has put it, and I quote, “in recent times funding for the NHMRC has flatlined, leading to reduced support for research projects, as well as fewer career support opportunities for our researchers”.
 
Now I am not seeking to make a particularly partisan point here. High rejection rates have been with us for quite a while.
 
But if we are to have an honest discussion, we can’t pretend that we are taking medical research as seriously as we might as a country if applications to our premier funding body are being rejected for budgetary reasons.
 
If we are going to have an honest discussion, we have to be discussing ways of getting that figure higher.
 
But, to be clear, the NHMRC has stood the test of time because of its focus on high-quality investment, on translation into practice and policy, and perhaps most importantly on integrity.
 
And as Health Minister I would intend to keep that long-standing reputation for quality, independence and integrity in the NHMRC untrammelled.
 
Which brings me to the Medical Research Future Fund, on which I want to spend the remainder of my time this morning.
 
Because just as Hughes and his contemporaries created a system that would last into the next century and beyond, so we must do with the MRFF. 
 
AAMRI says the MRFF is a “once-in-a-generation opportunity to revolutionise health care in Australia”.
 
I agree.
 
Now, again, in the interests of being frank, Labor did not approve of the Government’s original intended method of funding the MRFF: a GP co-payment, cuts to the Medicare Safety Nets, sharp increases to PBS co-pays, and so on.
 
None of those measures were acceptable to Labor – or the community.
 
And so they were rightly rejected by the Parliament.
 
But it’s worth noting that the MRFF has still been funded by other health cuts – measures that couldn’t be blocked by the Senate.
 
This year’s Budget papers again confirmed that MRFF – and again I quote – “consist[s] of uncommitted funds from the Health and Hospitals Fund, plus … the estimated value of health function savings published in the 2014-15 Budget”.
 
I wish we had a $20 billion MRFF without $20 billion of other health savings – without the abolition of the HHF, without the Medicare freeze, without deep hospital cuts.
 
But five years later, we are where we are. Labor welcomes the fact that the MRFF is almost fully capitalised, and we look forward to the final credit being made to the Fund next year.
 
In fact, let me say unequivocally as the new Shadow Minister:
 
Labor supports the MRFF in Opposition, and we will maintain and strengthen it when we win Government.
 
I say ‘strengthen’ because the MRFF is far from perfect.
I want to address three concerns in particular today.
 
The first is about how the MRFF’s priorities are determined.
 
In theory, of course, Priorities are set every two years by the Australian Medical Research Advisory Board, in the context of a five year Strategy also laid out by the Board.
 
Those are good pieces of work, and I thank Professor Ian Frazer and the AMRAB for their contribution.
 
But in practice, I think you’d agree that MRFF priorities are actually determined by the Government’s allocations to four ‘key streams’, and then to the initiatives within those streams.
 
Some of those allocations are entirely consistent with the AMRAB’s Strategy and Priorities. Some aren’t.
 
The real problem is that we have no idea how or why those allocations are made.
 
Let me give you an example.
 
The MRFF 10 Year Plan includes over $300 million for the commercialisation of medical research.
 
Of course that will be a useful investment. Commercialisation is one way that your work reaches Australians.
 
But there is an opportunity cost.
 
Put simply: the money we spend on commercialisation is money we can’t spend on something else. 
 
How did the Government decide that the best possible use of that $300 million was commercialisation?
 
How did it decide, for example, that commercialisation was twice as important as Indigenous health research, which has been allocated around half as much?
 
Again, I’m not questioning commercialisation itself, and there may be good answers to those questions.
 
But we just don’t know, because there’s no transparent process through which the Government sets MRFF priorities.
 
My second concern is about how grants themselves are awarded.
 
We learned at Senate Estimates last month that of 231 MRFF grants so far, one in four have been awarded without a competitive process. A quarter of them.
 
The Department of Health is getting back to us on how much funding that represents.
 
But logically it could be almost $100 million this year, and well over $1 billion over the next 10 years.
 
That’s a lot of taxpayer money to spend without a competitive process.
 
Frankly, I don’t think it passes the test of good governance.
 
Now, some of those grants have gone to people in this room, and no doubt all of them will be useful in some way.
 
But again, we won’t know that we’re making the best possible use of the MRFF until all grants are awarded through some competitive process.
 
My third concern compounds the first two, and it’s about a lack of transparency.
 
I’ve already suggested that there’s a lack of transparency around processes – how priorities are determined and grants are awarded.
 
But the lack of transparency also extends to outcomes.
 
Let me give you two quick examples.
 
Under the MRFF Act, the Minister must publish detailed information on grants “as soon as practicable” after they are made.
 
But in reality, except for the odd media release, reporting on grants is patchy.
 
The Parliament and the public weren’t given a consolidated list of grants until Labor asked for it at Senate Estimates in April.
 
And the list wasn’t updated until we asked for it again last month.
 
Similarly, the Act obliges the Minister to table a report every two years on whether grants were consistent with the AMRAB’s priorities.
 
Again, that’s meant to happen “as soon as practicable” after the two year period of the Priorities ends.
 
But for the Priorities ending in 2018, the report wasn’t tabled until October this year – 10 months late.
 
So it’s clear that reporting could be improved.
 
I think the three concerns I’ve outlined all stem from an excess of ministerial discretion.
 
Now, I am not opposed to the elected government of the day being able to identify key research priorities. 
 
The MRFF is designed to be strategic, to allow a government to set a national vision. That’s good.
 
As a former Minister, and now an aspiring Minister, I’m also not opposed to a little ministerial discretion.
 
But in our Westminster system, ministerial discretion is usually balanced by ministerial accountability.
 
With discretion must come transparency and accountability.
 
There should be more of that in relation to the MRFF.
 
One of the things I am interested in considering is how to better combine the Government’s role in determining priority areas with the rigour of NHMRC processes.
 
For example, as the current Government has already done in limited instances, governments could identify research priorities to be funded by the MRFF, and then ask the NHMRC to identify the most efficacious bids for research in that field. 
 
That of course would be in addition to the existing NHMRC funding and processes.
 
In general, governments - by which I mean this Government and future Labor governments – should be bound more by the Strategy and Priorities set out by the independent experts on the AMRAB.
 
Within the priorities and the funding quantums set out by the AMRAB and the government, grants should awarded through competitive processes.
 
And I’d like better reporting across the board, so that the Parliament and the public can hold the government to account.
 
That’s the standard I intend to hold the current Minister to, and it would be the standard I upheld as Health Minister.
 
To conclude, I raise these concerns not to undermine the MRFF – far from it.
 
I raise them because I want to strengthen the MRFF so that it outlasts its makers, as the NHMRC has done.
 
The NHMRC itself has made the point that integrity is important because it maintains community trust.
 
That’s vital for any program that spends taxpayer money.
 
And so I’m keen to work with you – and indeed the current Government – to address the concerns I’ve outlined.
 
And no doubt there will be other opportunities for us to collaborate in the months and years ahead.
 
I look forward to working with you as we aspire to the “infinite health and happiness” that Billy Hughes promised.
 
Thank you and I look forward to taking your questions.