Academy of the Social Sciences in Australia

Academy of the Social Sciences in Australia Promoting the Social Sciences Tuesday 3 rd May 2011 Julia Evans General Manager Research Infrastructure and Science Policy Branch Science and Infrastructure Division Department of Innovation, Industry, Science and Research Canberra RE: ASSA response to the 2011 Strategic Roadmap for Australian Research Infrastructure Discussion Paper Dear Julia, On behalf of the Academy of the Social Sciences in Australia (ASSA) I am pleased to be able to provide these comments on the Discussion Paper for the 2011 Strategic Roadmap for Australian Research Infrastructure. The Academy welcomes the opportunity to respond to this important issue and will be more than happy to promptly follow up these comments with you, the Department of Innovation or any of the Expert Working Groups convened to develop the Discussion Paper, on any matter for which additional information is desired. Please do not hesitate to contact me should you require anything further. I thank you for your time in this matter. Yours sincerely, Dr John Beaton Executive Director 28 Balmain Crescent, Acton ACT 2600 GPO Box 1956 Canberra ACT 2601 Telephone: 61 2 6249 1788 Facsimile: 61 2 6247 4335 ASSA.Secretariat@anu.edu.au http://www.assa.edu.au ABN: 59 957 839 703

Academy of the Social Sciences in Australia Promoting the Social Sciences Response from the Academy of the Social Sciences in Australia to the 2011 Strategic Roadmap for Australian Research Infrastructure Discussion Paper May 2011 Introduction The Academy of the Social Sciences in Australia (ASSA) welcomes the opportunity to comment on the Discussion Paper for a 2011 Strategic Roadmap for Australian Research Infrastructure (SRARI). A foundational element of ASSA s Constitution is the commitment to comment where appropriate on national needs and priorities in the area of the social sciences. The Academy is engaged substantively in the debate and development of policies to develop leading edge research infrastructure in Australia. ASSA welcomes the Australian Government s initiative to firstly develop a roadmap guiding strategic investment in Australian research infrastructure, as well as to continually reassess and update that roadmap. ASSA takes this opportunity to respond to issues raised in chapter two of the 2011 SRARI Discussion Paper 1, noting that these issues have broader implications for the needs of Australian social sciences for strategic investment in productive research infrastructure. In particular, ASSA draws attention to responses to questions 2.B.1 and 2.E.1. The first of these responses highlights the need for investment in collating and making accessible those data sources, including administrative and other forms, which are the essential underpinning of sound social sciences research. ASSA acknowledges that assessment of research outcomes is a valuable and essential feature of the conduct of publicly funded research in Australia and supports this assessment, understanding that such exercises are necessary retrospective. The response at 2.E.1 highlights the need to ensure that regimes to measure the quality of Australian research output including in particular that represented by the Excellence in Research Australia assessments do not, through their retrospectivity, through their focus on established disciplinary alignments, or through their privileging of international over domestic esteem (or vice versa), result in assessments which undermine investment in research infrastructure that has been previously agreed upon as of strategic value for Australia. 1 http://www.innovation.gov.au/science/researchinfrastructure/documents/2011_roadmap_discussion_paper.pdf (1.5mb) 1

Response to Promoting and Maintaining Good Health The Academy wishes to respond to issues raised in the second chapter of the 2011 SRARI Discussion Paper, which addresses the findings of the SRARI Promoting and Maintaining Good Health Expert Working Group. 2.A.1 What are your views on the key research directions identified, and are there other areas that have not been included? The 2011 SRARI Discussion Paper focuses on three areas of research endeavour; biomedical science, clinical medicine, and population and public health. The paper has completely overlooked health services research although that is recognised by the National Health & Medical Research Council (NH&MRC) as the fourth pillar of research in this capability 2. Health Services Research (HSR) is a multi-disciplinary research activity with an implicit objective of improving the health services patients receive. Thus it is an area of applied rather than 'basic' research - it uses theories of human behaviour from contributing disciplines, along with evidence from the medical sciences, to generate and test hypotheses about the delivery of health care 3. Health services research can include research into health systems and system wide policy, though increasingly there is a tendency to differentiate between research on specific service delivery and research in system wide financing and organisation, health workforce, information and IT, and governance. The World Health Organisation has described this field of research as the brains of the health system. The need for health services and health systems research is highlighted by current health system challenges to ensure optimal use of resources, providing care at a cost that is sustainable within a country s resources. This is particularly so in Australia, given the drive for widespread health system reform: It is imperative, therefore, that countries develop their capacities to analyse and understand the strengths and weaknesses of the system in place so that they can adapt health financing policies accordingly, implement them, and monitor and modify them over time 4. The Discussion Paper also states that new research, properly implemented, will provide long term savings to the health sector. However, this oversimplifies the process whereby clinical health research findings are translated into the delivery of health services which, over time, deliver improved health outcomes and lower health care expenditure. In fact, on the whole new advances in medicine cost the country more, not less. For example, according to the Productivity Commission, technological advances have been responsible for over one third of recent increases in health care spending, more than twice the contribution of population ageing 5. That is not to say that the additional spending is not worthwhile, as it can deliver real benefits in health outcomes; however, it emphasises the challenge in ensuring value for money in the adoption of new medical technologies, and efficient delivery and financing systems. If Australia is to respond to the ageing population in a sustainable way, health care will need to adapt and change. Health services research plays a critical role here in evaluating innovations to assess their impact on cost, quality, equity and/or access. Unlike biomedical science and clinical medicine, much service innovation is context specific: research findings about innovations in other countries may not be viable or cost effective in Australia with its different legal framework, service models, cost structures and professional cultures. Accordingly, ASSA recommends that a fourth group, health services research (HSR), be added to those three listed by the 2011 SRARI Discussion Paper as research areas within the Promoting and 2 NMHRC Strategic Plans 3 Definition used by Health Services Research Association of Australia and New Zealand 4 World Health Report 2010 5 Australian Productivity Commission, Review of Medical technology, 2005 2

Maintaining Good Health capability from which maximum benefit will be gained through a wider provision of access to... facilities and databases for researchers from across the sector 6. 2.B.1 What are your views on the research infrastructure Capability areas identified, including their relative priority and their ability to support the current and future research needs? The paper identifies areas for investment which will strengthen biomedical analyses linked to population and disease specific cohort studies. It overlooks the need for developments in the infrastructure which supports health services and health systems research. These include investments in appropriate data sources, including population studies and administrative data, in easier access to these data, and investment in the key disciplines of health services and health systems research which include economics and econometrics, statistics (especially techniques for data mining and analysis of large data sets) and other social sciences. ASSA recommends higher priority be given to investing in the collation of data sources and the provision of access to them for social researchers and others conduct health services research and health systems research. 2.C.1 What are your views on the existing funded facilities, including their ability to meet the current and future research needs? To date, the commitment by the NH&MRC the primary vehicle for the direct public funding of health research and the infrastructure to support it to health services and health system research has been weak. According to NH&MRC figures, last year, almost half of its $700m of taxpayers money was spent on basic science, with a further one third on clinical medicine. A small amount, 14%, went to public/population health, and only 5% to health services research. The NH&MRC Centres for Research Excellence (CREs) have also failed to address such system-type issues. For example, of the 15 CREs funded in 2010, 6 were clinical, 8 public health, and 1 deals with translational research with an unspecified focus. Since the 1960s, reviews of Australian health and medical research have consistently called for a greater investment in health services and systems research to meet the coming challenges of a sustainable health care system 7. Peter Wills, in 2000, recommended the establishment and funding of a number of substantial research centres in this field. Following yet another review in 2004, the NH&MRC made a commitment to increase its support of health services research and announced two new funding strategies; the development of partnership projects, and the development of partnership centres of excellence. Partnership projects commenced in 2008, with a further 27 funded in 2010 accounting for 0.5% of total funding, though to date these have been mostly about clinical service delivery rather than health systems financing and organisation. The Research Partnership Centres of Excellence, the flagship of the commitment, were reviewed again in 2007, subject to a round of consultation in 2009, promised in 2010, and promised again in 2011, but currently there is no information pertaining to these grants on the NH&MRC website. The new Centres for Advanced Health Research promote collaboration across universities, hospitals and medical institutes to allow a more programmatic approach to important research questions, to build research capacity, and to enhance the impact of research; but the focus is restricted to clinical applications. The aim is to promote research excellence where clinical care is provided. There has already been a 6 2011 Strategic Roadmap for Australian Research Infrastructure Discussion Paper, Canberra: Department of Innovation, Industry, Science and Research, March 2011, p20. 7 J Hall Health services research in Australia, Australian Health Review, 2001, vol. 24 no. 3, pp.35-38. 3

significant investment in the development of clinical/translational research, such as the Practitioner Fellowships, the Translating Research into Practice Fellowships, the Centres for Clinical Research Excellence, and the National Institute for Clinical Studies and its fellowships. Much of this should build capacity. Clinical research is also supported by NH&MRC Program Grants which allow such consortia to be developed. There are also investments at State levels for this range of activities in NSW for example, there is the Clinical Excellence Commission and the Agency for Clinical Innovation, and nationally the Australian Commission on Quality and Safety in Health Care has an expanded role in this space. Given the breadth and depth of investment in basic science and clinical research with the funds available, it is not clear why there is a need for a new infrastructure investment strategy in these areas. The relative weakness of the investment in health services and systems research, however, threatens to impede the benefits which will potentially flow from this investment. ASSA recommends that existing funding processes be restructured to ensure the delivery of adequate funding to research infrastructure for health systems and services research, in order that the maximum benefit is realised from the ongoing public investment in basic health science and clinical research. 2.E.1 What are your views on the cross-disciplinary requirements identified, including their relative priority and ability to support the current and future research needs? The identified needs outlined in the Discussion Paper are further development of the Synchrotron, strengthening the biostatistical and bioinformatics capability, and of the National Imaging Facility. The requirements for health services and health systems research differ from these. They are an increased investment in the relevant disciplines of psychology, sociology, political science, management science, and health economics. This should involve not just more training and educational opportunities, but also the development of suitable career paths so as to maintain talented researchers in Australia and in this field. There are also needs for organisational forms supported with adequate funding to enable and encourage cross-disciplinary collaboration. ASSA notes that the impact of the Excellence in Research Australia assessments (ERA) on the allocation of resources for research infrastructure investment will be potentially extremely significant, both for research the Maintaining and Promoting Good Health capability, and for Australian social sciences research more broadly. There are few HSR-specific journals, and even fewer A* or A journals encompassing HSR in the ERA journal rankings. A number of the top ranked journals in this field exclude articles which are focused on one country s policy, and others are specifically focused on the US. Relevant output may be published in general journals in contributing discipline areas; without cross-disciplinary contributions being assessed, ranking at the two-digit discipline group does not capture excellence in a multi-disciplinary field. The scoring system and journal ranking employed in the current ERA assessment exercise give low ranking to journals that engage in debate concerning Australian (health) policy. Without proper weight being given to the publication of such research papers, the ERA assessment exercise is not able to comprehensively measure the quality of research output of health services researchers. ASSA notes that, as in the case of HSR, much of the research conducted in Australia which is cutting edge and will be of the most public benefit in the medium to long term, is conducted at the boundaries of current disciplinary arrangements, and its value is necessary difficult to capture when measuring research outcomes to date. ASSA recommends that, in developing a Roadmap which will provide guidance on investment in research infrastructure that is strategically beneficial to Australia, care is taken to ensure research evaluation and funding processes, and in particular those of the ERA, are not conducted and reported in a such a manner that their retrospective evaluations act to counter strategically beneficial research infrastructure investments. 4

Recommendations The preceding paragraphs imply some amendment to the findings contained in the 2011 SRARI Discussion Paper s consideration of the strategic developments, emerging trends and changing focuses in the Promoting Maintaining Good Health capability, in order that the Strategic Roadmap for Australian Research Infrastructure which it informs can best meet its stated aim of making strategic infrastructure investments to further develop its research capacity and improve research outcomes over the next five to ten years 8. The Academy of the Social Sciences in Australia wishes to make the following recommendations regarding the 2011 SRARI Discussion Paper: ASSA recommends that a fourth group, health services research, be added to those three listed by the 2011 SRARI Discussion Paper as research areas within the Promoting and Maintaining Good Health capability from which maximum benefit will be gained through a wider provision of access to... facilities and databases for researchers from across the sector ASSA recommends higher priority be given to investing in the collation of data sources and the provision of access to them, for social researchers and others conduct health services research and health systems research. ASSA recommends that existing funding processes be restructured to ensure the delivery of adequate funding to research infrastructure for health systems and services research, in order that the maximum benefit is realised from the ongoing public investment in basic health science and clinical research. ASSA recommends that, in developing a Roadmap which will provide guidance on investment in research infrastructure which will be strategically beneficial to Australia, care is taken to ensure research evaluation and funding process, and in particular those of the ERA, are not conducted and reported in a such a manner that their retrospective evaluations act to counter strategically beneficial research infrastructure investments. ASSA thanks the Department of Innovation, Industry, Science and Research for the opportunity to provide this input on the development of a Strategic Roadmap for Australian Research Infrastructure. ASSA would be happy to assist the Department further by assembling Fellows and other social scientists for consultation on the structure of a Strategic Roadmap for Australian Research Infrastructure and the policy settings which it would imply. 8 2011 Strategic Roadmap for Australian Research Infrastructure Discussion Paper, Canberra: Department of Innovation, Industry, Science and Research, March 2011, p4. 5

Contributors: Professor Jane Hall FASSA 9, ASSA Policy & Advocacy Committee and Director of the Centre for Health Economics Research and Evaluation at the University of Technology, Sydney Professor Deborah Cobb-Clark FASSA, Director of the Melbourne Institute of Applied Economic and Social Research at the University of Melbourne Dr Stephen Duckett FASSA, Adjunct Professor at the Australian Centre for Economic Research on Health (UQ and ANU) Professor Jordan Louviere FASSA, Executive Director of the Centre for the Study of Choice at the University of Technology, Sydney With the assistance of: Professor Hal Kendig FASSA, ASSA Policy & Advocacy Committee and Head of the Ageing, Work and Health Research Unit at the University of Sydney and the Secretariat of the Academy of the Social Sciences in Australia. The Academy of the Social Sciences in Australia The Academy of the Social Sciences in Australia is an autonomous, non-governmental organisation devoted to the advancement of knowledge and research in the various Social Sciences, and to the representation of Australian Social Sciences and Social Scientists. The Academy is recognised by the Australian Government as one of Australia s four Learned Academies, and consists of an elected Fellowship of approximately 500 of Australia s most prominent Social Science researchers, representing seventeen Social Science disciplines. ASSA strives to foster excellence in social Science research; to encourage the advancement of the Social Sciences in Australia; to act as a coordinating group for the promotion of research and teaching in the Social Sciences; to strongly support efforts to encourage and facilitate research collaboration between Australian and overseas researchers; and to consult, advise, and comment where appropriate on national needs and priorities from the perspective of the Social Sciences. 9 FASSA Fellow of the Academy of the Social Sciences in Australia. 6