JULY 2006
NATIONAL HEALTH AND MEDICAL RESEARCH COUNCIL
A NEW NH&MRC ACT AS OF JULY 1 2006
HEALTH MINISTER MAY NOW HAVE POWER OVER SCIENTIFIC RESEARCH
opinion piece
On July 1 2006 a new law came into effect in Australia that gives one politician power to potentially influence the course of Medical Research in Australia.
The Bill was hailed as the best way to simplify the structure and improve the accountability of Australia's prestigious independent , expert body responsible for administering federal medical research funds and drawing up clinical health guidelines. In many ways the Bill did achieve its goals.
But, whether by accident or design, some changes to the protocols for appointments to the NH&MRC Council and Committees could, if misused, hamper sensitive areas of scientific endeavour. With the removal of safeguards that previously required the Minister for Health to consult each State and Territory Health Ministers and seek nominations from Peak Bodies before making appointments to the NH&MRC, many in the Australian Health and Medical Research world are quietly concerned that there now is potential for a Minister to leave a footprint on NH&MRC boards through preferential appointments. Researchers remain quiet mainly because they do not wish to rock the boat for fear of funding repercussions. But clouds are gathering and it could be stormy weather ahead. The fear is not necessarily about a particular member of parliament but while such a loop hole remains the future is at risk. This Act must be amended to ensure independence in scientific research.
A Minister for Health is not required or even expected to have any qualifications, expertise or background in health, science or research, yet the new NH&MRC Act now gives that person freedom to appoint anyone he or she may choose to the most important research administration body in the country. Since the new Act has made criteria for some committee member qualifications broader, accountability and transparency for the Ministerial now relies only on a requirement to "consult appropriately". During the Bill debate, a definition was sought for "consult appropriately" but the Bill remains silent on this.
The current Minister for Health wrote a document for his peers when the Bill was put to the Parliament . It explained that the amendments were simply aimed at streamlining what was otherwise a slow and cumbersome appointment process. This, by the way, is the same Minister who had personal right of veto over assessment of group of medicines and told Australians late last year that we should all take a cold shower over RU486 because his CMO had advised him that RU486 was too dangerous for him to consider allowing it to be assessed. Shortly after this very public announcement the CMO's office gently pointed out that the Professor in fact had not quite said that at all. The Minister received criticism and was accused by some of letting his morals get in the way of his judgement. The Minister lost his control over that drug in February 2006 with the resounding vote to pass of Amendments to the Therapeutic Goods Administration (TGA) Act that removed his personal power base.
It is interesting to note that the TGA amendments were all about good governance and removing political control over clinical and health issues. Yet only a month later the NH&MRC Bill was put and the same parliamentarians passed that Bill in May, removing some existing governance protocols and giving that same Minister supreme power to appoint the members of a council that advises on vital clinical issues and medical research. Cynics might muse about the coincidence that so soon after losing his control of medication assessment, the Minister for Health gained potential new power over medical research.
In Australia in 2002 two controversial Bill were put before parliament. They were both about use of human embryos in medical research. They attracted heated debate from within and outside the parliament.
In Australia last year there was much debate about stem cell research and in particular about embryonic stem cells. A review of therapeutic cloning was commissioned , and Former federal Judge John Lockhart ( now deceased) was in the Chair. The review committee finalised its recommendations on December 19 2005. Sadly the Chair died in January 13th 2006. The recommendation was to lift the ban which was currently in place with the statement
" To this end, we support the continued use of both adult and embryonic stem cells under existing guidelines for research and do not recommend that any additional legislative restrictions be applied."
"On the contentious issue of Somatic Cell Nuclear Transfer (SCNT), sometimes known as therapeutic cloning, the Committee has given its support for SCNT and the creation and the use in research of certain other types of experimental embryos in the very early stage of their development and under strict ethical and scientific regulation.
and the proviso that
"The Committee agreed that the existing prohibitions in place to prevent reproductive cloning and the placement of prohibited embryos in the body of a woman should be maintained."
click HERE to read the Lockhart review report
However after its recommendations were handed down the report gathered dust in the Parliamentary library for 6 months. However the issues were finally dealt with ejected by the Federal parliament in late June. Again a cynic might look quizzically at the timing of the Lockhart rejection and ask whether there could have been a reason for the delay because the NH&MRC Bill was passed in late May 2006 and due to come into effect just days after the Lockhart decision. The current Health Minister supported the move to maintain the ban on this research. Could the new NH&MRC Bill allow a safety net for conservatives? If the Lockhart recommendations had been accepted could the Minister for Health have still pulled a rabbit from his hat by using his new found power to appoint members to the NH&MRC council and ethics committee where the majority of whom were all all eminent but also of a particular view point that he could rely upon to reject this type of research on ethical grounds ? Aah, no, that is pure fantasy. Our Minister for health would never do such a thing. And anyway, fortunately for science and the community, one safeguard still exists. The NH&MRC council and committees now report to the NH&MRC CEO and no longer to the Minister, so such a plan could never work.
click HERE to read the Prime Minister's Media Statement on the government's decision on the Lockhart conclusions - Friday 23rd June 2006
click HERE to read article on the Lockhart review in The Australian June 23 2006
The New NH&MRC Act came into being on July 1. At that point many people on the various NH&MRC committees still had time to serve in their terms. There was no recommendation or requirement in the New NH&MRC Act for the Minister to make changes to any, let alone all of the NH&MRC committees, but on July 1 2006 new members were announced on every committee and the council of the NH&MRC. Some saw more casualties than others. Only 3 of the 14 Australian Health Ethics Committee members get a seat on the new look board. According to one newspaper report, not all were happy to go. Usually good governance involves staggering board terms to ensure expertise and continuity of knowledge. This is the system used in the Australian Senate. The sweeping changes to AHEC beg the question of just how "appropriate" was the Ministerial consultation process on the matter of NH&MRC appointments ?
Since the Act came into being about a week ago there has already been media attention given to the make up of newly appointed NH&MRC council and especially the ethics committees. No one would doubt that these are all eminent people with excellent credentials. However questions have been raised in particular with regard to public statements made by some about their attitudes to Embryonic Stem Cells. People are seeking reassurance that there is adequate diversity on the committees and that the membership does reflect an appropriate consultation process on the part of the Minister . Some want to see the appointment criteria used by the Minister. No doubt, for the sake of transparency, he will be able to satisfy us as to why he made the changes to the Council and Committees on July 1 and this will end further speculation.
But this still leaves the door ajar with regard to the Act. Surely legislative changes should lead to more transparency and accountability of political activity not less !
The NH&MRC Act needs to be amended to remove the power recently given to the Minister for appointment of members of the NH&MRC.
Maybe a system similar to that used for the TGA Therapeutics Council would be worth considering - here the Minister chooses from short lists of nominees for particular prescribed portfolios. The nominations are drawn from various appropriate prescribed sectors , organisations and groups of organisations.
read my backgrounder PDF on the NH&MRC Bill and the appointment process - Click HERE
read recent media reports :
Canberra
Times , 6th July page 2 -
"DEMS BACK CLAIMS OF BOARD STACKING"
see the Bill and related documents on the Australian Parliamentary website - click HERE
read the Parliamentary Library Brief on the NH&MRC BILL : click HERE
read the Opposition Opinion to the Bill ( ALP & DEMOCRATS) : click HERE
read Medical Journal of Australia's comments on the Bill ( especially see the post script) - click HERE
Find out more about the great work of the NH&MRC - click HERE
see who is on the NHMRC Council and Committees - click HERE
read the actual NH&MRC legislation - via the index to Act Compilations - click HERE