Australia could and should have the world’s best health system
2nd February, 2017
By Professor Tony Cunningham AO FAHMS
This opinion piece ran in The Australian under the title Here is a failsafe proposal to slash health costs: start spending now
New Health Minister Greg Hunt has stated an admirable goal for Australia: for our nation to have the best health system in the world. This is a goal that is achievable and should be supported by us all.
With healthcare costs growing year-on-year, reaching this goal is going to take some different thinking if we are to afford operating the world’s best health system.
It may sound counterintuitive, but one way we can reduce the long-term health inflation pressures is to invest more in health and medical research. Deloitte Access Economics has calculated that investing in health and medical research delivers at least a $3 return for every $1 invested. This return comes from improved diagnostics, new drugs and other treatments, vaccines and the evidence needed to give effective advice on how to prevent medical conditions from occurring in the first place.
Preventative medicine is one area where Australia has had tremendous success. Skin cancer rates are improving dramatically thanks to Australians following evidence-based advice, and vaccines developed here, such as the Gardasil vaccine that prevents cervical cancer, are saving lives and money.
As a virologist and infectious diseases specialist, much of my work is in the area of vaccines. Recently I’ve been involved with the development and trialling of a vaccine that prevents shingles and is highly efficacious in older people, the research for which was published just two months ago. Shingles can be a debilitating disease in older people, leaving them in so much pain that they can’t function or even bear to have clothes touching their skin. It can lead to expensive, prolonged hospitalisation or permanent nursing home admission.
Bringing a vaccine to market takes significant investment of time and money, but the financial savings vaccines offer more than offset this investment. And you cannot put a price on the health benefits brought about through diseases not being contracted. Just think of polio.
Australia has the medical research record and researchers that can ensure vaccine discoveries and many more are achievable. Just this month there was a huge Australian medical research announcement made about Venetoclax receiving Therapeutic Goods Administration approval for use here. Venetoclax effectively “melts away” certain types of lymphatic cancer and longer-term could lead to other cancers being treated through further development.
The research and development of Venetoclax is a classic medical research story in the sense that the initial discovery was made almost 30 years ago. This discovery was then researched and applied in different ways to the point that a drug was developed and then tested via clinical trials. The initial discovery, research and development for Venetoclax occurred in Melbourne at the Walter and Eliza Hall Institute. But it was through applying this research with the help of medical staff and patients at Peter Mac and the Royal Melbourne Hospital that the drug reached the point that it could be used to treat people with lymphatic cancer.
Other recent discoveries that have reduced hospitalisation include transplantation of pancreatic islets to prevent loss of consciousness in brittle diabetes, and the prevention and treatment of serious food allergies
Embedding health and medical research in hospitals and other healthcare settings could lead to Australia having the best health system in the world. Hospitals with clinician researchers working in them and with close ties to medical research institutes are the highest performing hospitals with the best outcomes for patients. By embedding research in hospitals and healthcare we will ensure Australians have access to discoveries sooner, and we can develop them here to benefit our health and our economy. A research culture encourages evidence-based medicine, resulting in the timely replacement of ineffective therapies with those that are effective. Based on his statement when he was appointed Health Minister, Mr Hunt understands this, and that is a good sign for Australia’s health.
Delivering the Health Minister’s vision for Australia having the best health system in the world means the Federal Government needs to continue investing in its flagship Medical Research Future Fund. This fund is key to improving the health system. Unlike traditional medical research funding, this fund will focus on taking our discoveries in the lab and turning them into new treatments, cures, medical devices, vaccines and drugs. It will boost the links between researchers and clinicians and also boost commercial development of discoveries, an area where we really fall short compared to overseas health systems.
The fund has steadily grown to nearly $4.5 billion, and is well on the way to meeting the Government’s target of $20 billion by 2020-21. It’s important for the Government to keep to its commitment and avoid the temptation of diverting money earmarked for the fund for quick fixes elsewhere.
Australians deserve to have the best health system in the world. We have the clinicians, allied health staff and researchers available to achieve this aim. Let’s change the health funding paradigm and make this goal happen.