Do you want your health care professionals to be the well informed?  Do you want them to make decisions using the most accurate diagnostic tools? Do you want them to consider all alternatives?  – It’s a no brainer, of course the answers are “yes”, “yes”, and “yes.”  However, it will only happen in these professionals are in an environment where cutting edge research is taking place.  Sadly, that is New Zealand no longer.  Our health has been sadly compromised by successive governments’ failure to invest in health care research.  Last week the Health Research Council (HRC) announced the successful applicants for the latest annual grant funding round.  Only 7% of all applications were funded. HRC chief executive Robin Old stated

“It’s really low. When I talk to my colleagues from all round the world they all think it is a crisis if the success rate falls below 20 per cent. Once it gets to 7 per cent I don’t care who you are or how famous you are, it’s incredibly challenging.” http://www.stuff.co.nz/national/health/7032969/Research-falters-as-funds-tighten

 Challenging is spin for munted.

Here’s what 7% looks like

Let’s look at a few numbers

  • Total grants awarded $65.7Million
  • Total salaries $24.3Million (37%)

Here are some back of the envelope calculations which give a ballpark idea of why the system is munted: If the average salary is $90K then funding is for 270 scientists (FTE) or an average of 5.2 scientists per grant (1).  Assuming the average number of scientists per grant is the same in grants that were not successful, then ~3900 FTE scientists applied (note some applied on more than one grant, they are counted more than once).

If each scientist put in 1 week’s work on each application then each $6.7M of work was done.  That is, the cost of applying was 28% of the salaries granted!

Add in HRC’s admin costs ~5% of total expenditure(1) or 13% of Salaries granted! Making the cost of the HRC grant round to be ~40% of salaries funded.  The system is broke.

Here’s another way of looking at it.

  • HRC annual contracts $90 Million.
  • Vote health budget $14 Billion.
  • Health Research Grants= 0.64%.

My quantitative analysis is very much ad hoc and easy to criticize.  However, the fact remains that an awful lot of time of many highly skilled individuals is spent chasing a diminishing pot of money. Some of my colleagues are so disillusioned won’t even bother applying to HRC now.  Many of the medical professionals stick to teaching and healing only.  Specialists won’t come to work in New Zealand because the academic positions they are offered come with little hope of research funding.  Then there are those scientists who have no teaching position and so live by the axiom – “granted or perish.”  Note – it’s no longer “publish or perish.”  Publications are no longer enough to justify your existence.  I face the “granted or perish” situation every year myself, despite an excellent publication record.

I don’t like writing negative posts, but it is hard to find a light at the end of the tunnel that isn’t a train coming the other way.  As a nation we need to make difficult choices about our health spend, one of them is do we become a “consumer” nation (some would say parasite) and just hope that others make the breakthroughs and we can afford to buy their technology, or do we become a “contributor” nation pulling our weight or better?  If we want the latter then nothing less than a four of five fold increase in health research grant funding will do.

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(1) Based on the 2011 annual report:

  • Total Contracts awarded: $89.9M
  • Total Running costs $4.35M
  • (HRC costs:  $3.92 M,Fees: $0.42M)
  • http://www.hrc.govt.nz/sites/default/files/Annual%20Report%202011%20Web%20version.pdf

Tagged: health, Research