‘Ironic and concerning’: MRFF public health research questioned

Just 40% of funding dedicated to researching preventive and public health is being spent on public health-related initiatives, in a revelation GPs say is impacting primary care. 
 
That is according to new Australian research which found that less than 40 cents in every $1 of research money through the ‘Preventive and Public Health’ initiative in the Medical Research Future Fund (MRFF) is truly being spent on preventive care.
 
The analysis of the Australian Government’s projects and grants issued through the MRFF, published in the Australian and New Zealand Journal of Public Health, shows that despite public health being a priority, many projects in that classification were more focused on treatment and cures.
 
‘Rigorous assessment is needed to ensure that funding is awarded to projects that align with the initiative’s apparent priorities,’ the first-of-its-kind study concludes.
 
The study’s co-author Associate Professor Leanne Coombe labelled the findings ‘ironic and concerning’.
 
She says they demonstrate confusion around the definition of public health, and ‘inadequate transparency’ when it comes to public health research funding in Australia.
 
‘This initiative is meant to focus on public health and over $238.8 million in funding has been distributed under this banner since 2018,’ Associate Professor Coombe said.
 
‘Even within those projects that were “prevention” focused, there was little focus on primary prevention research – initiatives that stop Australians from getting sick in the first place, rather than early detection, treatment or slowing disease progression.
 
‘To take the burden off the health system, we need to invest in genuine public health and prevention research.’
 
RACGP Expert Committee – Funding and Health System Reform (REC–FHSR) Deputy Chair Dr Emil Djakic told newsGP the research is telling, saying it points to a lack of foresight in funding decisions.
 
‘Progressing research and investment in these areas is clearly worthwhile and delivers value, but the time cycle and return on investment is very long,’ he said.
 
‘Our system is not geared towards public health changes that might take generations to show return on investment and that’s very sad, because that’s actually what it’s going to take to change some of the public health threats.’
 
The new research comes as separate data estimates that for every $1 spent in the primary care system, there is around $1.60 in healthcare system benefits.
 
A recent newsGP poll also revealed that 68% of respondents said the greatest benefit of having more Australian general practice-based research is stronger evidence for clinical decisions.
 
Dr Djakic said more research into the preventive benefits of general practice care would show its value, but currently, not enough is being done.
 
‘It’s time to not only talk the talk, but walk the walk, and that is funders actually need to get serious about supporting the long-term investment in the population,’ he said.
 
Just last month, the RACGP launched the 10th edition of its flagship preventive healthcare guidelines, the Red Book.
 
The new edition of the Guidelines for preventive activities in general practice includes the latest recommendations on evidence-based screening, prevention of chronic disease, early detection of disease, and empowering patients through health education and promotion.
 
Recent research has shown that GPs are the most trusted source of health information, which GP and REC–FHSR member Dr Michael Bonning says exemplifies the ‘central role’ they play in prevention and early intervention.
 
‘Opportunities need to be extended and funded for doctors to spend time with patients with a focus on prevention, and to have ready sources of current information on interventions, counselling, and local services,’ he told newsGP.
 
‘A role also exists for doctors to provide translation of latest evidence for prevention to the broader community.’
 
The research found the MRFF has 22 funded Initiatives, and, overall, only 57% of the 249 projects and around half of the funding granted through the six public health-related initiatives included in the study were for genuine public health research. 
 
Fellow REC–FHSR member Dr Cecilia Xiao believes secondary and tertiary prevention ‘has gotten more attention’ in recent years.
 
‘[This is] due to the significant comorbidities with chronic disease management and significant costs to the healthcare system,’ she told newsGP.
 
‘If we do not boost investment in prevention, we will continue to suffer from, treat and pay for preventable chronic diseases for generations to come.’
 
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funding Medical Research Future Fund preventive health research