Speech for the Minister for Health and Children, Mr. Micheál Martin T.D., at the launch of the Department´s “Making Knowledge Work For Health: A Strategy For Health Research”
I am delighted to be here today to launch Making Knowledge Work for Health: A Strategy for Health Research which provides a framework for the development of health research on the island of Ireland. This strategy will enable the development and application of new knowledge to help ensure that we have a first class health service which delivers health and social gain for the population.
Over the last century, medical research has arguably advanced human health more than all the previous 5,000 years combined. Scourges such as polio and measles have been virtually eliminated and the arsenal of treatments to fight AIDS and cancer have been vastly increased.
Our understanding of what makes people healthy and, on the other hand, susceptible to disease, has expanded dramatically over recent decades. All the indications are that there are even more significant advances ahead in our understanding of human health and disease.
Those of us with a background in education are well aware that knowledge is a precious commodity. Knowledge based innovation and new ways of thinking in maximising the use of existing resources are required for the future development of health research if continued health gain and sustainable growth are to be realised.
This document – Making Knowledge Work for Health: A Strategy for Health Research provides a framework for the development of health research to enhance health and quality of life and help ensure that our research compares favourably with the rest of the world. I believe that an active research community working close to the delivery of health care in clinical settings, laboratories, the community, third level institutions and the healthcare industry is critical to the improvement of the quality of health services generally and to improving equity in access to services and in health status. It is vital for professional development and career satisfaction of health service staff. It is also important for the translation of ideas into medical and IT products that can add value to our economy.
The Strategy emphasises a partnership approach to developing a thriving research culture in the health services, a partnership between health agencies, third level institutions, the research charities and the healthcare industry. The framework proposed in this document is built on the foundation of partnership and provides a structure for much greater co-operation between the interests involved. It also recognises the added-value to be gained from co-operation in research for the island of Ireland as a whole.
The core proposals in this document are for a strengthening of support for scientific research for health and the development of an innovative research and development function in the health services. These proposals are complementary and mutually supportive. Funding for both strands of the research strategy will be allocated according to the principle of competitive peer review to ensure quality and value for money.
New Health Strategy
The 1994 Health Strategy “Shaping a Healthier Future” gave an impetus to the development and evaluation in the health services and set the parameters within which health care was to be delivered in the 1990s. That National Health Strategy had equity, quality and accountability as its three main principles. Along with these three principles the new National Health Strategy currently being developed has an additional principle of people centredness. Research will play its part in ensuring that these principles are realised in the implementation of the Strategy.
Making Knowledge Work for Health is a vital building block in the preparation of the new National Health Strategy. Its analysis and proposals are relevant to all the consultative groups working on the themes of the new strategy and in particular to those analysing issues related to quality services, human resources and e-health. The proposals in the document also complement the National Health Information Strategy, being developed in the Department, which proposes to channel the explosion of new information and research findings becoming available in the health area to provide the best evidence for clinical and resource decisions in the health services.
One of the key proposals in gathering information throughout the health services for service delivery even more than for research is the unique patient identifier. This will enable outcomes to be assessed and improved as it will connect and thus help integrate service provision wherever it is provided. However it is critical that arrangements which are workable are put in place for the benefits of this unique identifier to be realised. I am concerned to ensure that in all cross sectoral initiatives (like REACH and E-government) policies generally take full account of health service needs and health benefits for the public in the implementation of any unique public service identifier whilst respecting public concerns about privacy and confidentiality.
Investment in Research in other Sectors
The proposals in this Strategy complement the investment in research that is underway under the National Development Plan through the Programme for Research in Third Level Institutions (PRTLI) organised by the Higher Education Authority and through the initiatives of Science Foundation Ireland, currently organised by Forfas. The PRTLI is building the capacity of the universities and colleges to undertake research and Science Foundation Ireland is funding research at world class level in biotechnology and information and communications technology to underpin the next phase of this country´s economic development. The proposals in this document for increased investment in science for health complement these important initiatives. This Strategy is another demonstration of the Government´s determination to build a knowledge based society and in particular, a world class health service based on the acquisition and application of the most up to date knowledge about health, disease and the effectiveness of health systems.
Two Pillars of the Strategy for Research
The Strategy proposes a thriving research culture being supported by two complementary but distinct pillars. They are the enhanced support for science for health and the establishment of a research and development function within the health services.
Science for health will offer funding to investigators on a competitive, peer review basis, to conduct research into human health and disease, epidemiology, public health and the way we run our health services. Despite the significant increase in our budget, the overall amount spent in supporting science for health is low by international standards. It is my intention to continue to build support for this aspect of the strategy. The budget for the Health Research Board has increased by over 350% since 1996 and further funding of £750,000 has been made available by my Department for research budgets which are currently administered by the Health Research Board.
The proposal for a Research and Development function in the health services is the most radical proposal in the Strategy. Its significance is that research is being recognised as a core activity of health agencies, intimately linked to the care of patients and clients. Health agencies will be given the opportunity to develop research to underpin national and regional health objectives, to support staff in undertaking research and developing research skills, to form close links with third level universities and colleges and to link up with the pharmaceutical and medical devices industries where appropriate. The intention is to capture the talent and enthusiasm of health staff to build the knowledge base for more effective health. The funding to support these activities will be allocated by competition and peer review. The Health Research Board has agreed to act as the agent of the Department in allocating funding.
The Strategy has proposed the appointment of a Director for R& D to the Department as soon as possible to drive the new initiative and to appoint a Forum for Health and Social Care Research to advise health agencies on research priorities to underpin the main objectives of the health services.
Relations, Co-operation and Common Action The Strategy for Health Research highlights the opportunities for co-operation in research on the island as a whole. There is excellent co-operation in a number of research areas at present and between the health research funding agencies. An all-island approach in certain fields of research will help overcome problems of the small population size of both jurisdictions. The two different health systems also provide great opportunities for researchers to learn from the experiences of each other’s system.
The document also highlights the continuing contribution made to biomedical research in Ireland by the London based Wellcome Trust, the largest medical research charity in the world, both in the form of competitive research awards and through the Matching Funds agreement of 1997-2000. The agreement provided an additional £6m for investment in biomedical and health sciences research, of which £3m is on going. The Trust has confirmed that it will continue to fund research in this jurisdiction on the basis of competitive peer review. The publication of this Strategy will create a climate in which it may be possible to interest the Trust in a further matching funds arrangement to address strategic issues in health sciences research.
Success in research is also about links, access to information and being aware of the broader perspective. The existing links with the education sector must be further enhanced and developed to ensure that the most effective and efficient use of intellectual and physical resources.
The health sector has been at the forefront of the revolution in knowledge that is such a feature of the age in which we live. Irish researchers have made outstanding contributions, at home and abroad, to increasing knowledge for health. Developing and expanding links with the third level institutions provides many opportunities for improving career paths for researchers. The work done as part of the Wellcome Trust matching funds agreement and the Health Research Board’s scheme designed to support researchers over a two year period is a very good example of the type of scheme that is essential if Irish graduates are to have the facilities to complete their training here or to be persuaded to return from abroad. In addition, the scheme is currently supporting ten Research Units by providing funding for them over a five year period. Much research is patient focused and investing in people and building multi-disciplinary teams will act as a catalyst to building stronger research units of benefit to those most in need.
I fully support all initiatives which further the interests of the health services and help ensure the overall successful use of research and innovation for health. The aim is to bring research results to bear on enhanced service provision as quickly as possible with improved planning and better outcomes. In this context I envisage an enhanced and positive role for the Health Research Board in combination with new research and development structures in the Department and health agencies to ensure maximum synergy in all parts of the health system.
Voluntary Agencies and Research Charities
I would also like to take this opportunity to mention the important contribution of voluntary agencies and research charities in raising funding for research and in translating the results of research into language that ordinary people can understand. These agencies are best known for their valuable role in targetting specific diseases, illness or disabilities. Their contribution to research must be recognised as being equally important. The Irish Heart Foundation and Arthritis Foundation to name but two have contributed generously and worked in partnership with the Health Research Board to further research.
The importance of health research has been recognised by the Programme for Prosperity and Fairness. This is the first time a national agreement between the Government and the Social Partners has addressed the issue of health research which further endorses its role within a knowledge based economy. I am strongly committed to supporting research for health and I recognise it as a vital part of the activities of the health services – essential to developing better health care.
I am sure that this Strategy will enhance the focus of medical and health related research on the pressing issues which can improve health status here in Ireland and indeed in the wider world. The framework outlined in the Strategy will provide an environment where world class research, innovation and creativity can flourish in a way that provides an improved quality of life for all. In doing so we can fulfill the demands for better health care for our population and career satisfaction for people in the health services quickly turning research into better services. At the same time this policy will assist in the development of products which contribute to the economic well being and reputation of the nation. These are the goals we must strive for.