Beyond Foresight- The Way Forward with a Blueprint for Change

• Introduction
• The Blueprint for Change
• The HRC’s Indicative Portfolios of Research
• The Way Forward
• References

Introduction

In December 1997, the Ministry of Research Science and Technology (MoRST) launched the Foresight Project. The purpose of the Foresight Project was to identify strategies to ensure that New Zealand developed a society based on knowledge and innovation, and that New Zealand obtained the greatest benefits from its investment in research. It began a process to change the way that research projects are conceived and funded through a more strategic approach to future needs and current realities.

The Foresight Project was valuable on many levels, but especially because it brought together diverse groups of strategic thinkers from many disciplines, with varying perspectives, and encouraged them to take a broader view of the research process. The Project initiated dialogue between funders, researchers and the consumers of research that would not otherwise have taken place. This was an important step and helped to identify the strengths and weaknesses of research in New Zealand.

As a result of the Foresight discussions, a total of 129 submissions were made to MoRST; 25 of these were from the health sector. The submissions outlined strategies for achieving the greatest benefits from research in all sectors where research and innovation were sought. These submissions provided the foundation for the changes that have followed.

The Blueprint for Change

In May 1999, MoRST released Blueprint for Change in which the Government’s expectations for the sector were broadly defined.  ¹   While the language in the Blueprint may confuse the uninitiated, the concepts outlined are not complex and the messages are important. Both the Foresight Project and the Blueprint sprang from one salient fact: the Government was spending $600m on research and was unable to quantify the benefit of that research to New Zealand. The Blueprint signalled a distinct shift in philosophy – that the Government would no longer simply announce the budget for research but would set clear objectives as to what that research must achieve. Researchers were asked to concentrate not on "outputs" (eg, publications, patents and conferences) but on "outcomes" (ie, what contribution the research would make to New Zealand, either directly or through global contributions to knowledge. Four high-level goals were identified for the Government’s research investment:

• The innovation goal, which aims to foster a culture of innovation in New Zealand by improving the country’s knowledge-base and technological capabilities, including the creation of knowledge, training of individuals and establishment of networks and knowledge dissemination systems.
• The economic goal, which recognises that technology makes businesses competitive, with a focus on research that will lead to new and improved products, processes, systems and services.
• The environmental goal, which acknowledges the importance of the environment for social and economic well-being and focusses on understanding the complex factors that contribute to the physical environment, its sustainable management and the reduction of hazards within it.
• The social goal, which focusses on research that will contribute to a greater understanding of social, biological, environmental, cultural, economic and physical determinants of well-being, including health.

Further to the specified goals, the Blueprint described the following 14 Target Outcomes, designed to help the Government achieve these goals through research investment:

• Wealth from new knowledge-based enterprises
• Innovative manufacturing and service enterprises
• Sustainable use of natural resources
• Wealth-creating food and fibre industries
• Future-focussed global intelligence
• Infrastructure for a knowledge society
• People with knowledge, skills and ideas
• Strong families and communities
• Maori development
• Vibrant culture and identity
• Health for all
• People living in safe and healthy environments
• Healthy, diverse and resilient ecosystems
• New Zealand in the global biophysical environment

These Target Outcomes are fully described in Blueprint for Change. The Government purchase agents (ie, the Health Research Council of New Zealand (HRC), the Foundation of Research Science and Technology, Technology New Zealand and The Royal Society of New Zealand) are required to invest in research to meet these goals. Hence, each of these Target Outcomes embraces a diverse range of research from many different sources. The Target Outcomes are essentially MoRST’s research "portfolios". To deliver research that addresses these Target Outcomes, the purchase agents must, therefore, also have a system of quantifiable "portfolios". The HRC has responded by creating nine Indicative Research Portfolios (IRPs) and the Foundation for Research Science and Technology has created 26 Strategic Portfolio Outlines (SPOs). The HRC’s research investment contributes across a number of Target Outcomes, but primarily to ‘health for all’.

The HRC’s Indicative Portfolios of Research

The HRC is a Crown Entity, owned by the Minister of Health and funded by MoRST. Many researchers see the HRC as an independent funding body, and may be surprised to see that HRC policy changes in ways that reflect government goals. In fact, as a Crown Entity the HRC must ensure that its research investment is relevant to the Government’s priorities and respond within two years to the directives for purchase agents laid out in the Blueprint for Change. The Ministry of Health, MoRST and the HRC are working together to enhance the contribution of research to health systems and health outcomes in New Zealand. On reviewing many of the current systems and policies, the HRC has seen much scope for positive change and for improving the management of the research investment.

As an initial step, the HRC Secretariat was restructured in May 1999. The old division between biomedical research and public health was replaced with a new division along the lines of research policy and research contracts. As a consequence, the Research Policy Group and the Research Contracts Group were set up. The Research Policy Group is responsible for developing the portfolio system and the HRC’s purchase strategy (ie, what research the HRC should be purchasing) and is responsible for monitoring and promoting all types of research. The Policy Group is helped in this task by up to 10 expert groups at any given time and by the HRC Statutory Committees (ie, the Public Health Research, Biomedical Research, and Maori Health Committees) and by the Pacific Island Health Research Committee. On the other hand, the Research Contracts Group is responsible for managing grant applications and the grant assessment process (ie, who does the research the HRC invests in and the standards that such research should meet). The Research Contracts Group is helped in this task by expert assessing committees and external referees and also by the HRC Statutory Committees and the Pacific Island Health Research Committee. The Council of the HRC makes the ultimate decisions on research policy and research contracts. More information about the new structure of the HRC Secretariat and appointed staff can be found on the HRC web site [http://www.hrc.govt.nz].

The HRC has also re-organised its current research investment into portfolios. A total of nine portfolios have been created and these are illustrated in Figure 1. In the final analysis, it was decided that the research portfolios should be as inclusive as possible and should embrace a wide range of research.

Figure 1: A diagrammatic representation of the HRC Indicative Research Portfolios (IRPs). Research within one IRP may also have links to other portfolios. The system is designed to be flexible and inclusive. Although there is a portfolio designated for Rangahau Hauora Maori, this research is focused in nature; research in other portfolios also addresses Maori health issues and disparities in health. Likewise, the health issues of Pacific peoples is a priority across all of the portfolios. The fundamental work done in the Biological Systems and Technologies portfolio is seen as a platform, contributing to research in all areas.

The portfolios have been depicted as pieces of a jigsaw, although some artistic licence has been taken in showing the connections between the research areas. This is a particularly pertinent analogy in the current investment climate. The symbolism is intended to convey that, rather than being separate categories of research activity, the portfolios are designed to be linked through the interactions of researchers and the overlapping of research topics. Just as all pieces are needed to display the full detail on a pictorial jigsaw, many health related research questions require input from a wide variety of disciplines before the full complexity of an illness or the extent of a health risk can be fully understood. Thus, the HRC has endeavoured to create a very flexible portfolio system that does not "pigeon hole" researchers into strict categories. The portfolio system has the flexibility of allowing a research group to have a research project classified as relevant to multiple portfolios and thus funded by more than one portfolio. This will not only facilitate links across research areas, but also allow researchers access to multiple funding pools and give the HRC more flexibility when allocating funds.

Now that research contracts are managed within a portfolio system, the HRC is well-positioned to better manage research investment. Contrary to some beliefs, this is a desirable outcome. When funds are limited, as is always the case, maximum value for money can only be achieved from identifying the greatest needs and finding the best ways to address those needs. This may be achieved through workforce development, increased funding of existing research, or broadening the base and scope of research efforts. Under the previous system, research was evaluated solely on scientific excellence. Areas of significant need were identified through specific "priority areas" (such as Maori Health, Pacific Island Health, Child Health, Women’s Health and Mental Health). These priority areas have all been subsumed into the portfolio system. While the previous system was effective and produced good results, some areas of research were neglected (eg, health services research and psychological medicine) resulting in loss of workforce capacity and a lack of important data.

While the HRC still holds scientific excellence to be a primary criterion for research funding, future investments will be more strategic in nature and include assessment of the research’s relevance to health outcomes. The HRC’s Research Policy Group will be able to map activities within each portfolio to see where research is needed and where collaborations would be desirable. Returning to the jigsaw analogy, this applies to the disciplines of the researchers as much as to the diversity of the research topics themselves. The HRC seeks to increase co-operation and collaboration between the research factions to ensure that diverse health problems receive the appropriate multi-disciplinary approach from the conception of the research proposal. A number of large groups are already seeking to link their expertise and the HRC will explore the creation of incentives to encourage collaboration wherever practical.

In June 1999, the HRC conducted a strategic analysis of the research being done and the research capability (including workforce, equipment and infrastructure) in each portfolio, producing a draft policy document for each. The draft documents outline the extent of the problems covered by the research and the groups most affected, the strategic objectives for the coming year and the areas that need to be built on or strengthened. Over 250 people attended the workshops that provided the preliminary information for these documents and 700 comments were received from a nationwide consultation process when the draft documents were posted on the HRC web site. An ad hoc working group for each portfolio guided the process throughout and produced the reports. The working groups comprised a total of 63 individuals with specific expertise. The final documents will be posted on the HRC web site by the end of April 2000. These are living documents that will be changed and updated on a regular basis. It is likely that the system of ad hoc working groups for each portfolio will also be preserved so that the strategic objectives in each area are always of the greatest importance and relevance.

The Way Forward

For many, the Foresight Project and the ensuing policy decisions were disturbing as they heralded an era of profound change. These changes followed repeated reorganisations of the health sector, including health-care providers. However, the changes marshalled by the Foresight Project and Blueprint for Change are timely, and vital if New Zealand is to compete in the global health research environment. Similar projects in the area of research, science and technology have been initiated in the UK, the USA, Australia, and many other countries around the globe. The impetus provided by such projects has led to wide-scale changes in research funding all over the world.

Conceptualising a perfect system for research funding that supports both excellent research and individuals is a major challenge. The highly competitive funding environment creates inevitable trade-offs between supporting the research workforce, investing in high-quality research, and investing in research that addresses the Government’s goals. Perhaps the best that can be hoped for is that a logical, dynamic and flexible system can be developed in such a way that rapid responses to changing priorities and needs can be easily achieved. Whilst the health research sector badly needs stability, it is also important that it is capable of evolving to ensure that the New Zealand health researcher does not become an endangered species in the global scene.

The HRC with its new Chair, Jane Holden, will be working over the next three to four months to set the future direction for the HRC through its Strategic Plan and its 2000 Purchase Strategy. There is strong commitment by the new Chair and the Council to seeking to increase New Zealand’s investment in health research. In addition, the Council is committed to ensuring that its research investment contributes to the Government Target Outcome of "health for all" and to the economic and social goals outlined in the Blueprint’.

In reality, many researchers are already doing highly relevant research that is of value in New Zealand and internationally. For the majority of New Zealand researchers, the shift required is attitudinal rather than an actual shift in the focus of their work. The tight funding environment in operation in this country means duplication of effort and wasted opportunities are luxuries that we cannot afford. Good communication and collaboration between research groups and clear strategies for addressing the ever-increasing burden of ill health that New Zealand is facing (like all developed nations) are essential in a small country with limited funds for research. New Zealand faces similar escalating health problems as other developed nations; however, New Zealand operates with a research budget that is only a fraction of that compared to most other developed countries. It is important to remember that this has always been the case and yet New Zealand researchers have nonetheless won two Nobel Prizes and have contributed to some of the truly great scientific discoveries of the 20th Century.

References

• Minister of Research, Science and Technology. Blueprint for Change: Government’s policies and procedures for its research, science and technology investments, 1999