HealthCareCAN, the national voice for health research institutes, hospitals, health authorities, and healthcare organizations in Canada, welcomes the opportunity to provide feedback to the consultation being undertaken by Canada’s three federal research granting councils on the creation of a new capstone research funding organization.
The reorganization of the federal research system, including the creation of the capstone research funding organization, is an exciting opportunity to strengthen Canada’s research ecosystem across disciplines and augment the connections between health research and the broader Canadian research ecosystem. For health researchers specifically, it offers a chance to enhance direct engagement with the federal government on research and innovation funding broadly and across disciplines, which is essential given the interdisciplinary nature of health research and healthcare innovation.
Done right, this reorganization of the federal research system will set up Canadian researchers and research organizations to tackle the country’s biggest challenges in a coordinated, multi-disciplinary way for the benefit of people across Canada.
HealthCareCAN’s recommendations are outlined in the section below, with a focus on the principles that must drive the reorganization of the federal research support system and the creation of the capstone organization, as well as the risks that must be mitigated to guarantee a smooth transition and buy-in from the health research community.
1. Develop a pan-Canadian research and innovation strategy and vision for health research.
HealthCareCAN is concerned about the federal government restructuring the research support system without setting out a pan-Canadian research and innovation strategy. Within this strategy, a vision for health research must be outlined.
The changes proposed through Budget 2024, including the creation of a capstone research funding organization and an advisory Council on Science and Innovation are important, but these new bodies risk being unsuccessful and ineffective if it is not clear what they are being created to achieve. Without a clearly outlined pan-Canadian research and innovation strategy and vision for health research co-developed with all relevant partners – including provincial and territorial governments, Indigenous governments and representatives, health system researchers and leaders, frontline clinicians, people with lived experience, academia, the private sector, and the non-profit sector –
HealthCareCAN is concerned as to how the performance of the capstone organization and Council on Science and Innovation will be measured. Changes to the federal research system implemented as recently as the late 2010s that have not achieved their intended purpose and impact and we do not want history to repeat itself. Research and innovation are too important to Canada’s success and prosperity, especially at this moment when our global peers are doubling down on their ambition and investment.
2. Maintain the connection between health research and broader health portfolio.
Health research is foundational to improving healthcare delivery, medical treatments, and health outcomes. While better synergy between the three federal granting agencies and federal research and innovation programs is necessary, this cannot be achieved at the expense of the strong connection that must be maintained between health research and the broader health portfolio.
As the government moves forward with the reorganization of the federal research support system, it must contemplate how this connection between the Canadian Institutes of Health Research (CIHR) and Health Canada will be maintained under a new capstone research funding organization. The federal government must implement a mechanism that maintains the connection between these two health organizations – and all other federal organizations or programs supporting health research and innovation – as well as the connection with the provincial and territorial ministries of health.
HealthCareCAN encourages the federal government to consider implementing the following approaches to maintain the connection between health research and the broader health portfolio:
Recognize the unique role of clinician-scientists within the Canadian research ecosystem, including as researchers involved in providing clinical care and in translating research into practice in the health system. The federal government must ensure the three federal research granting councils and the capstone research funding organization support this critical research role through their mandate and programming. The model adopted by the Fonds de recherche du Québec – Santé (FRQS) should be considered.
3. Preserve the main tenets of the Canadian Institutes of Health Research Act.
The Canadian Institutes of Health Research Act is comprehensive legislation that establishes the CIHR and outlines its mandate, objectives, powers, and structure. Comparatively, the enacting legislation for the other granting agencies, the Social Sciences and Humanities Research Council Act and the Natural Sciences and Engineering Research Council Act, are much less exhaustive, simply outlining the constitution and powers of the two granting councils.
The preamble of the Canadian Institutes of Health Research Act is unique among the three acts and paramount to the mission of CIHR and health research in Canada. It describes Parliament’s recognition “that Canada should be an internationally acknowledged leader in contributing to the global advancement of health research and that excellence in health research is fundamental to improving the health of Canadians and of the wider global community”. It also highlights the important role that CIHR and its institutes play in attracting and retaining top health research talent, developing high-quality scientific knowledge, translating that knowledge into policy and practice, and enhancing Canada’s economic development and job growth and creation. The values delineated in the Act’s preamble must be preserved and must be core to the mandate of the new capstone research funding organization.
Unlike the other granting council acts, the Canadian Institutes of Health Research Act includes an objective for CIHR “to excel, according to internationally accepted standards of scientific excellence, in the creation of new knowledge and its translation into improved health for Canadians, more effective health services and products and a strengthened Canadian health care system” and prescribes ways the CIHR should achieve this objective. HealthCareCAN encourages the federal government to preserve this objective and ensure it is a central goal for the new capstone research funding organization.
4. Involve health researchers working in the health system in the reorganization process and new structure.
Most health research in Canada is conducted in healthcare organizations. This makes health researchers working in the health system important partners for the federal government when it comes to making changes to health research funding, and broader research and innovation programs given the interdisciplinary nature of health research.
However, health researchers working in the health system are often excluded from important federal government tables that are making decisions that impact the ability and manner by which these researchers can conduct their work. This is especially so when it comes to federal innovation funding and programs, with the default approach involving engaging with academia and the private sector.
As the federal government moves forward in establishing the capstone research funding organization and the Council on Science and Innovation, health researchers working in the health system must be involved throughout the process and present in the final structures that are created. HealthCareCAN contends that researchers currently working in health research institutes, hospitals, and healthcare organizations should be members of the CIHR’s advisory body, the capstone research funding organization’s board of directors, and the Council on Science and Innovation. This will enable them to inform the government’s work by providing insight into the unique perspective and needs of health research carried out in clinical settings and health researchers working in the health system.
5. Continue to support investigator-led and early career investigator research.
With the creation of the capstone research funding organization that will have as part of its mandate advancing mission-driven research, the federal government must commit to maintaining current levels of support for investigator-led research. Funding for investigator-led research must continue to be provided based on peer review and excellence. It must grow proportionally with any overall increases in federal research funding going forward.
Similarly, continuing to properly support early career investigators is important to ensure that Canada is training, attracting, and retaining highly talented researchers to sustain its research talent pipeline.
6. Consolidate all mission-driven research under the capstone research funding organization.
There are many federal agencies and programs that currently fund mission-driven research, including the National Research Council Canada (NRC), Canada First Research Excellence Fund (CFREF), Strategic Science Fund (SSF), Canada Foundation for Innovation (CFI), the Canadian Biomedical Research Fund (CBRF), the Biosciences Research Infrastructure Fund (BRIF), and Genome Canada. These agencies and programs should be folded into the capstone research funding organization so that it encompasses all mission-driven research structures at the federal level.
Similarly, the capstone research funding organization should provide coordination for federal funding to mission-specific entities, such as Brain Canada.
7. Provide direct and equal access to funding programs for healthcare organizations.
Researchers working in the health system offer unique perspectives on healthcare needs and all-important access to population groups needed to conduct health research. Clinician-scientists working directly with patients can understand and identify challenges in care, conduct research to develop a solution, and then translate that solution into practice for the benefit of those receiving care. Despite the crucial role of health researchers working in the health system, they are often unfairly excluded from directly accessing federal research and innovation funding.
Healthcare organizations are largely dependent on their affiliation with universities or relationships with private sector organizations to access federal research and innovation funding programs. For example, health research institutes and healthcare organizations must go through affiliated universities when applying to the CFI, the Research Support Fund, the Canada Research Chairs, Mitacs, and others. More recently, the federal government’s Innovation Superclusters Initiative and the Strategic Innovation Fund (SIF), except for Stream 4, are all industry-led initiatives.
Furthermore, to partner with universities or the private sector and benefit from federal funding, healthcare organizations are often required to provide in-kind support, such as researchers’ time, space and time in their labs, and/or matching funds.
The current approach also impedes the ability of healthcare organizations who are not affiliated with universities or other eligible academic institutions from accessing the federal research and innovation funding outlined above. This is an issue of equity since many such organizations are providing care in settings outside major urban centres where most universities operate, including in rural and remote areas. Populations in these areas do not have the opportunity to access cutting-edge, best available care – which is what health research and clinical trials are – to the extent those living in urban areas can.
If the ability of healthcare organizations to directly and equally access federal research and innovation funding is not addressed or is exacerbated through any changes made in the reorganization of the federal research support system, it will only further contribute to the great concern of the health research community that health research will have reduced visibility, focus, and funding under the reorganization.
Health research institutes and healthcare organizations must have direct and equal access to all federal research and innovation programs under the reorganization. Health research institutes and healthcare organizations must be expressly listed as stand-alone organizations eligible for funding given that this is where most health research is conducted in Canada.
8. Better supporting knowledge translation, implementation, and commercialization of health research.
Canada currently struggles in translating, implementing, and commercializing health research. Researchers working in the health system are the people who take the results of research and apply it through the patient care they provide – another reason that ensuring they have access to federal funding is so critical.
The reorganization of the federal research support system is an opportunity to better support knowledge translation, communications, implementation, and commercialization in the health sector. This must include support to sustain these innovations and new models of care once implemented.
9. Reorganization of the federal research support system must be funded and part of larger transformation efforts.
A change to the governance model is only one element of a much larger transformation of the federal research support system that is needed to best position Canada’s research ecosystem for success. If the federal government makes governance changes without making any other changes to the system, the governance changes on their own will be insufficient to address the broader and immediate challenges facing health researchers and the Canadian research community.
The creation of the capstone research funding organization holds a unique opportunity to bolster multidisciplinary strategic research in Canada. This includes focusing Canada’s approach to mission-driven, interdisciplinary research including with international partners.
The creation of the capstone research funding organization is an opportunity to address long-standing barriers to collaboration, such as the sharing of data and biological samples, between researchers in different provinces and territories. Such changes align with the mandate of the capstone research funding organization to better coordinate and streamline the federal research system, as well as to foster international partnerships since these changes will make Canada a more attractive partner to other nations.
The federal government indicates that it intends for the reorganization of the federal research support system to be cost neutral. In HealthCareCAN’s view, this will not be achievable in the short term. Experiences of other jurisdictions that have undertaken such changes, like Quebec, have needed to increase funding to implement the reorganization and to carry out pursuits that formed part of the new mandate, such as mission-driven research.
Even over the longer term, the experiences of other jurisdictions suggest that cost savings are not among the chief benefits obtained from such a reorganization; rather, they have seen value created for the research community through improved organization and interconnectivity.
It is vital that the federal government consider the cost of implementing the proposed reorganization of the federal research support system and fund the process accordingly. This is a massive, multi-year undertaking that cannot be funded from the current budgets of the three federal research granting councils.
10. Structure and composition of the capstone research funding organization must best support Canadian research excellence.
The structure and composition of the capstone research funding organization are crucial to the success of the federal research support system reorganization. HealthCareCAN recommends that whoever leads the capstone research funding organization must be a respected scientist who is responsible for leading the strategic direction of science, research, and innovation in Canada. They would work with partners and stakeholders from across the scientific community, including healthcare organizations and patient partners, in achieving this objective.
The appointment must be a non-political one, with the individual selected through a rigorous, independent process. This is crucial to the long-term success of the organization, including to ensure that the research community, partners, and the public have the utmost confidence in the institution and in Canadian research.
11. Stand up the Council on Science and Innovation and ensure it best supports Canadian research excellence.
In addition to establishing the capstone research funding organization, Budget 2024 includes a commitment to create an advisory Council on Science and Innovation. The Council should be stood up as soon as possible, with consideration given to the interplay between the Council and the capstone research funding organization.
Regarding the composition of the Council on Science and Innovation, HealthCareCAN strongly encourages the federal government to include at least one health researcher currently based in a health research institute, hospital, health authority or healthcare organization as a member of the Council.
It is our view that the Council cannot be an entirely government-led organization as is the case with the Canada Research Coordinating Committee (CRCC). The research community and the federal government’s partners must see themselves reflected in the Council if it is to receive buy-in and achieve its objectives.
HealthCareCAN recommends having an equal amount of representation from the three research areas represented by the three federal research granting councils as well as equal representation from the different types of organizations conducting research (e.g., health research institutes, post-secondary institutions, industry, government, and so on). The Council should be made up of forward-thinking researchers, entrepreneurs, and innovators. It should also incorporate the perspectives of researchers at all career levels, including students and trainees.
The above-outlined approach would ensure diverse perspectives are informing Canada’s science, research, and innovation direction. This includes ensuring representation from “on the ground” individuals that are often not well-connected to government decision-makers but are experienced and knowledgeable about the challenges and opportunities facing science, research, and innovation in Canada.
As part of our submission, there are two additional elements that HealthCareCAN would like to highlight for the government’s consideration.
Firstly, we recognize and appreciate the federal government’s desire to move forward on implementing the commitments outlined in Budget 2024 related to research and innovation so that details on these changes can be included in the Fall Economic Statement. However, the short consultation timeframe is not conducive to the broad engagement that the Minister of Innovation, Science and Industry and the Minister of Health requested be carried out in their letter to the presidents of the three federal research granting councils. A month-long consultation does not allow for meaningful consultation with the breadth of important partners in the health research space, including First Nations, Inuit and Métis partners and patient partners.
It is concerning that the voices of many crucial groups may not be properly reflected in the reorganization of the federal research system. This is especially worrisome considering the implications of health research on these groups, the significant change being proposed, and that such change has long been called for, including by the Advisory Panel on the Federal Research Support System in its report which was presented to the federal government over a year and a half ago. HealthCareCAN would encourage the federal government to treat this engagement period as the first in an ongoing set of consultations to inform this work as it moves forward.
Secondly, while HealthCareCAN is aware that the federal government, namely Innovation, Science and Economic Development Canada (ISED) and Health Canada, are already carefully planning the transition from the current system to the future one, it is important to reiterate the necessity of ensuring that there are no disruptions to current research funding programs. As this transition begins over the fall and as further changes occur over the coming months and years, HealthCareCAN encourages the federal government to remain transparent with partners, continue to communicate and consult with partners, and plan to allow for longer consultation periods on any future changes.
SUBMITTED
July 17, 2024
FOR FURTHER INFORMATION
Bianca Carlone
Government Relations and Policy Analyst
bcarlone@healthcarecan.ca
Jonathan Mitchell
Vice President – Research and Policy
jmitchell@healthcarecan.ca
