Enabling the success of academic health science Centres in Australia: Where is the leadership?

To the Editor:
In a recent perspective in the Journal, Theile and colleagues called for national leadership in the creation of academic health science centres (AHSCs) through partnerships and collaborations that better link Australian universities, research institutes and health services. The mission of one of the most influential AHSCs in the world, the Mayo Clinic, is to “provide the best care to every patient every day through integrated clinical practice, education and research”.

In Australia, it may be increasingly difficult for AHSCs to reach this ultimate goal as we are losing the clinical academics who integrate the tripartite mission of research, teaching and improving patient care within the public health system. In the United States, clinical academics still lead the best performing AHSCs as chief executives and department heads. Here, recruitment in academic medicine is declining, the clinical research workforce is ageing, and senior academics and mentors are retiring. This loss of clinical academic leadership will be to the detriment of patient care in Australia's health system.

At times of budgetary restraint, clinical research can be viewed as a non‐essential expense by the health system. During periods of financial restraint, hospitals do not have the funds to support the cost of infrastructure and protected time for clinical researchers. In reality, funding young clinical researchers is an important contribution to the ongoing improvement of patient care. We hope that the emergence of the AHSCs will provide new impetus to better fund applied clinical research and translational science throughout Australia's public health system.