Professor Brendon Kearney AO

Astrong desire to improve the health system and to establish a culture of physician leadership have been the overarching themes of Professor Brendon Kearney’s varied medical career, ultimately leading him to receive two Australian Honours, most recently as an Officer of the Order of Australia (AO).

Already a Member of the Order of Australia for work relating to establishing the Hansen Institute, supporting the Bali bombing rescue and contributing to the 2004 Banda tsunami rescue efforts, Professor Kearney received an AO in June for his work in health technology assessment (HTA).

HTA uses data to evaluate the safety, efficacy and costeffectiveness of a health intervention. The HTA drive, Professor Kearney explains, is to improve access to high cost/high value medical technology, based on data and evidence – a quest he began in the 1980s, creating the first HTA committee to advise on inclusions in the Medicare Benefits Scheme.

He was interested in HTA as a method of planning and managing the introduction of high-cost technologies that were emerging to treat burns, cardiac and other conditions, when it was clear that not every hospital could afford all the technology.

A haemotologist by profession, Professor Kearney has been lured to leadership roles including as chief executive officer of the Royal Adelaide Hospital (RAH) and the then-Institute of Medical and Veterinary Science (IMVS) by a passion to solve problems in health care.

He studied how some of the most eminent international health organisations, including the Mayo Clinic, the Johns Hopkins University Hospital, and Massachusetts General Hospital achieved their success and what kind of physician leadership was necessary to build that success.

He has concluded that physician leadership needs to be better supported in Australia.

Yes, it has to be in a multidisciplinary team these days, but the physician should be part of the leadership team, he says; that’s what leads to better outcomes for patients and the community.

‘All doctors need to be physician leaders, even at the level of clinical practice,’ Prof Kearney says. ‘We are best placed to advocate for patients because we have a unique understanding of the patient-doctor relationship that other clinical groups may not have – and that’s from the level of clinical practice right through to leading clinical services and clinical organisations.

‘I think there is still a need for stronger physician leadership in medicine in Australia and in South Australia particularly. We know that if you have integrated service, teaching and research, the best quality outcomes occur in that setting when there is very strong physician leadership. Not all doctors realise they are physician leaders.’

Professor Kearney has just returned from chairing the Asia Policy Forum, which involved bringing representatives of South East Asian countries together with major pharmaceutical and technology companies to devise a strategy to implement universal health coverage across Asia.

‘We discussed high-cost technologies and how to introduce them in countries across the spectrum from low-income to well-developed countries to improve health care services,’ he says.

‘The project has made real progress. We supported early career training in health technology, and that gave ministers and departments confidence they could carry out their own assessments and make decisions about new technology.

‘We also worked on the basis that universal health coverage increases the GDP of a country – there is international evidence and experience, but it’s a very big step for countries to take.

‘Countries like Thailand and Indonesia have made remarkable inroads by using health technology to work out the basic benefit package for health care.’

Professor Kearney’s next project will capitalise on his HTA knowledge: he’s working with the WHO Committee on Medical Devices to ensure essential devices are available.

‘This work has come out of the COVID epidemic when countries such as India didn’t have the oxygen supplies we take for granted,’ Prof Kearney says. ‘We’ll advise the WHO executive on what needs to be done to provide essential technologies.’