TGA advisory committees: information for prospective applicants

Rachel

                   I'd like to acknowledge… Acknowledgement of country. In the spirit of reconciliation, the Department of Health and Aged Care acknowledges the traditional custodians of the country throughout Australia and their connections to land, sea and community. We pay our respects to the elders past and present and extend that respect to all Aboriginal, Torres Strait Islander people here online with us today. 

                   Now, without further ado, I will pass over to today's chair, Sarah Symes, to introduce the rest of our panel. Sarah is the Assistant Secretary of our Regulatory Engagement Branch here at the Therapeutic Goods Administration. Thank you, Sarah. 

Sarah Symes

Thanks, Rachel.

 Good evening, everyone. Professor Robyn Langham is a former member of the Advisory Committee on Medicines and is currently the Chief Medical Advisor of the Therapeutic Goods Administration in Australia. She's a nephrologist and was a clinical researcher. 

                   Professor Langham is also a Director of the Australian Medical Council and chairs the Human Research and Ethics Committee at the Royal Children's Hospital in Melbourne. Welcome, Robyn. 

                   Professor Terry Campbell is a longstanding member of the Advisory Committee on Medical Devices. Professor Campbell is Emeritus Professor of Medicine at the University of New South Wales and Emeritus Consultant Cardiologist at St Vincent's Hospital, Sydney. 

                   His research interests included cardiac electrophysiology and pharmacology. Professor Campbell is the Chair of the Medical Devices and Human Tissue Advisory Committee. He's had over 30 years of experience in lecturing and tutoring in physiology, pharmacology, therapeutics and clinical medicine. Welcome, Terry. 

                   Dr Danielle McMullen is a member of the Advisory Committee on Medicines Scheduling. Dr McMullen is an experienced healthcare leader and is the Vice President of the Australian Medical Association and past President of AMA New South Wales. 

                   She has strong skills in systems design, medicines regulation, advocacy and leadership. Dr McMullen has a passion for doctors' health and is a current member of the Doctors' Health Services Board. She's also a GP by day who strives to provide comprehensive patient-centred care to her patients. Welcome, Danielle. 

                   And finally, Ms Joanne Muller is a member of the Advisory Committee on Medicines. Ms Muller has been a Consumer and Community Representative in the health sector since 1994. She holds formal qualifications in science, teaching, law and governance. Currently, she sits on a number of statutory bodies and working groups with a focus on health. 

                   She has over 35 years in non-executive director roles in a wide variety of organisations and served six years as the legal member of the Cancer Council Ethics Committee, a human research ethics committee registered with the NH and MRC and is an occasional lecturer on ethics and law for health students at two universities. 

                   In the 2023 Australia Day Honours, she was appointed as a member of the Order of Australia for significant service to youth, to community health and to the law. Welcome, Joanne. 

                   This webinar is an opportunity for you to hear from current and past members of statutory advisory committees and gain a first-hand insight into the role and expectations of committee members. We will not be discussing the application process in detail during this session. However, I will touch on it at the end of the webinar. We will include some frequently asked questions on our website following this webinar. 

                   There are seven statutory advisory committees that provide independent expert advice to the TGA. Diversity in the membership is important. The advice provided by these committees is a critical element in the regulatory functions of the TGA. 

                   Members are paid in accordance with the provisions specified by the Remuneration Tribunal. The current daily sitting fee for a chair is $1,247 and for a member it's $938. The Remuneration Tribunal specifies the general provisions for travel expenses and travel allowance for committee members. 

                   Meetings are held in person at the TGA offices in Canberra, virtually via WebEx or hopefully soon Teams, or a mix of both. The expected number of meetings varies per committee, and there's some listed there on the side of that slide.

                   Thank you. There are 35 vacancies across the seven statutory advisory committees and five of those are consumer health positions. Appointments are for up to three years. 

                   Applications are open for a period of four weeks and close at 11:30 on Sunday the 26th of May 2024. 

                   Applications should be submitted through the Department of Health and Aged Care Vacancies, which can be found at the website listed on the screen (https://healthjobs.nga.net.au). Applications must include a cover letter stating the relevance of your experience and expertise, a preference for one or more committees, a current curriculum vitae, a short biography, a fully completed and signed declaration of interest, contact details of two referees, and your contact details. 

                   The assessment process takes into consideration specific fields of expertise required for each committee, geographical diversity, cultural and linguistic diversity, and the government's gender diversity target where women hold 50% of the positions on the statutory advisory committees. 

                   The Minister will select the new members and new members will be appointed with their term of appointment commencing on the 1^st of January 2025. Induction sessions for new members will be conducted in November and December of this year, and unsuccessful applicants will be notified following the new member appointment process. 

                   Members are appointed to provide professional input in relation to matters coming before the committee based upon their specialist knowledge and expertise. Sometimes a conflict of interest may arise when a member's personal interests conflict with committee duties so that the member may not be or may be perceived to not be independent, objective, and impartial in relation to those duties. 

                   For this reason, we require new members to sign a deed of undertaking in relation to confidential information and conflict of interest upon appointment to a committee. Please have a look at our website for further information about conflicts of interest and confidentiality obligations. 

                   So I will pass now to Professor Langham who is joining us from Melbourne. 

Robyn Langham

                   Thanks, Sarah. Apologies for that. I had to let the dog in. And I really also want to be able to acknowledge the traditional owners of the lands where I am at the moment, the Wurundjeri Woiwurrung people of the eastern Kulin nations, and pay my respects to their elders past and present. 

                   This is, and together with Danielle and Terry, this seems like a bit of deja vu. It wasn't last year we did this, it was two years ago. And that represents the cycle of when we are looking for new members for our advisory committees. 

                   My association with the TGA started as an advisory committee member and a little bit like the dude who liked the razors so much he bought the company, I just loved the work so much that I ended up working for the TGA. And I've got to say, the job I have at the moment is the best job in the world, but that's not what you guys are going to hopefully be applying for.

                   So, what is the work, I guess is the major question. I do remember when I first started and my very first meeting, the message that I was given loud and clear, and I still remember it, which is this is the best journal club in the world. 

                   It is the reflection of the work that the TGA does in a regulatory fashion, which means that every drug or device or biological or whatever that is registered for supply in Australia must go through a process of approval. 

                   And even though the TGA has a whole lot of staff that are medics and pharmacists and chemists and engineers. And I'm sure I'm forgetting somebody, but the decisions around the evidence that's presented to us from sponsors of drugs or devices obviously can be evaluated and assessed. But we don't have necessarily the broad spectrum of expertise that our advisory committees can bring us. 

                   And so the advisory committees are really there to be able to help the evaluators, which are the medics and the pharmacists, et cetera, et cetera, to answer some specific questions where there might be a little bit of gap in knowledge. And that sort of knowledge that the advisory committee is asked of can be very, very clinical in nature. 

                   It can be specific to the specialty. It can be specific to a particular pharmacokinetic, pharmacodynamic… I know everyone's eyes are glazing over just when I mention those words. But on the main, on the whole, it's actually trying to reach out to the specific clinical specialties where these drugs are going to, or these devices are going to be used. What does it give you apart from being absolutely the best journal club in the world? 

                   It does give you new skills. And there is a huge science around the regulation of drugs and devices. And it gives you the opportunity to really interact with the science of regulation, with the legal frameworks that sit around regulation. And it helps, I think, really you to understand and to even act in a more sort of in-depth and informed way as a clinician, as you use any of these drugs and devices. 

                   It helps you as a consumer, especially, to be able to inform what it is the community needs from a consumer perspective. So the range of skills that really contribute to the good functioning of these advisory committees can be as broad as a really sharp-end, narrow visioned academic, to a general practitioner, to a consumer whose experience in their interaction with the health profession and the health system in Australia is just so valuable. 

                   You get new skills, and obviously you meet new people. And the sorts of people that you meet, you'll meet three of them, four of them tonight. Or four of them, I'm one, sorry. I feel like I'm meeting the others still too all the time, but you'll meet four of them tonight. But it's just an example of the sorts of people you meet, the networks that you meet, and you can make. 

                   I guess just to finish off, two years ago I encouraged one of my colleagues to join the committee. She was a clinical pharmacologist. I thought her skills would be really useful, and she was expressing an interest in being involved. 

                   I emailed her and I asked her, look, it's two years now since I sat on the advisory committee, what do you want me to be able to say as your experience in the last two years?

                   And she said… And she's on the Advisory Committee on Medicines, and she says, “it's like a journal club on steroids. It's full-on learning about novel drugs, their accompanying diseases from different fields of medicine, applying a public health lens and considering the diverse perspectives of the multidisciplinary group. It's really good. If you're up for a challenge, come join us”. 

                   And that's her words verbatim. And I don't think I can add any more to that, other than when you do put your application together, when you do your cover letter, really focus on what it is you're going to bring to the committee, what you're bringing. Not what you're going to get out of it, but what you're bringing. And that really helps us to decide who… That you're going to be valuable to the committee in the long run.

                   I don't know of anyone who doesn't put their hand up for a renewal at the end of their term either, so that must be another vote of positivity. I'm going to be quiet now. And who am I handing on to? Terry, over to you, Terry.

Terence Campbell

                   Thanks very much, Robyn. And hello and welcome, everybody. I think you got some of my background in the introduction, but I've had 30 years on various regulatory committees, starting with five or six years on ACM back in the 1990s when it was called ADEC. It was basically doing the same thing. And then 15 years on PBAC, and the most directly relevant to what we're talking about today is my last five or six years as a member of the Australian Committee on Medical Devices. 

                   I also chair the Reimbursement Committee for Medical Devices. Just, we're talking today about TGA committees which decide on marketing of devices or drugs or various other things and look at efficacy and safety. 

                   But there's another step, particularly for medicines and devices, and that is, are they going to be reimbursed or covered by the various payers. In the case of drugs, that's the PBS. In the case of devices in the private sector, that's the committee I chair. 

                   They are different committees, and we're not looking for members at the moment, but it's just a little bit of background, that there's a set of committees that look at efficacy and safety and then a second set of committees which look at cost effectiveness. Is this good value for money for the country, for taxpayers' money?

                    During most of the time I've been on these various committees, up until retiring in stages over the last couple of years, I had a busy academic cardiological career and just anticipating questions about time commitment, I didn't have any trouble marrying the two together. As long as you don't mind being busy. It's certainly possible to do that.

                   I think it's really important work. The country needs to be its own keeper and watchdog on what drugs, devices and various other entities we have in the country, and they need to be looked at carefully. And it's a crying shame if they're not being looked at by various experts and practitioners and clinicians, pharmacists, et cetera from Australia.

                   That's the sort of people we want. And parallel with that, we want excellent consumer representatives to keep an eye on the committees and make sure that the interests of the consumers are being looked after. 

                   Some of the big issues that might come up in questions. The time commitment, I've kind of already mentioned that. Obviously, it varies from committee to committee. Generally, it's a fair amount of activity for a short period of time leading up to each meeting. 

                   I'll second what Robyn said. It's a wonderful journal club. It's a wonderful way of continuing your medical or pharmaceutical or whatever it is, education. Keeping up with what's going on, particularly outside your narrow area of interest. That's one thing, is time. I think it can be managed if you want to do it and it's important work. 

                   Conflicts of interest will come up. They're an issue. You're constantly being asked about your conflicts of interest and asked to write them down. It doesn't preclude you from being on one of these committees if you have conflicts of interest, but I would say that if you have a lot of them, for example, if you work with industry on a fairly regular basis in developing new devices or medicines or whatever, it probably would be difficult. You'd have to make a decision as to which way you wanted to go. 

                   The other thing that comes up from time to time is confidentiality. Obviously, this certainly comes up in the various committees I’ve been on. People on the committees may well belong to, for example, another medical or pharmacy or whatever committee, a professional panel or their relevant royal college or whatever. And they want to tell their colleagues in that life about what's going on in the committee. 

                   Well, basically, the answer is you can't just do that. You need to check with the chair of the committee and or with the department before you can do that. It's just something to bear in mind before signing up. 

                   I think I don't have much more to say. I think I'll leave it for questions at that and hand over to Danielle McMullen.

Danielle McMullen

                   Hi again. Danielle McMullen, I'm a GP in my day job, but actually the TGA work is quite fascinating, and I really enjoy it. And obviously, it's a good place when people stick around as long as Terry and Robyn have. Maybe I'll still be here in another 15 years as well. You never know. Hopefully. But time does fly. I can't believe it's two years since we last had one of these as well. 

                   I sit on the Advisory Committee on Medicines Scheduling and have really enjoyed my time there. It was a steep learning curve at first. I'll talk a bit about how I got here, but I certainly didn't come from a huge, long background in medicines regulation. And so there was a lot of learning to be done about how it operates. But a really supportive group. 

                   The TGA secretariat are fantastic, and the other committee members are great. And there's no question that's too silly, whether it's in the meeting or out of session, about the way things work. It’s been… They're really a supportive group. And the papers are always prepared in a really excellent way. You understand what's coming to the meeting. You understand the questions you're being asked. 

                   And as someone who sits in lots of committees, in lots of forums, I still maintain that TGA has some of the best meeting papers that are easy to understand. And I think most of my comments are with an ACMS lens because that's the only committee I've sat on. But certainly in this one, you don't need to be an expert in regulation. There are other people on that committee who have the regulatory background. 

                   But as more of the clinical or independent members, you're there for your clinical expertise or your consumer expertise, if you're the consumer, or pharmacy. And it's really about, how do scheduling changes impact real life? And so how would this translate into the real world, into your clinical office, into your community pharmacy or to you as a consumer? 

                   What are the access issues? What are the medicine-specific or ingredient-specific issues that we should be aware of? And using that broad clinical expertise to apply to different medicines or substances, because there's a joint meeting also with the chemicals scheduling committee. 

                   I find it interesting because it lets me think of something outside of the clinic room, and using your brain a bit differently to how you're doing clinical medicine. But obviously that expertise hopefully is valuable to the TGA. 

                   And I think in terms of what skills are most valuable, I think a key one is being able to take pretty complex, lots of complex information that might be new to you, and coming up with a quick common-sense response. There's a lot of, there's a diverse range of substances and some of them you'll know really well and some you won't even be able to pronounce, let alone have ever heard of. 

                   And I think while there's plenty of time to digest the meeting papers, you have some time ahead of the meetings, still being able to discuss those… And it's a skill that many clinicians have already, as being able to take a complex problem and come up with a solution and some advice pretty quickly. 

                   What ACMS, the medicines scheduling, is about, is substances where the sponsor or another group has asked us to, has asked the TGA to consider its scheduling. 

                   So that's whether it's prescription only or a pharmacy medicine, or Schedule 4, Schedule 8, and discussions about where that should sit. And we've got a scheduling framework to help decide that. 

                   And many of you will be aware of some of the types of things that come through. It can be everything from paracetamol pack sizes to all sorts of nasal sprays and migraine medicines and substances in cosmetics and herbal remedies. There really is a broad range of substances that come through. And so it makes for exciting meetings with all different things, and looking at the risks and benefits and the clinical use of substances. 

                   And I think time-wise is one that comes up. Our committee has three meetings a year, and those usually last either one or two days and can be in-person or online. 

                   And the prep time, the way it works and the way a number of the committees work is that committee members will be allocated agenda items to present on. And so, obviously, if you're presenting an item or two, there is a fair amount of work. It's probably a few hours per item, I would say, in terms of preparation that you've got to come up with your five- or ten-minute presentation on that issue. And your presentation back to the group on your opinions of what should happen. And then the group discusses them as a whole. 

                   For the items that you're not presenting on, it's more of a brief overview of the agenda pack, so that you've got a bit of an understanding of the questions, but not as much of a deep dive.

                   I'd certainly say there's overall a few hours’ prep. And then if you're presenting, there's a couple more hours for each item ahead of that. And I think that's probably most of it from me. I will hand over to… I think we've got Jo next.

Joanne Muller

                   Thanks, Danielle. Good evening, everyone. I'm joining you tonight from the lands of the Gadigal people, and I pay my respects to their elders past and present. And I thank the TGA for the opportunity to talk about the consumer health member role on the TGA statutory advisory committees. 

                   I'm in my third year as a member of the Advisory Committee on Medicines, and I've also attended a couple of the Advisory Committee on Medical Devices. And as you've heard, there are five other advisory committees, each covering a slightly different area. 

                   Under part six of the Therapeutic Goods Regulation, the membership of each of these advisory committees says it may include a member with expertise in consumer health issues. I did my research before the meeting and it appears that all of the committees actually do include a member with expertise in health consumer issues. 

                   And it's five of these roles that are available at the next appointment round. Of course, the inclusion of stakeholders, as the consumer person would be characterised as, is really best practice in any regulatory process. 

                   And the role of the consumer health member is to promote the consumer perspective, really being squarely at the decision-making table for the advice that that committee is providing to the TGA. And this advice flows through to improvements in the quality and safety of healthcare in Australia, which, of course, makes it very rewarding work. 

                   Before I come to some specific details of the role, which I've been asked to talk about, I wanted to share a little bit about my first meeting on the Advisory Committee on Medicines. It was early 2022. It was an out-of-session meeting to consider a Covid-related medication, and I don't think that's breaching confidentiality. The papers were very well-presented. I had excellent ICT support provided to me to get me up and running and used to how the papers were presented. 

                   And the meeting was extremely well-supported by the staff in every, every other way. The discussion during the meeting was rigorous, respectful and challenging all at the same time. What struck me really early in the meeting was the absolute dedication of the members of that committee. Their dedication was palpable, even though we were meeting electronically, of course, back in that time. 

                   The expertise of the committee members was clearly of the highest calibre. This was real work, which had real benefits to the health of Australians, and I was hooked well and truly before the end of that first meeting. 

                   To unpack some of some specific insights into the role and the expectation… And noting that these are my comments, and they've not been censored in any way by the TGA, no one's asked to see them. But this is just my personal views. It certainly is a large amount of reading, which a number of people have alluded to, that's required for every meeting. And probably the consumer member will be much slower at reading the material. Because most of the information there will be new information. 

                   And so, at least in those first few meetings, you're probably going to have to dedicate a few days to reading the papers prior to every meeting. There are areas of the paper that will require the particular attention of the member of the panel with the expertise in the consumer health issues. 

                   For example, on the Advisory Committee on Medicines, I have a particular focus on the consumer medicine information sheet, as well as the consideration around unmet needs for health service, health in the community. 

                   You'll need to have the ability to read and at least have a basic understanding of the outcomes of research papers, clinical trials and other medical and scientific materials that are in the matter. While you are definitely not going to be the expert as the consumer health person, you really do need to be able to follow the discussion and understand it sufficiently to be in a position to be informed, to ask relevant questions, and to make comments from the consumer health perspective that are meaningful. 

                   You'll find the other members of the committee are very respectful of the consumer voice and will understand that you are not fully across all of the terminology or all of the science and medicine behind everything. However, you really have to have done your homework as well. Asking relevant questions will promote your overall effectiveness in the committee discussions. 

                   The role requires insight into when the matters you wish to raise, so the consumer-focused questions, when you should raise them during the discussion. Because frequently the scientific or research or clinical trial information should be discussed first before you raise your consumer health issues, so that the committee can properly consider them after they've wrangled through the other issues. 

                   This role really does involve working in a very wide, multi-disciplinary team environment. It requires exceptional skills in integrating and distilling complex issues so that the best possible advice is provided by the committee to the TGA. 

                   My advice to those that are thinking of applying. Only apply if you've really got sufficient time to commit to these roles. These are just too important not to give them the proper amount of time commitment. There is usually only one opportunity to make a contribution on each medicine or device or vaccine. And the Australian community deserves to be well served by the consumer representative on all those advisory committees.

                   Only apply if you've got the sufficient background to understand the Australian healthcare setting and the moving parts and have an overview of that. 

                   Only apply if you've got the ability to read and understand high-level materials, and also have the relevant community engagement that allows you to truly represent consumer health issues. Having a broad consumer and community base is also essential in my view. 

                   Personally, it's been an absolute privilege to serve as a member of the ACM and I've taken the responsibility that goes along with the appointment very seriously. It's been extremely rewarding, and I take the opportunity to wish you all the best should you decide to make the application. Thank you.

Sarah Symes

                   Hi, everyone. Thank you to the panel for sharing your valuable insights and experience. 

                   So, I’ll go to the first question, and this is open to anyone from the panel to respond to. What career stage and level of qualifications would you expect of applicants?

Terence Campbell

                   Well, I'll jump in if you like, having had the longest exposure to it.

Terence Campbell

                   I think all career stages, pretty much. You need to be fully trained in whatever discipline it is that you're bringing to the committee. But beyond that, what we want is a mix of newer people with new interests and more experienced hands who want to keep an eye on things as well. And sometimes there's a very constructive tension between the two in discussions and so forth. So I don't think it matters what stage of your career you're at. It matters that you're interested and have some qualifications that you feel may be of use to one of these committees or more than one of these committees.

Danielle McMullen

                   I think as Robin and Jo both highlighted, it is about the skills mix. From time to time, when the applications come in, the TGA looks at who's sitting on committees and what sort of skills gaps there might be. 

                   And so really in your cover letter, being able to highlight… We know that people have really interesting careers now. And so while your clinical career might look quite junior, if you've got a history that actually you worked as a researcher or you had a pharmacy career before or an academic career here, and you can bring that knowledge… You might actually only be quite a, for example, a junior gastroenterologist, but you've got this whole history that means you've got excellent skills in understanding clinical evidence and journal articles and processing what to do next. 

                   Or you have a background in regulation. We really are looking for people with interesting backgrounds. And so highlight that in your letters. It's not all about ticking a box. I know sometimes in medicine at least, there's a lot of, which box have you ticked, which qualification do you have? And here it is about if you can articulate your skills, that's really what they're looking for. 

Sarah Symes

                   Thank you. The next question is, what training is available to upskill prospective applicants who take on these roles?

Robyn Langham

                   I might try that one. For every committee member, there's induction sessions that happen before your appointment commences. And then even once you've done all your induction session, there's an opportunity for mentoring and shadowing by other committee members to get your mind around the vibe of the place. 

                   And we're also exploring other options at the moment, and needs for our committee member training. One example, and I keep promising this and it does feel like it's been going on for two years, but one option is actually for the TGA and staff to help our advisory committees by providing some professional development, particularly in the space of real-world evidence, and how that is contributing to the changes in the regulatory landscape, for example. 

                   There's lots of opportunities, lots of time. And Jo, I think you said it, the papers and the support that's given by the TGA support staff are absolutely exceptional, extraordinary, and the help and the support is there if you need.

Sarah Symes

                   Thanks, Robyn, and thank you for your kind words. This question goes to Jo. Have you ever been misunderstood and do you have opportunity to clarify your question fully?

Joanne Muller

                   Absolutely. As in, I'm not often misunderstood. Those that know me and those that may have just heard me know that I'm pretty good at talking. However, I do try and limit the amount of airtime I take up in meetings, because it is very important that we get the clinical part of the advice absolutely spot on. 

                   And certainly I've never felt that I couldn't ask a question. I certainly agree with Danielle, no question is a silly question. I know that I have used incorrect terminology to explain my question, but one of the other members will pick that up and will assist me with that without… There's certainly no embarrassment or anything like that. And they will work with me ‘til they understand my question. 

                   And on a number of occasions, a question that I have asked has resulted in different recommendations being made, which I have to say, when you then see something on the news where a certain drug has now been approved for in a particular way… And I won't breach confidentiality, but when you see it on the news and it's a big deal for many so people to have a particular drug available or to a particular age group or… And I know that I played a role in that. 

                   When I said this is real-world decision-making, it is real-world decision-making. The simple answer to that question is, I may have been misunderstood initially, but the committee members worked with me to see the issue that I was raising. 

                   And then I wouldn't say all the time I've got the right end of the stick. They will say, oh well, we can see why you think that, but this means this, and they'll explain it to me. It's an incredible process. And I think the journal club on steroids is absolutely correct. And being the consumer member means you've probably got to hold on a bit by your fingernails sometimes, because the minds are just so incredibly fast. But a very valuable experience all around.

Robyn Langham

                   I'm often misunderstood. Do you want to hear it? No, no, I'm kidding.

Sarah Symes

Thanks, Jo, that was a lovely response. The next question is, are meetings continuing remotely or is there a lot of travel involved?

Danielle McMullen

                   I think that one is easy. At the moment, they're all both. Either fully online sometimes, if it's a truncated agenda, like our next ACMS one is just online. But most of the time you're facilitated to be both in person or online.

                   I think there is some value if you're a new committee member, at least trying to get along to one is really helpful. Meeting the TGA staff in person and your other committee members. It's those networks that you build between, and just getting a bit of a feel for how the place works. 

                  But certainly to be accommodating, particularly for people who might have… There’s a couple of questions about disability. I'm sure the TGA is trying to be as adaptive as possible to meet needs of committee members. And if mobility is an issue or travel and other family commitments or other things, there's certainly a number of people on my committee who are always online or nearly always. 

                   I've met all of them in person at some stage, but who generally come online. Whereas I'm one of the people who would rather be there in person if I can, try and travel for most of them. It's pretty flexible.

Terence Campbell

                   Certainly agree with Danielle about the importance of face-to-face if you can do it. And I know the committee I'm on at the moment, the ACMD is pushing gently for people to come face-to-face, and many of them did to the last meeting. We’re hoping to make that a more regular thing. But there'll always be scope for people who for various reasons can't make it to attend online.

Robyn Langham

                   And I should put in a plug for the TGA's brand new buildings that are purpose-built and pretty schmiko. And if any of the committee members do want to… The tour of the labs seem to be about the only attractive part of the bargain, but absolutely it's good to come out and see our new digs.

Joanne Muller

                   And if I can endorse that, I've had the tour twice. Having been a former science teacher, I found it absolutely fascinating. And so certainly another one of the benefits of being on the committee is seeing the amazing building and the amazing work that's done in that building. Much appreciated.

Danielle McMullen

                   I joined in Covid, I haven't had a tour yet. I've got to hit up the team for a tour the next time I'm in town.

Robyn Langham

                   Danielle, I'm happy to offer these tours, but I'm never the one that actually runs them. Yes, not a problem. You get a tour and you get a tour and you get a tour.

Sarah Symes

                   We'll get you a VIP pass, Danielle. 

Robyn Langham

                   They're extraordinary.

Sarah Symes

                   Thank you. The next question is, do members generally take days off their day jobs for meetings, and how many days off work are required for each meeting?

Robyn Langham

                   Well, it does depend in a way. Some of the meetings are single day meetings. Some of them run over two days. I know for my role on the ACM, the committee was fairly understanding if I wasn't able to attend for both and I could just attend for one. 

                   But absolutely, I think Jo has said, this is a very important committee. The opportunities are there, and time does need to be dedicated towards supporting and optimising your role on the committee. 

                   I'm probably like most other medics in that all the reading I did was after hours. Yes, the day itself, come to the meetings and make the most of, well, listening and learning, but also being able to contribute. 

Robyn Langham

                   And being able to contribute the best you can means reading everything, just reading and preparing for it. Yes, there is a commitment.

Danielle McMullen

                   I'd echo that. It's not one where you can multitask in the meeting or try and do it from home while doing something else. There just is actually so much content and it moves at such a pace on the day because everyone is well-prepared. And so you really, you kick through quite a lot of complex content on the day. 

                   Yes, if it's one day, two day, you've got to be ready to be present for those couple of meetings. And if I'm presenting it usually, I'm pretty slow at my science-type writing and reading. And it does take me a solid weekend if I'm presenting an item. Otherwise, there's evening reading and you can chunk it up and read the things if you're just, if you're not presenting.

Joanne Muller

                   Can I add that usually the papers come out with at least one weekend, but often two weekends prior to the meeting, which usually gives people opportunities to read so that they don't have to take time off work. And also obviously evenings as well.

Sarah Symes

                   Thank you. The next question is, I work as a scientific and regulatory advisor to industry. Could skills like this be useful if conflicts are managed?

Robyn Langham

                   It depends on the industry. I guess if the industry is the pharmaceutical industry or the device industry, it becomes a little bit problematic in order to be able to handle conflicts appropriately. 

                   The sorts of conflicts that are able to be managed are instances where someone has accepted a transfer of payment for something else, but not necessarily being an employee. I feel like an employee of an industry which does business with the TGA, which has an important relationship with the TGA might be a conflict that's too hard to overcome. It does depend on the industry. If it's the building industry, not a problem.

Danielle McMullen

                   Yes, and pretty common conflicts. But again, medical clinicians or veterinary clinicians or whoever's been… The odd conference attendance type thing, or if you've been an advisor on things, you can often manage these one-off ones. It's where there's been lots of ongoing relationships that's difficult. 

                   And similarly, obviously as per my intro, it's pretty common around the committees to have some conflicts with other peak bodies. We've got vets and pharmacists and human doctors and all sorts on the committee that I sit on, and many have roles with peak bodies or other groups, advocacy or connection, and there's pros and cons to that.

                   Obviously these type of people tend to be really well … And same with consumers, involvement in consumers health forum or other groups means you're connected. But we've also got to be cognisant of where those hats, which ones you take on and off when, and managing those conflicts. It can be a challenge but not insurmountable. 

Danielle McMullen

                   And so if you're really keen to apply, I’d say put things in there and work on a conflict management plan. But being open and upfront about it's helpful. 

Sarah Symes

                   Thank you. The next question is do practitioners on the committee have to be subject matter experts? For example, can a GP with no expertise or training in complementary medicines be on the complementary medicines committee?

Danielle McMullen

                   Robyn, you have something to say there, but I my view on some of the clinician input is that it depends on exactly what each committee is looking for. Sometimes particularly GP-type input is about what happens in the real world. 

                   We have quite broad expertise about the impacts, and so I would say that there would be the opportunity. But it may depend on the committee if they've got a bunch of GPs already and they're actually looking for specific expertise, it may not be this round. But I don't know if there's anything different, Robyn, that you were going to add.

Robyn Langham

                   No, I think you’ve probably nailed it, Danielle. I really think it's important not to underplay the importance of particularly our consumer input in the processes that are that are currently underway.

                   And general practitioners equally as a specialist in input. Broad experience is as valuable as very refined, sort of narrow, high-level expertise.

Terence Campbell

                   It's a theme that's come up several times. A committee needs a diversity of expertise. Clearly at various levels it's going to need experts in complementary medicines. But having a GP on a committee like that could be enormously useful because they're going to see another side of the whole complementary medicine scene in their patients.

Danielle McMullen

                   And as a GP who doesn't do tons of it, you may understand that most of the time patients are taking all sorts of things and we may or may not know. Whereas someone who just has a real focus there does tend to know exactly what patients are on. Yes, there's pros, and we take all sorts. 

Terence Campbell

                   GPs don't always get told, but it's an important area. Australians spend more on complementary medicines than they do on the PBS.

Sarah Symes

                   Thank you. We've popped the link up with various references, and just to… We're getting a little bit short on time, but to put you at ease we will try and get back to the questions, as many of the questions as possible that have come in that we don't get to on the panel. The next question is, is there a role for a nurse on the committees?

Danielle McMullen

                   Who wants to take it? Again I think it comes back to the skills mix, so skills and expertise. And nurses are definitely a valuable source of expertise. And there's quite a lot of, depending on your nursing background, all sorts of experience you may have had with the use of medicines and research type things. It's a broad group. I think I mentioned in ours we’ve got all sorts of people from different health… It really is a multidisciplinary group. 

                   And there's not a specific checklist of we're looking exactly for this, which is why we call out for broad applications and then try and fit with the skills mix that is needed in particular committees year to year. 

Joanne Muller

                   When I did my research on the consumer members of each of the advisory committees there was one whose background was in nursing. They had done a number of other things. If I can suggest to the person that asked the question that if they just go to the TGA website, it does have the members of each of the committees and it does give you a bio of each member. Maybe you could have a look there and read for yourself the backgrounds of the different consumer members.

Sarah Symes

                   Thank you. If we are interested in multiple committees do we need to submit an application for each committee or one application for all committees?

Robyn Langham

                   That's a question for you, Sarah. I'm pretty sure the process is one application but mention all your interest, all the committees that you're interested in. How's that? 

Sarah Symes

                   That's perfect. Thank you Robyn. I’d hire you. 

Robyn Langham

                   Excellent. Thank you. Thank you. If only I was looking for a new job.

Sarah Symes

                   Can people with a disability be a member of a committee? 

Robyn Langham

                   Yes, absolutely.

Terence Campbell

                   Of course. 

Robyn Langham

                   Absolutely.

Sarah Symes

                   Good answer. What are the subcultures of committees?

Danielle McMullen

                   This is where I say, my committee's the best, no, my committee's the best. It's actually just a really good group of people, is what I found at mine. And really collaborative. When I've had a couple of tricky items, I've had the other person who might be presenting reach out, hey, are you also struggling? Because you are supposed to do things, come up with your own independent idea of what you think going forward. 

                   But it is okay to talk to each other. Hey, I'm struggling with this one. What concepts should we be considering, what's the main… It really is, it's good. And we look forward to catching up each time we get together. At least that's ACMS. Hopefully the others are just as fun.

Robyn Langham

                   All of the committees have their own their own sort of vibe. I go to all of them and I guess it's really, the joy is in the discovery. Wouldn't you say, Jo, rather than being pre-warned?

Joanne Muller

                   Absolutely. I've only been a member of two and just a few meetings for the medical devices. And I guess they were a little bit more technical and because they're dealing with devices rather than medicine, so there was more engineering kind of concepts. But I felt equally at home with both committees. 

                   And certainly there was no substantial difference to the manner in which they received me as the consumer member or received my input from the consumer perspective. My expectation is that all of the committees would equally welcome the consumer voice. 

Robyn Langham

                   Thanks, Jo, and Danielle yours is the best committee, clearly.

Danielle McMullen

                   Of course!

Sarah Symes

                   Thank you. Is this open to New Zealand residents?

Robyn Langham

                   I don't think so, but Sarah I think that's a question for the TGA team to confirm or otherwise. 

Sarah Symes

                   I think Jo covered this a little bit in her conversation, in her presentation rather. I think it's about being able to provide advice in the Australian context. You've got to have a sufficient enough understanding of the Australian context and broader environment to be able to provide advice that's relevant to the committee that you're on. 

Joanne Muller

                   Sarah, I would say that I think you need to have your connections within the Australian community and more broadly and so you know what's happening in the health system here.

                   And whilst of course there are lots of similarities to New Zealand, in many ways, we are quite different in other ways. And so I would think that from my perspective an understanding of the Australian community and health profile is extremely important. 

Sarah Symes

                   Thank you I'll just throw it open to the panel for any other general comments they might want to make before we do our final closing.

Danielle McMullen

                   Just that I spied a question that we didn't quite get time for but around still some confusion about exactly what are you looking for and on which committees. And I think probably the reason it's confusing is because it's broad. I'd say evidence-based medicine is a good, a key skill particularly for committees like ACM and devices where they're looking at new and novel therapies. And really having to dig into the evidence base as to whether this should be available, what are the safety things around it. 

                   Some of the other committees in… I find that ACMS is often a bit more practical because the medicine has already been approved. We have a strong understanding of its safety profile usually. It's caveats because there's all sorts of things that come up. But often it's about the real world implications because most of the science is already settled.

                   There's different committees with different focuses, and having a bit of a read around and finding where you might be fit… But if you're not sure, articulating where your skills are and making that obvious and where your interests might be and we'll help find you the right spot. 

Joanne Muller

                   And if I can add in part six of the regulations it actually lists the kinds of specialties of medical practitioners that can be considered for each committee. That might give a starting point for some people. 

Sarah Symes

                   Thank you everyone. A big thank you to all of our panellists, thank you to everyone who took the time to submit a question. A reminder that we are going to get back in writing to the questions that we weren't able to cover off in conversation today, but I hope you all have a lovely Wednesday. And if there's any further information we can provide please get in touch using the contact details available in the presentation. Thank you.