A panel of investors, economists and sector specialists gathered in Sydney to confront an uncomfortable truth: Australia is world-class at creating medical technology, and world-class at failing to commercialise it.

On a Tuesday evening in Sydney, three investors and a health economist took the stage at a MedTech Compass showcase event to do something the Australian life sciences sector doesn't do often enough: speak plainly about what is broken, and what might actually fix it. The MedTech Innovation Investment Panel brought together Oona Reardon MMPP, Managing Director of Pulse Economics; Jeff Reid, Partner at Bioshore; Hashan De Silva, Managing Partner at KP Rx; and David Atkins from the BioNSW Investment Committee. What followed was a candid, occasionally uncomfortable, and ultimately instructive conversation about capital, culture, and the gap between Australian ingenuity and Australian ambition.

A Nation of Inventors, Not Commercialisers

The framing problem was established early. Australia generates approximately six to seven per cent of global medical technology intellectual property annually, a remarkable figure for a country of its size. Yet when it comes to venture capital investment per capita, the country sits somewhere between twentieth and twenty-fifth in the world. The gap between those two numbers is not a coincidence. It is a structural failure.

"We're really good at the R when it comes to R&D," said Jeff Reid of Bioshore. "What we're crap at is the D." Reid, who has operated on both sides of the commercialisation fence, raising capital for startups and bringing overseas products to the Australian market, was blunt in his diagnosis: there simply isn't enough knowledgeable risk capital to take what universities are generating through to viable commercial outcomes. Too many promising technologies, he argued, either die in the funding gap or are forced offshore before they have the chance to prove themselves domestically.

Hashan De Silva offered a structural explanation for why that gap exists. Australia's superannuation system, now managing close to seven trillion dollars in assets, has created a paradox: an enormous pool of long-term savings managed in ways that make long-term, illiquid investments practically impossible. "Australia is the hardest market to raise capital in," De Silva said, pointing to the annual performance benchmarking regime that forces super funds to beat the market every year. Venture capital, with its characteristic J-curve of early losses and delayed returns, is fundamentally incompatible with that model. The result is that smaller, more nimble funds, the ones capable of writing early-stage cheques, are steadily absorbed by larger managers who replicate each other's strategies from publicly available disclosures. "The smaller funds that can do interesting things, that write smaller cheques, don't exist anymore," De Silva said.

The Problem with Being a Bad Buyer

If the capital side of the equation is difficult, the reimbursement side is arguably worse. De Silva was direct: Australia is "probably the second worst buyer of healthcare in the world after New Zealand." The complaint is not merely about price; it is about posture. Australian companies seeking reimbursement pathways find themselves treated as commercial adversaries rather than partners in advancing patient care. Regulatory timelines from the TGA offer little certainty. For a startup weighing the Australian market against the United States, the calculus rarely favours staying home.

Oona Reardon offered a practitioner's perspective on why that dynamic is so damaging for early-stage companies. Having spent years evaluating MBS and PBAC submissions for the Department of Health, she understands the framework that founders often encounter too late: a system that demands rigorous health economic justification before it will move. The issue is not that the system asks hard questions, it should, but that founders frequently arrive at the reimbursement stage without having collected the right data to answer them. "They've collected quality of life data using their own tool," she noted, "and then you can't create an economic model." The consequence is six-figure remediation costs that many startups simply cannot absorb.

Reardon advocates for what she calls the "three Ps" framework: founders should be thinking about the payer (federal government, private insurer, or public hospital), the provider (whether clinicians will actually adopt the technology and what incentivises them to do so), and the patient (using validated quality of life instruments that align with established clinical practice). This is not advice for the commercialisation phase. It is advice for the design phase.

Capital Is There, Just Not Where You'd Expect

David Atkins, representing BioNSW, pushed back on the narrative of pure capital scarcity. The problem, in his view, is less about total quantum and more about structural access. "I think there is capital available," he said. "It's probably not going to come to many of you through the VCs in Australia." Australian VC, he observed, tends to behave more like small private equity, cautious, late-stage, risk-averse, than the kind of early-conviction investing that propels startups through their most uncertain years.

What does exist, Atkins argued, is a substantial family office infrastructure that remains largely untapped as a source of medtech funding, not because the appetite isn't there, but because those investors lack the tools to evaluate complex deals. BioNSW's work is focused on bridging precisely that gap: connecting capital that wants to participate in medtech with the due diligence capability it currently lacks. He also struck a note of measured optimism about the superannuation system over a longer horizon, pointing to models in France and the UK where structural reforms have begun unlocking institutional capital for venture. "If we look back over a five to ten year time frame," he said, "some of that super capital will start making its way into venture."

Atkins was equally insistent that founders not treat geography as destiny. "I would never sit there and say the reason I can't succeed is because I'm in Australia. I think the reason why you can succeed is because you're in Australia." The competitive difficulty of the global medtech industry, he pointed out, is universal, not uniquely Australian.

Relationships Before Rounds

One of the sharper practical insights of the evening came from De Silva, speaking from the experience of six financing rounds across four years. The worst mistake a founder can make, he said, is to have their first conversation with an investor at the moment they need money. "You know the people. The worst thing to do is to have your first, second, third, fourth, or fifth meeting when you're asking for money." The implication is clear: the work of capital raising happens in the quiet periods, in the relationship-building that most founders neglect while their heads are down executing. "It's a people thing," he said. "It's very rarely a technology or IP. I mean, they're important, but if you don't know one another, it's never going to happen."

If You Were Prime Minister for a Day

Asked what single policy change they would make to transform the Australian medtech landscape, the panel's answers were revealing in their specificity. Reardon pointed to digital health funding, noting that the Department of Health has effectively closed the door on AI technologies and software as a medical device, a position she described as a massive barrier. Reid went further, arguing for a government mandate requiring super funds to invest a minimum percentage of assets under management into the startup ecosystem. "That would be transformative for us as an industry overnight," he said.

De Silva's answer focused on procurement reform: a collaborative model, he cited Intermountain Health in Utah as a precedent, where government and companies co-design clinical trials around cost-saving outcomes, with reimbursement tied to demonstrated results. The effect would be to make Australia a compelling first market rather than an afterthought. Atkins, noting his decades abroad, called for a government-funded lead investment structure similar to the British Business Bank, designed to catalyse co-investment from institutional sources that currently lack the confidence to lead deals alone.

The Stakes

The stakes of this conversation extend well beyond the investors in the room. Australia's medtech sector represents a genuine comparative advantage: a pipeline of clinical innovation generated in world-class research institutions and tested against one of the developed world's most complex health systems. The failure to convert that pipeline into durable commercial outcomes is not inevitable. It is a policy problem, a structural problem, and, as the panel made clear, partly a cultural problem about how the sector values and supports the long, difficult work of turning ideas into treatments.

The companies that pitched that evening demonstrated what is possible when founders are prepared, clear-eyed, and focused on the problem rather than the technology. The ecosystem, as one panellist generously noted, was itself the winner on the night. But ecosystems don't fund clinical trials or navigate the PBAC. Capital does. And until Australia builds the structural conditions that allow that capital to flow toward its best ideas, the gap between what this country invents and what it commercialises will remain a standing indictment of misplaced caution.

The MedTech Innovation Investment Panel was convened by MedTech Compass in Sydney, with support from BioNSW, the NSW Government, UNSW Founders, the George Institute for Global Health, and the Medical Technology Association of Australia.

Why This Matters for ARCS Members

Regulatory affairs professionals, clinical research associates, and therapeutic goods specialists sit at the intersection of exactly the challenges this panel identified. The failure to embed health economic thinking early in product development, before clinical trials, not after, is a workforce capability issue as much as a funding one. As the sector works to close the commercialisation gap, professionals who can speak the language of reimbursement, clinical evidence, and regulatory strategy from day one will be increasingly indispensable. The competencies ARCS Australia develops in its members are not peripheral to this conversation. They are central to it.