Daniel McCabe has overseen the biggest changes to digital health in this country. Now he’s off to sort out the health technology assessment system.
The digital health sector is about to lose one of its best assets with the news that top public servant Daniel McCabe is being moved sideways to take on another project in the Department of Health, Disability and Ageing.
Mr McCabe, currently first assistant secretary of the DoHDA’s Medicare benefits and digital health division, will move to the technology assessment and access division in the next few weeks.
Simon Cleverley, assistant secretary for digital health, told TMR today that Mr McCabe’s stewardship had been a gamechanger for digital health in Australia.
“Daniel has always been very patient-centric. It’s always been about what is in the best interest of patients,” said Mr Cleverley.
“That has allowed us to open up and have a really in-depth dialogue with all of our stakeholders about what that means.
“That has really paved the way. That’s not about technology, that’s about a deep conversation with all stakeholders about what is in the best interest of patients, and by virtue of that, what’s in the best interest of clinicians, and by virtue of that, what’s in the best interest of how Australia has established a learning health system.
“That’s a long-term ambition, but had it not been for Daniel’s stewardship over that last seven years, there’s no way we could sit here and talk about the fact that that’s an achievable thing over the coming period of time.”
Mr McCabe’s move is believed to be a direct swap with the current first assistant secretary of the TA&A division, Duncan McIntyre.
While a sideways move, it is understood Mr McCabe’s performance in digital health has been impressive enough for his bosses to want him overseeing upcoming and crucial reforms to the health technology assessment process.
He has overseen the establishment of the Sparked FHIR accelerator – crucial to interoperability – and the Sharing by Default legislation which will give Australians increasing power over their own healthcare data.
Clearly Mr McCabe’s boss, health secretary Blair Comley believes he is the right person to lead that HTA reform process.
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Reactions from Mr McCabe’s colleagues in the MB&DH division are mixed. While wishing him well, some have told TMR they are gutted to be losing his skills and leadership.
Mr Cleverley said Mr McCabe was leaving the division in good shape, however.
“Daniel helped establish the Digital Health Oversight Committee, which has brought together the Commonwealth and the states and territories to have a shared vision for what we need to do at the national level with shared capability services,” he said.
“We have a strong understanding of what’s needed at that level. He leaves digital health in a really strong position in that regard.”
Mr McCabe was also one of the driving forces behind the establishment of Sparked, the FHIR accelerator run by the CSIRO, which has now become a global leader.
“Australia was a laggard when it came to data sharing standards in world terms,” said Mr Cleverley.
“We now have the world’s most active fire accelerator program. That speaks for itself.”
Also part of Mr McCabe’s legacy is the Sharing by Default legislation which will see its next expansion coming on 1 July with the mandating of provider uploads of pathology reports and digital imaging reports to the My Health Record.
“Ultimately, his legacy will impact Australians for generations to come,” said Mr Cleverley.
The federal government’s overhaul of the HTA system is entering a critical new phase, with the DoHDA preparing to shift from policy review to implementation.
The reforms stem from the landmark HTA Policy and Methods Review, launched in 2022 amid mounting concern that the existing reimbursement system was too slow, fragmented and poorly suited to emerging therapies such as gene treatments, precision oncology and companion diagnostics.
The final report, released in September last year, made 50 recommendations spanning PBS processes, evidence standards, consumer engagement and pricing pathways.
At the centre of the reform effort is the Technology Assessment and Access Division, which is expected to play an increasingly strategic role as the Commonwealth attempts to balance faster patient access with mounting fiscal pressure on the PBS.
The reforms are designed to modernise how Australia assesses medicines, vaccines, diagnostics and devices, including greater use of real-world evidence, streamlined pathways for lower-risk technologies and more flexible approaches for ultra-rare disease therapies.
Officials are also examining managed entry agreements and “bridging funding” models that could allow earlier patient access while evidence continues to mature.
The review is widely seen inside the sector as the most consequential redesign of Australian HTA since the early 1990s, when Australia became one of the first countries to formally embed cost-effectiveness analysis into PBS decision-making.
Over the remaining calendar year, the focus is expected to shift toward operational delivery and stakeholder negotiation.
Departmental sources expect an implementation roadmap to crystallise progressively through 2026, with “early win” reforms likely to include streamlined submission processes, stronger consumer engagement requirements and greater publication transparency.
More structurally difficult reforms, including adaptive reimbursement models, integrated diagnostics assessment and large-scale real-world evidence infrastructure, are likely to take longer.
The coming period is also expected to involve intensive negotiations across the pharmacy and medicines sectors as government attempts to align HTA modernisation with broader PBS sustainability and access objectives.
