Hello again from medConfidential,

We’re still here! And so, for another few months at least, is NHS England – and hopefully, given Mr Streeting’s stated intentions, is your local GP…

What happened since our last Bulletin

The Government published its “10 Year Plan” (10YP) with most of the deliverables due after the next election, and with improvements to your family doctor coming after 2035. Perhaps you’ll have to “say goodbye to your data (and say goodbye to your GP)”?

We published a short series of longer pieces on the 10 Year Plan, the consequences of which will be felt throughout the life of this Parliament – but some headlines include:

• As people have worked out that “Federated Data Platform” is just another name for Palantir, the term “Single Patient Record” has been coined as the new euphemism.

• You’ll be given a “Single Patient Record”, which you’ll be told you “own” and “control” – over which you will find you have little or no meaningful control or ownership*, as it will contain everything the State wants to record about your health for its own uses, from your DNA to the activity sensors on your device.

• Another of the grand ideas in the 10YP is for hospitals to take over GP practices – making your GP about as ‘local’ as your Jobcentre, while you’ll simultaneously lose the only part of the NHS that treats you as a person over the long term. 

• They’ll be AI recording consultations in these new centres; every word you say, summarised – and they’ll keep the transcripts to check the summaries, and the audio recordings to check the transcripts. Artists made art.

*The contradictions and caveats in the 10 Year Plan mean your opt-outs, both the “National Data Opt Out” and your “GP Data  Opt Out”, may protect you less after some future date (maybe in 2026?) than they do today.

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What’s happening now

The Covid pandemic had temporary rules on data and procurement, which assumed that everyone was acting in the best interests of everyone else, and that no-one would be greedy and profiteer for their own narrow gain at public expense. 

The PPE procurement mess with Baroness Mone has been high profile and long running. Less noticeable has been one ‘sockpuppet’ of HDRUK – an organisation which decided that the rules didn’t apply to them, and started cheating by using data for purposes that were not related to Covid (except in the fiction of HDRUK’s own paperwork). Because HDRUK’s paperwork claims that its uses are “for Covid”, NHS England believes the paperwork – and neither the ICO nor NDG will disagree with the details, which is the sort of defence Baroness Mone would entirely agree with. 

In that same spirit, Mr Streeting – or strictly speaking, his Department – has written a Direction to NHS England to re-use the “Covid only” datasets for purposes that are not Covid related. Following the leadership of HDRUK (see previous paragraph) these re-uses will first be for some “consented cohorts” and then for some “unconsented cohorts”, i.e. everyone. The consented cohorts include the volunteers at UK Biobank, which is still refusing to answer questions about where it sent the NHS data of its 500,000 participants, and why. And the new project “Our Future Health” is watching its predecessor closely…

Your ability to opt out has always been a gift of the Secretary of State, and the Department of Health in England’s recent public engagement – parts of which are barely more than a push poll – has provided a wide range of views which the Secretary of State will take as license to do whatever he wanted beforehand.

He could make the National Data Opt Out stronger and more effective – as some people have said they want – or he could try to take away your opt out so that it doesn’t apply to uses of data by the Department of Health and NHS England, which is what NHS England and his Department wants. Mr Streeting’s plan for the new ‘Health Data Research Service’ (HDRS) will take your data even if you have opted out of research – so Wes could decide you have to opt out yet again, even if you opted out before. (And, once again, opting out may involve punishing parents via a different process for their kids…)

One question we’ve been asking for months, to which DH has no credible answer, is if you have opted out of your data being used in research, will your data be included in the HDRS?

As the National Data Guardian put it in her Annual Report 24/25 (p5): “Exemptions granted for essential planning and operational work mean it no longer reflects what many believe it offers. This risks undermining trust.” We agree and would go further, as those exemptions are also deemed to apply to non-essential work.

What’s coming next

Mr Streeting thinks that the solution to NHS problems is to replace your doctors with ‘his’ AIs, many of them running in Palantir – aka “Making Palantir Irreplaceable”, despite the fact that “Palantir isn’t magic”. In the meantime, the 10 Year Plan has started in maternity care with the sickest babies, and will move up the ages from there – while Mr Streeting’s officials remain incentivised to confuse dystopia with efficiency, and Palantir’s vision may be “Making Americans Irreplaceable” to “healthcare”.  

As we wrote back in January, this Government is obsessed with building an ‘Everyone Database’ – the latest incarnation of which hides behind Mr Starmer’s 26 second announcement of the Blair government-in-exile’s “digital ID cards”.

medConfidential will keep the streams separate for as long as government does, but if you would like to follow this aspect of our ‘rest of government’ work, you can visit NO2ID’s new website, subscribe (for free) to the NO2ID Substack, or sign up to join NO2ID’s Bulletin mailing list by sending an email to hello@no2id.uk 

Seasons’ greetings

This will be our last Bulletin before the New Year. We wish you and your loved ones well for the festive season. Should you feel inclined, medConfidential is always grateful for your support, as we also appreciate so many of you being on our mailing list. As ever, please do pass this Bulletin on to anyone to whom you think it may be relevant.

Warm wishes,

Phil Booth & Sam Smith
18th December 2025

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