When the current Government wanted to force Scunthorpe steel works to stay open it used primary legislation and the minimum of powers. Mr Streeting’s Department of Health in England is being much more opaque in similarly changing the law to force technology companies to do whatever he says, increasing what he can demand just before legislation is finalised widening who he can force to do it (but after it has been debated).

The NHS works on “information standards” – agreements on how systems work, what they can do, and how they can talk to each other. These are normally consensus documents, written collaboratively and implemented by IT providers for their NHS customers. These standards (and companies) can determine the contents of screens that doctors click in their systems – the standards don’t apply to doctors, but the standards can make items mandatory in order for a doctor to record your diagnosis or issue your prescription. 

Government wants to force private IT providers like TPP (of Frank Hester fame) and Palantir to comply with anything a civil servant writes down in a letter.

The detail

Government has drafted a regulation to give proclamations the force of law for health and care providers or their “IT provider” (under D(UA)25 schedule 15 clause 3 (4)).

Clauses 3–5 require consultation for new standards (including with medConfidential?), but there’s a get out for anything the NHS currently does – If an existing standard is being updated, or it’s a legal obligation, DHSC can simply proclaim it under 2(b).

“Legal obligation” within the meaning of this power can be as little as an anonymous civil servant sending another letter to NHS England that those subject to the powers have to follow, or suffer public censure, a governing style recently synonymous with Donald Trump.

Clause 7 shows that this drafting predated discussions of abolishing NHS England, because it leaves NHS England in charge and indeed, it is NHS England who publish the list of letters today.

Because the Department of Health in England spent so much on Palantir, if they’re not going to overspend their tech budget then they need to move all spending on data infrastructure into Palantir (so it becomes FDP budget). This will include the infrastructure that produces research datasets, a change that will have deep consequences for research priorities (but which does not seem to have been discussed with the research community).

The Regulation gets discussed on the 29th April by a House of Commons committee that has no members as of 28th April (and Parliament’s website blocks the Internet Archive from (independently) keeping a copy of that page to prove it, so here’s a PDF). Whether the House of Lords will discuss this is currently unknown.