Hello again from medConfidential,

It’s been a while, but we do try to stick to our promise not to write until it is relevant.

Nine months after the general election gave us a new Government, Labour’s plans for the NHS and your medical records are becoming somewhat clearer. And we now know that the Health Secretary, Wes Streeting, wants to take charge of your medical notes – because, he says, “the NHS [of 2024] is broken”.

The NHS of 2029

Mr Streeting knows that by the end of this Parliament in 2029/2030, advances in treatment will make it increasingly normal for you to be able to take your cat to the vet to have your cat’s cancer effectively cured. Precisely which cancers and how much it will cost are currently uncertain, but decades of research are starting to show results for humans too.

Wes also knows that it would be morally, practically, emotionally, but especially politically intolerable for you to be able to have your vet cure cancers in your cat, when you and your loved ones cannot receive equivalent treatment on the NHS – successful trials, etc. having been passed.

To avoid this future NHS of 2029, Labour’s Health Secretary believes he must be able to micromanage the NHS of 2025. In practice, this means taking political control of everything the NHS knows about you and every way in which you interact with it, then doing exactly what Mr Streeting and his AIs think should happen. (Wes doesn’t trust doctors, onlytechnology and politicians…)

It is certain there will be a lot of details to work through in this fundamental take-over, and most of that work hasn’t even started. (We started writing a document going through some of those details, and it reached 30,000 words before the follow-up announcement meant we now have to rewrite large chunks! We hope to post some parts to our website over the summer.)

The NHS of 2025

In line with these plans, Wes Streeting and Keir Starmer have announced that the Department of Health in England will become one public body rather than the current two.

Abolishing the parallel duplicate bureaucracy of NHS England and putting the NHS in England under Wes Streeting’s direct political control will make it easier to change the NHS. Some of those changes may be improvements – medConfidential certainly hopes they will be, and will continue to work to ensure that they are – but change and improvement are not necessarily the same thing.

Wes Streeting’s NHS of 2025 will do what Wes wants, and he will use the data infrastructure of the NHS – aka NHS England’s Federated Data Platform, i.e. Palantir – to make sure his decrees are followed. We already know this means grabbing a copy of your GP medical notes for a new ‘central care record’, which Wes is disingenuously trying to brand as “patient passports”. As with all previously attempted GP data grabs, once copied from your doctor’s guardianship to the centre, all the data in that platform will be up for sale. (The current price list hasn’t been updated in a while but, as the page says, “all pricing is under review”…)

The new Health Secretary prioritised economic growth, while the old NHS England had put its focus on diseases of the rich, and the new DH/E will carry on using the system imposed on hospitals to prioritise operating theatres and “optimise” waiting lists. Wes Streeting’s NHS will use everything it sucks into its central care record to make those decisions – and under the border control of Wes’s so-called ‘passport’ scheme, it seems likely you’ll have to have a central care record, readable wherever the NHS logo is seen.

When Wes Streeting – or any future Health Secretary, of any future political bent – decides to micromanage NHS treatments for particular conditions, to prioritise the ‘diseases of the rich’, or to de-prioritise certain things, the new Department of Health in England will allow him to do that. 

Don’t forget that Streeting’s first act in Government was to criminalise some doctors providing healthcare around gender; now he’s targeting ADHD and mental health care – how very Elon Musk. But of course his successor will equally be able to limit PrEP, IVF cycles, or other aspects of your health care based on their political beliefs. Decisions about your care will be made less and less by your doctors and be constrained more and more by politicians. 

We don’t doubt Wes Streeting believes he’s doing the right thing – but that was equally true of the politicians who imposed limits on teachers when they created “Section 28”, restricting school lessons on healthy and safe relationships. Just as Mr Streeting does today, those politicians believed they were doing the right thing; two generations later, the harm those politically motivated interventions caused is plainly clear – indeed, Wes himself has argued this, as quoted here.

Change needs Parliament to decide

One piece of good news is that some of the above will require Parliament to pass new laws, and those new laws are not written yet. What does get written may be good or may be poor, but it will at least have to be written down and it will have to be debated in Parliament.

Any new law will, for example, have to write down when and where people’s National Data Opt-Outs apply. The old Department of Health in England never wanted patients’ opt outs to apply to them – a political decision for which bureaucrats at NHS England could never be held responsible. Indeed, this evasion is one example of why the changes are happening.

Any new law will also have to state what Wes Streeting – a politician, not a doctor – can and cannot do with the information in your medical notes. Is he going to be in charge? Will there be full transparency and qualified, independent oversight? The current Government seems to want to be responsible for everything, and Wes will almost certainly use that authority if Parliament gives it to him.

Wes’s grand vision for data could be simple: every use of NHS patients’ data could be consensual, safe, and transparent. The Secretary of State could commit to telling you how your data is used, including for your own direct care – and that if you don’t want your data used for purposes other than your direct care, then it won’t be. And, with all the powers he is seeking, he could make sure that these commitments are met.

It could be that simple. Will it be?

Will those who want their health data mined to feed “America First” AIs be free to make that informed decision, and will those who have objected to any and all such uses have their wishes respected?

Time will tell. We’ll be here.

Phil Booth & Sam Smith
16th April 2025

coordinator@medConfidential.org

P.S. We only send you – and 10,000 or so other people – this newsletter / Bulletin when we have something worth reading; we don’t want to waste your time or goodwill, and we greatly appreciate your interest. As we also appreciate the generosity of those of you who are able to donate to our work. 

Between these irregular Bulletins, we do post news and updates on our website – often going into more detail than in the newsletter. If you would like to receive an email when we do that, we have a new list to which you can sign up to get notifications when we post on our website, which may be up to a few times a week at busy times. (Bulletins will continue to be sent out at most a few times a year, which we don’t propose to change.)