When the whole 10 year plan comes out tomorrow we’ll start reading it, but the night before what’s out is the last press release before the 10 year plan – ie only the bits that Government most wants to talk about because they think they’re the best parts… 

Mr Streeting’s 10 year plan will replace your GP surgery with a “neighbourhood health centre” in the same way you have a “neighbourhood job centre (plus!)”, with the service promises that applied to your local sure start centre (and it’ll go the same way). 

The “single patient record” controlled by the Health Secretary will replace your GP record with a politician owned medical history, taking control of all the medical notes made by doctors across your life. Everything you’ve told a doctor in the last 35 years is in those notes – it may have been sensitive and important at the time, and it’s all still sitting there. 

Your GP has responsibilities to you over your health records; the Secretary of State will do whatever the politician of the day wants, because the data controller for your medical records is the politician of the day. They will make decisions for political reasons.  

Your GP writes your notes for the importance of your health and future treatment. But the creepy centres will be incentivised to confuse dystopia with efficiency and use “ambient voice technology” with microphones in the rooms to transcribe everything and have an AI summarise it for your permanent notes. “Clinical safety” will require a full transcript is kept to protect the organisation, and then the audio recordings will be kept because they too are needed to protect the organisation. The effects on individual patients matters less to the hospitals – your GP receptionist might feel like a bit of an ogre at times, but they work for your GP who has some responsibility to you. In contrast, the neighbourhood health centre’s bouncer works for someone far away, and hospitals are barely responsible to anyone, which is why Mr Streeting wants Palantir’s AIs to monitor every birth in every maternity unit. 

If you want any doctor to see the sensor data recorded by your smartwatch or phone (how you sleep, how you walk, how you’re breathing or your heart rate) you’ll be required to share it all with the national health record and Palantir in order for any of it to be seen by your doctor. Mr Streeting wants to know how often you masturbate while wearing a smartwatch (or get laid, and yes, his algorithms can tell the difference), and he’ll share how often you go for a walk with DWP and sell it all off to anyone who wants to buy all the data..

As parents know from their children’s health, Government finds it easier to blame families for kids being repeatedly off school with illness and not do prevention to avoid kids getting sick in the first place. Kicking people off PIP doesn’t make them less sick, and closing GPs doesn’t decrease the hospital backlogs, but it does help hide them.

Details aren’t out yet

Today is the best day the 10 year plan will have in its lifetime. We’ll read it all when it’s out and see what the consequences are.

Perhaps there’s no real need to worry, because Mr Streeting will u-turn like all his cabinet colleagues, and should do because the good things they want can be delivered in other quicker ways. As we saw in our recent look at community health centres, policy says that in theory GPs can refer for a scan directly, but the hospital running the centres says in practice they can’t. But the hospitals must have forgotten to mention that in meetings.

Writing the 10 year plan Mr Streeting only listened to people who run hospitals, so the plan calls for hospital outposts to replace your GP practice (and is why GP isn’t getting more money, and why the priority is “from hospital to community” not “do more in primary care”. Your hospital will come into the community for a while, other services will go away, and then the hospital will withdraw once again.

We’ll be here.

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