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Keir Starmer has launched the Labour government’s new 10-year health plan, which he claims will “revolutionise” the NHS in England. He says it will bring care closer to home, digitise access, and focus on prevention over crisis.

But buried within the 168-page document is a major expansion of private sector involvement in core NHS services, infrastructure, and technology — all funded with public money, with little oversight and no clear funding breakdown.

The grand promise: care on your doorstep, AI in your pocket

Starmer and Health Secretary Wes Streeting have framed the plan as nothing less than a rebirth of the NHS.

It rests on three pillars:

• Shifting care from hospitals to communities,
• Modernising with cutting-edge technology,
• And focusing on prevention to reduce long-term demand.

A new Neighbourhood Health Service — the flagship reform — promises 200 health centres across England by 2030, offering everything from GP appointments and mental health support to debt advice and help to stop smoking.

These centres will be open 12 hours a day, six days a week, aiming to make care more convenient and local.

Alongside this sits an ambitious digital overhaul: AI “scribes” will automate GP admin, the NHS App will become a front door to the health system, and genomics (using a person’s DNA to help predict, diagnose, or even prevent disease) and wearables will help track and predict disease before symptoms even emerge.

On paper, it reads like a tech-forward, patient-friendly reboot.

But behind the rhetoric lies a radically different NHS — one with the private sector built into the foundations.

Behind the curtain: private providers embedded at every level

The most critical — and under-reported — aspect of Labour’s plan is its quiet but deliberate opening up of NHS services to private contractors. The document explicitly states:

“We will continue to make use of private sector capacity to treat NHS patients… and will enter discussions with private providers to expand NHS provision in the most disadvantaged areas.”
(Fit for the Future, p.12)

This is not an emergency stopgap.

It is a policy shift — embedding private health firms as long-term partners, particularly where public services are thin.

In practice, this means that more NHS treatments, scans, rehab, diagnostics and dental work will be delivered by private companies, subsidised by the taxpayer.

And it doesn’t stop there.

The return of PFI — rebranded and repackaged

One of the most alarming aspects of the plan is the proposed return of Private Finance Initiatives (PFIs) — the discredited New Labour policy that saw hospitals built with private capital and then leased back to the NHS at extortionate rates.

Labour now proposes to revisit that model under a new name:

“We will develop a business case for the use of Public Private Partnership (PPP) for Neighbourhood Health Centres, ahead of a final decision at the autumn budget.”
(p.15)

This raises the spectre of PFI 2.0: hundreds of new centres built by private investors, who will then extract decades of profit from long-term NHS lease or service contracts.

We’ve been here before. These partnerships turn into millstones. The taxpayer pays three times over while private equity walks away fat and happy.

No details are offered about interest rates, risk-sharing, profit caps, or exit strategies.

Selling off the digital NHS?

The plan envisions a highly digitised NHS: patients will use the NHS App to access personalised care, AI tools will help doctors diagnose and document, and genomic data will guide early intervention.

But almost all of this infrastructure will be developed by private tech firms — with the plan stating:

“We will expand the role life sciences and technology companies can play in service delivery.”
(p.14)

This means critical platforms — the new digital backbone of the NHS — could be owned, operated and controlled by private corporations, not the health service itself.

There is no discussion of intellectual property rights, data sovereignty, or who profits from the use of patient information.

You can’t call it a public health service if the software is owned by Silicon Valley. If the data, code and IP aren’t public, the system isn’t either.

The document vaguely references “open standards” but offers no commitments on in-house development, open-source licensing, or limits on vendor lock-in.

Missing numbers, missing ownership, missing accountability

Despite repeated references to a £29 billion funding uplift, the plan provides no detailed breakdown of how that money will be spent — or how much will go to private providers, tech companies, or infrastructure partnerships.

There is also no new legislation, regulation, or transparency framework proposed to govern:

• Private partnerships in service delivery

• Ownership of new digital systems

• Profit margins or return on investment for private health firms

• Procurement transparency for the new neighbourhood centres

This is not oversight — it is design.

A Trojan Horse for the corporate carve-up of the NHS

Labour’s 10-Year Health Plan presents itself as pragmatic, modern, and people-centred.

But behind its polished language and tech jargon lies an unmistakable agenda: the quiet outsourcing of core NHS functions to the private sector, with no limits and no guarantees that the public will retain control, ownership, or long-term value.

Starmer may not be selling off the NHS in the way past Conservative governments tried — but he’s laying out the red carpet for private capital to own its future.

Unless the public demands transparency, accountability, and clear red lines, Labour’s reform plan may not be remembered as a rescue — but as the start of the NHS’s final sell-off.

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