ABSTRACT
This chapter shows the simplest moral ecosystem of a health service provider and the dynamic web of dyadic moral links among its stakeholders. The provider can be an organisation or a professional individual with single occupancy at the internal stakeholder level: a single individual holding the roles of owner, manager and employee and with no partners. In England, integrated care, a policy goal since the 1960s and a statutory duty since 2012, introduced new primary care models with increasing reliance on market mechanisms for their funding. The introduction of new system goals has changed the demographics in both the number of stakeholder groups and the 'spatial' distribution of a given group in terms of environments. This has precipitated a marked 'genetic' differentiation within and among stakeholder groups: that is to say, distinctly different groups within one environment. The social and environmental responsibilities of healthcare, effectively the ethical dimensions of sustainability, constitute the ethos of healthcare.
