Palantir and the NHS: Why US tech giant’s latest move is such bad news
But there are deeper problems with the FDP. It risks stealing oxygen – and funding – from other critical work already underway to help the NHS finally merge its patient records. For example, openSafely, a national flagship data platform for health research, was developed by Ben Goldacre and a team in Oxford and used for vital Covid research. It is fully open source, secure and a path forward for trustworthy health research. It also costs a fraction of what Palantir does.
Additionally, cramming so much access and control into the center might not make sense. For some issues – vaccinations, personnel deployment planning – there are clear arguments in favor of a national solution. But ultimately, most care is delivered locally and planned regionally. There are already places like London that have developed solutions to pool patient data to better plan care – at a fraction of the cost of the FDP. It’s far from clear how they will interact with the FDP, or if they can survive the new system.
Other competitors – such as a British consortium of universities and open source companies that are apparently bidding for the deal – would have been happy about a fair breach of the FDP contract. But let’s face it: You probably don’t have a snowball chance of beating Palantir’s established advantage, which was gained through a mix of insider influence and watermelon cocktail lobbying.
Once Palantir is in, it’s going to be hard to get out. The technical architecture is proprietary – and other government agencies struggled to get rid of Palantir when they tried. Having a single provider to help you bring data together And Analyze it too, risk creating a dangerous private monopoly over vital NHS infrastructure.
In fact, if you take Palantir boss Alex Karp at his word, that’s the plan. “We are working toward a future in which all major institutions in the United States and their allies abroad conduct significant portions, if not all, of their operations on Palantir,” he wrote. “Most other companies target small segments of the market. We see and want to grasp the whole.” This reads like an explicit declaration of intent to strive for monopoly power.
It is also clear that they are in it to profit. Their Chief Technology Officer, Shyam Shankar, recently wrote: “The problem with def[c]Contracting is not the popular narrative that contractors make too much money. In fact, they make too little money… Innovators will need outsized profits to motivate progress.” Monopolies and greed may be good for Palantir’s stock price, but they don’t align with the ethos of a public health service.
Better connecting the NHS’ disparate health data systems will pose major challenges and the NHS will face trade-offs – buying consultants, for example, may be easier in the short term but prove more expensive in the long term. But at the moment the government is walling off legal letters in which even fundamental questions about the FDP are asked. And they also create facts on the ground that could favor Palantir. The legal basis for all of this is unclear now that the pandemic-related suspension of patient data protection has expired.
People care a lot about how their health data is used. We go to the doctor to share our worries, our fears, and our pain — and if we don’t trust that this conversation is private, we might not go at all. People want to feel safe contributing their health data to the benefit of the NHS – but when the government overtakes patient trust and overhauls patient record systems without explaining what it intends to do, who will see the data and what the safeguards are, folks line In a month in 2021, more than a million people opted out of having their health data shared because they didn’t trust recent government plans to consolidate their GP records. The history of the NHS is a graveyard of such schemes: massive, expensive white elephants, all of which failed because the government didn’t take the time to get the governance or consent right.
It’s time the government learned from these mistakes. We can build a better future for our patient data – if we take the time to design carefully, respect patient choice and think about what system will serve the NHS in the long term. Anything else is likely to fail, setting the cause of progress back another five years.