There are many reasons why Palantir’s increased involvement in the UK’s health care system is troubling, including, first and foremost, the company’s close ties with the US military and intelligence industrial complexes.
The U.S. spyware giant Palantir, with intimate ties to defense, intelligence and security industries around the world and a long, proven track record of never once turning a profit, has won another juicy contract with the UK’s crisis-ridden National Health System (NHS), this time to help reduce the backlog of 6 million patients waiting for elective care. Here’s more from the FT:
The US company’s data processing technology will be spread across 30 hospital trusts — bodies that organise healthcare in regions across the country — in March in a bid to help cut NHS waiting lists that have spiralled higher during the coronavirus pandemic.
The rollout comes after a recent pilot of Palantir’s Foundry system at the Chelsea and Westminster Hospital Trust helped reduce the inpatient waiting list by 28 per cent — the equivalent of tens of thousands of patients — for all non-emergency surgeries, including for cancer treatments.
The expansion will consolidate Palantir’s position as the preferred operating system for the NHS, following its use in the management of ventilators and PPE equipment during the pandemic, and the delivery of the nationwide Covid-19 vaccination programme through 2021.
While the backlog project is still a proof-of-concept, the NHS is paying £23.5mn for a two-year licence for the technology, expiring in December 2022.
Palantir, which employs more than 600 people in the UK and plans to hire an additional 250 this year, processes sensitive health and national security data for UK public authorities, including NHS England, the Cabinet Office and the Ministry of Defence.
There are many reasons why this is troubling. One is Palantir’s well-documented ties with the U.S. military, the CIA and other intelligence agencies. Through its venture capital arm, In-Q-Tel, Langley provided the lion’s share of the funds needed to get Palantir up and running back in 2003. The agency was also reportedly Palantir’s sole customer during its early years as the company refined its technology.
The day before Palantir’s listing on the New York Stock Exchange, an article in the BBC noted that “the company — sometimes described as the ‘scariest’ of America’s tech giants — got its start working with US soldiers in Iraq and Afghanistan.” Its main line of business these days is to provide data-mining technology to support US military operations, mass surveillance, and predictive policing. Its technology is also used by ICE to identify illegal migrants before detaining and deporting them as well as by the NSA. In February 2021, Palantir’s chief operating officer famously bragged to investors that Palantir was driving towards being “inside of every missile, inside of every drone.”
The company also supplies software to other public agencies and corporate clients. Like many Silicon Valley giants, Palantir has not posted a single annual profit in its 19-year existence. Following its IPO in Oct 2020 the company’s share price surged, reaching a record high of $35.18 in late January 2021, before gradually fluttering back down toward the original IPO price of around $10.
Since the beginning of the pandemic Palantir, like many tech giants, has sought to capitalize on new opportunities in healthcare. As Lambert reported in September 2020, Palantir was one of a number of companies selected to help collect, store, process and share data for the United States Department of Health and Human Services (HHS) in a project that “poses a grave threat to the data privacy of all Americans,” according to the Electronic Frontier Foundation (EFF).
On the other side of the Atlantic, the UK Government signed a deal in March 2020 with an assortment of private tech firms, including Palantir, to help run the NHS’s massive COVID-19 “data store”. It was supposed to be a short-term arrangement but in December of the same year the Department of Health and Social Care awarded Palantir an additional two-year contract, worth up to £23 million, to help run the NHS’ massive database. The contract, awarded on December 11, paved the way for Palantir to play a major, long-term role in the NHS beyond COVID as well as in other government agencies.
“It wasn’t clear what precisely Palantir had been given access to,” wrote Mary Fitzgerald, openDemocracy’s Editor in Chief, and Cori Crider, a US lawyer and a founding Director of Foxglove, a new non-profit that exists to make tech fair: “the list of NHS datasets that the firm will draw on have been redacted from the contract. What is clear, though, is that the government deliberately struck this deal on the quiet – knowing it would be controversial.”
As Fitzgerald and Cirder note, Palantir won three consecutive massive no-bid contracts to manage the largest pool of patient data in NHS history – with the price leaping in six months from £1, to £1m, to £23m. And all of it made possible by the British government’s suspension of tedious-but-vital procurement law (which determines who is allowed to bid for government deals) during the early months of the pandemic.
Foxglove and openDemocracy brought two legal actions about the data deals, which led to the publication of the secret contracts while also securing “a (grudging) commitment” from the UK government not to extend the Palantir deal beyond COVID without first consulting communities.
Palantir wants to diversify into health sciences for obvious reasons: it is a fast growing, rapidly privatizing industry with huge money-making opportunities for technology companies. As a 2019 op-ed in the Guardian noted, the NHS has one of the planet’s most valuable repositories of data:
Primary care records that cover sometimes decades of consistent, high-quality, trusted data on 55 million individuals, potentially covering their entire health histories. On top of that, an estimated 23 million care records document episodic treatments when patients receive secondary or specialist care. Accountants Ernst & Young estimate its value at £9.6bn annually.
For pharmaceutical companies, such comprehensive data is considerably more valuable than any sample. Large, clean, consistent and trusted datasets such as the NHS’s are a goldmine. Already, medical researchers are deriving useful results from machine-learning techniques – for instance, in providing rapid diagnoses of cataracts and other common eye diseases. And with progress in medical research increasingly driven by such techniques, the value of NHS data will only increase over time. It is a glistening prize for major health and pharmaceutical providers – or, indeed, big tech companies looking to move into the field.
That is why, as the leaked documents* say, “obtaining commitments on the free flow of data is a top priority” for the US (you can find this on page 22). Free flows of data, including removing barriers to “data localisation”, imply that very sensitive health data could be taken and placed on servers outside of UK domestic law.
*A reference to provisional US-UK trade papers leaked by the Labour Party
While it is clear that good data management has a vital role to play in the future of health and social care provision, it is hard to fathom why the UK’s National Health Service — the first health system in any Western society to offer free medical care to the entire population — would partner with a company that deals in death on such a vast scale and whose founder and CEO, Peter Thiel, does not believe that healthcare is even a public good.
It is also clear that NHS Digital is doing a pretty shoddy job of managing and protecting patient data, having already shared vast reams of personal, private data with more than 40 private companies. Now it will be sharing even more of that data with a company that has intimate ties with police and security forces all over the world and which has played an instrumental role in many of the worst security scandals of the past decade, from Cambridge Analytica (allegedly) to the Iraq and Afghanistan wars, to the mass surveillance programs conducted by NSA and GCHQ and exposed by Edward Snowden.
According to the FT article, Palantir’s technology allows its clients to gather together “disparate data, such as number of patients waiting per clinician, operating theatre schedules, staff rosters and patient-specific pre-surgical tests, into a single system that surgeons and other clinical staff — rather than just admin and scheduling staff — could also use”:
The dashboard allows clinicians to see which patients needed to be prioritised at a glance, allowing them to make real-time decisions on scheduling surgeries. Highlight text
“The solution has been a game-changer for me — it’s helping me to do my job faster and more efficiently, and has reduced my administrative burden,” said Jeffrey Ahmed, consultant gynaecologist at Chelsea and Westminster Hospital.
He added his team was now in the “advanced stages” of using the technology to tackle the outpatient waiting list, “to achieve the same benefits we’ve got for elective patients”.
The decision to award Palantir more business with the NHS comes just six months after the UK’s Department for Health and Social Care announced it was terminating a contract with Palantir over the management of social care data, following a massive protest campaign involving more than 50 groups. This was taken as a tentative sign that the UK government may finally be pivoting away from using Palantir’s services, at least in the healthcare sector. That is now clearly not the case.
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Thank you, Nick.
This is just the start. The pandemic provides the excuse for further gutting of the NHS. A recent report for the government by McKinsey identified fresh opportunities where the private sector, especially technology, could play a part.
Keep an eye on the US’ C3AI. Health Secretary Sajid was an adviser there and still owns some of the shares.
It won’t get better under Labour as Starmer’s leadership campaign was part funded, advised and manned by United Health and its lobbyists. Some of Starmer’s shadow ministerial team are also beneficiaries of the largesse.
Thanks for the heads up, Colonel. Will certainly be keeping an eye on C3AI from now on, especially if Sajid hasn’t even bothered to sell his shares in the company. It’s incredible to see just how overtly corrupt the British political establishment has become in recent years.
They are overly corrupt because they are permanently in power. The very slight threat that was Corbyn has been crushed and Starmer is total establishment and crushing all slightly leftish opposition. To wit, now anyone who even questions Nato and its rightiousness, and any opposition to war is being ruthlessly expelled from the Labour party.
Thank you and well said, John.
It will be interesting how much Labour can mobilise on the streets for the local elections as so many people attracted by Corbyn have left or been expelled.
Further to your comments yesterday about the royal navy and follow ups by David and me about the wider armed forces, the maintenance of service equipment has become corrupted. So have many of the top brass.
Many of the army’s vehicles and the RAF’s tankers are leased from and serviced by the private sector. There are no longer in house skills. If the forces have to deploy, it’s not clear if the civilians will or can deploy alongside the regulars.
Many army barracks are owned by the City’s Nomura and Terra Firma. However, the state as tenant remains responsible for upkeep, not the private sector landlords.
Yes. I noticed that two nights ago on the Prime Ministers Questions. The usually confrontational British pols all sounded like the Tabernacle Choir in their support of Ukraine. It seemed delusional.
Thank you, Nick.
We should take this further off line. Yves, JLS and Lambert have my private e-mail address if you wish to get in touch.
OK, will ask them for it. Cheers Colonel.
From here it looks as if the plan is to destroy the NHS.
Why ?
The NHS is an embarrassment to the US healthcare extraction system.
After all if a international power, a nuclear capable power , and a world trading power can support an effective healthcare system what does that say about the US’s healthcare extraction system ?
We mustn’t have an English speaking partner with an NHS that works.
Oh and Canada is next.
Thank you, Bob.
It’s unlikely that the NHS will be abolished. A political / organisational fig leaf is likely to be kept, so that the private sector pillage can be hidden.
The corruption is not just in Whitehall, central London location of some of the British government to readers outside the UK, but in the provinces, too.
Not saying that NHS will be abolished.
Rather that it will be reduced to rubble by using a fake/failed IT project by a dodgy outfit that extracts billions of dollars / pounds and leaves a greatly diminished system.
Then we will hear the usual “Big government doesn’t work.” “Socialism doesn’t work” “Government corruption is to blame.”
It will end up as some sort of voucher scheme, where the voucher won’t cover the cost of the service even though it will pretend to. So some people won’t have, say, a hip replacement because they can’t afford the delta cost, while others pay the delta. Either way, cost savings for gov, with bonus of the elderly poors dying earlier.
I’m waiting for UK pension to be moved from a statutary benefit to a means tested part of the welfare setup.
Gloom.
With Palantir coming in, I expect that one of the purposes is to eventually take over all data processing of the UK’s health care system so that they will lose the ability to do so themselves having outsourced this capability to a private entity. So here, the UK government could just as likely have chosen Amazon to do this but the point was to destroy that capability which has already been seriously eroded. As Lambert say, everything is going to plan.
Thank you, Rev.
Last autumn, I did some work for the Bank of England. BOE officials are worried that much of the financial services industry, and wider critical infrastructure, have outsourced IT and other services to US defence (sic) contractors like Amazon, Google and Microsoft.
Failure often happens, before the project even starts, the bigger the project, the greater the failure! Example: NHS NPfIT (a giant outsourced contract vehicle 2003-2013) that failed spectacularly in 2011 … vs US VA VistA (originally developed by local IT and medical staff 1994-2018)) that was successful (see Wikipedia). The host organization has to have successful long term planning, and long term development of internal and local staff to carry it forward. If the host management and local technical talent are unavailable, because they were never developed (usually do to internal competition for resources) or because the parent government organization “has other plans” … outsource contracting is the only choice left (often a feature not a bug). This would be a problem for any organization wanting to improve, for-profit or non-profit. The root failure is human foibility on individual and collective levels.
When a cancer patient needs priority in terms of us “secretarial bods” it already happens rather well. The clinician, when uploading the dictation, simply puts an entry in a “priority field”.
We must type it in 48 hours. Or else. It’s amazing how well, you know, basic clinical judgment and rapid tests at all key cancer centres, can enable the clinician to know when to put a mark in this field.
Plus the amount of followup on cancer patients (including frequent consultations with oncology pharmacists and specialist oncology nurses) alongside “standard” consultations is amazing – even to someone like me who worked in (different part of) health care for 25 years. Knowing how these algorithms work, now seeing “things at the coal face” I’m even less sold on them.
So foundry was used in the UK for the management of ventilators and PPE equipment which was an unmitigated disaster. It is claimed that it was used in the delivery UK Covid-19 vaccination programme through 2021. Most of the planning for COVID vaccinations was actually done by drug wholesalers and pharmacy’s yet something did change to the UK vaccination rollout in the UK during late 2021. During late 2021 the UK vaccination booking system started displaying available slots further away from your home location. Those slots shown to users of the booking system definitely did not reflect availability (based on pharmacy availability data). It might be a stretch but it seems possible that booking slot availability was changed to save government money by D
dissuade vaccinations and analytics were used to predict the effects of certain strategies.
From the Foundry Website it says : Foundry closed the feedback loop to empower users to perform data driven prioritisation and decisions on vaccine allocation, site selection, priority cohort uptake, and more with real-time information.
There is no way that analytical processes should significantly help reduce the backlog of 6 million NHS patients. The reported benefits are that the analytics can be used to prioritise the NHS backlog efficiently. The only way to reduce the backlog is to use analytics to create barriers to patients so that they eventually give up.
There are plenty of databases with excellent analytics and NHS data on the NHS backlog is not spread across different systems. What foundry appears to be is a system for decision modelling with monitoring and feedback. It does not look like it really holds data but has access to it and strictly speaking the modelling is not about individuals.
What we should be really afraid of is the Palantir Apollo software which seems to automate decision modelling and changes without any sort of ethical review. An administrator could set an objective of saving money without considering how many people will die as a result. In my view there may be a place for these systems but generally people abuse the systems especially with complex processes in such a way that the unexpected consequences out weigh any benefits. UK patients should expect their procedures to be scheduled at the other end of the country.
And the voters expected anything different to happen with a Tory government?