The company that aspires to be inside “every missile,… every drone,” including, it seems, those belonging to the Israeli Defence Forces, is now running the patient data platform of the world’s second largest public health care system. 

The Rishi Sunak government this week finally announced its decision, presumably made long ago, to hand the management of all NHS England patient records to Palantir, a tech company whose client list includes the US military, intelligence agencies and ICE, as well as the armed forces of the UK, Israel and other western countries. The five-year contract between NHS England — the non-departmental government body that runs the National Health Service in England — and Palantir is worth £360 million ($450 million), but that figure could rise as high as £480 million ($600 million) if, as expected, it is extended by two further years.

That’s a lot of money for a company that, like so many other Silicon Valley giants, is yet to post a single annual profit in its 20 years of operations. More valuable still is the NHS’ patient data system, which is the largest repository of health data in the world. As WIRED UK magazine reported in 2019, before Palantir had even signed its first contract with the NHS, Amazon, Google and the rest of Silicon Valley all wanted to get their hands on the data trove. Unsurprisingly, patients were less keen on the idea:

Careful use of health data could save lives, cut costs of delivering health care and even become a nice little earner for the NHS – indeed, an EY analysis that’s frequently touted by the government suggests opening up the vaults could earn the underfunded public health organisation as much as £9.6 billion annually. But the tradeoffs could be our privacy, letting big tech further monetise medicine, and locking hospitals and clinics into expensive tech systems that will cost us more in the long run.

“Ripping the Whole [of the NHS] from the Ground”

The £360 million deal grants Palantir and its four partners, Accenture, PwC, NECS and Carnall Farrar, responsibility for overhauling and managing that system. The government’s decision to pick Palantir may not have come as a surprise to close observers — more than a year ago we reported that NHS England had quietly instructed NHS Digital to gather patient data from NHS hospitals and extract it to its data platform, which is based on Palantir’s Foundry enterprise data management platform — but that doesn’t make it any less controversial.

This is a company whose co-founder and current chairman of the board, Peter Thiel, recently described the British public’s affection for the NHS as “Stockholm Syndrome.” Speaking in an Oxford Union debate, he said the country “could rip the whole thing from the ground and start over” (as opposed to the slow death that successive UK governments have been subjecting it to), and that British people needed to stop thinking of the NHS as “the most wonderful thing in the world.”

This comes from a man who makes much of his money from the national security state, pens homages to Carl Schmitt and Leo Strauss, and is a member of the Bilderberg Club’s steering committee. Palantir, the company he co-founded and whose board he still chairs, is one of the darkest companies in the tech sphere, which is saying a lot. From my previous post, NHS to Use US “Spy-Tech” Firm Palantir’s Platform to Extract Patient Data Without Patient Consent:

Named after the “seeing stones” used in The Lord of the Rings, Palantir was set up in 2003 with seed money from the CIA’s venture capital arm, In-Q-Tel (IQT). It is one of the darkest companies in the tech sphere. While it is making significant inroads in the corporate world, its main line of business 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.

When, in 2018, thousands of Google employees refused to participate in Project Maven, a secret Pentagon-funded AI pilot program aimed at the unmanned operation of aerial vehicles, the project was taken up by Palantir. Critics warn that the technology could pave the way to autonomous weapons that decide who to target without human input. In February 2021, Palantir’s chief operating officer boasted to investors that Palantir was driving towards being “inside of every missile, inside of every drone.”

Right now, the company is providing technical and moral support to Israel’s genocidal onslaught on Gaza, reports Middle East Eye:

In a social media post on 12 October, it said: “Certain kinds of evil can only be fought with force. Palantir stands with Israel.”

In a letter to shareholders issued on 2 November, the company said: “We are one of a few companies in the world to stand up and announce our support for Israel, which remains steadfast.”

Announcing the company’s third-quarter profits on the same day, Alex Karp, Palantir’s chief executive and a co-founder of the company, said: “I am proud that we are supporting Israel in every way we can”…

Speaking to Fox Business earlier this month, Joe Lonsdale, another of Palantir’s co-founders, said Israel was “doing what it has to do and eliminating the bad guys” and “we are trying to keep the good guys armed and ahead”.

Lonsdale said: “When we were building Palantir we actually learnt a lot from the Israelis. They’re quite good at what they do and one of my proudest moments was when Israel started working with Palantir. So Palantir helps Israel do a lot of things too.”

Middle East Eye asked Palantir what technology or support it was providing to Israel’s armed forces but had not received a response at the time of publication.

Patients’ Fears

Besides helping the “good guys” in Israel eliminate the “bad guys” in Gaza, Palantir will soon be using its Foundry operating system to help address the NHS’s existential crisis, or at least so we are lead to believe. That crisis includes a waiting list for elective treatment that has almost tripled over the past decade, to 7.7 million. According to NHS England’s National Director for Transformation Dr Vin Diwakar, the platform will help “tackle waiting times, join up patient care and make the health service sustainable for the future”.

But it will also result in yet more private sector involvement in essential NHS processes — something successive British government have been encouraging since the 1990s. One of the people who began this long process of piecemeal privatisation is former Prime Minister Tony Blair, who in 2003 told a meeting of private healthcare executives that he wanted to open the whole of the NHS to outside competition. In July this year, he urged the government to further expand the role of the private sector in the NHS while encouraging patients to take up private healthcare offers.

The companies involved in this latest deal, particularly Palantir, Accenture, the disgraced accountancy firm formerly known as Arthur Andersen that is closely involved in the World Economic Forum’s Digital Transformation Initiative, and the scandal-tarnished big four auditor PwC, hardly inspire trust and confidence. Many NHS patients and staff members have serious reservations. A case in point: Dr Latifa Patel, chair of the British Medical Association (BMA), who wrote the following on BMA’s :

The decision to award Palantir, a large US-based multinational, the contract for the Federated Data Platform – software which is designed to bring together existing NHS patient data systems – is deeply worrying. Having made our concerns plain for several months on this, and having written to the secretary of state of health and social care and urged for a rethink, our fears about how patient information may be used and handled going forward have not diminished.

“This contract is valued at an eye-watering amount – money which is desperately needed for direct care to help patients right now, and other health and social care services which remain in such crisis, not to mention the ongoing workforce shortages. Going forward, we cannot and must not allow patient data to be exploited. We need to know just how confidential patient data will be used within this data platform and the extent of the role that Palantir, which has commercial interest in this decision, will play.

Patients are no less sceptical. NHS England argues that working with Palantir should not cause patients concern because the information it will share is “pseudonymous” or stripped of identifying details. However, as the patients’ group Patients 4 NHS noted in an August communique, “it’s not hard to piece together anonymised health records in a way that can lead to patients being identified.”

In June, a poll from YouGov found that almost half of adults (48%) in England who have not yet opted out of the data platform are likely to do so, should the platform be introduced and run by a private company. According to a report published by Doctors’ Association UK, “if anything like that number actually choose to exercise their National Data Opt–Out, it will have a catastrophic impact on the quality of NHS data, an extremely precious British health resource.”

In light of the following exchange between Palantir CEO Alex Karp and BBC journalist Victoria Derbyshire, you can hardly blame the patients for wanting to opt out:

Alex Karp: Almost every other private  company in the world besides my company will take that data and transfer it to somebody else. And so if you’re in England you assume that when a private company touches your data, they’re going to use it for their purposes.

Victoria Derbyshire: Yes.

AK: Palantir doesn’t do that…

VD: But you might in the future.

AK: We’ve never done it in 20 years…

VD: Sure but you may in the future…

AK: Well, first of all we wouldn’t even be able to… The way our product is set up, I don’t even have access to the data. Our product does not allow us to do that…

VD: What I’m putting to you is that if you’ve got all that data, as Doctors’ Association UK says, an extremely precious British resource in one place, that opens the door in the future to it being sold. Correct?

AK: By the UK Government, not by me…

VD: You can see why people are concerned, then?

AK: Absolutely.

The current and previous UK Governments have already shown they cannot be trusted with NHS patients’ data. In the summer of 2021, executives at NHS England came up with an ingenious plan to digitally scrape the general practice data of up to 55 million patients and share it with any private third parties willing to pay for it. NHS England allowed patients to opt out of the scheme; they just didn’t bother telling them about it until three weeks before the deadline, presumably because if they had, millions of patients would have opted out.

When the FT broke the story, a scandal erupted, especially when it was revealed that the Government had already shared UK hospital data and medical records with over 40 pharmaceutical, consultancy and data companies worldwide, including McKinsey & Company, KPMG, Novavax, AstraZeneca, Experian and companies co-founded by the Sackler family. NHS England officials responded by shelving the scheme, saying they needed to focus on reaching out to patients and reassuring them their data is safe.

That, of course, hasn’t happened. Instead, they waited for the scandal to die down before embarking on an even more egregious scheme — namely, this one! And this time round, patients will not have the option of opting out. After initially stating that participation would be voluntary in an FAQ in August, NHS England explicitly ruled out the possibility of opting out when the document was updated in October. “Patients can only opt out of sharing their data for research and planning, not for direct patient care,” it says. Open Democracy:

NHS England has rejected data privacy campaigners’ calls to allow patients to opt out of having their health data shared on the so-called Federated Data Platform. It claims this is not necessary because patients’ data will be anonymised and the platform will be used for “direct care” only.

Conservative MP David Davis said “that is not good enough” and that the decision to award Palantir the contract “will prove a mistake”.

“It is virtually impossible to anonymise health data simply because of the density of the data in our health records and it being all too easy for that data to be re-identified,” he added.

COVID-19 Pandemic: Perfect Entry Point

After making its bones in the military, intelligence and surveillance industry complexes, Palantir began looking to diversify its activities across a wide range of corporate sectors, particularly  health and life sciences. The COVID-19 pandemic offered the perfect entry point while the NHS, boasting one of the richest centralised repositories of patient data on the planet, offered the perfect prize.

In March 2020, the UK Government signed a deal with an assortment of private tech firms, including Palantir, to help run the NHS’s massive COVID-19 “data store,” which is now being upgraded into the federated data platform. The company charged a mere £1 for its services, which was enough to get its foot in the door. What was supposed to be a short-term arrangement blossomed into a two year contract with the Department of Health and Social Care, worth up to £23 million, to help run the NHS’ database.

To achieve its goals, the company has deployed lobbying tactics honed in the US, as the New York Times reported last month:

It has enlisted political figures, senior health executives and multiple consulting firms, according to interviews with N.H.S. officials, industry insiders and people involved in Palantir’s operations. Last year, after requests for proposals were sought for the £480 million contract, Palantir poached N.H.S. England’s deputy director of data services and its artificial intelligence director…

“Palantir’s extensive lobbying efforts in the U.K. are an obvious attempt to whitewash their background at the heart of the world of espionage — with all its implications for ethical behavior and lack of transparency,” [Conservative MP David David] said in a statement.

The revolving doors have been swinging hard and fast since the pandemic began. In 2021, a number of former Palantir officials went on to work for the government. One of them, Mike Spiers, joined the Department of Health and Social Care in December 2020, six months after leaving Palantir, and would go on to become the Chief of Staff, Deputy Director, to the COO of Covid Testing. In February this year, the Mirror reported that Isaac Levido, a lobbyist brought into Sunak’s inner circle to help devise his election strategy, was also lobbying on behalf of Palantir.

Palantir’s takeover of NHS data services has met strong resistance from certain quarters, which is expected to continue in the nation’s courts. Dozens of civil society groups have kicked up a storm about the prospect of so much highly sensitive personal data being handled by one US company, especially one so deeply embedded in the rapidly emerging mass surveillance industry.

“Is Palantir really the kind of company we want at the very heart of the National Health Service?” asks Cori Crider, director of Foxglove, a campaign group dedicated to challenging the excesses of tech giants. “This is a company who, at the start of the pandemic, had no track record of working with healthcare staff. They’re not a healthcare company. They weren’t a health data company. They were essentially a tech company who supported spies, police, the military and border forces.”

In September 2021, the UK’s Department for Health and Social Care was forced to terminate a contract with Palantir over the management of social care data, following a huge protest campaign involving more than 50 pressure groups led by Foxglove. The move 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 was clearly not the case.

This entry was posted in Guest Post on by Nick Corbishley.