> The US technology company was awarded a £330 million contract in 2023 to collate operational data, including patient information and waiting lists.
That contract value is ridiculous - how many full time staff do they have on this project and what rates are they charging? How can some say ‘operational data collection’ is worth a third of a billion to NHS over the alternatives of using a third of a billion on patient healthcare and actual medical research? This needs an investigation around how this contract was ever approved.
nhs is famous dumb and has spent years trying to stop using fax machine. £330 million is nothing over a few years.. NHS budget for 2024/25 is circa £242 billion.
the entire annual intake from capital gains tax is £20 million or so
I think you mean £20 billion for that latter figure. This is largely because a significant amount of assets are held in ISA's (£20k a year contribution per person allowed) , or via personal property which is capital gains exempt or in a pension which is again, capital gains exempt.
Thus only the wealthiest are outside these boundaries, and they often will not liquidate holdings until their death to pay inhertiance tax, or in trusts which will liqudiate over decades as they can pay inheritance tax over a very long period.
This is not to mention the large amounts of off-shore holdings.
Many people opt for off-shore bonds (which have a number of advantages) which means paying normal tax instead of capital gains, so the capital gains figure doesn't really capture investment as a whole.
I checked, and you can of course donate to Led By Donkeys either as a one-off or monthly via their web page https://donate.ledbydonkeys.org/ but they don't have a way to contribute to specific campaigns.
This is why I disagree with the idea that we should keep increasing funding to the NHS. The argument always seems to come to a false dichotomy of "either this or the American system" as though other systems don't exist, and as though the NHS isn't top heavy with bureaucrats and questionable contracts
The truth is that the NHS is very bad not due to funding, but for structural reasons.
The fact I can't even see a GP I'm not registered with (not even an option to pay extra) is ridiculous. You have absolutely no control over your health at all.
With private, you get exactly what you want, whenever you want it.
You can absolutely see a GP you’re not registered with if you are travelling and need to. I have done it multiple times. I have been offered it same or next day after calling 111.
As someone who largely worked at startups and smaller companies before joining the NHS it genuinely confused me how no one would ever say no to anything when I first started working there.
The projects I worked on were genuinely absurd... My team alone spent millions on things that literally wouldn't have made any difference to the quality of healthcare in the UK.
Apparently we were given a budget and we had to find a way to spend it otherwise it would be cut. At any normal company we should have all immediately have been made redundant.
Isn’t this true for any project ever attempted? The only reason this project exists is because millions have already been wasted on trying to do this in house
I assume the purpose of Palantir is to enable the Federal government to circumvent the constitution by framing their new spy agency as a public/private partnership. From that lens the funding makes sense.
The purpose of Palantir is to watch over Mordor and the other lands of Sauron. He's only got one eye, one attention span, he needs intelligent agentic processing to administrate the realm. Who are you going to entrust, Gorthak The Orc? The Nazgul? They have their own priorities, their own limitations.
It was incredibly expensive to run East Berlin as a panopticon state, with a large fraction of the population on the payroll as informers to the 100,000 Stasi agents. Obvious conclusions were missed all the time because of the sheer difficulty of keeping track of facts cross-referenced on paper in filing cabinets in a large office building. This volume of classified siloed information is toxic for the occupation, operationally unusable. People were disappeared or even executed on mere suspicion because it would have been too difficult to rustle up proof.
Thiel looked at our prospects for effectively running an authoritarian surveillance state in Afghanistan and Iraq, looked at how many American contractors we would have had to devote to that, how many people we would have had to torture on a routine basis, how fast we might learn the language, and said "I think I can do better. A softer touch, a smarter system for controlling people. This is what AI is for, running society after this liberal democracy fiction falls away"
NB: The Palantir were created by the Elves, not by Morgoth or Sauron. The problem is that it takes a lot of will to use one and not have things of importance hidden (it shows what you think is important, not what is important), and as it turns out holders of one stone can influence what holders of other stones can see, if their will is greater. The Enemy doesn't get ahold of a stone until Minas Ithil falls and becomes Minas Morgul, and that's well into the Third Age. Two thousand years after the Last Alliance of Men and Elves, the second defeat of The Enemy, and the first destruction of Sauron. Which is still a thousand years before the start of Frodo's adventure. Lots of time in Middle Earth.
The rest of your comment is, unfortunately, spot on.
I find it weird that people would downvote this, I know you should not complain about it, but this comment is correct. The UK does have a (uncodified) constitution. Also of note; even countries with a codified constitution have parts that are uncodified.
>> There is absolutely a Constitution in the UK, it is simply not codified into a single document. <link>
That's got to be the understatement of (many) centuries. AFAIK the UK constitution isn't even even codified into millions of documents, let alone a "single" one. Saying it's not in a "single" document is like saying my trillions of dollars aren't in a "single" bank account. The number of partitions really isn't the problem with that statement here.
Is there a single human (or even computer program) that could even definitively list all the sentences in this "constitution", let alone an arbitrary citizen who needs to be able to become aware of them to be able to follow them? (Note I'm not asking for interpretation, but literally just listing the sentences.) Could they even do this with infinite time? Is it even possible to have an oracle that, given an arbitrary sentence, could indisputably tell you if it is in the constitution?
Maybe that's asking too much. Forget enumerating the laws. Per your own link: "...this enables the constitution to be easily changed as no provisions are formally entrenched."
If this doesn't itself sound silly, hopefully you can at least forgive people for getting irritated at the proposition that there totally exists a "constitution"... that nobody can point to... and that doesn't actually do the one thing many people want from a constitution: being more entrenched than statutes.
> Also of note; even countries with a codified constitution have parts that are uncodified.
Not sure what countries you're referring to, but at least in the US, this is not the case. There is a single document that is the constitution, and (thankfully, so far) nobody is disputing what words are in fact written on that document. And that document absolutely is supreme to statutes.
Interpretation of the words is obviously left to courts in the US, and courts can interpret it differently changing the effective law, but "constitution" is not a synonym for "effective law", and nobody argues over what the words to be interpreted are. And even those interpretations are still written down!
You are technically correct. But the distinction between devolution and a Federation of states gets very blurry when you take a look at what's happening with voting in the US these days.
You are technically incorrect about the UK not having a constitution. It's just not all compiled into a single written document.
Technically correct only if you accept "vague set of traditions" as a valid definition for "constitution". This both contradicts common usage and enables tyranny, so I recommend rejecting it.
Where can I find the official list of which acts are part of the constitution? And what additional obstacles exist to changing those acts beyond the obstacles to changing non-constitutional acts of parliament? In common usage, a constitution is something that restricts changes to ordinary law. If a "constitution" is made entirely from ordinary law it cannot function as a constitution.
A contrarian view although I do dislike contracting with foreign companies for roughly similar reasons: Palantir's technology looks good and I think it probably works. Most things don't work.
It seems a bad idea in the first place for a public organization to award a single company a huge contract for both the software licences and all the consultancy and implementation efforts.
I suppose the issue is that the NHS themselves have historically been terrible at managing their software. Nobody I know who I rate as even mediocre and above would or have worked at the NHS, and those I do know who have have, I wouldn't hire into junior roles.
I have no doubt that it's an extremely complicated mixture of 100s of systems, but anyone who has lived here knows how terrible it is. GP surgery's have for years had to send paper files across to new practices when a patient moves. The new NHS app is great, but I can see from my history that > 90% is missing.
Another great example of how good the NHS is at this, is the fact that nurses & doctors would have to scroll down a combo list without any typeahead to pick a medication, which would be in an A-Z list of every medication ever.
So, closing the circle, is there a reason to bring in a company that hires people at and above our level of competence, who have the expertise to implement a system to bring the NHS out of the dark ages of IT? Yes. There are many.
There will always be concerns about data, about security, but I'd much rather data be in the hands of a corporation that doesn't leak it than an unknown company getting billions in contracts, building software worse than someone with a $20 Claude extension, and then leaking it to hackers.
> I have no doubt that it's an extremely complicated mixture of 100s of systems, but anyone who has lived here knows how terrible it is.
Yep, as someone who's worked at a couple of small startups trying to sell into the NHS, it's terrible. A big part of the problem seems to be that there's no centralised procurement: each trust (of which there are ~200) does their own precurement. And a lot of the companies (the big established players are the worst) at most pay lip service interoperability. So you end with a big mess of system that don't talk to each other.
And they're not setup to pay "market rates" that are competitive with private employers to their in-house developers. So it's hard for them to attract and retain good in-house developers where they have them (although there are still some great people working there).
Internal restrictions are such that even aspiring software Devs find hurdles to doing basic automation. I know someone who wanted to use python, yes just use it, and it took months to be allowed to do that on an NHS machine.
Is there any proof that Palantir has ever leaked client data? From a security perspective they are one of the few companies that hold IL6, which means they can handle highly classified/top secret information.
They work with many international governments and companies, and I would imagine any sort of unapproved leak would be disastrous for their brand.
> It seems a bad idea in the first place for a public organization to award a single company a huge contract for both the software licences and all the consultancy and implementation efforts.
I'm not 100% convinced that the consultancy/implementation being the same as the software vendor is a bad thing.
Depending on the contract it can give you better exit clauses, implementation costs can be subsidised by SaaS revenue, you might have novel clauses for PS overspends, you get rid of the 'implementation vendor blames software vendor' thing, if you need modifications/enhancements to the base product then it sits with the same person, plus we don't know if Palantir's system is easily made for an independent implementation consultant to pick it up and be able to do everything without having to do some backend magic.
For those wondering, FDP stands for Federated Data Platform
> Our mission for the NHS Federated Data Platform is to provide a secure, flexible system that connects data across NHS organisations to improve patient care, streamline services, and support informed decision-making.[1]
Or, the non politicized take is that they think the software could improve the data landscape of the NHS, which, if we are bring honest, has a lot of room for improvement.
I am an American so the plight of the NHS has no direct impact on me, but I'd argue that Palantir is a fundamentally political company and thus there is no room for non-politicized takes.
There have been recent articles in the FT about a man (who surname, funnily enough, sounds like swindle) who was an advisor to Palantir while also being chair of 4 NHS Trusts and pushing the trusts to put more of their data into Palantir.
I think you would need a lot more context to say if 0.019% is too high. If this platform is driving real operational improvements and is the core software backbone, then it doesn't seem particularly unreasonable.
Palantir is under immense economic pressure to deliver this integration at high quality on time. This incentive structure, combined the publicly traded nature of the company, risks corrupting its core founding goals of embodying the evil of Sauron on earth and hurting as many people as it can, as badly as possible. However, Thiel is an extremely competent, mission focussed leader and I agree with the doctors: he will get this program back on track mission-wise without pissing off shareholders too much.
The reality is that no program so far has really been successful within the NHS. Money is burnt at an alarming rate and the companies taking on these contracts are incompetent at best.
If staff don't want to work with it then they're not fulfilling their roles.
What if any of us took a job and then refused to work with Microsoft or [Insert company] due to personal reasons? We'd be jobless.
People arent robots, they are allowed their own thoughts and free will. Your comment implies any behavior against the interests of a corporation is somehow a sin. This is such a gross take.
That contract value is ridiculous - how many full time staff do they have on this project and what rates are they charging? How can some say ‘operational data collection’ is worth a third of a billion to NHS over the alternatives of using a third of a billion on patient healthcare and actual medical research? This needs an investigation around how this contract was ever approved.
https://www.england.nhs.uk/wp-content/uploads/2020/02/removi...
nhs is famous dumb and has spent years trying to stop using fax machine. £330 million is nothing over a few years.. NHS budget for 2024/25 is circa £242 billion.
the entire annual intake from capital gains tax is £20 million or so
Thus only the wealthiest are outside these boundaries, and they often will not liquidate holdings until their death to pay inhertiance tax, or in trusts which will liqudiate over decades as they can pay inheritance tax over a very long period.
This is not to mention the large amounts of off-shore holdings.
(source: a UK voter)
I checked, and you can of course donate to Led By Donkeys either as a one-off or monthly via their web page https://donate.ledbydonkeys.org/ but they don't have a way to contribute to specific campaigns.
Thanks for mentioning them though.
The fact I can't even see a GP I'm not registered with (not even an option to pay extra) is ridiculous. You have absolutely no control over your health at all.
With private, you get exactly what you want, whenever you want it.
The projects I worked on were genuinely absurd... My team alone spent millions on things that literally wouldn't have made any difference to the quality of healthcare in the UK.
Apparently we were given a budget and we had to find a way to spend it otherwise it would be cut. At any normal company we should have all immediately have been made redundant.
https://www.contractsfinder.service.gov.uk/Notice/0f8a65b5-2...
AND they're putting private information at risk by working with Panantir
this isn't a "delivery" product, it should be an institutional pillar of the system
It was incredibly expensive to run East Berlin as a panopticon state, with a large fraction of the population on the payroll as informers to the 100,000 Stasi agents. Obvious conclusions were missed all the time because of the sheer difficulty of keeping track of facts cross-referenced on paper in filing cabinets in a large office building. This volume of classified siloed information is toxic for the occupation, operationally unusable. People were disappeared or even executed on mere suspicion because it would have been too difficult to rustle up proof.
Thiel looked at our prospects for effectively running an authoritarian surveillance state in Afghanistan and Iraq, looked at how many American contractors we would have had to devote to that, how many people we would have had to torture on a routine basis, how fast we might learn the language, and said "I think I can do better. A softer touch, a smarter system for controlling people. This is what AI is for, running society after this liberal democracy fiction falls away"
The rest of your comment is, unfortunately, spot on.
https://en.wikipedia.org/wiki/Constitution_of_the_United_Kin...
More importantly, the UK is a Constitutional Monarchy, with ultimate legislative power vested in Parliament rather than the Monarch.
It doesn't look like a duck, it doesn't quack like a duck, yet you insist that this goose-shaped creature is a duck.
That's got to be the understatement of (many) centuries. AFAIK the UK constitution isn't even even codified into millions of documents, let alone a "single" one. Saying it's not in a "single" document is like saying my trillions of dollars aren't in a "single" bank account. The number of partitions really isn't the problem with that statement here.
Is there a single human (or even computer program) that could even definitively list all the sentences in this "constitution", let alone an arbitrary citizen who needs to be able to become aware of them to be able to follow them? (Note I'm not asking for interpretation, but literally just listing the sentences.) Could they even do this with infinite time? Is it even possible to have an oracle that, given an arbitrary sentence, could indisputably tell you if it is in the constitution?
Maybe that's asking too much. Forget enumerating the laws. Per your own link: "...this enables the constitution to be easily changed as no provisions are formally entrenched."
If this doesn't itself sound silly, hopefully you can at least forgive people for getting irritated at the proposition that there totally exists a "constitution"... that nobody can point to... and that doesn't actually do the one thing many people want from a constitution: being more entrenched than statutes.
> Also of note; even countries with a codified constitution have parts that are uncodified.
Not sure what countries you're referring to, but at least in the US, this is not the case. There is a single document that is the constitution, and (thankfully, so far) nobody is disputing what words are in fact written on that document. And that document absolutely is supreme to statutes.
Interpretation of the words is obviously left to courts in the US, and courts can interpret it differently changing the effective law, but "constitution" is not a synonym for "effective law", and nobody argues over what the words to be interpreted are. And even those interpretations are still written down!
No, it's a living thing. Why is this your sticking point on the existence of a constitution or not?
You are technically incorrect about the UK not having a constitution. It's just not all compiled into a single written document.
I have no doubt that it's an extremely complicated mixture of 100s of systems, but anyone who has lived here knows how terrible it is. GP surgery's have for years had to send paper files across to new practices when a patient moves. The new NHS app is great, but I can see from my history that > 90% is missing.
Another great example of how good the NHS is at this, is the fact that nurses & doctors would have to scroll down a combo list without any typeahead to pick a medication, which would be in an A-Z list of every medication ever.
So, closing the circle, is there a reason to bring in a company that hires people at and above our level of competence, who have the expertise to implement a system to bring the NHS out of the dark ages of IT? Yes. There are many.
There will always be concerns about data, about security, but I'd much rather data be in the hands of a corporation that doesn't leak it than an unknown company getting billions in contracts, building software worse than someone with a $20 Claude extension, and then leaking it to hackers.
Just my 2p
Yep, as someone who's worked at a couple of small startups trying to sell into the NHS, it's terrible. A big part of the problem seems to be that there's no centralised procurement: each trust (of which there are ~200) does their own precurement. And a lot of the companies (the big established players are the worst) at most pay lip service interoperability. So you end with a big mess of system that don't talk to each other.
And they're not setup to pay "market rates" that are competitive with private employers to their in-house developers. So it's hard for them to attract and retain good in-house developers where they have them (although there are still some great people working there).
Is there no one in the UK with any competence?
> who have the expertise to implement a system to bring the NHS out of the dark ages of IT?
Why on earth do you think that's Palantir?
> but I'd much rather data be in the hands of a corporation that doesn't leak it
Until the US government wants it, at least.
But it looks like lobbying by US corporations has resulted in the NHS quietly deleting it's open source policy https://www.digitalhealth.net/2025/12/nhs-england-quietly-re...
So would I and I think Palantir will leak it.
They work with many international governments and companies, and I would imagine any sort of unapproved leak would be disastrous for their brand.
I'm not 100% convinced that the consultancy/implementation being the same as the software vendor is a bad thing.
Depending on the contract it can give you better exit clauses, implementation costs can be subsidised by SaaS revenue, you might have novel clauses for PS overspends, you get rid of the 'implementation vendor blames software vendor' thing, if you need modifications/enhancements to the base product then it sits with the same person, plus we don't know if Palantir's system is easily made for an independent implementation consultant to pick it up and be able to do everything without having to do some backend magic.
> Our mission for the NHS Federated Data Platform is to provide a secure, flexible system that connects data across NHS organisations to improve patient care, streamline services, and support informed decision-making.[1]
[1] : https://www.england.nhs.uk/digitaltechnology/nhs-federated-d...
"We send the EU 350 million pounds a week. Why not send it to Palantir instead?"
(Not that the comparison would make much more sense if it were, apples and doorframes.)
Either they are completely ignorant about what palantir is and who it's owned by (would be very concerning) or they are corrupt and were bribed.
no british person would down vote this - at least not one with any integrity
Definitely not a conflict of interest...
The total contract value was £182,242,760 over 5 years.
For context that's Roughly 0.0002% per year of NHS budget.
https://www.contractsfinder.service.gov.uk/notice/2e8c61c0-f...
Even if I assume that you meant 0.02%, which is equal to 0.0002, that would put their budget at £1.8e12, which I am also strongly inclined to doubt.
100 × ((182/5)/196000) = 0.019%
Which, to me, still seems too high a number for a data management function: I make it about 1000 persons-worth of per-capita GDP.
[1] https://www.england.nhs.uk/long-read/financial-performance-u...
(</s>? Maybe? hard to say tbh)
If staff don't want to work with it then they're not fulfilling their roles.
What if any of us took a job and then refused to work with Microsoft or [Insert company] due to personal reasons? We'd be jobless.
Modern HR culture is working hard to address this terrible failing. </s>
Could you be a bit more specific? No IT initiative at all? No attempt to create a national data spine?