Palantir’s McArdle states that Thiel made these comments in a personal capacity. McArdle adds that their CEO has expressed disagreement with these comments and expressed a desire for a healthcare system in the US that serves the underprivileged and underserved, similar to how they perceive the British system does.
There is much speculation in the UK regarding the specific nature of the data that Palantir would manage and how it would be utilized.
Zhang suggests the existence of three sets of “de-identified” data, meaning data with patient names and other identifying information removed, which might be considered for inclusion in the system.
The first type of data is primary care data, which can be easily extracted from your general practitioner’s computer system. The second type is hospital data used for payments, which is essentially an Excel spreadsheet containing information about every patient who has received care and the treatment they received. The third type of data is the most difficult to access, as it is stored within individual hospitals’ systems. This type of data includes detailed day-by-day information such as doctors’ notes and clinic letters, but it has traditionally been challenging to obtain due to being locked behind proprietary software. Zhang explains that the NHS has around 20 to 30 different hospital systems, each functioning as a separate company.
The NHS emphasizes that regardless of the company constructing the system, it will be the NHS that determines the utilization of data flowing through it. The NHS does not assume trust without reason, hence the chosen supplier of the federated data platform will solely operate under the guidance of the NHS. They will not have control over the data in the platform, nor will they be allowed to access, use, or distribute it for their own interests. The NHS has also implemented specific measures to prevent any supplier from acquiring a dominant position in managing NHS data.
However, this message has not alleviated concerns among the public that this information may be monetized in the future.
David Wrigley, deputy chair of the GP committee in England for the British Medical Association, expresses apprehension about the participation of profit-driven external companies in healthcare. He emphasizes the preference for the NHS to independently develop this system. Wrigley believes that healthcare should be financed through taxation without any involvement of profit motives, including the handling of patient records and data usage.
Palantir refutes the accusations of being untrustworthy in handling NHS data and exploiting it for financial gain. McArdle clarifies that these claims fail to grasp the true purpose of their software. Unlike other tech companies, Palantir’s focus is not on gathering, analyzing, or trading data. Instead, they offer tools to assist customers in comprehending and managing their own information, providing training and support for utilizing these tools.
However, the opposition to Palantir potentially winning the contract is not solely based on the details of the agreement, but rather on the existence of a contract in the first place. Numerous critics contend that the NHS should be cultivating its own teams to perform this kind of work. Wrigley asserts that there is currently a scarcity of digital experts within the NHS due to government funding reductions, which has created a self-perpetuating cycle.
If Palantir wins the contract, there are concerns among researchers that NHS patients may refuse to share their data with any part of the NHS as a form of protest. In a previous attempt by the NHS to implement data-sharing for research purposes, over 1 million individuals chose to opt out within a month. Barbara Prainsack, a professor at the University of Vienna who focuses on the social, ethical, and regulatory aspects of medical data, states that the consequences of this situation will greatly harm people’s trust. Studies have shown that the public is willing to share data with commercial organizations as long as there is honesty, transparency, and a clear public benefit in the relationship. The lack of public discussion surrounding this contract creates an impression of secrecy and suggests that there may be something being concealed.
Marianne still has concerns about involving Palantir, a company unfamiliar to her, in resolving the NHS’s data issue. She believes it would be more reassuring if the NHS handled it alone rather than involving a private company. However, she acknowledges that it is likely too late to change the situation.
