On 28 February, Keir Starmer had a great success with Donald Trump in the Oval Office. After listening to a variety of people with close knowledge of Maga and the presidency, he struck the right notes in reassuring Trump on defence spending and closer British-American technical cooperation.
Where did he go next? Not to high-five his staff or indulge in a celebratory beer, but to an ugly, liver-coloured brick building at 1025 Thomas Jefferson Street NW. It houses the Washington HQ of the data analytics company Palantir Technologies, where he was hosted by Alex Karp, the firm’s CEO and co-founder. He saw military kit and enthused about how Britain wouldn’t over-regulate AI, instead seizing its opportunities in pursuit of “a new economic deal” with advanced technology at its core.
By his side was an ebullient Peter Mandelson, Starmer’s freshly appointed ambassador in Trump’s Washington. As co-founder of Global Counsel, the strategic advisory company which specialises in helping its clients around regulatory and political problems, Mandelson had long been a vocal supporter of Palantir in London.
And why not? He is no longer employed by the consultancy, and Palantir is exactly the kind of company to appeal to Donald Trump. Its other founder, Peter Thiel, the billionaire conservative libertarian and co-founder of PayPal, has been a big supporter of Republican politicians, including JD Vance. Thiel has also been a pungent critic of democracy – in 2009, he wrote in an essay that he no longer believed “freedom and democracy are compatible” – and of the NHS.
Palantir has attracted left-wing flak for its involvement in the US military and intelligence, and its support for Israel. But if Britain is waiting for a liberal, Guardian-reading cutting-edge tech company to help modernise the state, we may be waiting for a while.
At any rate, around a quarter of Palantir’s global workforce are now based in London, helping the government on policing, military contracts – and, crucially, working deep inside the NHS. There are revolving doors, too. Matthew Swindells, who was deputy chief executive of the NHS in England and, from 2005 to 2006, senior policy adviser to the Labour health secretary Patricia Hewitt, is now at Global Counsel; Indra Joshi, director of AI at NHSX, and Harjeet Dhaliwal, deputy director of data services at NHS England, have both joined Palantir.
Peter Thiel himself has been an outspoken critic of the British health system. He pithily encapsulated his social philosophy in November 2023: “Highways create traffic jams, welfare creates poverty, schools make people dumb and the NHS makes people sick.” It’s hard to think of two people more intellectually opposed than Thiel and the NHS founder, Nye Bevan.
Even so, during the pandemic, Palantir, founded in 2003 and at the leading edge of data management, struck a deal with the British government. It would create a system to make it far easier to gather essential information across the NHS, and ultimately help create the efficiencies Wes Streeting, the Health Secretary, now desperately needs.
The raw information is incredibly valuable. Covering every social grouping, age, condition and ethnicity, Britain’s long-accumulated NHS data are a unique resource which could be used around the world to develop new medicines, target individual groups with better treatment and streamline healthcare systems. Accessing this information has been compared to a North Sea oil and gas bonanza for the digital age. This is a rare bit of contemporary British good fortune. The United States, for instance, with its silos of university and private hospitals, many of them excellent, has nothing like it.
The problem is that, while in theory the “NHS” exists as a single data source, in practice it’s a giant hodgepodge of trusts with different and often incompatible software. So if, for instance, you wanted to investigate hospital records in varied parts of the country to discover how long a certain procedure normally takes – and therefore plan operating-theatre times better – it would be virtually impossible to integrate the data.
So Palantir created the Federated Data Platform, or FDP, which, in the words of one of its executives, “by pulling data, allows NHS trusts to use their own data to make better decisions and create greater efficiency.” Bringing all the data together on one platform, so you can use it better, makes sense.
Palantir isn’t the only one that has spotted possibilities. Matt Freer, a consultant anaesthetist working in the NHS in Scotland, set up Infix Support during Covid and used its software to grind away inefficiencies in operating theatres caused by poor planning. Using data from five years’ worth of Scottish operations, he has increased theatre efficiency by more than 25 per cent, which he says is equivalent to an extra 10,000 hip operations a year. This is the kind of thing Streeting needs to happen everywhere, driven by clinicians and front-line staff.
Meanwhile, Palantir was given a seven-year, £330m contract with NHS England to gather the data from up to 240 NHS trusts and integrated care systems and put it all on its platform. There has been some pushback – but with around 100 trusts now signed up to the project, NHS England has been using the consultancy firm KPMG to persuade the rest to follow suit.
Its critics fear that Palantir will anonymise the priceless data hoard it oversees and sell it on, making a fortune: in the words of one, “It’s as if we have handed them the keys to North Sea oil – and paid them for it.”
Louis Mosley, Palantir’s UK and European vice-president, assures me this just isn’t so. Under the terms of the contract, he says, it would be illegal. Palantir is only “a data processor with no agency or ownership over the data, which belongs to the NHS. It’s the same relationship you have,” he says, “with Microsoft Word, writing your article. They don’t own what you write.”
But what about the monopolistic nature of its contract with the NHS? Mosley says, fairly, that Palantir is offering unique technology; it makes no more sense for the NHS to build its own capabilities than it would be for the NHS to build its own MRI scanners. Eventually, as in all market transactions, competitors will appear.
This sounds convincing. But for British rivals wanting to bring efficiencies across the NHS, Palantir is a chillingly huge machine. They would fear all the health service’s IT resources and trust financing would have been mobilised to get the Palantir system running, and that others would find it increasingly difficult to get a look in.
Vaishnavi Behl of the London School of Economics argues that “by integrating its proprietary ‘Foundry’ software into the NHS core systems, Palantir is poised to gain unprecedented influence over the UK’s healthcare infrastructure”.
And there is a fundamental question about how big tech contracts ought to be handled. One data platform expert says: “The single fundamental problem with the Palantir contract is that the government is outsourcing all of the work to one company in one go… and what you get is vendor lock-in. The state doesn’t understand the work, they can’t see the work… You develop no knowledge, no understanding of it. It’s not just about data – it’s about the skills and the understanding which is now inside Palantir.”
NHS England, is, of course, dead – or soon will be, as Wes Streeting made clear in his recently announced reforms. This implies that the Palantir contract may now have to be redrawn with the Department of Health. If so, there is an opportunity here. When NHS England published the original contract, an astonishing 416 of its 586 pages were redacted – the kind of wholesale, thick marker-pen blacking out you’d usually only find in a sensitive military contract. Thanks to the Good Law Project, that was successfully challenged last March, though the victory was only partial.
This is not something that can be left hanging. Digital companies have been harvesting data – including copyrighted material, to the of the horror of the creative industries – to build AI systems in increasingly controversial ways. Is shipping Britain’s entire medical data to a US company whose founder doesn’t believe in the NHS – a company so close to the American military, at such a politically turbulent time, with so little public discussion – entirely shrewd?
This is a bigger story than one about Palantir. The politics of our age is now in part about relations between governments and the technology giants. We need them. In this case, the NHS desperately needs access to its own data, and computer systems that are entirely compatible.
And yes, of course it can’t build its own data systems. If anyone’s to blame for this contract, it isn’t Palantir, which is only doing what it does. The problem is what Dominic Cummings calls the blob – the British state bureaucracy, which has failed to outsource crucial work in a carefully balanced way, and which lacks the professional skills in data to look ahead or fully comprehend what’s going on.
The AI and tech giants – increasingly allied to the Trump White House, with its brimming mix of genial menace – come with political baggage. They arrive with investment and heft at a scale that can crush British competition. And they have often emerged from an anti-social-democratic, even anti-democratic, ideological world-view.
Because of all of this, we need assurances – that the NHS contract will now be made fully public; that it will rigorously affirm the ownership of our data, including over subsidiary products; and that the use of data to improve efficiency by British companies will be explicitly encouraged. Alongside this, the Government Digital Service, launched by the Tories in 2010, needs to be revived and enhanced, so that we have a minimum of nous in these areas. This has not been, I hope, a conspiratorial or paranoid account. But such safeguards would be a bare minimum.
[See also: Bridget Phillipson’s education bill is pleasing no one]
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This article appears in the 19 Mar 2025 issue of the New Statesman, The Golden Age