Doctors, Not Dashboards: a £360m Palantir platform won’t solve the ‘greatest workforce crisis in NHS history’
For many of us, the NHS is one of the greatest ideas in British history: health care for all, regardless of the ability to pay. But the NHS is in crisis.
This winter, the NHS faces its biggest test in a generation – Covid and flu rates are spiking, and there aren’t enough doctors and nurses to keep up.
The NHS is currently running a staggering 110,000 vacancies. Government has failed to recruit and hold on to essential medical staff.
So when new Health Secretary Thérèse Coffey announced a target – with no obvious plan for achieving it – that no-one should wait more than two weeks to see a doctor, medics and nurses across the land snorted aloud.
It is “tinkering around the edges”, they said, with a “complete and glaring absence of a workforce plan” that would have “minimal impact”. Even former Health Secretary Jeremy Hunt piled in: “GPs alone have 72 targets. Adding a 73rd won’t help them or their patients because it’s not more targets the NHS needs, it’s more doctors.”
And the vultures are gathering. In the British newspaper of record, columnists now say openly that it’s time to scrap universal health care for all that is free at the point of access.
So, what is the government trying to do? Hire thousands of doctors, nurses and social care staff? Fix issues with retention so we keep the ones we have? Train and keep data science talent, so the NHS is fit for the future?
Nope. They’re going to buy a giant data dashboard from Palantir.
The Federated Data Platform – NHS Data Grab 2?
Earlier this year, the government announced plans for a new £360m “Federated Data Platform”. There’s little information about how this platform will work. But it appears to be an attempt to do many of the things that last year’s NHS Data Grab would have done – centralise control over the nation’s health records.
The architecture is different, but the political idea is the same: that overworked staff need “the long screwdriver from Whitehall” to make them more efficient.
The NHS Data Grab was put on indefinite pause after over a million people opted out of the scheme.
Yet the government seems to be forging ahead with this new £360m dashboard, despite recently announcing a second delay to opening the deal for bids.
Some doctors fear this will jeopardise the patient relationship. Sure, some aspects of care can be centrally managed – most of us don’t mind getting a text to go get that Covid vaccine. If more efficient systems will take work off doctors’ and nurses’ plates, that’s got to be a good thing.
But what about when a faceless bureaucrat starts cajoling you about your weight? Or a teenager trying to get hold of contraceptives? Some things we just want to talk about with a doctor – face to face, in private. At the moment, the government says it needs to access your health data centrally for ‘direct care’. What they haven’t said is which parts of your health care they think should be run by central government.
And once the centre can read our health records under the umbrella of ‘care’, without safeguards, we’re on the slippery slope to access by private researchers and pharma firms for profit.
The FDP’s aims seem poorly thought out, communicated even less well, and ill-suited to meet the moment: a workforce crisis of epic proportions.
And who’s the favourite to win the as-yet-unpublished contract? Peter Thiel’s Palantir.
As we’ve said before: a firm whose entire history is supporting governments to harm, not heal, does not belong in healthcare. Foxglove has campaigned against Palantir’s role in the NHS since it first got its claws in via a no-bid £1 deal at the start of the pandemic. (That freebie, by the way, went up to £23m, and is now the reason Palantir may win the £360m deal). Like all dealers in addictive products, with Palantir, the first hit’s always free.
Perhaps because of this controversy, Bloomberg reports Palantir has been trying to buy its way in through the backdoor by taking over existing NHS suppliers. And they are actively lobbying and hiring NHS talent to try and land the FDP contract.
But this issue goes beyond Palantir.
The battle for the future of the NHS
The NHS faces stiff challenges:
- Workforce shortages across health and social care.
- An aging population with increasing demands while we fail to retain doctors and can’t train new ones fast enough.
- It is being bled of cutting-edge capacity like data science – not least to firms like Palantir – which it desperately needs to retain for the long run.
OK, so what should government do?
- A workforce plan before a dashboard. You can’t paper over staffing problems with a dashboard. Government should focus on the problems clinicians say matter to them. Techno-solutionism steals oxygen from these urgent issues.
- Transparency, trust, choice. It’s hard to trust what you don’t understand. Patients don’t understand the government’s plans for data centralisation and have repeatedly said they don’t want private access that doesn’t benefit the NHS.
- Don’t get between doctors and patients. People will resist centralisations of care on matters that belong between a patient and a GP. Some aspects of care can, and perhaps should, be run centrally; others can’t.
- Data for patients and the NHS – not for profit. By all means let’s use data better to help the NHS – but with far greater transparency and patient control, and with trustworthy open-source providers, not £360m lock-in white elephant firms like Palantir.