How Palantir will steal the NHS
Stealth privatisation was always the endgame for public-private-partnerships.
Britons are divided on many matters, but one uniting force that cuts across regional, party and class lines is jealous pride for the NHS and fierce resistance to its privatisation and the importation of America’s grisly omnishambolic health care “system.”
But while the British people oppose privatisation, the British investor class are slavering for it. Oligarchs love to loot public services, which is why the IMF is so adamant that the countries it “helps” sell off their public water, housing, even their roads and schools and museums.
Normally, the corrupting, immiserating effects of privatisation happen so slowly that they can feel like a natural phenomenon, a gradual change in the weather that makes everyone a little colder, a little more uncomfortable every day, until one day, the situation is unbearable.
But there have been moments of “big bang” privatisation where governments and oligarchs speed-ran the process of looting the public coffers and transferring them to private hands — think of the sell-off of ex-Soviet state industries to connected insiders.
Or think of Thatcher’s sell-off of council homes, an airdrop that converted shelter from a human right to an asset, in which “market forces” were allowed to “optimise” the housing system, with the result that everyday people can’t afford a home, while wealthy speculators trousered billions.
Thatcher had a supermajority, and she understood how to play different economic blocs against each other, resulting in the “shock therapy” of the 1980s. Her successors — both Tories and New Labour — had to move more slowly:
https://jacobin.com/2022/10/liz-truss-mini-budget-imf-boe-government-debt-brexit
Back to the NHS. It has been subject to the death of a thousand literal cuts, as Tories and Labour alike have starved it of resources. More importantly, both parties have turned ever-larger chunks of the NHS over to private-sector looters who have taken over hospitals, services, record-keeping and more.
These “public-private partnerships” were billed as a “third way,” combining the strengths of both the public and private sectors. In reality, they were a way to transfer a ever-larger sums from the public purse to private investors.
Public-private partnerships (PPPs) are a heads-I-win, tails-you-lose proposition. When a private sector manager takes over a public service and extracts so much profit from the system that it risks collapse, the public sector is blamed for undersubsidising the service, and the looter can demand more money.
Lather, rinse, repeat. After decades of this, everyone understands how PPPs can be used to siphon endless sums out of the public coffers. But there’s a more sinister aspect to PPPs that is only just coming to light, exemplified by Palantir’s leaked plans to take over the NHS.
Palantir is one of the most sinister companies on the global stage, a company whose pitch is to sell humans rights abuses as a service. The customers for this turnkey service include America’s most corrupt police departments, who use Palantir’s products to monitor protest movements.
https://journals.sagepub.com/doi/abs/10.1177/0003122417725865#articleCitationDownloadContainer
Palantir’s clients also include the Immigration and Customs Enforcement, a federal agency who rely on Palantir’s products for their ethnic cleansing:
https://theintercept.com/2018/03/26/facebook-data-ice-immigration/
Palantir also sells to the CIA:
https://www.bloomberg.com/features/2018-palantir-peter-thiel/
One of Palantir’s best markets is the UK, where it has insinuated itself into numerous public services:
https://privacyinternational.org/sites/default/files/2020-11/All%20roads%20lead%20to%20Palantir%20with%20Palantir%20response%20v3.pdf
That includes the NHS, where Palantir has been jockeying for an ever-larger slice of the health service’s private procurements. But the company’s reputation has preceded it, and even NHS commissioners understand that they risk public outrage if they sign over the NHS to a notorious private-sector surveillance company.
Palantir has a solution. The company has effectively unlimited access to the capital markets, as well as to its deep-pocketed founder Peter Thiel, a cartoon villain who’s written that women shouldn’t be allowed to vote and that democracy and freedom are incompatible.
All that liquid capital means that Palantir doesn’t have to win NHS contracts — it can simply buy up other companies that have won them. Palantir’s strategy leaked to Bloomberg, and Olivia Solon lays it out:
In a Sept 2021 email with the subject line “Buying our way in…!” Palantir regional boss Louis Mosley describes a plan to go around “hoovering up” NHS contractors, to “take a lot of ground and take down a lot of political resistance.”
(A Palantir spokesman said the email was “regrettable” and “not an accurate characterization of our relationship with the NHS”)
Palantir’s Mosley said he’d target NHS software suppliers with “credible leadership” and revenue between £5–50m, offering their founders “v. generous buyout schedule (say 10x, especially if all stock),” adding “(we might even be their only real exit option).”
Palantir also urged the lobbying group TechUK to pressurise the NHS and other government departments to buy commercial, proprietary systems rather than building their own.
Palantir ran their own separate lobbying as well, hiring Indra Joshi and Harjeet Dhaliwal away from the NHS to push their agenda in Westminster:
For backup, they retained Global Counsel, a lobbying firm run by the Blairite archvillain Peter Mandelson, to push Palantir to the UK government. Mandelson is one of the great monsters of New Labour, masterminding a plan to permanenly disconnect British households from the internet if any member of the family was accused — without proof — of illegaly downloading music:
Palantir’s plans are bearing fruit. In Dec 2020, the company won a £23.5m no-bid contract to manage NHS patient data:
The deal was successfully challenged by Foxglove, who represented Opendemocracy in a suit to force the government to make future Palantir deals subject to public tender:
The real prize isn’t a mere £23.5 contract, though: the NHS is about to open to bids for a massive, £360m IT project. That’s where Palantir’s plan to buy out its rivals for the deal could bear real fruit.
That’s not a bug in PPP, it’s a feature. The point of PPP is to apply market dynamics to public service provision. Foremost among these market dynamics is the right of company owners to sell their businesses to other companies.
The UK — along with the rest of the west — has spent 40 years waving through anticompetitive mergers, under a doctrine that holds that monopolies are “efficient” (Thiel agrees: according to him, “competition is for losers”).
The combination of lax merger scrutiny and PPP inevitably leads to this kind of play: one deep-pocketed company can “hoover up” all the contractors to the NHS and form a single entity that can hold the NHS to ransom.
Palantir’s commitment to proprietary, secretive software development methodologies makes it utterly unsuitable for NHS service provision. Compare the NHS to Ben Goldacre’s landmark “Better, broader, safer: using health data for research and analysis”:
Goldacre argues that the only way to unlock the medical insights in aggregate NHS patient data is with public software: an open and free “trusted research platform” that anyone can audit and verify.
While the code for this platform would be public, NHS patient data would never leave it. Instead, researchers who wanted to investigate hypotheses about the effectiveness of different interventions would send queries to the platform and get results back — without ever touching the data.
This is a system that only works if it’s hosted by democratically accountable public services — not by private actors accountable to their shareholders, and certainly not secretive companies whose primary expertise is in helping spy agencies conduct mass surveillance.
Image:
Gage Skidmore (modified)
https://commons.m.wikimedia.org/wiki/File:Peter_Thiel_(51876933345).jpg
CC BY 2.0
https://creativecommons.org/licenses/by-sa/2.0/deed.en
Cory Doctorow (craphound.com) is a science fiction author, activist, and blogger. He has a podcast, a newsletter, a Twitter feed, a Mastodon feed, and a Tumblr feed. He was born in Canada, became a British citizen and now lives in Burbank, California. His latest nonfiction book is Chokepoint Capitalism (with Rebecca Giblin), a book about artistic labor market and excessive buyer power. His latest novel for adults is Attack Surface. His latest short story collection is Radicalized. His latest picture book is Poesy the Monster Slayer. His latest YA novel is Pirate Cinema. His latest graphic novel is In Real Life. His forthcoming books include Red Team Blues, a noir thriller about cryptocurrency, corruption and money-laundering (Tor, 2023); and The Lost Cause, a utopian post-GND novel about truth and reconciliation with white nationalist militias (Tor, 2023).
