> 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.
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"
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.
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.
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.
> 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).
> 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.
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.
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.
> 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.
Partially redacted details here. The award was over 5 years for half that amount, but could be extended to 10.
https://www.contractsfinder.service.gov.uk/Notice/0f8a65b5-2...
https://www.adamsmith.org/blog/apparently-the-nhs-is-the-wor...
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
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.
Don't care. I don't want any of the wankers over there at Palantir involved with the NHS.
(source: a UK voter)
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"
There's no federal government in the UK, nor constitution
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.
There is absolutely a Constitution in the UK, it is simply not codified into a single document.
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 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.
Just my 2p
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.
Does it run on Windows 95?
> 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).
Imagine the kind of open source EPR that could be built with £330 million.
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...
> but I'd much rather data be in the hands of a corporation that doesn't leak it
So would I and I think Palantir will leak it.
> 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.
> The US technology company was awarded a £330 million contract in 2023
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...
That would imply that their annual budget was £1.8e14, which I seriously doubt.
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.
The NHS's actual current annual budget is £195.6B in 2025/2026 [1]. The contract value declared at the link given above is £182M over 5 years. So:
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...
What were NHS execs thinking signing a contract with palantir?
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.
Or those execs are ignorant about their staff's concerns.
Reductive take
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.
Definitely not a conflict of interest...
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.
(</s>? Maybe? hard to say tbh)
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.
> The reality is that no program so far has really been successful within the NHS.
Could you be a bit more specific? No IT initiative at all? No attempt to create a national data spine?