If data-sharing technology can be used to improve the NHS, by boosting workflows and making the use of operating theatres and other resources more efficient, this will be a good thing for the service and the public. Such is the claim made on behalf of the deal signed last week with the American company Palantir Technologies and four partners. For £330m over seven years, the businesses are contracted to build what is known as a federated data platform (FDP), through which England’s 42 integrated care systems and 215 health trusts, but not GPs or social care providers, will be able to share patient data in order to organise care and promote public health.
Palantir’s roots lie in military intelligence, making it a controversial partner. Its founder, Peter Thiel, backed Donald Trump in 2016, and the non-profit group Foxglove has launched a campaign and is threatening legal action to block a deal for which it claims the public’s consent has not been sought. But whatever happens in court, and putting to one side ethical concerns about Palantir itself, the case for the deal is weak. NHS press releases have claimed that there have been waiting list reductions in two trusts using Palantir’s Foundry software. But out of 36 trusts, the Health Service Journal reported that only eight cited any specific benefit from the pilot, while at least seven refused to join or pulled out.
With details of the contract not yet public, it is also unclear how the NHS will extricate itself should it decide against renewing the contract. Confusion, meanwhile, surrounds the issue of if and how patients can opt out – a point about which NHS England has changed its mind twice. Medical research is not among the FDP’s uses and pharmaceutical companies will not have access. But public confidence was damaged by previous IT failures, and issues around privacy and trust are acknowledged by leading figures, including the NHS Confederation’s chief executive, Matthew Taylor, who support data-sharing in principle. These should have been examined by a public consultation and discussed in parliament.
Did NHS bosses act too hastily in signing off a deal before crucial questions had been answered? If so, one reason is surely the seriousness of the crisis engulfing the health and care system, and health leaders’ desperation to do something about it. This week ministers reached a pay deal with consultants (though this has yet to be voted on). But the junior doctors’ dispute continues, while waiting lists are at record levels and workforce shortages will be worsened if Rishi Sunak follows through on a pledge to reduce immigration by changing visa rules (almost 58,000 care workers moved to the UK in 2022-23, while the number of NHS staff with a nationality other than British rose by 45,000).
Efficiency and innovation have long been the mantras of those seeking to increase the role of business in public services. Promises to cut waiting lists and increase productivity are hard to resist. But while data-sharing is not snake oil, nor is it a miracle cure. The health system’s most serious problems are long-term underinvestment, the rising burden of chronic disease and a depleted, demoralised workforce. Hopefully, the new platform will deliver benefits. But there is a risk that the opaque negotiations and clumsy announcement of a scheme whose rationale has not been properly explained or scrutinised will undermine rather than strengthen trust in public services.
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