NHS staff refusing to use FDP over Palantir ethical concerns (freevacy.com)

by chrisjj 172 comments 357 points
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172 comments

[−] twobitshifter 42d ago

> 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.

[−] DaedalusII 42d ago
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

[−] zipy124 42d ago
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.

[−] mgaunard 42d ago
Many people opt for off-shore bonds (which have a number of advantages) which means paying normal tax instead of capital gains, so the capital gains figure doesn't really capture investment as a whole.
[−] DaedalusII 42d ago
[flagged]
[−] pgalvin 42d ago
Your entire comment is filled with false claims and figures.

In 2025-26 there are an estimated 39.1 million people paying income tax - 56.0% of the population [1]. Of course, in the last census, 20.7% of the population were children [2]. About 3.1% of the population are UK students in University education [3], and about 18.6% of the population are retired [4]. I've also missed all the 18-year-olds in their final year of school, which is roughly 1.1 million or 1.6% of the population [5]. About 8.8 million, or 12.6%, are pensioners who pay income tax that I have double counted, usually due to private pensions and other sources of income [6].

Totally these numbers gives a rough estimate that suggest only about 12.6% of working age people do not pay income tax. This is in line with the government's own statistics putting those claiming Universal Credit at 10.6% of the population [7], or those economically inactive at 12.9% [8]. This is wildly different to your implication that 61% of people are too lazy to work.

Unemployment, which is roughly defined as those out of work who are actively looking for work, is at 5.2% [9], which it is worth noting is slightly below the EU and Euro area average of 5.9% and 6.2% respectively [10]. Direct comparisons are difficult to make, but it is certainly indicative of the UK falling within what is considered a healthy range.

Furthermore, take-home pay on a £100,000 salary is £68,561 [11], giving an effective income tax of 31.4% - far below your claim of 71%. True, there is the so-called "£100k tax trap" which gradually reduces your tax-free allowance above this salary. But this still gives just a 37.6% tax on £125,000, or 41.1% on £200,000. You may consider these to be high, but they are far, far below your claim of 71% income tax.

[1] https://www.gov.uk/government/statistics/income-tax-liabilit...

[2] https://www.ethnicity-facts-figures.service.gov.uk/uk-popula...

[3] https://www.universitiesuk.ac.uk/latest/insights-and-analysi...

[4] https://www.gov.uk/government/statistics/dwp-benefits-statis...

[5] https://www.gov.uk/government/publications/infographics-leve...

[6] https://www.ftadviser.com/content/291a4ce0-9287-4118-849b-ff...

[7] https://www.gov.uk/government/statistics/dwp-benefits-statis...

[8] https://www.ons.gov.uk/employmentandlabourmarket/peoplenotin...

[9] https://www.ons.gov.uk/employmentandlabourmarket/peoplenotin...

[10] https://ec.europa.eu/eurostat/statistics-explained/index.php...

[11] https://www.gov.uk/estimate-income-tax

[−] spwa4 42d ago
I think the reason behind this is that the UK NHS is using a lot of budget on long-term ill people who they believe aren't really long-term ill, or who at least could be working. Essentially, they feel they can't trust their employees and want LLMs to do it instead.

So they want LLMs to look at all the files, and essentially kick a lot such people off the NHS. That's what they're paying for.

In other words they want to "Elon Musk the NHS, DOGE-style".

This is, of course, highly illegal to do. There is no way giving medical data to a US consultancy does not violate UK and EU law something awful. The government knows this, does it anyway. Which is one reason you won't be able to do anything about this: the government has zero intention to respect the law in this case. You will, of course, be expected to pay your taxes correctly.

[−] exe34 42d ago

> paying 71% income tax

Do you have a citation for this? I'm interested in how this figure was extracted from where it came.

[−] maest 42d ago
I think they're confused/disingenuous and talking about the _marginal_ tax rate at 100k.

There's a segment of a few thousand pounds where your marginal tax rate skyrockets because you lose your tax free allowance at that income level.

It's stupid, annoying and has some minor economic effects, but it's very different from a 71% income tax rate.

[−] exe34 42d ago
It was a rhetorical question, of course they were being disingenuous. Marginal tax rate doesn't have the same ring as 70% tax.
[−] dmoy 42d ago
More like 40% effective tax rate at £100k, even including employer side of things?
[−] LightBug1 42d ago
Don't care. I don't want any of the wankers over there at Palantir involved with the NHS.

(source: a UK voter)

[−] mhh__ 42d ago
[flagged]
[−] clort 42d ago
No.

I checked, and you can of course donate to Led By Donkeys either as a one-off or monthly via their web page https://donate.ledbydonkeys.org/ but they don't have a way to contribute to specific campaigns.

Thanks for mentioning them though.

[−] LightBug1 42d ago
Donated. Cheers
[−] mhh__ 42d ago
It'll come good any day now, the sensibles rightful place in charge of the plebs will be reaffirmed in 2029 I'm sure
[−] mindslight 42d ago
You're really bashing a straw man of "the sensibles rightfully in charge of the plebs" to argue in support of a system that will be overtly in charge of the plebs without even nominal democratic accountability? Talk about mental gymnastics.
[−] mhh__ 39d ago
Which system is that?
[−] Apocryphon 42d ago
Entropyless? So you’re saying they’re highly efficient?
[−] LightBug1 42d ago
Welcome to the club.
[−] gmerc 42d ago
"dumb". Call it what it is, corruption
[−] stuaxo 40d ago
Sorry but the Adam smith institute is a ridiculous think thank that cherry picks Adam smith, he would be spinning in his grave at the misuse of his name.
[−] jpfromlondon 39d ago
it's not an Adam Smith fan club it's an independent research think tank, easily one of the best, up there with Brookings...
[−] dwedge 42d ago
This is why I disagree with the idea that we should keep increasing funding to the NHS. The argument always seems to come to a false dichotomy of "either this or the American system" as though other systems don't exist, and as though the NHS isn't top heavy with bureaucrats and questionable contracts
[−] mgaunard 42d ago
The truth is that the NHS is very bad not due to funding, but for structural reasons.

The fact I can't even see a GP I'm not registered with (not even an option to pay extra) is ridiculous. You have absolutely no control over your health at all.

With private, you get exactly what you want, whenever you want it.

[−] array_key_first 42d ago

> With private, you get exactly what you want, whenever you want it.

In the US this isn't how it works. You can't see whoever you want unless you have a really, really good plan. Otherwise, you need referrals. And lots of specialists won't see you without a referral anyway.

And, the wait is often on the order of months. I know that's something people complain about in the UK but I assure you, it happens that way in the US too even though we're paying 10x as much.

I know private in the UK is quite good. What you need to understand is that the only reason it's any good at all is because of the NHS. It has to remain competitive. If you go full private, then it very quickly decays.

[−] mgaunard 42d ago
A specialist also requires a referral in the UK. There are also much more medicines which are prescription-only than in the US.

That's why in practice we have all these (private) services to get easy GP appointments via phone, video or even online forms. While everyone knows those appointments can't realistically do any real medical work, they serve to give you prescriptions and referrals.

It's just a gatekeeping mechanism, that you can more easily bypass if you have money. The more you pay, the more they care about your user experience and how streamlined it is.

[−] reillyse 42d ago
In the US if I want to see my primary care doctor I need to wait 2 months for the appointment.

I pay $500 per month for the privilege (and a $50 copay)

So I’m paying $1000 in the time period where I’m getting no service.

[−] zdragnar 42d ago
Where in the US are you? I was able to book a visit with my primary the very next day less than a month ago.
[−] array_key_first 42d ago
Not the person you replied to but I'm in North Texas and I just recently had to reschedule my physical. And yup, the next appointment is 2 months out.

I also had cancer in the past and you might think that that would mean I get faster appointments. I do not.

And I have a very, very, very good PPO plan.

[−] tracker1 42d ago
That was my thinking... even for specialists, I can generally get into a new one within a few weeks.

My SO is on state Medicaid (cancer) and does experience the kinds of waits mentioned above... so I guess it does follow similarly for government/state backed healthcare, where I'm mostly out of pocket.

But even when I had relatively typical coverage, I didn't have issues getting into a doctor more often than not. I think getting my sleep study was the longest wait I had for anything, they were months backed up with appointments... but my kidney and retina specialists were somewhat easy to get started with.

[−] 0xffff2 42d ago
As usual when people say "the US", we're papering over the fact that the United States is really 50 countries in a trench coat.
[−] IneffablePigeon 42d ago
You can absolutely see a GP you’re not registered with if you are travelling and need to. I have done it multiple times. I have been offered it same or next day after calling 111.
[−] harvey9 42d ago
You can call any GP surgery to get emergency treatment for up to 14 days if you're not registered with a GP surgery or are away from home. https://www.nhs.uk/nhs-services/gps/gp-appointments-and-book...
[−] shigawire 42d ago
With private, you get exactly what you want, whenever you want it... If you can afford it.
[−] te_chris 42d ago
So naive. Private only works this way in Britain because it doesn’t have to be responsible for anything. It’s a luxury good and works accordingly.

We have insurance, it’s amazing! But it’s fake. If you want to know how a whole system of this would work, look at the US

[−] iamtheworstdev 42d ago
* if available in your area or within your means of travel, which may include flying to another state
[−] jaccola 42d ago
If only there were some system where the incentives could freely flow through and permeate every level of the sector. Where those organisations that provide sub-standard care die and those that excel receive outsized funding...
[−] kypro 42d ago
As someone who largely worked at startups and smaller companies before joining the NHS it genuinely confused me how no one would ever say no to anything when I first started working there.

The projects I worked on were genuinely absurd... My team alone spent millions on things that literally wouldn't have made any difference to the quality of healthcare in the UK.

Apparently we were given a budget and we had to find a way to spend it otherwise it would be cut. At any normal company we should have all immediately have been made redundant.

[−] 0xy 42d ago
The rate of increase of healthcare funding for the UK is 2,000% higher than France's rate of healthcare funding increases from between 2010 and 2019, according to World Bank data.

The UK healthcare system is uniquely incompetent, administratively bloated and drives very suboptimal value for money.

UK citizens appear to be in a collective delusion about the NHS that allows them to continue ineptly bumbling through mediocrity while perpetually fleecing more tax money to line the pockets of administrators.

Meanwhile actual frontline workers in the NHS are completely ripped off in salary. Nurses get paid peanuts, while even neurosurgeons earn less than 1/6th of their American counterparts.

To plug the gap by skilled healthcare workers bailing over these horrific conditions, the UK has been importing people to fill these gaps, often with severely lower competence (usually because of completely faked qualifications or outright fraud [1]).

[1] https://www.hrmagazine.co.uk/content/news/hundreds-of-nhs-nu...

[−] timthorn 42d ago
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...

[−] mhh__ 42d ago
The NHS is a huge organisation (~2 million employees alone) with enormous problems along these lines - they should pay 10x if it delivers.
[−] sandworm101 42d ago
A system whereby millions of people seek services from thousands of potential providers, with a life-or-death need to track which services and products were delivered where and when ... ya. It is a billion-dollar data problem. But that is the cost for the luxury of being able to walk into any hospital in the country and expect them to know everything about your conditions at a moment's notice.
[−] crimsoneer 41d ago
I mean, for comparison, the UK Gov "Integrated Data Service" costed around £250m and delivered literally nothing.

Building software for and integrating 200-ish NHS trusts, who generally have their own cloud/tech stack etc, is not actually super cheap.

[−] user3939382 42d ago
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.
[−] MeteorMarc 42d ago
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.
[−] mhh__ 42d ago
A contrarian view although I do dislike contracting with foreign companies for roughly similar reasons: Palantir's technology looks good and I think it probably works. Most things don't work.
[−] cmiles8 42d ago
The Palantir brand has become incredibly toxic and, from what folks report, the software just isn’t very good either. A lot of smoke and mirrors hype not matched by substance.
[−] dariosalvi78 42d ago

> While Louis Mosley, the executive vice-chair of Palantir in the UK, maintains that such campaigns are ideologically motivated and could harm patient care,

this is EXACTLY why it is of outmost importance to own those critical systems, and not delegate them to foreign companies, especially if from a country explicitly hostile towards Europe

[−] shevy-java 42d ago
Any government that hands over citizen's data to a private entity, even more so one that is primarily foreign, should be investigated for being a traitor to the public. That's a general statement, not solely confined to the Palantir guys. They kind of gave it away by chosing that name alone already - damn thieves (https://en.wikipedia.org/wiki/Palant%C3%ADr).
[−] ssgodderidge 42d ago
For those wondering, FDP stands for Federated Data Platform

> Our mission for the NHS Federated Data Platform is to provide a secure, flexible system that connects data across NHS organisations to improve patient care, streamline services, and support informed decision-making.[1]

[1] : https://www.england.nhs.uk/digitaltechnology/nhs-federated-d...

[−] _slih 42d ago
palantir is a US company subject to the cloud act. patient data from 123 hospital trusts is now one mlat request away from us law enforcement regardless of where the servers sit.
[−] QuadmasterXLII 42d ago
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.

(? Maybe? hard to say tbh)

[−] tjpnz 42d ago
Do I as a patient get to opt my medical information out?
[−] i_love_retros 42d ago
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.

[−] tonnydourado 42d ago
As an interesting linguistic coincidence (or not), FDP is a commonly used acronym in Portuguese, standing for "filho da puta", literally, "son of a whore", but semantically it's approximately "asshole/jerk/dickhead".
[−] aimemobe 33d ago
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[−] pratyushsood 42d ago
[dead]
[−] StacyRawls 40d ago
[dead]
[−] heraldgeezer 42d ago
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[−] beanjuiceII 42d ago
fire them easy decision
[−] smashah 42d ago
Why do Epsteinist Companies feel they have the right to not only billions of dollars of citizens in other countries, but also their health record data?
[−] mustHaveIRON 42d ago
fire them, plenty would be happy to have the job
[−] cynicalsecurity 42d ago
Brits: left EU, drifted to US that treats them like crap. A wise choice, what can I say.

"We send the EU 350 million pounds a week. Why not send it to Palantir instead?"

[−] krona 42d ago

> 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...