How Palantir got into the NHS

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0:08Today, how the world's scariest company cracked the NHS.

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0:54When Palantir won its contract with the NHS back in 2023, there was a fair amount of concern. One of the world's biggest tech companies, mostly known for its surveillance and military software, was promising to transform the UK's health service. Palantir was awarded a£330 million contract to build a new digital platform that would seamlessly join up patient data and make the whole process of treating people easier, quicker, better. Now, it just needed to convince its customers. This really interesting thing happens in May 24. All the top NHS data professionals and experts get kind of summoned to a conference, or like a meeting, if you like.

1:43They were health service people, data experts, the people who were really charged with using the federated data platform and really making it work. And that meeting doesn't take place inside the NHS or at a conference centre. It takes place inside Palantir's headquarters. That's not normal. Our sources who were at that meeting told us they'd never heard of that happening before. Investigative journalist Lucas Armin began digging. With his colleague Peter Gagan, he was determined to find out more about this meeting. Just to enter the building, you need to sign a non-disclosure agreement, which again was very new to a lot of the people going into that room.

2:19And what they described to us is this kind of classic Silicon Valley vista of table tennis and pool and a free bar and loads of salads and, you know, like cool tech stuff going on. Cool tech stuff. You can picture it. But then the attendees who were standing around drinking and chatting got a summons. They go downstairs to an auditorium, NHS bosses are on stage, and our source says they basically got slapped down. They got a dressing down for not using the FTP. So they then said, okay, well, let us show you what it can do. And Palantir kind of demoed it and said, you know, this is how amazing our software is.

2:59This is how it works. Who's got questions? And somebody stood up and said what apparently a lot were thinking, which is that this looks absolutely rubbish. and that we're already doing a lot of these things. And we don't understand why we need to migrate from a system that works to one that actually looks like it's, in some cases, inferior.

3:23Why did they? And was it true? From The Guardian, I'm Noshin Iqbal. Today in Focus. What did Palantir actually do for the NHS?

3:38Lucas Armin, welcome to Today in Focus. Thanks for having me. You're an investigative reporter for Democracy for Sale. And along with your colleague, Peter Gagin, you've been taking a long, hard look at Palantir and its relationship with the NHS. You and Peter published your findings in the London Review of Books and then later in The Guardian. But where did your investigation begin? There were kind of two key questions that we were set out to answer in this investigation. The first was, how did the world's scariest company, as it's referred to, end up in charge of all of our health data in the NHS?

4:15And how did it win a 330 million pound contract to kind of rewire the health service? I first started looking at Palantir in 2023 when we were doing stories around the tendering of this contract that they subsequently won. You know, we read about who they were and how they were founded. It came up very much in the kind of post-911 CIA world. And CIA was their first client and also their funder in the beginning. And it just seemed like a fascinating journey that this company had then ended up in charge of our health data. I mean, you talk about the CIA because Palantir did famously talk itself up as being essential to military and security services in the US.

4:51And it has big contracts with the Pentagon, with ICE, with the IDF. How did it grow its influence in the UK? When Palantir arrived in Britain, it was a relatively unknown company. It didn't have many connections. It didn't have much clout. This would have been kind of mid 2010s. And they win their first insignificant contract in 2015. That's kind of their first public contract in Britain. It was worth about 700 grand. And it was for the government digital service to do some kind of data analytics work within the cabinet office. And at that time, they were very much security services industrial complex.

5:28They hired Mandelson and Global Council to reposition themselves so that they were no longer seen as a kind of shadowy military contractor. So just to explain, Peter Mandelson, former disgraced ambassador to the US, had a... How do you describe Global Council? PR firm? Consulting firm? Global Council call themselves an advisory company. In practice, they were lobbyists. The company has gone into liquidation. and they were very clever, very artful lobbyists. We know from our sources that Peter Mandelson was extremely interested personally in Palantir from the very beginning. And he was annoyed that Global Council wasn't making more money.

6:05And so Palantir rocked up and they ended up being one of Global Council's biggest clients. They had a 30k a month retainer. And a big part of that sell was they were able to put Palantir executives in rooms with leaders from the health service, with shadow ministers, with ministers, with everybody they needed to talk to. And Mandelson and Global Council were very, very smart in the way they operated. So they effectively took advantage of Britain's incredibly weak lobbying laws. And what do you mean by that? So basically, in Britain, if a third party is paid by a company to talk to a minister or a permanent secretary, that counts as lobbying legally and that must be declared transparently.

6:50Everything else that happens is not considered lobbying for the purpose of the law. If you do a drinks party and some people just happen to be there, that's off the record. If you organise an event and you invite a whole group of stakeholders and at that event Palantir execs happen to speak to everybody else who's in the room, that's off the record. There's this extraordinary quote in the piece, I'm going to mangle it, but it says something like if at some point you have to register this meeting, it means you've massively fucked up. You have to really fuck up, yeah, to actually register activity.

7:22That's what a former global council source told us. Right. They were organising lots of kind of health policy lunches and events. So they were clear that they wanted, they were targeting the NHS. A former global council source told us NHS was always seen as the holy grail. It wasn't just global council and Peter Mandelson, was it? I mean, there were other names, you should say, involved. Could you tell me a bit more about that groundwork and how they laid it? It's one of the most sophisticated kind of influence campaigns that I can remember reporting on. Also crucial to their kind of success was the hiring of this guy called Isaac Levito.

7:53And if you have a long memory, you'll remember that he ran Boris Johnson's election campaign in 2019. And he later ran Rishi Sunak's 2023 campaign. So he was very plugged into the Tory side of it. He's a very bolshy Australian guy. He's very like good at what he does. Very good at what he does. And the other really smart thing Palantir did was they started snapping up and poaching very smart senior people from within the NHS. And this is key, isn't it? It really is, I think. So tell me about the kind of people they were taking from the NHS. Middle managers, doctors, scientists. They took people with very strong levels of expertise in AI and in digital and in transformation.

8:31Right. All the places they were trying to hit. So not only is Palantir poaching key NHS staff for its UK operation, it hires a UK CEO, former Conservative councillor and English aristocrat with quite a family history, Louis Moseley. Tell me about him and the role he then plays.

8:51Lucas Amin:The UK is, we believe, the country outside of the US and China that has the best quality and quantity of the kind of engineering talent that you need to build software like ours. So Louis Mosley is famously known for being the grandson of Oswald Mosley, who's the leader of the British Union of Fascists. Now, there's absolutely no suggestion that Louis shares the politics that his granddad did, to make that clear. But he joined Palantir in 2017. He'd previously worked for Rory Stewart, actually. Right, okay. And he'd been a councillor in Kensington. He's an extraordinarily well-connected guy. He's very charming, very clever, very good at working a room.

9:35So how did they start to land contracts here in the UK? Looking back, it's the COVID-19 pandemic that really accelerated Palantir's ascension in Britain. And specifically, in March 2020, Boris Johnson, Dominic Cummings, they held this summit, which they called a Digital Dunkirk. And Palantir was at that summit. And Palantir said they were incredibly motivated by the urgency of the crisis, and they would be happy to actually give their services to the UK for just one pound. And what were they offering at that point for a pound? So Palantir, what they offer is they're essentially a data analytics and integration company.

10:13And they say, you've got all these different systems, all these different bits of information that can't kind of speak to each other. Imagine, for example, like your emails don't actually connect to your WhatsApps and that doesn't connect to, I don't know, your LinkedIn profile. So at an organizational level, they're offering to connect all those things, which in the health service could be extremely valuable. And so that's how Palantir got their first NHS contract. They charged just one pound. And that was the first time I'd ever heard of such a thing because who, frankly, would sell their services to government for a pound?

10:45It just didn't seem to make any sense. I actually thought it was a misspelling. Well, it turned out it wasn't. And actually, it was a sales tactic called land and expand. Okay. Tell me more about land and expand. So land and expand means you land, you get a toehold in an organization. And once you kind of have that foot in the door, you then start to pump the price. And what Palantir have a kind of track record of doing is turning up in moments of crisis and offering their services for an extremely cheap price. And they did this in March 2020, just as we were going into lockdown. It was a health data contract.

11:18And from there, they became an increasingly important and expensive supplier to the NHS. That one pound deal became a million pound deal and then a 23 million pound deal. And crucially, this deal was no longer just about supporting the health service during the pandemic. Right. It was a wider contract to kind of help the NHS process its data and build out its information sharing systems. So this was a way to show that we can do this using the pandemic to show that they could actually streamline the NHS on a small scale at that point. Yeah, but the big jewel in the crown that Palantir were always searching for was this£330 million deal to rebuild the data architecture of the health service.

12:01Well, Lucas, as your investigation revealed, and as you've said, the NHS was seen as this holy grail for Palantir. Just the idea of all that data from, you'd imagine, almost every single person in the UK. How did they go about getting into the health service? Effectively, this is what all your influence and your lobbyists are helping to do, is to what they call tilt the tender. And just explain the tendering process a bit for the listeners. A tendering process is the kind of process in which, as a government department, you say, okay, we want to buy this thing. Who are the suppliers that could provide it to us?

12:39And who's going to give us the best deal? And what Palantir set out via Global Council to do, which is perfectly legitimate, is to influence that process. Okay. Tell me more. The best reporting on this actually came from the FT. And they were able to show that the tender, which is kind of the specification of what this product should look like, actually included screenshots of Palantir's own software. So it already showed there was a bias towards what they'd seen from Palantir as an example to then give out to other companies saying, this is kind of what we want. Yeah. But actually, as they knew, Palantir already had that.

13:12Yes, exactly. And Palantir slogans, you know, they often claim to be a single source of truth. and that specific phrase also popped up in the tendering. Wow, okay. So it's very difficult for a competitor to actually compete against that. We should mention NHS England says that it, quote, conducted a rigorous competitive fair and transparent procurement process over 11 months in line with public contract regulations where any eligible supplier could respond. So Lucas, the really lucrative work for Pantier within the NHS was this thing, and listeners, please bear with the acronym, the FDP. The Federated Data Platform.

13:50Can you tell me what it is and why it's so valuable? The Federated Data Platform basically has three functions. Its first job is to try and join up data. Right. Like your GP is not always talking to the place where you got your blood tests, is not always talking to the hospital, you organise a surgery. And we've all kind of turned up with armfuls of paper showing what's happened to us because our clinician can't see it in front of them. So the first thing it's supposed to do is fix that. The second thing is once you've got that data, Palantir is building a suite of apps that tackle specific clinical problems to help cut waiting lists or speed up cancer diagnoses.

14:28There are specific apps built that pull the right pieces of information together for that specific problem. The third thing is it's a platform for doing analytics and forecasting so that when analysts are kind of looking ahead to say a rough winter and they're trying to figure out bed capacity or A &E intakes and stuff like that. They've got really rich, useful data to build that on. We know that multiple governments have tried and failed to centralise and streamline NHS data. So I guess, Lucas, is there an argument that actually this was a good thing? I think there's a very compelling argument that NHS information management needed reform.

15:09and there was also a terrible tragic history of government failures and botched jobs in the past tony blair was the first to try they spent about 12 billion pounds trying to centralize patient data in a similar way to this and we then had something called care dot data when again there was this top-down centralized approach let's put all the health data in one place and in that case what happened is the government ended up selling the records to the private health insurance and and public trust was just so badly damaged because people really care about the health data. They don't want companies to know their most intimate secrets.

15:47So Lucas, ultimately, why did the NHS choose Palantir for this contract? Well, I think they chose Palantir for this contract because the tender was effectively tilted in Palantir's favour and the very sophisticated influence campaign basically bore fruit. The rationale has always been they have the best product on the market and they can do things that no one else can. They have magic code, if you like, a secret sauce that British firms just can't compete with.

16:22Aside from the civil liberty concerns, one of the most extraordinary parts of your reporting is that it uncovers the actual use of it. So at this point, doctors, nurses, clinicians within the NHS of being told that, okay, we have Palantir, we have whatever the software's called, now you must use it. What did they find? What we've seen is the rollout of the FTP began in April 2024. And almost immediately, there were problems and there was resistance. So there was this meeting, all these experts are giving a dressing down, irrespective of them saying that, essentially, this is quite rubbish. What happens next?

17:00So then the rollout begins. And last month, the health department's top data official was in front of the select committee and he said 139 hospital trusts which is two-thirds of all hospital trusts right are now live and by the way that includes most of the important and big ones okay and he said this number 139 that's the benchmark that shows us that this is an important piece of software that it's needed and that it's wanted the thing is it jarred a lot with what sources were telling us okay because they said that they were being strong-armed by NHS leadership into going live on the platform so that the NHS could report on the success of the rollout.

17:42So hang on, just so I'm clear on this, essentially they had to show that they logged in to the FDP. They had to basically tick a few boxes in order to have what's called a live version of the FDP in their trust. But what they also said is that they don't use it they don't use they don't use it after all that because it has no functionality so we thought for a while about how we could evidence this and we ended up obtaining under freedom of information rules the average weekly logins data for all the trusts that were supposedly live into a bunch of the most important apps that were on the fdp okay and what we learned there is that of these 139 live trusts, actually usage was incredibly low.

18:27There were 54 trusts who hadn't even logged in to a single one of the eight apps that the NHS released data for. 46 only logged into one of the eight apps that they were collecting data for. And what we saw is that only a very small minority of trusts were actually using the kind of majority of the suite of tools that Palantir had built. And part of the reason for that is that different trusts are at different stages of their kind of digital journey. So some have really good systems. And for them, they would be downgrading to switch across to Palantir. So Leeds Teaching Hospital Trust famously was ahead of the pack.

19:06In private correspondence that was obtained under Freedom of Information, Leeds Teaching Hospital's NHS Trust, they said to the NHS England that they would actually lose functionality rather than gain it if they adopted Palantir's platform. This is mind-boggling. So according to your sources, Palantir built something that wasn't even as good as what some of the NHS already had in use. And Leeds wasn't the only trust that this was the case for. You also reported on Greater Manchester. One really interesting point about Greater Manchester and the care board, and this came up at select committee, is that not only do they match the functionality that Palantir have in terms of integrating information, but they say they can exceed it in ways that Palantir really can't hope to compete with.

19:51And that is because they have integrated GP data and they've integrated data from the local council. As it stands, Palantir doesn't really have the license. It's not within the terms of the contract to do that. It also doesn't have the social license to do that because they're not trusted. And this chap was telling the committee that they've worked for years in community to build that public trust that allows people to consent to sharing their records from their doctor and from their counsel. And so you're actually getting that full integrated picture for the first time. Which is what had been hoped for and needed the whole time.

20:28That was the dream, yeah. But from Palantir's perspective, one could imagine that this giant tech company could say, well, hang on a second, we promised that we were going to speed up cancer diagnosis. We've built you an app just for that. And this is groundbreaking technology. And the fact that there's been this sort of refusenic attitude and taking it up, that's actually what's damaged the product. One of the most interesting parts of the usage story is about this app called Cancer360. So Cancer360 brings together all the different bits of data that might be held about a cancer patient's journey, puts them in one place to make the clinician's diagnosis faster.

21:07Keir Starmer said it was groundbreaking technology. Louis Moseley bigged it up on X. And what we saw when we got the data, the usage data, is that only six trusts of the 139 that were live had bothered to log in even once in nine months. One of the reasons that clinicians are not using it, because our sources work in the health service and they use the FTP every day. It's been described to us as a glorified spreadsheet. Our source said, fine, if you don't know how to use Excel, this is probably going to be pretty useful. But for me, as someone who's worked in this field for decades, it doesn't change my clinical practice at all.

21:44And that kind of criticism is not confined to one app. Lucas, what else did you find? For a long time, NHS England has remained extremely upbeat and positive about the transformational benefits the FTP is having. One thing we did in our investigation is we managed to get sight of lots and lots of internal documents from within NHS England. And what they reveal for the first time is that at senior levels of leadership, they are acutely aware of all of the problems that Palantir software has. They describe the software as slow and clunky. They admit it has a poor user experience. Within internal documents?

22:23Prepared for the leadership. They also acknowledge that Palantir's system is actually up to 10 times slower at analysing data than the current system they have in use. But that's their whole cell. Yeah. So it appears that we're paying for a downgrade. And what Palantir will say in response to this and what they said to us is that you can't do a like for like comparison. Right. Because they have additional security measures embedded in the FTP and therefore it's not fair. OK. But all I would point out is it wasn't us that was doing that comparison. This is NHS England saying it.

23:05Lucas, as we found out last month, there are still ongoing concerns about Palantir's access to data. Can you tell me a bit more about that? Yeah. So Palantir's line for a long time is that we're just a software company. We don't have access to the data. It's encrypted. We don't see identifiable patient information. And that's the NHS line too. It has emerged that Palantir have been given access, unlimited access, to identifiable patient information in one specific context of the FDP. And the minister was forced to apologise for this last month in front of the select committee. And what does that mean?