Pluralistic: Doctors' union may yet save the NHS from Palantir (12 Feb 2026)


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A haunted, ruined hospital building. A sign hangs askew over the entrance with the NHS logo over the Palantir logo. Beneath it, a cutaway silhouette reveals a blood-spattered, scalpel-wielding surgeon with a Palantir logo over his breast, about to slice into a frightened patient with an NHS logo over his breast. Looming over the scene are the eyes of Peter Thiel, bloodshot and sinister.

Doctors' union may yet save the NHS from Palantir (permalink)

If you weren't paying close attention, you might think that the most grotesque and indefensible aspect of Keir Starmer's Labour government turning over NHS patient records to the American military contractor Palantir is that Palantir are Trumpist war-criminals, "founded to kill communists":

https://www.thecanary.co/trending/2026/01/07/palantir-kill-communists/

And that is indeed grotesque and indefensible, and should have been grounds for Starmer being forced to resign as PM long before it became apparent that he stuffed his government with Epstein's enablers and chums:

https://www.thenational.scot/news/25451640.streeting-defends-peter-mandelsons-relationship-jeffrey-epstein/

But it's actually much worse than that! It's not just that Labour hand over Britain's crown jewels to rapacious international criminals who are deeply embedded in a regime that has directly threatened the sovereignty of the UK. They also passed up a proven, advanced, open, safe, British alternative: the OpenSAFELY initiative, developed by Ben Goldacre and his team at Jesus College Oxford:

https://www.opensafely.org/

OpenSAFELY is the latest iteration of Goldacre's Trusted Research Environment (TRE), arguably the most successful patient record research tool ever conceived. It's built atop a special server that can send queries to each NHS trust, without ever directly accessing any patient data. Researchers formulate a research question – say, an inquiry into the demographics of the comorbidities of a given disease – and publish it using a modified MySQL syntax on a public git server. Other researchers peer-review the query, assessing it for rigour, and then the TRE farms that query out to each NHS trust, then aggregates all the responses and publishes it, either immediately or after a set period.

This is a fully privacy-preserving, extremely low-cost, rapid way for researchers to run queries against the full load of NHS patient records, and holy shit does it ever work. By coincidence, it went online just prior to the pandemic, and it enabled an absolute string of blockbuster papers on covid, dozens of them, including several in leading journals like Nature:

https://www.digitalhealth.net/2022/04/goldacre-trusted-research-environments/

This led HMG to commission Goldacre to produce a report on the use of TREs as the permanent, principal way for medical researchers to mine NHS data (disclosure: I was interviewed for this report):

https://www.gov.uk/government/publications/better-broader-safer-using-health-data-for-research-and-analysis

This is a near-miraculous system: an ultra-effective, ultra-cost-effective, Made-in-Britain, open, transparent, privacy-preserving, rigorous way to produce medical research insights at scale, which could be perfected in the UK and then exported to the world, getting better every time a new partner signs on and helps shoulder the work of maintaining and improving the free/open source software that powers it.

OpenSAFELY was the obvious contender for NHS research. But it wasn't the only one: in the other corner was Palantir, a shady American company best known for helping cops and spies victimise people on the basis of dodgy statistics. Palantir blitzed Westminster with expensive PR and lobbying, and embarked on a strategy to "hoover up" every small NHS contractor until Palantir was the last company standing. Palantir UK boss Louis Moseley called it "Buying our way in":

https://pluralistic.net/2022/10/01/the-palantir-will-see-you-now/#public-private-partnership

It worked. First, Palantir got ÂŁ60m worth of no-bid contracts during the acute phase of the pandemic, and then it bootstrapped that into a ÂŁ330m contract to handle all the NHS England data:

https://www.theregister.com/2023/11/22/palantir_wins_nhs_contract/

It was a huge win for corruption over excellence and corporate surveillance over privacy. At the same time, it was a terrible blow to UK technological sovereignty, and long-term trust in the NHS.

But that's not where it ended. Palantir continued its wildly profitable, highly public programme of collaborating with fascists – especially Trump's ICE kill/snatch-squads – further trashing its reputation around the world. It's now got so bad that the British Medical Association (BMA) – a union representing more than 200,000 UK doctors – has told its members that they should not use the Palantir products that the NHS has forced onto their practices:

https://www.bmj.com/content/392/bmj.s168/rr-2

In response, an anonymous Palantir spokesperson told The Register that Britons should trust its software because the company is also working with British police forces:

https://www.theregister.com/2026/02/11/bma_palantir_nhs/

The BMA is a very powerful, militant union, and it has already run successful campaigns against Starmer's government that forced Labour to shore up its support for the NHS. The fact that there's a better, cheaper, more effective, technologically sovereign tool that HMG has already recognised only bolsters the union's case for jettisoning Palantir's products altogether.

(Image: Gage Skidmore, CC BY 2.0, modified)

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Upcoming books (permalink)

  • "The Reverse-Centaur's Guide to AI," a short book about being a better AI critic, Farrar, Straus and Giroux, June 2026

  • "Enshittification, Why Everything Suddenly Got Worse and What to Do About It" (the graphic novel), Firstsecond, 2026

  • "The Post-American Internet," a geopolitical sequel of sorts to Enshittification, Farrar, Straus and Giroux, 2027

  • "Unauthorized Bread": a middle-grades graphic novel adapted from my novella about refugees, toasters and DRM, FirstSecond, 2027

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Colophon (permalink)

Today's top sources:

Currently writing: "The Post-American Internet," a sequel to "Enshittification," about the better world the rest of us get to have now that Trump has torched America (1006 words today, 27741 total)

  • "The Reverse Centaur's Guide to AI," a short book for Farrar, Straus and Giroux about being an effective AI critic. LEGAL REVIEW AND COPYEDIT COMPLETE.

  • "The Post-American Internet," a short book about internet policy in the age of Trumpism. PLANNING.

  • A Little Brother short story about DIY insulin PLANNING

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