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This is so disingenuous. The whole point is that in a publicly funded health system many people disagree with this access being available in the first place. Th

This is so disingenuous. The whole point is that in a publicly funded health system many people disagree with this access being available in the first place. The UK government tries to paint a picture whereby giving such access will allow a raft of plucky UK startups to revitalize the NHS, when in reality we are just handing over our data and taxpayer money to the likes of Palantir.

kmlx 4y ago
publicly funded systems routinely use privately funded solutions. there’s nothing new or special here. that fact that people disagree means nothing and should be ignored as people disagree all the times about anything and everything.
- oliwarner 4y ago
  No, that's relatively new. The NHS used to own its radiography suites. It used to own its land and buildings. It used to hire doctors and nurses and support staff directly. But because of a [also recent] forced-tender system, and high breakthrough prices on in-housing projects, it was deemed "cheaper" to let private providers burden the upfront costs of equipment, land and building management, and short contract management. Shock, horror! Letting "interface companies" extract profit makes services more expensive, and now we're paying more, it's even less affordable to talk about major public capital investment to bring these critical, primary services back in-house. The NHS needs to stand up for itself and politicians need to start talking about 20y plans. Making ends meet today isn't enough. Giving up, adding insurance companies to the mix won't do anything but make it even more expensive.
  - stepbeek 4y ago
    Yes! The UK has viewed private sector efficiency as axiomatic throughout my life. The New Statesmen has a good article on the systemic impact of such decisions in the current issue: https://magazine.newstatesman.com/2022/09/28/dieter-helm-capitalism-works-best-with-a-strong-state/content.html https://magazine.newstatesman.com/2022/09/28/dieter-helm-cap...
    - nonrandomstring 4y ago
      Culminating with us more or less selling-out GCHQ to Amazon. A lot of voices are starting to frame this as national security. Regardless of political alliances and so-called "special relations" this is no longer about mere business. The frame of acquisitions, mergers, and contracts no longer adequately captures the risks. It's about where power lies and who actually runs a nation. If Huawei can be deemed a first-class threat, then so can Palantir, and this sort of revelation only makes that clearer.
  - boomskats 4y ago
    Sadly, selling it off to private US social care firms will be deemed the only solution to our recently imposed budget deficit.
    - oliwarner 4y ago
      Maybe, I don't think it'll happen quickly though. Nobody wants US healthcare, not even the US; to willingly introduce it here would be instant political suicide. That gives me hope. And Conservatives have screwed things so hard in the past 12 years, I think there's genuine appetite for public investment. The current Labour party isn't the government it very nearly could have been in 2017 but if their recently energy policy[1] is anything to go by, they're not afraid of borrowing to invest in long term savings. Energy is a great example. If we could become independent of oil and not just swap that for lithium/cobalt dependencies, that probably is worth the outlay. Healthcare falls into a similar bracket. The added bonus is that if Labour gets a PR-like voting system implemented, it might be harder for any one (or two) parties to dominate politics and we could focus on goal-orientated politics. Maybe. 1: https://www.theguardian.com/politics/2022/sep/27/labour-will-launch-publicly-owned-energy-firm-keir-starmer-vows https://www.theguardian.com/politics/2022/sep/27/labour-will...
      - pessimizer 4y ago
        This is an extremely cynical and conspiratorial thought, but I wouldn't be surprised if the Conservatives haven't made a deal to hand the next elections over to Labour in return for helping them get rid of Boris, and with this interim sacrificial government of Truss to ram through a bunch of things that even Tories would think it would be political suicide to publicly support. Then Starmer can glide in, and do things that the Tories could never get away with doing, like privatizing healthcare. > The added bonus is that if Labour gets a PR-like voting system implemented, it might be harder for any one (or two) parties to dominate politics and we could focus on goal-orientated politics. Maybe. I doubt the PLP will ever show any serious effort to get this done. There's nothing they hate more than voting, and if there's any consistent policy from Labour it's that voting is an unfair commentary on things that average people are neither qualified nor deserving to discuss. They spend a significant amount of time as individuals trying to find people to remove the vote from.
  - VieEnCode 4y ago
    This should be the top comment, but this place is full of Thiel Stans, hence their bemusement.
  - oliwarner 4y ago
    If you're unaware of how tender breaks public services, here's an example. Hospital needs a new MRI suite. To them, this would cost £2m for the machine, £400k for the room, and £500/h in running cost, £1.4m/year. The first 5 years costs are: £3.8m, £1.4m, £1.4m, £1.4m, £1.4m, ... But which trust has £4m in their back pocket for y1 cost? Even if they did, it's a large project so has to go out to tender. A capital-investment-backed provider comes back with a flat cost of £2m/year. They might have the additional cost of land but many of these [currently, right now in many hospitals] operate in containers in the carpark. At £2m, they break-even after Y4 and produce £600k a year profit from Y5 for another 11 years. NHS loses £6.6m over 15 years. And it's not that simple because their £2m bid will be interesting but there'll another for £1.5m at half-duty that will sell operational time to private providers, even direct-to-public (increasingly popular in the UK) at massive markups. They'll break even in Y3. Possibly even quicker if the hospital realises it needs full duty and pays triple-rate to book the machine out. So the NHS picks a private provider. They make a 5 year saving, and take an 11 year beasting. And at the end of it, or even halfway through it when they discover they need even more capacity, they find out that their old suite is now a support ward. Or managers have moved in, or it's just fallen down. The cost to build a new suite isn't the £2.4m it would have been, it's £4m. To get so assuming we would now need two machines, it's an £8m y1 cost to bring this back in-house. The long-term budgetary flexibility required to go back to running your own services is staggering and something that is very hard to sell to people not looking at TCO.
    - wil421 4y ago
      How are you depreciating the MRI machine? Why is the year one cost so high? I would’ve expected the MRI machine to depreciate over a decade.
      - chalst 4y ago
        Depreciation is a term relevant to valuing assets and liabilities on the balance sheet and P&L accounts. oliwarner's figures are cashflow figures, a completely different kind of account, which is what you look to when asking how much financing is needed, a key factor in whether the purchase is given the go-ahead.
  - WastingMyTime89 4y ago
    > The NHS needs to stand up for itself and politicians need to start talking about 20y plans. If you are serious, I have bad news for you. The situation is going exactly as expected. That’s the traditional Tory plan. Defund, complain it doesn’t work now that it doesn’t have money then make private. British voters can only blame themselves. Between Brexit and decades of voting for the worst of the Tory, if they were less stupid, their country situation wouldn’t be so bad.
    - formerkrogemp 4y ago
      > If you are serious, I have bad news for you. The situation is going exactly as expected. That’s the traditional Tory plan. Defund, complain it doesn’t work now that it doesn’t have money then make private. > British voters can only blame themselves. Between Brexit and decades of voting for the worst of the Tory, if they were less stupid, their country situation wouldn’t be so bad. I've yet to see, in decades of Tory rule, much but decline, neglect, and scandal. Tax cuts and service cuts. That's all everyone needs apparently. Unfortunately, labor seems so incompetent at gaining power that it seems almost like a "managed opposition." Maybe I'm being too generous to their electorate as well. The UK is a tourism attraction at this point, a historical relic found in a curio shop or flea market. Or soon will be at its current clip.
    - linuxftw 4y ago
      Socialized medicine was always going to be unaffordable in the long term. If it wasn't a burden, then the 'cost cutting' measures probably wouldn't have been implemented. Having the government in charge of something means it's always going to be inefficient.
      - WastingMyTime89 4y ago
        > Socialized medicine was always going to be unaffordable in the long term. Why? Sorry but that’s horse shit. There is nothing preventing socialised medicine for working. It costs less per capita nowadays than it did when it was put in place and productivity skyrocketed since. The economic arguments were always the very privileged hiding their greed and contempt for the rest of us behind a fine veneer. I truly believe some of them even came to believe it to help themselves sleep at night. It doesn’t mean we all have to drink it.
  - Schroedingersat 4y ago
    > The NHS needs to stand up for itself and politicians need to start talking about 20y plans. There's a 20 year plan. Make sure the private system that replaces it after spending 20 years looting it is as profitable as possible.
- boomskats 4y ago
  > that fact that people disagree means nothing and should be ignored as people disagree all the times about anything and everything. I believe the mechanism you're advocating for is generally referred to as a dictatorship.
  - MaxBarraclough 4y ago
    Charitably, I think they meant Unanimity is the exception, not the norm.
  - sleet10 4y ago
    “”…Patient trust is vital to our NHS, so foreign tech companies such as Palantir, with their history of supporting mass surveillance, assisting in drone strikes, immigration raids and predictive policing, must not be placed at the heart of our NHS,” British lawmaker David Davis, a member of the Conservative Party and former Secretary of State for Exiting the European Union, said during a House of Commons debate in June 2021.” “…Palantir’s history as a “Peter Thiel-backed, CIA-initiated company” could deter patients from sharing their data. “We should get rid of Palantir and build our own open-source software…”” …on the other hand, from: https://www.theguardian.com/society/2022/jun/21/palantir-concerns-over-data-firm-poised-to-be-operating-system-of-nhs https://www.theguardian.com/society/2022/jun/21/palantir-con... “…Louis Mosley said Palantir’s origins were as a defender of personal privacy. “Palantir was actually started to guard against government overreach into personal privacy. Much of the software we’ve built is to prove [sic] those kinds of protections.”…” …from: https://www.tatler.com/gallery/most-glamorous-mitford-descendants https://www.tatler.com/gallery/most-glamorous-mitford-descen... : “…Louis Mosley, is the eldest grandson of Sir Oswald and Diana Mosley (née Mitford) and head of London operations for data firm, Palantir. Before Mosley’s successful career at the sleek software company (which had a role in tracking down terrorist Bin Laden in 2011), the 38-year-old was a Conservative party activist. Politics has run through Louis’ family for generations as his grandparents, Sir Oswald and Diana Mosley, became key figures in Britain’s far-right political movement in the 1930s.” ( …Oswald Mosley, btw.: https://en.wikipedia.org/wiki/Oswald_Mosley https://en.wikipedia.org/wiki/Oswald_Mosley )
- denton-scratch 4y ago
  The NHS posesses the largest, most-complete collection of national medical and health data in the world. Certain senior managers have been trying to share that collection with private firms for years. There have been various contortions along the road; initially, the plan was that all GP surgeries would be required to upload patient data to the (shareable) national collection. The government partially backed down, allowing patients to opt out of that kind of sharing. A separate opt-out was required for data concerning hospital treatment. Both required patients to acquire and submit a paper form; there was no opt-out website. Then they changed the structure of the sharing system a little, rendering prior opt-outs moot; you had to opt-out again. You'd think the government would be able to make a lot of money out of this data; but one of the scandalous early deals they made was to sell the data of a million patients to the Society of Actuaries. For £3,000. Actuaries work for insurance companies; and insurance companies would dearly love to get their hands on people's health data. But £3,000? Now Palantir's core business is collecting data. It isn't a medical company. Corellating "anonymised" data is what they do. They are hostile to privacy, and they are famously secretive. There are people in government who want to privatize the NHS completely. Unfortunately for them, the NHS is probably the most popular institution in the UK; so they salami-slice. Various NHS services are privatized by stealth; the last CT scan I had was conducted in a van in the hospital carpark, run by some US health conglomerate. Various testing services have been fully privatized, with the original NHS services shut down. So there are two threads behind this story: the creeping privatisation of NHS services, and the involvement of this creepy company in handling patient data.
- amcoastal 4y ago
- dijit 4y ago
  You’re right, but only symbolically so. Sweden walked this same path and is deeply deeply suffering the privatisation. Doctors are nowhere to be seen, waiting times are absolutely impossible to work with. You basically have to beg to see a doctor and even then they will likely decline you unless you’re in pain. It’s ridiculous. It can be directly attributed to the privatisation of the underlying services.
roenxi 4y ago
One of the lesser-known risks of giving control of the health care system to the government is that the government will have control of the health care system. It just isn't news that a company that specialises in getting government contracts has a plan to get a government contract. There are too many tautologies here to get interested in them. Next thing we'll discover that the politicians are running the healthcare system based on political calculations instead of medical advice!
AzzieElbab 4y ago
Telus(large Canadian telco) did this in Canada. Never heard a squick
MomoXenosaga 4y ago
Probably a controversial statement on HN but FUCK AMERICAN DISRUPTORS. I like my socialist privileges thank you very much.

kmlx 4y ago

publicly funded systems routinely use privately funded solutions. there’s nothing new or special here. that fact that people disagree means nothing and should be ignored as people disagree all the times about anything and everything.

oliwarner 4y ago
No, that's relatively new. The NHS used to own its radiography suites. It used to own its land and buildings. It used to hire doctors and nurses and support staff directly. But because of a [also recent] forced-tender system, and high breakthrough prices on in-housing projects, it was deemed "cheaper" to let private providers burden the upfront costs of equipment, land and building management, and short contract management. Shock, horror! Letting "interface companies" extract profit makes services more expensive, and now we're paying more, it's even less affordable to talk about major public capital investment to bring these critical, primary services back in-house. The NHS needs to stand up for itself and politicians need to start talking about 20y plans. Making ends meet today isn't enough. Giving up, adding insurance companies to the mix won't do anything but make it even more expensive.
- stepbeek 4y ago
  Yes! The UK has viewed private sector efficiency as axiomatic throughout my life. The New Statesmen has a good article on the systemic impact of such decisions in the current issue: https://magazine.newstatesman.com/2022/09/28/dieter-helm-capitalism-works-best-with-a-strong-state/content.html https://magazine.newstatesman.com/2022/09/28/dieter-helm-cap...
  - nonrandomstring 4y ago
    Culminating with us more or less selling-out GCHQ to Amazon. A lot of voices are starting to frame this as national security. Regardless of political alliances and so-called "special relations" this is no longer about mere business. The frame of acquisitions, mergers, and contracts no longer adequately captures the risks. It's about where power lies and who actually runs a nation. If Huawei can be deemed a first-class threat, then so can Palantir, and this sort of revelation only makes that clearer.
- boomskats 4y ago
  Sadly, selling it off to private US social care firms will be deemed the only solution to our recently imposed budget deficit.
  - oliwarner 4y ago
    Maybe, I don't think it'll happen quickly though. Nobody wants US healthcare, not even the US; to willingly introduce it here would be instant political suicide. That gives me hope. And Conservatives have screwed things so hard in the past 12 years, I think there's genuine appetite for public investment. The current Labour party isn't the government it very nearly could have been in 2017 but if their recently energy policy[1] is anything to go by, they're not afraid of borrowing to invest in long term savings. Energy is a great example. If we could become independent of oil and not just swap that for lithium/cobalt dependencies, that probably is worth the outlay. Healthcare falls into a similar bracket. The added bonus is that if Labour gets a PR-like voting system implemented, it might be harder for any one (or two) parties to dominate politics and we could focus on goal-orientated politics. Maybe. 1: https://www.theguardian.com/politics/2022/sep/27/labour-will-launch-publicly-owned-energy-firm-keir-starmer-vows https://www.theguardian.com/politics/2022/sep/27/labour-will...
    - pessimizer 4y ago
      This is an extremely cynical and conspiratorial thought, but I wouldn't be surprised if the Conservatives haven't made a deal to hand the next elections over to Labour in return for helping them get rid of Boris, and with this interim sacrificial government of Truss to ram through a bunch of things that even Tories would think it would be political suicide to publicly support. Then Starmer can glide in, and do things that the Tories could never get away with doing, like privatizing healthcare. > The added bonus is that if Labour gets a PR-like voting system implemented, it might be harder for any one (or two) parties to dominate politics and we could focus on goal-orientated politics. Maybe. I doubt the PLP will ever show any serious effort to get this done. There's nothing they hate more than voting, and if there's any consistent policy from Labour it's that voting is an unfair commentary on things that average people are neither qualified nor deserving to discuss. They spend a significant amount of time as individuals trying to find people to remove the vote from.
- VieEnCode 4y ago
  This should be the top comment, but this place is full of Thiel Stans, hence their bemusement.
- oliwarner 4y ago
  If you're unaware of how tender breaks public services, here's an example. Hospital needs a new MRI suite. To them, this would cost £2m for the machine, £400k for the room, and £500/h in running cost, £1.4m/year. The first 5 years costs are: £3.8m, £1.4m, £1.4m, £1.4m, £1.4m, ... But which trust has £4m in their back pocket for y1 cost? Even if they did, it's a large project so has to go out to tender. A capital-investment-backed provider comes back with a flat cost of £2m/year. They might have the additional cost of land but many of these [currently, right now in many hospitals] operate in containers in the carpark. At £2m, they break-even after Y4 and produce £600k a year profit from Y5 for another 11 years. NHS loses £6.6m over 15 years. And it's not that simple because their £2m bid will be interesting but there'll another for £1.5m at half-duty that will sell operational time to private providers, even direct-to-public (increasingly popular in the UK) at massive markups. They'll break even in Y3. Possibly even quicker if the hospital realises it needs full duty and pays triple-rate to book the machine out. So the NHS picks a private provider. They make a 5 year saving, and take an 11 year beasting. And at the end of it, or even halfway through it when they discover they need even more capacity, they find out that their old suite is now a support ward. Or managers have moved in, or it's just fallen down. The cost to build a new suite isn't the £2.4m it would have been, it's £4m. To get so assuming we would now need two machines, it's an £8m y1 cost to bring this back in-house. The long-term budgetary flexibility required to go back to running your own services is staggering and something that is very hard to sell to people not looking at TCO.
  - wil421 4y ago
    How are you depreciating the MRI machine? Why is the year one cost so high? I would’ve expected the MRI machine to depreciate over a decade.
    - chalst 4y ago
      Depreciation is a term relevant to valuing assets and liabilities on the balance sheet and P&L accounts. oliwarner's figures are cashflow figures, a completely different kind of account, which is what you look to when asking how much financing is needed, a key factor in whether the purchase is given the go-ahead.
- WastingMyTime89 4y ago
  > The NHS needs to stand up for itself and politicians need to start talking about 20y plans. If you are serious, I have bad news for you. The situation is going exactly as expected. That’s the traditional Tory plan. Defund, complain it doesn’t work now that it doesn’t have money then make private. British voters can only blame themselves. Between Brexit and decades of voting for the worst of the Tory, if they were less stupid, their country situation wouldn’t be so bad.
  - formerkrogemp 4y ago
    > If you are serious, I have bad news for you. The situation is going exactly as expected. That’s the traditional Tory plan. Defund, complain it doesn’t work now that it doesn’t have money then make private. > British voters can only blame themselves. Between Brexit and decades of voting for the worst of the Tory, if they were less stupid, their country situation wouldn’t be so bad. I've yet to see, in decades of Tory rule, much but decline, neglect, and scandal. Tax cuts and service cuts. That's all everyone needs apparently. Unfortunately, labor seems so incompetent at gaining power that it seems almost like a "managed opposition." Maybe I'm being too generous to their electorate as well. The UK is a tourism attraction at this point, a historical relic found in a curio shop or flea market. Or soon will be at its current clip.
  - linuxftw 4y ago
    Socialized medicine was always going to be unaffordable in the long term. If it wasn't a burden, then the 'cost cutting' measures probably wouldn't have been implemented. Having the government in charge of something means it's always going to be inefficient.
    - WastingMyTime89 4y ago
      > Socialized medicine was always going to be unaffordable in the long term. Why? Sorry but that’s horse shit. There is nothing preventing socialised medicine for working. It costs less per capita nowadays than it did when it was put in place and productivity skyrocketed since. The economic arguments were always the very privileged hiding their greed and contempt for the rest of us behind a fine veneer. I truly believe some of them even came to believe it to help themselves sleep at night. It doesn’t mean we all have to drink it.
- Schroedingersat 4y ago
  > The NHS needs to stand up for itself and politicians need to start talking about 20y plans. There's a 20 year plan. Make sure the private system that replaces it after spending 20 years looting it is as profitable as possible.
boomskats 4y ago
> that fact that people disagree means nothing and should be ignored as people disagree all the times about anything and everything. I believe the mechanism you're advocating for is generally referred to as a dictatorship.
- MaxBarraclough 4y ago
  Charitably, I think they meant Unanimity is the exception, not the norm.
- sleet10 4y ago
  “”…Patient trust is vital to our NHS, so foreign tech companies such as Palantir, with their history of supporting mass surveillance, assisting in drone strikes, immigration raids and predictive policing, must not be placed at the heart of our NHS,” British lawmaker David Davis, a member of the Conservative Party and former Secretary of State for Exiting the European Union, said during a House of Commons debate in June 2021.” “…Palantir’s history as a “Peter Thiel-backed, CIA-initiated company” could deter patients from sharing their data. “We should get rid of Palantir and build our own open-source software…”” …on the other hand, from: https://www.theguardian.com/society/2022/jun/21/palantir-concerns-over-data-firm-poised-to-be-operating-system-of-nhs https://www.theguardian.com/society/2022/jun/21/palantir-con... “…Louis Mosley said Palantir’s origins were as a defender of personal privacy. “Palantir was actually started to guard against government overreach into personal privacy. Much of the software we’ve built is to prove [sic] those kinds of protections.”…” …from: https://www.tatler.com/gallery/most-glamorous-mitford-descendants https://www.tatler.com/gallery/most-glamorous-mitford-descen... : “…Louis Mosley, is the eldest grandson of Sir Oswald and Diana Mosley (née Mitford) and head of London operations for data firm, Palantir. Before Mosley’s successful career at the sleek software company (which had a role in tracking down terrorist Bin Laden in 2011), the 38-year-old was a Conservative party activist. Politics has run through Louis’ family for generations as his grandparents, Sir Oswald and Diana Mosley, became key figures in Britain’s far-right political movement in the 1930s.” ( …Oswald Mosley, btw.: https://en.wikipedia.org/wiki/Oswald_Mosley https://en.wikipedia.org/wiki/Oswald_Mosley )
denton-scratch 4y ago
The NHS posesses the largest, most-complete collection of national medical and health data in the world. Certain senior managers have been trying to share that collection with private firms for years. There have been various contortions along the road; initially, the plan was that all GP surgeries would be required to upload patient data to the (shareable) national collection. The government partially backed down, allowing patients to opt out of that kind of sharing. A separate opt-out was required for data concerning hospital treatment. Both required patients to acquire and submit a paper form; there was no opt-out website. Then they changed the structure of the sharing system a little, rendering prior opt-outs moot; you had to opt-out again. You'd think the government would be able to make a lot of money out of this data; but one of the scandalous early deals they made was to sell the data of a million patients to the Society of Actuaries. For £3,000. Actuaries work for insurance companies; and insurance companies would dearly love to get their hands on people's health data. But £3,000? Now Palantir's core business is collecting data. It isn't a medical company. Corellating "anonymised" data is what they do. They are hostile to privacy, and they are famously secretive. There are people in government who want to privatize the NHS completely. Unfortunately for them, the NHS is probably the most popular institution in the UK; so they salami-slice. Various NHS services are privatized by stealth; the last CT scan I had was conducted in a van in the hospital carpark, run by some US health conglomerate. Various testing services have been fully privatized, with the original NHS services shut down. So there are two threads behind this story: the creeping privatisation of NHS services, and the involvement of this creepy company in handling patient data.
amcoastal 4y ago
dijit 4y ago
You’re right, but only symbolically so. Sweden walked this same path and is deeply deeply suffering the privatisation. Doctors are nowhere to be seen, waiting times are absolutely impossible to work with. You basically have to beg to see a doctor and even then they will likely decline you unless you’re in pain. It’s ridiculous. It can be directly attributed to the privatisation of the underlying services.

roenxi 4y ago

One of the lesser-known risks of giving control of the health care system to the government is that the government will have control of the health care system. It just isn't news that a company that specialises in getting government contracts has a plan to get a government contract. There are too many tautologies here to get interested in them. Next thing we'll discover that the politicians are running the healthcare system based on political calculations instead of medical advice!

AzzieElbab 4y ago

Telus(large Canadian telco) did this in Canada. Never heard a squick

MomoXenosaga 4y ago

Probably a controversial statement on HN but FUCK AMERICAN DISRUPTORS. I like my socialist privileges thank you very much.