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Why is it up to Palantir to make this suggestion rather than other (local) parties?

by newsclues 2y ago

robertlagrant 2y ago
I don't think I understand the question - I wouldn't say it's up to them in particular.
- newsclues 2y ago
  Why isn’t anyone else (with a local stake in the issue) coming up with the solutions?
actionfromafar 2y ago
It's not? They just try to sell their wares.
KaiserPro 2y ago
Politics. Palantir are operating nationally, and have the government’s ear, as does delloitte. They also have the expertise, time and motivation to write out a plan for making things better, rather than local firefighting. After all, who are you going to listen to? one single admin in a trust somewhere, or a very large data company who you've paid lots of money to do all this stuff?
p_l 2y ago
"Local" parties (tories) split NHS trusts into smaller pieces which heavily impacted efficiency (Scotland IIRC escaped it)
- robertlagrant 2y ago
  It's not the number of trusts that's the problem - it's the massive trust-based pushback against centralisation. Remember NHS Digital? NHS England? Things keep being established to try and centralise for efficiency, and it's not working. My observation (caveat emptor) is that trusts push back so hard, and aren't necessarily staffed with technical top performers in the first place, and have such misaligned incentives to centralisation from IT to doctors to everything else, that it can't happen.
  - soco 2y ago
    They way I read it around here, those trusts would love it very much to get a healthcare system similar to the US one. Aren't they already well on the way?
    - robertlagrant 2y ago
      I don't know - what do you mean by "healthcare system"?
  - p_l 2y ago
    I see it as a case of forced decentralisation leading to bad incentives. When you had few NHS trusts covering entire UK, you could easily handle common issues because their scale matched close enough to cover entire vertical slice. Now you have trusts cut in size creating incentives against cooperation if only because of how funding is going to be arranged, and even if there's centralised service like NHS Digital... it's not the entity that is going to fight for budget for trust-local employee training and support needs.
zimpenfish 2y ago
> Why is it up to Palantir to make this suggestion It isn't but also people have been saying this kind of thing for years and it just doesn't get anywhere or make the news. e.g. https://publications.parliament.uk/pa/cm200607/cmselect/cmpubacc/390/390.pdf https://publications.parliament.uk/pa/cm200607/cmselect/cmpu... from 2006 is all about « The National Programme for IT in the NHS (“the Programme” or NPfIT) was set up to provide such services, using centrally managed procurement to provide impetus to the uptake of IT and to secure economies of scale." »
- robertlagrant 2y ago
  > The National Programme for IT in the NHS (“the Programme” or NPfIT) That programme definitely made the news because it was a ludicrously expensive disaster. Some useful things came out of it (e.g. better hardware and bandwidth for trusts) but so much money was wasted. It's one of the UK's most famous failures. It's good you bring it up, though.
  - mattlondon 2y ago
    IIRC there was talk of that being a disaster because they wanted to avoid giving the contract to one single company and mandated it was split up with different companies doing different bits. So they deliberately sharded the contract and so there was endless bureaucracy and politics and blame-gaming between the companies who are normally competing against each other for work and so on. It's kinda interesting really. I don't think it would have gone much better if a single company did everything as the often seems to be a clusterfuck regardless (example: post office horizon system)... Then you look at a big company like meta or Google and they're churning out systems that pretty much work and at huge scale.. are the people incompetent at consulting companies? Are the customers incompetent? Perhaps there are a million legacy dependencies that needs to be dealt with (but that is true with meta etc al too). Interesting interesting. I know freelancers whose line of work is basically to get contracted in while Fujitsu or Accenture or IBM or whoever is there doing work, and basically just try to stop them pulling the wool over the eyes of the clients. Their whole careers have basically been calling bullshit on consultants.

Why is it up to Palantir to make this suggestion rather than other (local) parties?

robertlagrant 2y ago

I don't think I understand the question - I wouldn't say it's up to them in particular.

newsclues 2y ago
Why isn’t anyone else (with a local stake in the issue) coming up with the solutions?

actionfromafar 2y ago

It's not? They just try to sell their wares.

KaiserPro 2y ago

Politics. Palantir are operating nationally, and have the government’s ear, as does delloitte. They also have the expertise, time and motivation to write out a plan for making things better, rather than local firefighting. After all, who are you going to listen to? one single admin in a trust somewhere, or a very large data company who you've paid lots of money to do all this stuff?

p_l 2y ago

"Local" parties (tories) split NHS trusts into smaller pieces which heavily impacted efficiency (Scotland IIRC escaped it)

robertlagrant 2y ago
It's not the number of trusts that's the problem - it's the massive trust-based pushback against centralisation. Remember NHS Digital? NHS England? Things keep being established to try and centralise for efficiency, and it's not working. My observation (caveat emptor) is that trusts push back so hard, and aren't necessarily staffed with technical top performers in the first place, and have such misaligned incentives to centralisation from IT to doctors to everything else, that it can't happen.
- soco 2y ago
  They way I read it around here, those trusts would love it very much to get a healthcare system similar to the US one. Aren't they already well on the way?
  - robertlagrant 2y ago
    I don't know - what do you mean by "healthcare system"?
- p_l 2y ago
  I see it as a case of forced decentralisation leading to bad incentives. When you had few NHS trusts covering entire UK, you could easily handle common issues because their scale matched close enough to cover entire vertical slice. Now you have trusts cut in size creating incentives against cooperation if only because of how funding is going to be arranged, and even if there's centralised service like NHS Digital... it's not the entity that is going to fight for budget for trust-local employee training and support needs.

zimpenfish 2y ago

> Why is it up to Palantir to make this suggestion It isn't but also people have been saying this kind of thing for years and it just doesn't get anywhere or make the news. e.g. https://publications.parliament.uk/pa/cm200607/cmselect/cmpubacc/390/390.pdf https://publications.parliament.uk/pa/cm200607/cmselect/cmpu... from 2006 is all about « The National Programme for IT in the NHS (“the Programme” or NPfIT) was set up to provide such services, using centrally managed procurement to provide impetus to the uptake of IT and to secure economies of scale." »

robertlagrant 2y ago
> The National Programme for IT in the NHS (“the Programme” or NPfIT) That programme definitely made the news because it was a ludicrously expensive disaster. Some useful things came out of it (e.g. better hardware and bandwidth for trusts) but so much money was wasted. It's one of the UK's most famous failures. It's good you bring it up, though.
- mattlondon 2y ago
  IIRC there was talk of that being a disaster because they wanted to avoid giving the contract to one single company and mandated it was split up with different companies doing different bits. So they deliberately sharded the contract and so there was endless bureaucracy and politics and blame-gaming between the companies who are normally competing against each other for work and so on. It's kinda interesting really. I don't think it would have gone much better if a single company did everything as the often seems to be a clusterfuck regardless (example: post office horizon system)... Then you look at a big company like meta or Google and they're churning out systems that pretty much work and at huge scale.. are the people incompetent at consulting companies? Are the customers incompetent? Perhaps there are a million legacy dependencies that needs to be dealt with (but that is true with meta etc al too). Interesting interesting. I know freelancers whose line of work is basically to get contracted in while Fujitsu or Accenture or IBM or whoever is there doing work, and basically just try to stop them pulling the wool over the eyes of the clients. Their whole careers have basically been calling bullshit on consultants.