Tag Archives: NHS

Palantir, politics and the future of NHS data

Drawing on his experience as a health minister and chair of the Health and Social Care Select Committee, GK’s strategic advisor Steve Brine examines the debate over Palantir’s role in the NHS and argues that evidence of patient benefit, delivery risks and credible alternatives should guide ministers’ decisions.

Senior Vice-President of Palantir UK Tom Watson is an old friend. We were in the Commons together for nine years and our paths crossed many times, not about health it must be said, but music, where we share a vision of creative sovereignty in the face of a powerful challenge from big tech.

Tom’s return to the political headlines was always likely to provoke a reaction but I was pleased to see him back; primarily because it means he once again had the all-clear in his battle with prostate cancer.

Back how? The former deputy leader of the Labour Party has joined American technology company Palantir as a senior vice-president. The appointment comes just as ministers approach a big decision about the company’s future role in the NHS.

Appearing recently on a BBC podcast, Tom warned against allowing what he called “mob rule” to determine government procurement decisions. His intervention was characteristically direct, but it raised a question that goes well beyond one company.

The bottom line is this: should our government allow political discomfort (justified or otherwise) with a supplier to override the practical interests of NHS patients?

At the heart of this debate is the NHS Federated Data Platform (FDP), a programme designed to connect information held across different parts of the health service, helping clinicians and managers make decisions about patient care, waiting lists and capacity.

In November 2023, a consortium led by Palantir secured a seven-year contract to deliver the FDP. Ministers now face a decision over a contractual break point in the early part of 2027.

Two parliamentary committees have recommended that the government take the option to break the contract and seek an alternative supplier.

And so, the search begins for compelling evidence that the existing arrangement is failing, or that a demonstrably better alternative exists, because in my experience the NHS cannot afford another technological false start.

Some NHS users have indeed complained about the technology itself. A British Medical Journal (BMJ) investigation published in July this year reported that NHS leaders had privately described aspects of the FDP as clunky and offering a poor user experience.

Having served as a health minister, and subsequently chaired the Health and Social Care Select Committee, I know how often the ambitions of NHS reform collide with the practical realities of delivery. The entire NHS Ten Year Plan is a case in point!

For decades, the NHS has struggled with fragmented information systems, inconsistent data and organisations unable to communicate with one another.

The consequences are not abstract. They mean operating theatres sitting underused while patients wait for treatment, unnecessary delays in discharging people from hospital, and clinicians spending time navigating disconnected systems.

The FDP was conceived to address precisely these challenges. It is not, as some commentary might suggest, a vast new database into which everyone’s medical records are poured. Rather, it provides a means of connecting and analysing information across existing systems, subject to governance and access controls.

The NHS does not need LESS intelligent use of data. It needs considerably MORE.

Indeed, the government’s wider ambitions for a modernised health service, including that Ten Year Plan, depend on greater use of artificial intelligence and a more joined-up approach to care.

Walking away from an established programme without a credible replacement risks repeating one of the NHS’s most frustrating habits: announcing transformation, beginning implementation and then changing direction.

Supporters of the FDP point to encouraging improvements. NHS England has reported increased theatre utilisation, more patients receiving procedures, improvements in cancer pathways and reductions in delayed hospital discharges.

But there is a necessary qualification.

Recent scrutiny, including by the Financial Times, has questioned whether some of the headline improvements can be directly attributed to the FDP. Some trusts have stopped using certain tools on the platform, and NHS England has acknowledged that improvements observed after the platform’s introduction do not automatically establish cause and effect.

That criticism deserves serious attention. But there is an important distinction between questioning the measurement of benefits and concluding that the technology has no value.

It is also striking that, unlike some previous NHS technology programmes, the FDP has not generated an overwhelming public backlash from the clinicians and operational staff expected to use it. There are complaints about usability and uneven adoption, certainly, but these sit alongside positive accounts from NHS organisations reporting practical improvements.

That is not proof of success, but neither is it the picture of an obviously failing system.

Incomplete evaluation is an argument for stronger scrutiny, not necessarily for abandoning a programme midway through implementation.

The politics of Palantir

Of course, much of the opposition to Palantir has little to do with such cold-eyed scrutiny of NHS operational performance.

The company’s American ownership, its co-founder Peter Thiel, and its work with defence, intelligence and immigration agencies have made it a lightning rod for political controversy.

These are matters on which people can hold sincerely different views, but we should be careful not to confuse opposition to a company’s activities elsewhere with evidence that its NHS contract is inappropriate or unsafe.

Palantir is not the owner of NHS patient data. It acts as a data processor, with NHS organisations retaining responsibility as data controllers.

The NHS relies extensively on international technology companies, pharmaceutical manufacturers, medical device suppliers and other private-sector partners. Their expertise is essential.

Surely the relevant test should be whether a supplier meets the necessary standards of security, effectiveness, accountability and value for money, not whether its founders hold political views with which some Labour MPs happen to disagree?

There are legitimate questions about supplier dependence and public trust, but they deserve to be distinguished from objections rooted primarily in political hostility towards the company.

Tom Watson’s intervention is interesting because it highlights an uncomfortable reality for government. Public procurement must operate within the law, but it must also serve the public interest.

In a recent conversation, someone described the FDP to me as a form of technological infrastructure that another supplier could, in theory, provide.

That is true, but it risks understating the complexity of what has been built. Palantir does not simply provide the cloud infrastructure on which the platform runs; its technology helps integrate data and supports the applications and operational workflows built around it.

There may well be credible alternatives, including other major international technology companies. But replacing the supplier is not necessarily the same as switching electricity providers. The government would need to establish what could be transferred, what would need rebuilding, how long that would take and at what cost.

And if the objective is greater technological sovereignty, replacing one American supplier with another hardly settles the argument.

Ministerial judgement

The government faces a difficult decision but, in my experience, the variables shift considerably when you’re making a political one rather than an operational one.

Palantir should be held rigorously to its contractual obligations, and the evidence of benefit must be strengthened. But – and this is my key point – the burden of proof should also apply to those advocating termination.

What would replace the existing platform? How quickly could an alternative supplier be brought in, and at what cost? What risks would that impose on patients, and would it deliver better results?

These are precisely the questions ministers must ask, and I am confident they are.

The wider lesson is that governments must resist the temptation to confuse a politically attractive announcement with successful public policy. Here I am less confident.

My instinct is that ministers should not exercise the February 2027 break clause unless the evidence presents a compelling case for doing so.

Ultimately, patients waiting for operations, cancer diagnoses or a safe discharge from hospital will not judge ministers by the ideological purity of their decisions.

They will judge them by whether the NHS is ‘fixed’.

What does Andy Burnham’s social care announcement mean for providers?

On Tuesday 29 July, Prime Minister Andy Burnham, Louise Casey and Health Secretary Yvette Cooper outlined the government’s approach to adult social care reform. Burnham said it was ‘shameful’ that decades of political point-scoring had come at the expense of meaningful reform and argued that he is prepared to spend political capital to deliver lasting change. The prime minister used the speech to make three key announcements.

First, Burnham confirmed that Louise Casey’s independent review of adult social care will be accelerated by a year, with final recommendations now expected by summer 2027. He said Casey had been asked to consider how the government could deliver a National Care Service, arguing that social care should become more preventative, person-centred and better integrated with the NHS.

Second, Burnham announced a renewed focus on the social care workforce. Building on the government’s plans to introduce a Fair Pay Agreement for care workers from 2028/29, he said ministers would explore wider reforms to improve pay, training and career progression. He also proposed creating clearer pathways between social care and NHS roles to help professionalise the workforce and improve recruitment and retention.

Third, Burnham announced the launch of cross-party talks on social care reform involving the Conservatives and Liberal Democrats. He argued that lasting reform would require political consensus and described the discussions as the first test of his commitment to a less adversarial style of politics. Burnham said common ground must be found if policymakers are to address challenges that have remained unresolved for decades.

Both Andy Burnham and Louise Casey signalled that future reform would involve greater scrutiny of private providers. Casey argued that there remains an important role for a mixed market in adult social care, but criticised providers perceived to be “profiteering” from care services. Burnham echoed these concerns, arguing that some parts of the sector have prioritised profit and cost-cutting over the quality of care and outcomes for vulnerable people. However, Burnham has historically adopted a pragmatic rather than an ideological approach to public service reform. As health secretary in the Brown-led government, he recognised the role that independent providers could play in increasing NHS capacity and reducing waiting times where they delivered value for patients and taxpayers.

As a result, he is unlikely to pursue reforms that materially reduce the private sector’s role in adult social care. Given the significant share of care capacity and expertise provided by independent providers, the prime minister is likely to be mindful of avoiding reforms that could destabilise the market by causing market exits and place further pressure on already stretched services. Instead, providers should expect a greater focus on accountability and transparency, clearer standards to improve the quality and consistency of care, and enhanced scrutiny of how public funding and provider profits are used. The NHS Modernisation Bill currently going through the Commons is one key place to watch if any substantive change is to come forward.

On funding, Burnham argued that significant improvements could be achieved through more effective use of existing resources before tax rises are considered. He highlighted the costs associated with avoidable hospital admissions and delayed discharges caused by inadequate social care provision, suggesting that greater investment in prevention could deliver substantial savings across the wider health system. However, significant questions remain about the long-term funding model for a National Care Service. Reports suggest officials are exploring options ranging from social insurance-style contributions to inheritance-based levies, although ministers have stressed that no decisions will be taken until Casey’s review is complete and the new prime minister remains constrained to some extent by Labour’s 2024 manifesto commitments on tax.

Phil Hope, GK’s Strategic Adviser and former care services minister under Andy Burnham at the Department for Health, who was directly referenced in the prime minister’s speech said: ‘The prime minister was clear that he wants to build a broad consensus around social care reform and move the debate beyond the political point-scoring that has hindered progress in the past. Bringing forward the Louise Casey review to 2027 creates an opportunity for that conversation to take place away from the pressures of a forthcoming general election. While concerns about profiteering were raised, there was little detail on the scale of the issue or how ministers might address it, making this an area the Casey review is likely to explore further.’

Steve Brine, GK’s Strategic Advisor and former health minister as well as chair of the cross-party Health and Social Care Select Committee said: ‘It was a hugely impressive performance from Andy Burnham with what was more a political than a policy announcement but his authenticity on the subject is welcome and important. It was really about creating the political conditions for reform rather than announcing the detail, but that day will come – along with who pays – and that is the next big moment. Casey’s challenge is to define what ministers actually mean by ‘National Care Service’ – is it about standards, funding, eligibility – and for the PM it’s how will someone’s experience be different in two, three or five years’ time? That’s ultimately how people will judge success.’

Treasury to Treatment: James Murray Appointed Health Secretary

As predicted, England has a new Health Secretary – James Murray.

Above all else, he deserves the goodwill that comes with inheriting one of the best jobs in government.

The Department of Health and Social Care is unlike any other brief. It combines immense public affection for the NHS with relentless operational pressure, difficult fiscal realities and an almost impossible expectation that Ministers can ‘fix’ deep-rooted problems decades in the making.

So my advice to James above all else would be this; you inherit a Ten Year Plan (and numerous other strategies) so don’t waste time and try the patience of the sector by re-writing them.

Focus on operationalising them and give your civil servants (as well as Jim Mackie who I suspect will be feeling deflated right now) a very clear steer from day one on your top three policy areas. Not the infamous three ‘shifts’ – they’re the means to the end – but the areas they know you personally will never drift from.

James takes office with a formidable in-tray. NHS waiting lists still high and a media (as well as a sector) that is sceptical recent falls weren’t more about politics than clinical reality.

Access to primary care continues to define the ‘retail offer’ in health, while care reform of course remains the great unresolved question of British domestic policy.

Not to mention a Ten Year Workforce Plan that remains illusive, medicine shortages (which I predict will grow as an issue in 2026) and rising demand because we are living longer, but often not healthier, lives.

And hanging over all of this is perhaps the biggest challenge of all; how we finally move from a sickness service to a genuine health service.

That is why the NHS Modernisation Bill he inherits matters. Much of the early discussion around it has understandably focused on the proposed Single Patient Record — a potentially transformative attempt to join up fragmented patient information across the NHS.

Done properly, this could save lives, reduce duplication, improve productivity and finally give clinicians the information they need at the point of care. Done badly, it risks becoming another expensive digital programme which loses public trust before it delivers meaningful change. The new Secretary of State will need Number 10 (whoever occupies it) to back him fully when the going gets tough.

But the Bill goes wider than that. It is likely to include measures aimed at modernising NHS structures, expanding the use of technology and AI, improving data sharing, reforming procurement and accelerating innovation adoption. And that’s before Labour MPs, increasingly keen to reject incrementalism, get their hands on amendments come the Bill Committee stage.

The challenge, of course, is delivery. Every Health Secretary arrives in office promising reform. Most discover the system is better at absorbing change than enabling it.

The NHS is enormous, complex and deeply institutionalised. Structural reform alone rarely changes outcomes unless accompanied by cultural change, workforce support and political honesty about priorities.

And that brings me to Wes Streeting. I know how hard it is to leave that Department so it can’t have been easy.

Politics is often too tribal to acknowledge effort when people leave office or move on from major briefs. But it is right to recognise the energy, seriousness and determination Wes brought to the health debate.

Whatever one’s politics, he helped force difficult conversations into the open — about productivity, reform, prevention and the need for the NHS to modernise if it is to remain sustainable.

Wes deserves credit for that as well as the HIV Plan, the Men’s Health Strategy and some lesser noticed progress around things like the Rare Diseases Plan or England (finally) testing newborns for Spinal Muscular Atrophy as a result of his work with Jessy from Little Mix.

The new Health Secretary will quickly discover there are a thousand competing voices telling him what matters most.

My hope is that, amid the noise, he keeps sight of a simple truth: the future sustainability of the NHS will depend not only on how we treat illness, but on how seriously we take the business of creating a healthier society in every sense of the word. We should all wish him nothing but success.

Steve Brine, consultant, podcaster, trustee, former MP for Winchester & Chair of the Health Select Committee

Prevention is the new cure podcast – all things health and politics

What is FemTech and is it the future of women’s health?

The term ‘FemTech’ refers to women’s digital health services in areas including reproductive health, menopause and maternal care. It covers medical devices, software, therapeutic drugs and consumer apps, amongst other innovative technologies. The concept of FemTech emerged in the 2010s in conjunction with discussions on gender equality in healthcare provision and the development of virtual care delivery models. As interest in the sector has grown, a new market has emerged for investors. The government has also caught wind of the importance that digitalisation plays in the future of women’s healthcare and is looking to promote the development of FemTech and is keen to encourage further investment in the sector.

Following backlash from the dire findings of the Ockenden maternity services review, which identified significant failings in the Shrewsbury and Telford Hospital NHS Trust, the Johnson-led Conservative government published its ‘Women’s Health Strategy for England’ in August 2022. The then government launched a call for evidence to support the development of the strategy, which led to stakeholders submitting requests for government support for the FemTech industry through improved collaboration between the NHS and private sector. The subsequent strategy encouraged the use of digital health technologies to support women’s access to information, healthcare professionals and healthcare options, stating ‘we want to see greater use of digital technologies to empower women by de-mystifying and simplifying the process for companies to scale and launch their products in the UK.’ The then government said that it would support stakeholders by working with National Institute for Health and Care Excellence (NICE) and the Medicines and Healthcare Products Regulatory Agency (MHRA) to speed up access to innovative health technologies.

The strategy fell by the wayside following successive changes in Conservative Party leadership. However, the Labour government is building on the Conservative’s work on women’s health policy and announced in October 2025 that it was developing a renewed women’s health strategy which would seek to reduce healthcare inequalities and improve women’s access to healthcare professionals. The strategy is being developed to work alongside the 10-Year Health Plan, the government’s long term plan for reforming the NHS in England. It is likely that the renewed strategy, when it is eventually published, will focus on reducing waiting times for women’s healthcare provision and developing new women’s health technologies. The timeline for the renewed strategy is currently unknown; however, the Department of Health and Social Care (DHSC) is likely to encourage stakeholder engagement with the process throughout 2026.

This is an important time for stakeholders working and investing in FemTech. The government is keen to encourage and promote the development of new FemTech solutions to support its wider policy objectives, such as reducing workplace absenteeism and modernising the delivery of health services. The government is looking to innovate and improve women’s healthcare by engaging with the industry and recognises that increased levels of digitalisation is the way forward.

If you would like to discuss the government’s approach to FemTech further, please contact Mariella Turley at mariella@gkstrategy.com

Can the NHS deliver its new cancer plan?

Steve Brine is a former Health (and cancer) Minister, as well as a Strategic Advisor at GK Strategy. He also co-hosts the health and politics podcast, ‘Prevention is the New Cure’.

The government’s long-awaited National Cancer Plan for England arrives at a rare moment of agreement in health policy.

There is broad consensus across politics, the NHS, and industry that the current model – reactive, hospital-centric and stretched – is no longer sustainable. The focus now is prevention. Diagnose earlier, intervene sooner, and reduce the burden of disease before it overwhelms services.

We should first welcome the fact we have a plan. Attempts to water it down into a ‘major conditions strategy’ did not enjoy the support of the cancer community – or myself (while Chair of the Health Select Committee).

The evidence from around the world is clear; a focused and ambitious cancer plan drives performance and outcomes.

This plan recognises three fundamental truths: (i) the NHS cannot treat its way out of crisis, (ii) workforce shortages remain a major constraint, (iii) unless prevention is properly embedded, our cancer outcomes will continue to trail those of comparable nations.

The new cancer plan reflects much of this thinking and like the NHS 10 Year Health Plan before it, its ambition is not found wanting.

It sets out a new measurable goal that three-quarters of people diagnosed with cancer will survive at least five years or live well with the disease. It also promises to recover the cancer standards (maximum 62-weeks from diagnosis to treatment and the 28-day faster diagnosis metric) by the end of this parliament.

We’ve always known early diagnosis is cancer’s magic key, but if we’ve not built a system that can deliver such, it’s empty rhetoric and cancer patients don’t need that.

Given how measurable these targets are month-on-month – alongside the little-reported promise to provide every patient with a tailored support plan covering treatment, mental health and employment support – this is a very significant piece of work. To meet them, ministers promise faster diagnosis, expanded screening and more personalised treatment.

While some of the ‘big bets’ in the plan revolve around the wider use of cutting-edge technologies such as genomic testing, multi-cancer blood detection, AI-supported diagnostics and robotic surgery. There is also continued acknowledgement that around 40% of cancers are preventable; linked to smoking, obesity, alcohol consumption and environmental factors (even if doubts remain whether ministers have the political capital for further battles on the ‘nanny state’).

The National Cancer Plan is thoughtful and long overdue. But without a parallel focus on workforce protection, system transformation and sustained investment, it risks repeating a familiar pattern – bold promises undermined by fragile (and patchy) delivery.

As with many NHS strategies, including the 10 Year Health Plan itself, the challenge lies not in intent but in execution.

The case for agri-tech in public health

The public health problem

Over one in four adults are obese, with an additional 36% classified as overweight in England. The prevalence of obesity has been steadily rising since 1993, with little evidence to suggest this trend is slowing. This is not solely an adult issue. The sharpest increases in obesity have recently been observed among children. Currently, 15% of children aged 2 to 15 are obese, and a further 27% are overweight. Projections from the Royal Society of Public Health suggest the situation will get worse. 39% of children are expected to be obese or overweight by 2029–30, rising to 41% by 2034–35.

The cost

The government estimates that obesity is costing the NHS £6.5bn a year and is the root cause of diabetes and heart disease and the second biggest preventable cause of cancer after tobacco smoking. Less conservative estimates that account for wider consequences suggest that poor diets cost the UK £126bn a year. There is a strong rationale for public health intervention and the Labour government is demonstrating a willingness to intervene. One of health secretary Wes Streeting’s big three healthcare shifts set out in this week’s NHS 10 Year Plan is a shift from treatment to prevention, and for public health this means intervention.

Government action

Trailing the publication of the NHS 10 Year Plan alongside an obesity strategy, the government has announced a new standard for food retailers to make the average shopping backet of goods healthier. Big food businesses will be required to report on healthy food sales and will be overseen by the Food Strategy Advisory Board. This builds on a government consultation launched in May on plans to tighten the sugar levy by reducing the minimum sugar content level from 5g to 4g and remove the exemption for milk-based drinks. This signals a clear appetite within government for more interventionist policies. Such an approach will undoubtedly incur backlash from anti-nanny state politicos and big industry actors. However, it also creates an opportunity for innovators.

Agri-tech innovators

A contested political environment driven by a firmer stance on obesity and healthy foods by ministers, creates a window for pragmatic, science-driven solutions. Crop biofortification to increase the nutritional profile of foods. Precision fermentation to produce low-fat dairy and bioactive compounds. Modified starches with a lower glycaemic index. The agri-tech sector is well-placed to engage and support the government to achieving public health outcomes. Junk food advertisement bans might grab the political headlines, but ministers will need solutions that measurably change health outcomes and improve the health of the nation.

What next

The NHS 10 Year Plan and the obesity strategy will feed into Defra’s set piece item due for publication later this year: the national food strategy. Broadening access to healthy foods dominates the political discourse around this food strategy. Improving public health and tackling obesity have shot up the political agenda and joining this up with food and farming policy is the key to successfully achieving these policy aims. Aligning with the government’s thinking and offering solutions to public health priorities will strengthen the agri-tech sector’s positions to shape policy and work alongside ministers and policymakers.