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How one of America's most controversial billionaires cracked the NHS

Palantir has built technology systems for the US intelligence, military and immigration agencies; a new deal could give it a lasting presence in the National Health Service.

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In early 2019, "James", a British healthcare analyst, received an unsolicited approach from a recruiter online. Such approaches are not uncommon in the sector, but this particular invite piqued James' interest; it came from a senior employee working in the London office of the US data analysis firm Palantir.

Launched by the Paypal co-founder and early Facebook investor Peter Thiel in 2003, Palantir has earned a reputation in its 17-year history for carrying out lucrative but contentious public sector work in the US, from developing "predictive policing" systems to building battlefield software. Over the last decade, the company has also expanded its work overseas, securing £39m in deals with the UK government alone. Propelled by this growth, its London office, set among the advertising agencies and film production companies on Soho Square, has become its largest globally

But while the company has hired large numbers of UK-based engineers away from US tech giants such as Microsoft, Google and Amazon, it appears to have had a notable shortage of British expertise in one of the sectors for which its data analysis software may be most disruptive: healthcare.

According to emails seen by the New Statesman, the company was seeking to resolve a shortage of UK healthcare expertise when it contacted James last year. An interview question posted by a candidate on the jobs site GlassDoor suggests the company has been exploring how it could work in the UK healthcare sector for nearly two years.

Despite this long-running recruitment strategy, the company has not yet been able to replicate its success in bidding for defence contracts with the NHS. Procurement data analysed by the New Statesman shows it hasn't won any paid work with the health service. But when Boris Johnson and his most senior adviser, Dominic Cummings, invited representatives of a number of US tech giants into Downing Street in early March, Palantir was among them.

Why was a company with no prior experience of working in British healthcare asked to help formulate the UK's response to the biggest health crisis in the history of the NHS?

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Accounts vary as to how Palantir was enlisted to work on the Covid-19 Data Store, the project to predict and manage the demands of the pandemic on NHS resources, which is also being supported by Amazon, Google and Microsoft.

In March, the Economist reported that the introduction may have been brokered by Faculty, an AI company based in London that is also working on the project. A former Faculty employee, Ben Warner, worked with Cummings on the Vote Leave campaign and is now an adviser on data science to Downing Street. Warner was named in April by the Guardian as one of two political advisers who attended meetings of the government's Scientific Advisory Group for Emergencies (SAGE). The other was Cummings. 

The contract didn't go to competitive tender, but two sources close to the project denied that Faculty brokered Palantir's introduction to Downing Street, noting that the companies haven't worked together until now. Palantir, the sources said, has its own contacts within central government, having worked for various Whitehall departments over the last decade. One source also denied that the company has met with Dominic Cummings.

Nevertheless, the chief adviser, who led the call for tech resources, is a long-time admirer of Palantir and its controversial founder, Peter Thiel. And, as OpenDemocracy reported this week, Cummings’ ally Michael Gove held a one-on-one meeting with Palantir's representatives in September 2019, around the time its executives were invited to a meeting with other tech firms to discuss healthcare data with the Health Secretary, Matt Hancock.

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In the autumn of 2015, just under a year before the Brexit referendum, Dominic Cummings met with Christopher Wylie, a political strategist who is now best known as the whistleblower who helped expose the Cambridge Analytica scandal. In his memoir Mindf*ck, Wylie recalls the meeting. "Cummings wanted to talk about identity, about psychology, about history, and, indeed, about AI," Wylie writes. "And then he mentioned Renaissance Technologies, the hedge fund set up Robert Mercer. Cummings had obviously read up on Cambridge Analytica, and he asked a lot of questions about how the firm worked. He was interested in creating what he called "the Palantir of politics" – a term I shuddered at."

Cummings cites Thiel, who serves as Palantir's chairman, several times on his blog, calling him a "legendary venture capitalist".

Thiel is a billionaire, a member of the Facebook's board of directors, and an outlier in Silicon Valley. In 2016 he became the most high-profile figure in the tech industry to endorse Donald Trump's presidential bid. Two years later, he said Trump had been "relatively successful" and that he would back him again in 2020.

Thiel's politics are unambiguous. He wrote in 2009 that he stands "against confiscatory taxes, totalitarian collectives, and the ideology of the inevitability of the death of every individual. For all these reasons, I still call myself 'libertarian'.” In the same essay, Thiel wrote: "I no longer believe that freedom and democracy are compatible."

Like Trump, Thiel aggressively opposes media coverage that he dislikes. In 2016, it emerged that he had secretly bankrolled lawsuits brought by the wrestler Hulk Hogan against Gawker Media, a US publisher that had outed Thiel as gay in 2007. Hogan won huge damages, eventually forcing Gawker to file for bankruptcy.

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Palantir's chief executive, Alex Karp — who publicly backed Hillary Clinton in 2016 — has sought to downplay criticism of the company's government work. Karp acknowledged to CNBC in January that the company's work for the US Immigrations and Customs Enforcement (ICE) agency involved "finding people in our country who are undocumented", but has previously justified selling the technology, despite the concerns from protestors and Palantir employees that it had been used to separate families.

“We at Palantir have a view that in societies where there is a functioning democracy - meaning there are checks and balances enforced by a functioning judiciary - we will provide the software and will continue to provide the software," Karp told the news agency Bloomberg last year. 

Palantir's involvement in the NHS Covid-19 Data Store, which was revealed in late March, drew the ire of privacy activists. The company's critics questioned whether it is appropriate to give an organisation that has received funding from the CIA, and is known for surveilling migrants, access to the medical records of the UK population, even if they are anonymised. Its defenders argue that a company trusted with handling data by an intelligence agency, such as the CIA, is well placed to process such sensitive information.

Few deny that the data store is likely to aid the NHS's response to the crisis. One source close to the project, which draws in up to 1,000 data sources a day to predict demand on the health service at both a local and national level, has described it as "the best planning tool hospitals have ever had", fuelling speculation that it may live on after the crisis. 

This would certainly be in Palantir's interest. As NS Tech reported in April, 45 of the company's engineers, equivalent to nearly 10 per cent of the company's UK workforce, have been working on the project, in exchange for a £1 fee. Its engineers have been charged with bringing together the datasets that Faculty analyses. Palantir's generosity is widely seen as a sign of the future role it envisages for itself in British healthcare.

NHSX, the transformation unit overseeing the project, has said that data will be destroyed or returned to the health service after the pandemic, but that it is also seeking to learn from the tech companies about how to use data more effectively in the future, prompting speculation that it, too, may see a longer-term role for the companies it has enlisted.

Some academics fear that the Covid-19 data store goes beyond standard privatisation, and that Karp's description of the company's relationship with governments is too simplistic. "What this will do [...] is to increase dependency on [Palantir's] technological infrastructure over time," says Lina Dencik, director of Cardiff University's Data Justice Lab. By "restructuring organisational practices", she says, Palantir creates a system that "risks displacing public infrastructure and the way policy is made."

Such concerns have also been exacerbated by reports that the New York Police Department struggled to obtain analysis in a standardised format from Palantir as its contract came to an end in 2017. Palantir said at the time that customers' "data and analysis are available to them at all times in an open and nonproprietary format".

The government itself has not inspired confidence in its ability to manage such an ally in a way that is transparent or accountable. The data-sharing agreements between NHS England and tech companies were only released on the eve of legal action from digital rights activists. And the NHS itself has wasted billions on poorly commissioned technology projects, most notably the National Programme for IT, which tried and failed to digitise patient records at a cost of £12 billion. Even when the programme was finally abandoned, the NHS continued to lose money as technology companies sued for hundreds of millions in lost revenue.

But while Palantir has many detractors, the company's work in British healthcare is likely to thrive under the Johnson administration. In Matt Hancock, it has a health secretary whose role as a breathless cheerleader for the tech sector has already raised eyebrows in the NHS. And in Dominic Cummings, it has a supporter who would like to remould the state in the image of Silicon Valley. The Covid-19 data store might be Palantir's first deal with the NHS, but it will not be the last.

Oscar Williams is a senior journalist at the New Statesman covering technology.