[HN Gopher] NHS staff refusing to use FDP over Palantir ethical ...
___________________________________________________________________
NHS staff refusing to use FDP over Palantir ethical concerns
Author : chrisjj
Score : 312 points
Date : 2026-04-03 09:36 UTC (13 hours ago)
(HTM) web link (www.freevacy.com)
(TXT) w3m dump (www.freevacy.com)
| QuadmasterXLII wrote:
| Palantir is under immense economic pressure to deliver this
| integration at high quality on time. This incentive structure,
| combined the publicly traded nature of the company, risks
| corrupting its core founding goals of embodying the evil of
| Sauron on earth and hurting as many people as it can, as badly as
| possible. However, Thiel is an extremely competent, mission
| focussed leader and I agree with the doctors: he will get this
| program back on track mission-wise without pissing off
| shareholders too much.
|
| (</s>? Maybe? hard to say tbh)
| imdsm wrote:
| The reality is that no program so far has really been
| successful within the NHS. Money is burnt at an alarming rate
| and the companies taking on these contracts are incompetent at
| best.
|
| If staff don't want to work with it then they're not fulfilling
| their roles.
|
| What if any of us took a job and then refused to work with
| Microsoft or [Insert company] due to personal reasons? We'd be
| jobless.
| Angostura wrote:
| > The reality is that no program so far has really been
| successful within the NHS.
|
| Could you be a bit more specific? No IT initiative at all? No
| attempt to create a national data spine?
| frogperson wrote:
| People arent robots, they are allowed their own thoughts and
| free will. Your comment implies any behavior against the
| interests of a corporation is somehow a sin. This is such a
| gross take.
| ChrisMarshallNY wrote:
| _> People arent robots, they are allowed their own thoughts
| and free will._
|
| Modern HR culture is working hard to address this terrible
| failing. </s>
| newfriend wrote:
| They are allowed to have thoughts and free will, and a
| company is allowed to fire you for not doing your job. It's
| not a sin, it's just business.
| twobitshifter wrote:
| > The US technology company was awarded a PS330 million contract
| in 2023 to collate operational data, including patient
| information and waiting lists.
|
| That contract value is ridiculous - how many full time staff do
| they have on this project and what rates are they charging? How
| can some say 'operational data collection' is worth a third of a
| billion to NHS over the alternatives of using a third of a
| billion on patient healthcare and actual medical research? This
| needs an investigation around how this contract was ever
| approved.
| user3939382 wrote:
| I assume the purpose of Palantir is to enable the Federal
| government to circumvent the constitution by framing their new
| spy agency as a public/private partnership. From that lens the
| funding makes sense.
| imdsm wrote:
| There's no federal government in the UK, nor constitution
| codeduck wrote:
| There is absolutely a Constitution in the UK, it is simply
| not codified into a single document.
|
| https://en.wikipedia.org/wiki/Constitution_of_the_United_Ki
| n...
|
| More importantly, the UK is a Constitutional Monarchy, with
| ultimate legislative power vested in Parliament rather than
| the Monarch.
| howerj wrote:
| I find it weird that people would downvote this, I know
| you should not complain about it, but this comment is
| correct. The UK does have a (uncodified) constitution.
| Also of note; even countries with a codified constitution
| have parts that are uncodified.
| dataflow wrote:
| >> There is absolutely a Constitution in the UK, it is
| simply not codified into a single document. <link>
|
| That's got to be the understatement of (many) centuries.
| AFAIK the UK constitution isn't even even codified into
| millions of documents, let alone a "single" one. Saying
| it's not in a "single" document is like saying my
| trillions of dollars aren't in a "single" bank account.
| The number of partitions really isn't the problem with
| that statement here.
|
| Is there a single human (or even computer program) that
| could even definitively _list_ all the sentences in this
| "constitution", let alone an arbitrary citizen who needs
| to be able to become aware of them to be able to follow
| them? (Note I'm not asking for interpretation, but
| literally just _listing_ the sentences.) Could they even
| do this with _infinite_ time? Is it even possible to have
| an oracle that, given an arbitrary sentence, could
| indisputably tell you if _it is in the constitution_?
|
| Maybe that's asking too much. Forget enumerating the
| laws. Per your own link: _"...this enables the
| constitution to be easily changed as no provisions are
| formally entrenched. "_
|
| If this doesn't itself sound silly, hopefully you can at
| least forgive people for getting irritated at the
| proposition that there totally exists a "constitution"...
| that nobody can point to... and that doesn't actually do
| the _one_ thing many people want from a constitution:
| being more entrenched than statutes.
|
| > Also of note; even countries with a codified
| constitution have parts that are uncodified.
|
| Not sure what countries you're referring to, but at least
| in the US, this is not the case. There is a _single
| document_ that _is_ the constitution, and (thankfully, so
| far) nobody is disputing what words are in fact written
| on that document. And that document absolutely is supreme
| to statutes.
|
| _Interpretation_ of the words is obviously left to
| courts in the US, and courts can interpret it differently
| changing the effective law, but "constitution" is not a
| synonym for "effective law", and nobody argues over what
| the words to be interpreted _are_. And even those
| interpretations are still written down!
| AlecSchueler wrote:
| > Is there a single human (or even computer program) that
| could even definitively list all the sentences in this
| "constitution"
|
| No, it's a living thing. Why is this your sticking point
| on the existence of a constitution or not?
| dataflow wrote:
| >> Is there a single human (or even computer program)
| that could even definitively list all the sentences in
| this "constitution"
|
| > No, it's a living thing. Why is this your sticking
| point on the existence of a constitution or not?
|
| Do you never write down or sign contracts? Are verbal
| promises adequate for you in all transactions?
|
| If you don't see the value of laws being written down -
| especially the most important ones! - I can't really
| convince you of it here on HN.
|
| But what I can tell is that most people who care about
| the legitimacy of government believe it is fundamental to
| fairness that there be a single source of truth that can
| tell them the laws under which they would be rewarded or
| punished, before those happen.
| howerj wrote:
| I think you have diverged too much...well from reality,
| in order to try to prove a point. Do you think most
| people, or lawyers, or judges in the UK spend their time
| trying to enumerate all the laws of the land before they
| proceed in their court cases? Do you think that people
| think that the UK system of government is illegitimate?
| What point are you trying to make? Because it is not
| grounded in reality. You can debate the merits of a
| codified constitution versus an uncodified one, but the
| UK does have a constitution, the vast majority of which
| is codified into many documents. The following two links
| might help you:
|
| https://en.wikipedia.org/wiki/Uncodified_constitution
|
| https://en.wikipedia.org/wiki/Convention_(political_norm)
| #Un...
|
| Note the second one applies to the US - a country with a
| _mostly_ but not completely codified constitution.
| exe34 wrote:
| > If you don't see the value of laws being written down
|
| I don't think this is helping much in the US right now.
| The orangefuhrer has shown he is willing to ignore
| clauses that are inconvenient.
| dataflow wrote:
| Nobody claimed it's helping or hurting. The debate is
| over what constitutes a _constitution_ , whether good or
| bad. There have been great governments without a
| constitution and terrible governments with one. "You
| don't have a constitution" does not mean "your government
| sucks", but it seems somehow people take it as such.
| exe34 wrote:
| > If you don't see the value of laws being written down -
| especially the most important ones! - I can't really
| convince you of it here on HN.
|
| It's a shame you can't really explain it. It's ineffable,
| isn't it.
| IAmBroom wrote:
| "I like scrambled eggs."
|
| "I do too, but the way Trump is behaving, pretty soon it
| will be illegal to ..."
| exe34 wrote:
| Pretty soon you won't be able to afford eggs.
| chrisjj wrote:
| That's an excuse for the list being not bang up to date.
| It is no excuse for the list being non-existent.
| howerj wrote:
| I believe interpretation is a part of the definition of a
| constitution, you do not, we have different definitions,
| oh well. I also believe the uncodified/codified
| distinction is not binary, it is obvious that the US
| constitution is far more codified than the UK
| constitution, the two are at opposite extremes.
| dataflow wrote:
| > I believe interpretation is a part of the definition of
| a constitution, you do not, we have different
| definitions, oh well.
|
| You can't just brush it aside as some quibble about
| definitions. It's a fundamentally substantive difference
| in the two structures: one of these has an indisputable
| source of truth (a foundation everyone can witness) that
| everything else is built on top of -- however shakily! --
| and the other _does not_. Regardless of whether you
| include the upper parts of this metaphorical building in
| your definitions or not, the foundations are not the
| same.
| howerj wrote:
| Yes, the foundations of the constitutions are not the
| same, one of them has a mostly codified constitution, the
| other has a mostly uncodified (uncodified but mostly
| written down, that is not a contradiction!) constitution.
| They both have constitutions however, so the phase
| "Britain has no constitution" is wrong. To be clear, I am
| not saying that is good or bad that Britain has an
| uncodified constitution, just that _from my definition
| (and most political and legal definitions) of what a
| constitution is the phrase "Britain has no constitution"
| is wrong_. Britain of course has laws, and laws about how
| new laws are made, etcetera. This forms a constitution.
| ponkpanda wrote:
| > It's a fundamentally substantive difference in the two
| structures
|
| Yes, it is a substantive difference but it does not
| follow that this difference provides the 'constitution'
| property.
|
| > one of these has an indisputable source of truth... the
| foundations are not the same
|
| They are so similar as to be almost the same and if an
| 'indisputable source of truth' exists anywhere, it is not
| in the written documents or their structure but unwritten
| norms and rituals sit beneath both.
|
| What stops a President from simply choosing to ignore a
| Supreme Court ruling and what prevents the King from
| returning to personal rule?
|
| The lack of arbitrary rule is a defining feature of both
| and relies on something that emerged rather than
| something imposed from without by written words.
| dataflow wrote:
| > What stops a President from simply choosing to ignore a
| Supreme Court ruling and what prevents the King from
| returning to personal rule?
|
| Legally? The fact that everybody under the president --
| including those in the military -- understand they are
| swearing their oath to the constitution -- not the King,
| not the Crown, not God, not the Supreme Court, not
| anything else. And that the Supreme Court says what the
| constitution means. And that if there is a clear and
| direct contradiction between the Supreme Court and the
| president, the former trumps (no pun intended) the
| latter.
|
| Physically? "Nothing", yeah. Same goes for non-
| presidents. If you can get enough people to follow you
| (or maybe at least enough of the people with guns)
| everything else becomes irrelevant, including whether
| your title was president or King or God or Constitution
| or whatever.
|
| > The lack of arbitrary rule is a defining feature of
| both
|
| It is emphatically not. There are lots of countries with
| constitutions that nevertheless have arbitrary rule. As
| there are countries without constitutions or arbitrary
| rule.
|
| > They are so similar as to be almost the same and if an
| 'indisputable source of truth' exists anywhere, it is not
| in the written documents or their structure but unwritten
| norms and rituals sit beneath both.
|
| No, that's exactly what those are not. Unwritten stories,
| traditions, and rituals are very much disputable. That's
| kind of the entire point of writing things down, and the
| point of the game we call Telephone. The indisputable
| bits are physical artifacts everyone can see with their
| _own_ eyes.
| OJFord wrote:
| And that's absolutely not what the commenter up-thread
| meant.
| istjohn wrote:
| From your link: "This enables the constitution to be
| easily changed as no provisions are formally entrenched."
|
| It doesn't look like a duck, it doesn't quack like a
| duck, yet you insist that this goose-shaped creature is a
| duck.
| ponkpanda wrote:
| >It doesn't look like a duck
|
| Some special amendment procedure is not the only or even
| defining feature of constitutional law. There is non-
| constitutional law that has this property and there is
| constitutional law that does not.
| istjohn wrote:
| I notice you are using the phrase "constitutional law"
| now, where as the original question was whether the UK
| can be said to have "a constitution."
|
| The oddities of this "duck" go far beyond its lack of
| entrenchment. It also lacks form and definition in the
| way that a puff of smoke lacks form and definition. It
| includes such nebulous elements as common law, unwritten
| convention, and even legal commentary of various law
| scholars. It's also said to be in constant flux as it
| evolves over time.
|
| It may be a useful abstraction within the context of UK
| law to refer to this amorphous blob as the
| "constitution," but for anyone unfamiliar with the UK's
| system of government, to say the UK has a constitution is
| grossly misleading in as much as all of the conclusions
| the listener will draw from that assertion will be false.
| It's like characterizing a chicken eating grain out of
| your hand as being "attacked by a dinosaur." The chicken
| may belong to the clade "Dinosauria" and may have
| inadvertently pecked your palm in its feeding frenzy, but
| in as much as it communicates information contrary to
| fact, it is a confabulation. At best, it's a lawyer's
| lie, to coin a phrase.
| FuriouslyAdrift wrote:
| I've heard it said that they have a constitution but it's
| written in pencil...
| istjohn wrote:
| ...in the air
| Zigurd wrote:
| You are technically correct. But the distinction between
| devolution and a Federation of states gets very blurry when
| you take a look at what's happening with voting in the US
| these days.
|
| You are technically incorrect about the UK not having a
| constitution. It's just not all compiled into a single
| written document.
| mrob wrote:
| Technically correct only if you accept "vague set of
| traditions" as a valid definition for "constitution".
| This both contradicts common usage and enables tyranny,
| so I recommend rejecting it.
| rounce wrote:
| The UK constitution isn't a "vague set of traditions", it
| is spread across a number of acts of Parliament.
| mrob wrote:
| Where can I find the official list of which acts are part
| of the constitution? And what additional obstacles exist
| to changing those acts beyond the obstacles to changing
| non-constitutional acts of parliament? In common usage, a
| constitution is something that restricts changes to
| ordinary law. If a "constitution" is made entirely from
| ordinary law it cannot function as a constitution.
| Zigurd wrote:
| Before you demand more explanation on the spot, you know
| there's a Wikipedia page for that. It explains the
| components how they are legitimated and the mechanisms of
| the UK government that rely on it.
| mapt wrote:
| The purpose of Palantir is to watch over Mordor and the other
| lands of Sauron. He's only got one eye, one attention span,
| he needs intelligent agentic processing to administrate the
| realm. Who are you going to entrust, Gorthak The Orc? The
| Nazgul? They have their own priorities, their own
| limitations.
|
| It was _incredibly expensive_ to run East Berlin as a
| panopticon state, with a large fraction of the population on
| the payroll as informers to the 100,000 Stasi agents. Obvious
| conclusions were missed all the time because of the sheer
| difficulty of keeping track of facts cross-referenced on
| paper in filing cabinets in a large office building. This
| volume of classified siloed information is toxic for the
| occupation, operationally unusable. People were disappeared
| or even executed on mere suspicion because it would have been
| too difficult to rustle up proof.
|
| Thiel looked at our prospects for effectively running an
| authoritarian surveillance state in Afghanistan and Iraq,
| looked at how many American contractors we would have had to
| devote to that, how many people we would have had to torture
| on a routine basis, how fast we might learn the language, and
| said "I think I can do better. A softer touch, a smarter
| system for controlling people. This is what AI is _for_ ,
| running society after this liberal democracy fiction falls
| away"
| da_chicken wrote:
| NB: The Palantir were created by the Elves, not by Morgoth
| or Sauron. The problem is that it takes a lot of will to
| use one and not have things of importance hidden (it shows
| what you think is important, not what is important), and as
| it turns out holders of one stone can influence what
| holders of other stones can see, if their will is greater.
| The Enemy doesn't get ahold of a stone until Minas Ithil
| falls and becomes Minas Morgul, and that's well into the
| Third Age. Two thousand years after the Last Alliance of
| Men and Elves, the second defeat of The Enemy, and the
| first destruction of Sauron. Which is still a thousand
| years before the start of Frodo's adventure. Lots of time
| in Middle Earth.
|
| The rest of your comment is, unfortunately, spot on.
| mindslight wrote:
| It's amazing how some people can read Tolkien's works and
| come away with an idea that it would be a _good thing_ to
| create new powerful artifacts that will inevitably fall
| under the control of evil. Perhaps because their minds
| have already been corrupted by the One Ring.
|
| I suppose it's just the _Don 't make the Torment Nexus_
| effect with a different motif.
| timthorn wrote:
| Partially redacted details here. The award was over 5 years for
| half that amount, but could be extended to 10.
|
| https://www.contractsfinder.service.gov.uk/Notice/0f8a65b5-2...
| DaedalusII wrote:
| https://www.adamsmith.org/blog/apparently-the-nhs-is-the-wor...
|
| https://www.england.nhs.uk/wp-content/uploads/2020/02/removi...
|
| nhs is famous dumb and has spent years trying to stop using fax
| machine. PS330 million is nothing over a few years.. NHS budget
| for 2024/25 is circa PS242 billion.
|
| the entire annual intake from capital gains tax is PS20 million
| or so
| zipy124 wrote:
| I think you mean PS20 billion for that latter figure. This is
| largely because a significant amount of assets are held in
| ISA's (PS20k a year contribution per person allowed) , or via
| personal property which is capital gains exempt or in a
| pension which is again, capital gains exempt.
|
| Thus only the wealthiest are outside these boundaries, and
| they often will not liquidate holdings until their death to
| pay inhertiance tax, or in trusts which will liqudiate over
| decades as they can pay inheritance tax over a very long
| period.
|
| This is not to mention the large amounts of off-shore
| holdings.
| mgaunard wrote:
| Many people opt for off-shore bonds (which have a number of
| advantages) which means paying normal tax instead of
| capital gains, so the capital gains figure doesn't really
| capture investment as a whole.
| DaedalusII wrote:
| it is also because if one excludes real estate holdings,
| people in the uk are actually not that wealthy
|
| 39% of UK population pay tax 82% of those people earn less
| than PS50k
|
| the other 61% of the country just sit around and consume
| money. tbh its not that bad, being an unemployed
| bodybuilder or alcoholic in wales on the dole beats making
| PS100k in london and paying 71% income tax.
|
| its almost a form of cuckoldery, you work in the city like
| a dog for hsbc, to pay for refugees and layabouts to sit
| around at gregs and spoons, and then said layabouts build
| startups and leave the country
| dmoy wrote:
| More like 40% effective tax rate at PS100k, even
| including employer side of things?
| exe34 wrote:
| > paying 71% income tax
|
| Do you have a citation for this? I'm interested in how
| this figure was extracted from where it came.
| maest wrote:
| I think they're confused/disingenuous and talking about
| the _marginal_ tax rate at 100k.
|
| There's a segment of a few thousand pounds where your
| marginal tax rate skyrockets because you lose your tax
| free allowance at that income level.
|
| It's stupid, annoying and has some minor economic
| effects, but it's very different from a 71% income tax
| rate.
| pgalvin wrote:
| Your entire comment is filled with false claims and
| figures.
|
| In 2025-26 there are an estimated 39.1 million people
| paying income tax - 56.0% of the population [1]. Of
| course, in the last census, 20.7% of the population were
| _children_ [2]. About 3.1% of the population are UK
| students in University education [3], and about 18.6% of
| the population are retired [4]. I 've also missed all the
| 18-year-olds in their final year of school, which is
| roughly 1.1 million or 1.6% of the population [5]. About
| 8.8 million, or 12.6%, are pensioners who pay income tax
| that I have double counted, usually due to private
| pensions and other sources of income [6].
|
| Totally these numbers gives a rough estimate that suggest
| only about 12.6% of working age people do not pay income
| tax. This is in line with the government's own statistics
| putting those claiming Universal Credit at 10.6% of the
| population [7], or those economically inactive at 12.9%
| [8]. This is wildly different to your implication that
| 61% of people are too lazy to work.
|
| Unemployment, which is roughly defined as those out of
| work who are actively looking for work, is at 5.2% [9],
| which it is worth noting is slightly below the EU and
| Euro area average of 5.9% and 6.2% respectively [10].
| Direct comparisons are difficult to make, but it is
| certainly indicative of the UK falling within what is
| considered a healthy range.
|
| Furthermore, take-home pay on a PS100,000 salary is
| PS68,561 [11], giving an effective income tax of 31.4% -
| far below your claim of 71%. True, there is the so-called
| "PS100k tax trap" which gradually reduces your tax-free
| allowance above this salary. But this still gives just a
| 37.6% tax on PS125,000, or 41.1% on PS200,000. You may
| consider these to be high, but they are far, far below
| your claim of 71% income tax.
|
| [1] https://www.gov.uk/government/statistics/income-tax-
| liabilit...
|
| [2] https://www.ethnicity-facts-
| figures.service.gov.uk/uk-popula...
|
| [3] https://www.universitiesuk.ac.uk/latest/insights-and-
| analysi...
|
| [4] https://www.gov.uk/government/statistics/dwp-
| benefits-statis...
|
| [5]
| https://www.gov.uk/government/publications/infographics-
| leve...
|
| [6] https://www.ftadviser.com/content/291a4ce0-9287-4118-
| 849b-ff...
|
| [7] https://www.gov.uk/government/statistics/dwp-
| benefits-statis...
|
| [8] https://www.ons.gov.uk/employmentandlabourmarket/peop
| lenotin...
|
| [9] https://www.ons.gov.uk/employmentandlabourmarket/peop
| lenotin...
|
| [10] https://ec.europa.eu/eurostat/statistics-
| explained/index.php...
|
| [11] https://www.gov.uk/estimate-income-tax
| spwa4 wrote:
| I think the reason behind this is that the UK NHS is
| using a lot of budget on long-term ill people who they
| believe aren't really long-term ill, or who at least
| could be working. Essentially, they feel they can't trust
| their employees and want LLMs to do it instead.
|
| So they want LLMs to look at all the files, and
| essentially kick a lot such people off the NHS. That's
| what they're paying for.
|
| In other words they want to "Elon Musk the NHS, DOGE-
| style".
|
| This is, of course, highly illegal to do. There is no way
| giving medical data to a US consultancy does not violate
| UK and EU law something awful. The government knows this,
| does it anyway. Which is one reason you won't be able to
| do anything about this: the government has zero intention
| to respect the law in this case. You will, of course, be
| expected to pay your taxes correctly.
| LightBug1 wrote:
| Don't care. I don't want any of the wankers over there at
| Palantir involved with the NHS.
|
| (source: a UK voter)
| gmerc wrote:
| "dumb". Call it what it is, corruption
| mhh__ wrote:
| The NHS is a huge organisation (~2 million employees alone)
| with enormous problems along these lines - they should pay 10x
| if it delivers.
| micromacrofoot wrote:
| as often the case with eternal consultants it probably won't
| deliver, plus the NHS will be perpetually on the hook for
| maintenance
|
| this isn't a "delivery" product, it should be an
| institutional pillar of the system
| RHSeeger wrote:
| But they'll pay even if it doesn't deliver.
|
| AND they're putting private information at risk by working
| with Panantir
| basket_horse wrote:
| Isn't this true for any project ever attempted? The only
| reason this project exists is because millions have already
| been wasted on trying to do this in house
| dwedge wrote:
| This is why I disagree with the idea that we should keep
| increasing funding to the NHS. The argument always seems to
| come to a false dichotomy of "either this or the American
| system" as though other systems don't exist, and as though the
| NHS isn't top heavy with bureaucrats and questionable contracts
| mgaunard wrote:
| The truth is that the NHS is very bad not due to funding, but
| for structural reasons.
|
| The fact I can't even see a GP I'm not registered with (not
| even an option to pay extra) is ridiculous. You have
| absolutely no control over your health at all.
|
| With private, you get exactly what you want, whenever you
| want it.
| shigawire wrote:
| With private, you get exactly what you want, whenever you
| want it... If you can afford it.
| stvltvs wrote:
| Pending availability of specialists, willingness to
| travel, etc.
| tracker1 wrote:
| If you're in a major metro area it's generally not too
| bad.
| dwedge wrote:
| Compared to the system of no access
| IAmBroom wrote:
| Same system, for the not-wealthy.
| iamtheworstdev wrote:
| * if available in your area or within your means of travel,
| which may include flying to another state
| IneffablePigeon wrote:
| You can absolutely see a GP you're not registered with if
| you are travelling and need to. I have done it multiple
| times. I have been offered it same or next day after
| calling 111.
| array_key_first wrote:
| > With private, you get exactly what you want, whenever you
| want it.
|
| In the US this isn't how it works. You can't see whoever
| you want unless you have a really, really good plan.
| Otherwise, you need referrals. And lots of specialists
| won't see you without a referral anyway.
|
| And, the wait is often on the order of months. I know
| that's something people complain about in the UK but I
| assure you, it happens that way in the US too even though
| we're paying 10x as much.
|
| I know private in the UK is quite good. What you need to
| understand is that the only reason it's any good at all is
| _because_ of the NHS. It has to remain competitive. If you
| go full private, then it very quickly decays.
| reillyse wrote:
| In the US if I want to see my primary care doctor I need
| to wait 2 months for the appointment.
|
| I pay $500 per month for the privilege (and a $50 copay)
|
| So I'm paying $1000 in the time period where I'm getting
| no service.
| zdragnar wrote:
| Where in the US are you? I was able to book a visit with
| my primary the very next day less than a month ago.
| tracker1 wrote:
| That was my thinking... even for specialists, I can
| generally get into a new one within a few weeks.
|
| My SO is on state Medicaid (cancer) and does experience
| the kinds of waits mentioned above... so I guess it does
| follow similarly for government/state backed healthcare,
| where I'm mostly out of pocket.
|
| But even when I had relatively typical coverage, I didn't
| have issues getting into a doctor more often than not. I
| think getting my sleep study was the longest wait I had
| for anything, they were months backed up with
| appointments... but my kidney and retina specialists were
| somewhat easy to get started with.
| array_key_first wrote:
| Not the person you replied to but I'm in North Texas and
| I just recently had to reschedule my physical. And yup,
| the next appointment is 2 months out.
|
| I also had cancer in the past and you might think that
| that would mean I get faster appointments. I do not.
|
| And I have a very, very, very good PPO plan.
| chrisjj wrote:
| > I also had cancer in the past and you might think that
| that would mean I get faster appointments. I do not.
|
| Sadly you do not may be because lower life expectancy ->
| lower return on treatment "investment".
| 0xffff2 wrote:
| As usual when people say "the US", we're papering over
| the fact that the United States is really 50 countries in
| a trench coat.
| chrisjj wrote:
| > the United States is really 50 countries in a trench
| coat.
|
| Appropriate attire... when you're in a trench :)
| mgaunard wrote:
| A specialist also requires a referral in the UK. There
| are also much more medicines which are prescription-only
| than in the US.
|
| That's why in practice we have all these (private)
| services to get easy GP appointments via phone, video or
| even online forms. While everyone knows those
| appointments can't realistically do any real medical
| work, they serve to give you prescriptions and referrals.
|
| It's just a gatekeeping mechanism, that you can more
| easily bypass if you have money. The more you pay, the
| more they care about your user experience and how
| streamlined it is.
| jaccola wrote:
| If only there were some system where the incentives could
| freely flow through and permeate every level of the sector.
| Where those organisations that provide sub-standard care
| die and those that excel receive outsized funding...
| thunderfork wrote:
| Unfortunately, a system with these qualities doesn't
| exist in practice. You just end up with the same too-big-
| to-fail macro organization minimizing their point-of-care
| labor spend and maximizing their management spend either
| way.
| harvey9 wrote:
| You can call any GP surgery to get emergency treatment for
| up to 14 days if you're not registered with a GP surgery or
| are away from home. https://www.nhs.uk/nhs-services/gps/gp-
| appointments-and-book...
| mgaunard wrote:
| While away from home, my son (5 yo) cut his finger and
| was in need of disinfectant and a bandage (steri strips).
|
| Pharmacy was useless, no medical skills or knowledge of
| their own products. Asked me to figure out myself what I
| needed and put it on my son myself.
|
| Local GP surgery sent us away: no registration, no visit.
| Me saying this was an emergency just made them suggest
| A&E.
|
| A&E is where we ended up, and while that definitely
| works, going to the emergency services of a large
| hospital for every little thing is not only a waste of my
| time but also of resources. It seems however to be the
| NHS way: whenever the littlest of troubles arise, just go
| to the hospital, or even call an ambulance.
| 0xffff2 wrote:
| Sorry for being too American to understand, but why would
| you need to talk to any medical professional to put a
| bandaid on your kid? Is this about NHS being paying for
| the bandaid? About medical expertise to apply a bandaid?
| phatfish wrote:
| You call 111 if you don't want to bother the 999 guys.
| 111 will tell you what you need to do, including "go to
| A&E".
|
| What is wrong with going to A&E for an (as you said
| yourself) emergency?
|
| A pharmacist dispenses medications and should know about
| their safe usage. They won't tell you how to bandage a
| wound.
| te_chris wrote:
| So naive. Private only works this way in Britain because it
| doesn't have to be responsible for anything. It's a luxury
| good and works accordingly.
|
| We have insurance, it's amazing! But it's fake. If you want
| to know how a whole system of this would work, look at the
| US
| kypro wrote:
| As someone who largely worked at startups and smaller
| companies before joining the NHS it genuinely confused me how
| no one would ever say no to anything when I first started
| working there.
|
| The projects I worked on were genuinely absurd... My team
| alone spent millions on things that literally wouldn't have
| made any difference to the quality of healthcare in the UK.
|
| Apparently we were given a budget and we had to find a way to
| spend it otherwise it would be cut. At any normal company we
| should have all immediately have been made redundant.
| 0xy wrote:
| The rate of increase of healthcare funding for the UK is
| 2,000% higher than France's rate of healthcare funding
| increases from between 2010 and 2019, according to World Bank
| data.
|
| The UK healthcare system is uniquely incompetent,
| administratively bloated and drives very suboptimal value for
| money.
|
| UK citizens appear to be in a collective delusion about the
| NHS that allows them to continue ineptly bumbling through
| mediocrity while perpetually fleecing more tax money to line
| the pockets of administrators.
|
| Meanwhile actual frontline workers in the NHS are completely
| ripped off in salary. Nurses get paid peanuts, while even
| neurosurgeons earn less than 1/6th of their American
| counterparts.
|
| To plug the gap by skilled healthcare workers bailing over
| these horrific conditions, the UK has been importing people
| to fill these gaps, often with severely lower competence
| (usually because of completely faked qualifications or
| outright fraud [1]).
|
| [1] https://www.hrmagazine.co.uk/content/news/hundreds-of-
| nhs-nu...
| sandworm101 wrote:
| A system whereby millions of people seek services from
| thousands of potential providers, with a life-or-death need to
| track which services and products were delivered where and when
| ... ya. It is a billion-dollar data problem. But that is the
| cost for the luxury of being able to walk into any hospital in
| the country and expect them to know everything about your
| conditions at a moment's notice.
| i_love_retros wrote:
| What were NHS execs thinking signing a contract with palantir?
|
| Either they are completely ignorant about what palantir is and
| who it's owned by (would be very concerning) or they are corrupt
| and were bribed.
| imdsm wrote:
| Reductive take
| stevesimmons wrote:
| There have been recent articles in the FT about a man (who
| surname, funnily enough, sounds like swindle) who was an
| advisor to Palantir while also being chair of 4 NHS Trusts
| and pushing the trusts to put more of their data into
| Palantir.
|
| Definitely not a conflict of interest...
| chrisjj wrote:
| Or those execs are ignorant about their staff's concerns.
| i_love_retros wrote:
| down voted by all the tech bro billionaire wannabes on
| hackernews
|
| no british person would down vote this - at least not one with
| any integrity
| basket_horse wrote:
| Or, the non politicized take is that they think the software
| could improve the data landscape of the NHS, which, if we are
| bring honest, has a lot of room for improvement.
| georgemcbay wrote:
| I am an American so the plight of the NHS has no direct
| impact on me, but I'd argue that Palantir is a
| fundamentally political company and thus there is no room
| for non-politicized takes.
| orochimaaru wrote:
| Have you used Palantir or know the infra on how it
| provides services? Or just giving sound bites you've read
| on media?
|
| You can mandate an installation on self managed infra. We
| install / use it on a completely self managed cloud
| install with pretty solid exfiltration protections. It's
| a data platform, provides interesting connections in the
| data. But that's where its utility ends.
|
| Do they work with US defense and govt? Sure they do. But
| you don't have to share your data outside of your cloud
| infra.
| georgemcbay wrote:
| What I am talking about has nothing to do with their
| technology. To know Palantir is an inherently political
| company you just need to hear Alex Karp speak.
| orochimaaru wrote:
| They're all political animals. Alex karp Is just gunning
| for a bigger share of the govt and defense data market.
|
| When you read the Anthropic and DoD (or DoW) saga,
| Anthropic ceo was happy to provide exceptions for use of
| clause.
| tt24 wrote:
| Boring comment. Let's say things that add value to the
| conversation please.
| IAmBroom wrote:
| An almost literal "No True Scotsman" fallacy, IRL.
| next_xibalba wrote:
| > completely ignorant about what palantir is and who it's owned
| by
|
| Perhaps you could give your take? When I look at the facts, I
| see a fairly humdrum data integration company that was a
| slightly early adopter of applied machine learning.
| MeteorMarc wrote:
| It seems a bad idea in the first place for a public organization
| to award a single company a huge contract for both the software
| licences and all the consultancy and implementation efforts.
| imdsm wrote:
| I suppose the issue is that the NHS themselves have
| historically been terrible at managing their software. Nobody I
| know who I rate as even mediocre and above would or have worked
| at the NHS, and those I do know who have have, I wouldn't hire
| into junior roles.
|
| I have no doubt that it's an extremely complicated mixture of
| 100s of systems, but anyone who has lived here knows how
| terrible it is. GP surgery's have for years had to send paper
| files across to new practices when a patient moves. The new NHS
| app is great, but I can see from my history that > 90% is
| missing.
|
| Another great example of how good the NHS is at this, is the
| fact that nurses & doctors would have to scroll down a combo
| list without any typeahead to pick a medication, which would be
| in an A-Z list of every medication ever.
|
| So, closing the circle, is there a reason to bring in a company
| that hires people at and above our level of competence, who
| have the expertise to implement a system to bring the NHS out
| of the dark ages of IT? Yes. There are many.
|
| There will always be concerns about data, about security, but
| I'd much rather data be in the hands of a corporation that
| doesn't leak it than an unknown company getting billions in
| contracts, building software worse than someone with a $20
| Claude extension, and then leaking it to hackers.
|
| Just my 2p
| forgotusername6 wrote:
| Internal restrictions are such that even aspiring software
| Devs find hurdles to doing basic automation. I know someone
| who wanted to use python, yes just use it, and it took months
| to be allowed to do that on an NHS machine.
| jjgreen wrote:
| Does it run on Windows 95?
| philipwhiuk wrote:
| > but I'd much rather data be in the hands of a corporation
| that doesn't leak it
|
| So would I and I think Palantir will leak it.
| basket_horse wrote:
| Is there any proof that Palantir has ever leaked client
| data? From a security perspective they are one of the few
| companies that hold IL6, which means they can handle highly
| classified/top secret information.
|
| They work with many international governments and
| companies, and I would imagine any sort of unapproved leak
| would be disastrous for their brand.
| nicoburns wrote:
| > I have no doubt that it's an extremely complicated mixture
| of 100s of systems, but anyone who has lived here knows how
| terrible it is.
|
| Yep, as someone who's worked at a couple of small startups
| trying to sell into the NHS, it's terrible. A big part of the
| problem seems to be that there's no centralised procurement:
| each trust (of which there are ~200) does their own
| precurement. And a lot of the companies (the big established
| players are the worst) at most pay lip service
| interoperability. So you end with a big mess of system that
| don't talk to each other.
|
| And they're not setup to pay "market rates" that are
| competitive with private employers to their in-house
| developers. So it's hard for them to attract and retain good
| in-house developers where they have them (although there are
| still some great people working there).
| RobotToaster wrote:
| Imagine the kind of open source EPR that could be built with
| PS330 million.
|
| But it looks like lobbying by US corporations has resulted in
| the NHS quietly deleting it's open source policy
| https://www.digitalhealth.net/2025/12/nhs-england-quietly-
| re...
| jmye wrote:
| > is there a reason to bring in a company that hires people
| at and above our level of competence
|
| Is there no one in the UK with any competence?
|
| > who have the expertise to implement a system to bring the
| NHS out of the dark ages of IT?
|
| Why on earth do you think that's Palantir?
|
| > but I'd much rather data be in the hands of a corporation
| that doesn't leak it
|
| Until the US government wants it, at least.
| Closi wrote:
| > It seems a bad idea in the first place for a public
| organization to award a single company a huge contract for both
| the software licences and all the consultancy and
| implementation efforts.
|
| I'm not 100% convinced that the consultancy/implementation
| being the same as the software vendor is a bad thing.
|
| Depending on the contract it can give you better exit clauses,
| implementation costs can be subsidised by SaaS revenue, you
| might have novel clauses for PS overspends, you get rid of the
| 'implementation vendor blames software vendor' thing, if you
| need modifications/enhancements to the base product then it
| sits with the same person, plus we don't know if Palantir's
| system is easily made for an independent implementation
| consultant to pick it up and be able to do everything without
| having to do some backend magic.
| krona wrote:
| > The US technology company was awarded a PS330 million contract
| in 2023
|
| The total contract value was PS182,242,760 over 5 years.
|
| For context that's Roughly 0.0002% per year of NHS budget.
|
| https://www.contractsfinder.service.gov.uk/notice/2e8c61c0-f...
| TimK65 wrote:
| That would imply that their annual budget was PS1.8e14, which I
| seriously doubt.
|
| Even if I assume that you meant 0.02%, which is equal to
| 0.0002, that would put their budget at PS1.8e12, which I am
| also strongly inclined to doubt.
| gnfargbl wrote:
| The NHS's actual current annual budget is PS195.6B in
| 2025/2026 [1]. The contract value declared at the link given
| above is PS182M over 5 years. So:
|
| 100 x ((182/5)/196000) = 0.019%
|
| Which, to me, still seems too high a number for a data
| management function: I make it about 1000 persons-worth of
| per-capita GDP.
|
| [1] https://www.england.nhs.uk/long-read/financial-
| performance-u...
| basket_horse wrote:
| I think you would need a lot more context to say if 0.019%
| is too high. If this platform is driving real operational
| improvements and is the core software backbone, then it
| doesn't seem particularly unreasonable.
| mhh__ wrote:
| A contrarian view although I do dislike contracting with foreign
| companies for roughly similar reasons: Palantir's technology
| looks good and I think it probably works. Most things don't work.
| cynicalsecurity wrote:
| Brits: left EU, drifted to US that treats them like crap. A wise
| choice, what can I say.
|
| "We send the EU 350 million pounds a week. Why not send it to
| Palantir instead?"
| OJFord wrote:
| I know they're similar numbers, but all you're really doing is
| making this look cheap, because it isn't a _weekly_ contract.
|
| (Not that the comparison would make much more sense if it were,
| apples and doorframes.)
| graemep wrote:
| A lot of EU countries are using Palantir and dependent on US
| big tech too
| mustHaveIRON wrote:
| fire them, plenty would be happy to have the job
| ssgodderidge wrote:
| For those wondering, FDP stands for Federated Data Platform
|
| > Our mission for the NHS Federated Data Platform is to provide a
| secure, flexible system that connects data across NHS
| organisations to improve patient care, streamline services, and
| support informed decision-making.[1]
|
| [1] : https://www.england.nhs.uk/digitaltechnology/nhs-
| federated-d...
| heraldgeezer wrote:
| muh ethics
|
| But they had no issue with any other db?
| tonnydourado wrote:
| As an interesting linguistic coincidence (or not), FDP is a
| commonly used acronym in Portuguese, standing for "filho da
| puta", literally, "son of a whore", but semantically it's
| approximately "asshole/jerk/dickhead".
| tonnydourado wrote:
| P.S.: Fuck Palantir.
| tjpnz wrote:
| Do I as a patient get to opt my medical information out?
| shevy-java wrote:
| Any government that hands over citizen's data to a private
| entity, even more so one that is primarily foreign, should be
| investigated for being a traitor to the public. That's a general
| statement, not solely confined to the Palantir guys. They kind of
| gave it away by chosing that name alone already - damn thieves
| (https://en.wikipedia.org/wiki/Palant%C3%ADr).
| kevincloudsec wrote:
| palantir is a US company subject to the cloud act. patient data
| from 123 hospital trusts is now one mlat request away from us law
| enforcement regardless of where the servers sit.
| orochimaaru wrote:
| Only if Palantir owns the servers and the storage. A lot of
| what Palantir does is on a clients infrastructure. The entire
| platform is installed on client infra. At least the one we have
| where I work is.
| chrisjj wrote:
| > Only if Palantir owns the servers and the storage.
|
| I believe no, MLAT scope is _not_ limited to servers /stored
| _owned_ by the target entity.
|
| If it was, MLAT would be routinely defeated by targets
| hosting on AWS, for example.
| beanjuiceII wrote:
| fire them easy decision
| smashah wrote:
| Why do Epsteinist Companies feel they have the right to not only
| billions of dollars of citizens in other countries, but also
| their health record data?
| IAmBroom wrote:
| "Epsteinist Companies" What does that neologism mean?
| smashah wrote:
| Companies related to the network of Epstein associates. They
| seem to have zero respect for people's rights and privacy.
| True enemies of freedom and children. We should not appease
| these people with incredulity when they are directly and
| specifically and correctly called out for destroying society.
| cmiles8 wrote:
| The Palantir brand has become incredibly toxic and, from what
| folks report, the software just isn't very good either. A lot of
| smoke and mirrors hype not matched by substance.
| asdff wrote:
| From what I've heard their money product is taking all the
| various government data systems and indexing them for search on
| one platform. Doesn't seem like much of a moat, but I guess
| that is what the bribes are for.
| cmiles8 wrote:
| It's not. The moat is just that it's challenging to get into
| that world as a vendor, but by all indications and
| observations folks cite the tech is pretty meh by 2026
| standards.
| dariosalvi78 wrote:
| > While Louis Mosley, the executive vice-chair of Palantir in the
| UK, maintains that such campaigns are ideologically motivated and
| could harm patient care,
|
| this is EXACTLY why it is of outmost importance to own those
| critical systems, and not delegate them to foreign companies,
| especially if from a country explicitly hostile towards Europe
| graemep wrote:
| Too late. The NHS is already heavily reliant on AWS. Not the
| only ones either.
|
| As things are Europe (except Russia and a few others) is
| utterly reliant on Americas. Read up on how difficult things
| became for the ICJ judge the US sanctioned. If the US ever
| blocked almost any European countries access to online services
| they economy would collapse.
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