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Private sector involvement in the NHS only works if it’s not monopolised

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Any sniff of private sector involvement in the NHS unnecessarily prompts clamourings from government critics about privatisation. In truth, the NHS needs private sector help and has benefitted from it as a prominent part of its structural operations as far back as the Blair/Brown era. The Health and Social Care Act of 2012 increased private sector involvement but emphasised the need for a diverse provider market with a healthy amount of competition and patient choice in order to improve patient care.

This approach can work but it is reliant on the element of competition; this is what keeps the costs low and the service quality high as private companies battle to win and maintain their contracts. There appears to be a worrying recent trend, however, that certain parts of the NHS’ operations are becoming monopolised by one or two big providers, squeezing out the competition and resulting in a dangerous combination of higher charges and poorer performance.

Big tech firms have been taking a more active role in the NHS as part of its digitalisation drive over the past few years, bringing with them expertise and talent, but also asking for billions of pounds in return. With armies of lobbyists and lawyers, they have a clear competitive advantage over smaller providers. An egregious example of this is that of Palantir, who have already taken multiple government contracts, including being awarded a £23m NHS contract without competition. After burrowing their way in, they have now set their sights on the NHS’ Federated Data Platform, worth over £360m.

The opening of the contract tender has been met by cries of foul play in the health industry, with many claiming that the cards are being dealt in Palantir’s favour. The length of the competition is undeniably short, at under a month, meaning that providers who don’t already have an existing knowledge of the NHS and a relationship with senior management are at an automatic disadvantage. With the backing of the Prime Minister, the services of some of Westminster’s most influential lobbyists, and a number of ex-senior NHS management figures behind it, Palantir has attempted to make its bid for the contract an inevitable success.

This has all been no coincidence. Leaked internal Palantir documents from back in 2021 revealed their regional head, Louis Mosley, describing their strategy for securing NHS contracts as “Buying our way in…!” The master plan being to buy up any smaller rival private companies that had existing relationships with the NHS, quite literally eradicating the principle of private competition and bulldozing a clear path to victory.

By freezing out competitors – who subsequently suffer in the UK market and cannot reinvest to make their own services better – Palantir is gaining a stranglehold on the UK’s health service. When costs shoot up and the quality of service plummets we will truly see the fallacy of allowing monopolised private sector integration within public services.

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