Martin Blanchard is a founder of Mental Health Action

Introduction

Palantir is only one among many US corporations that profit from UK government contracts and increase our dependency and vulnerability. The surge of revulsion against Palantir’s presence in our NHS has been incredible and inspiring. There is no question we need to rid ourselves of a company that boasts of its role in the Gaza genocide, parades its authoritarian world view with unabashed arrogance and disparages the values at the heart of our healthcare system. Surely the strength of public opinion, Palantir’s antipathy to the ethos and core values of the NHS, the many demonstrations of the inadequacies of its software and the possibility of mismanagement of our data should be more than enough for government to terminate its contract for the Federated Data Platform at its review point next year, if not before.

Only the beginning

However, cutting links with Palantir will not signal the end of our unhealthy dependency on big US corporations, but rather, the first sweep of the brush aimed at establishing our digital sovereignty. There are other US corporations that are also involved with the violence in Gaza, mass population surveillance, border control, work with the Central Intelligence Agency, global exploitation and devastating eco harm. These are the US tech corporations we employ to provide the crucial digital infrastructure across our NHS and social care services, much of our health research, and our other essential public services. Their market value runs to trillions of dollars, with each corporation’s worth being bigger than many countries. Together, these US Artifical Intelligence (AI) firms have a market value equivalent to US Gross Domestic Product. Collectively, they are known as ‘Big Tech’ and have been welcomed into our public services by our government as part of its drive for improved productivity.

Big Tech and its ‘panopticon’

Embedded in the NHS we find Microsoft, Amazon, Google and Oracle, whose trillion dollar investors have enabled them to develop and furnish data centres (aka ‘public clouds’) with cutting edge technology and so provide a ‘compute monopoly’.  Habitually buying out or heavily investing in any start-ups and companies perceived as commercial threats, they also have a ‘knowledge monopoly’ that is built on a lack of sharing (let us call it what it is – theft) of intellectual property rights. This comes from joint work with public institutions globally and a unique overview of all the thousands of companies that use their ‘clouds’, giving them the business ‘intelligence’ which enables them to decide where they can most advantageously invest, or whom they should buy out. This has rightly been likened to a ‘panopticon’ – a type of 18^th century prison architecture with in-built system of observation and control.

Promise, promises

Armed with these capabilities, they have infiltrated many sectors of the economy and the public arena, renting out services from their ‘clouds’ to even the largest of private corporations and numerous governments around the world including in Europe, Israel, India, Australia, and across Latin America. Since about 2010 this has included our UK government, with Big Tech moving into our healthcare sector and NHS from around 2015. Entry is made with promises that their Tech’s abilities will provide solutions to improving productivity at a time of global economic stagnation and governments’ reluctance to adequately fund even essential services.

Importantly, Big Tech’s wealth and associated monopolies also enable them to control the global ‘digital value chains’ which consist of product development, delivery and management in each sector of the economy, and to gain the power that comes with providing the essential social infrastructure for whole nations.

Shifting the delivery of healthcare

The growing influence of US Big Tech within the NHS has marked a profound shift in how our healthcare is delivered, organised, and monetised for profit and how our health care data is commodified. These corporations are not just providing tools, they are actively reshaping the foundations of care, where it happens, how it operates, and who ultimately benefits. Even more, their established monopolies over essential digital infrastructure and knowledge create dependency in users, leaving large corporations, start-ups and state institutions as ‘locked-in’ rent payers.

Giving such power to Big Tech in our economy and our government will inevitably reduce the ability to control our own digital destiny. These corporations will reduce the control we have over our data, define the infrastructure, software, and hardware abilities provided, and take part in determining what is needed and future priorities. To put it plainly, Big Tech’s intrusion threatens our control of our national digital assets and can be construed as a level of ‘corporate state capture’.  If we do nothing about this, it will further develop into a form of digitally derived ‘colonialism’ with the effect of increasing the movement of our wealth to the US economy.

Hiding in plain sight while extracting profit

Working from within the NHS makes it difficult for these threats to be recognised because of the way Big Tech operates. For example, they do not deal with NHS Providers directly but rather use a vast marketplace of private vendors which Big Tech misleadingly call ‘partners’. These companies rent their place on ‘cloud’ and pay for the required training to work there. Only when trained are they able to sell the use of their particular software etc to an NHS  Provider and to set it up on ‘cloud’. Once linked to ‘cloud’ the NHS Provider must then also pay Big Tech rent for usage of its infrastructure. Also a percentage of any profits made by ‘partners’ while they are on cloud is taken by Big Tech, rumoured to be at around  30%. With the large choice of companies available, an appearance of ‘competitive tendering’ is created, making it difficult to use Monopoly Law against Big Tech. On top of this, there is extra value to be extracted in that many of the ‘solutions’ provided will involve the need for the use of Big Tech’s own (native) AI -or that of any of their ‘subsidiaries’. Unlike machines, AI does not wear out through use and need replacing but instead improves in its performance and becomes more valuable.

This model used by Big Tech locks healthcare and related public services into long-term dependency on ‘cloud’ while shifting value and control away from the public sector.  The more services there are that use ‘cloud’ and the longer they remain in situ, the closer Big Tech can move towards control of the core of our health and social care provision and their governance.

Big Tech’s ‘cloud’ becomes the environment in which critical technologies are developed and deployed not just for health and social care, but similarly for other sectors’ institutions and services that sustain our society.  This risk of loss of control of what some call ‘digital sovereignty’ is now recognised across the world, with the European Parliament and various initiatives in Latin America, Australia and India actively seeking to find alternatives and remove Big Tech.

Conclusions

We must be careful not to be taken in by any simple solutions that might be offered by government for the difficulties created by the use of Big Tech as outlined above. The only real solution is to develop a genuine ‘public cloud and stack’ which we own and control, which excludes Big Tech entirely from the public sphere, and with which we can meet all our public service needs. Only this can provide us with the ability to become a nation based on equality and human rights that we have struggled for so long to become.

The call is for all of us to campaign against the ‘corporate capture’ of our essential services that help to make our country what it can be at its best. Big Tech are simply too powerful and too close to the US administration to be allowed to be an integral part of our infrastructure. Their mission above all else is simply to maintain US supremacy.

If you would like to read more detail about what needs to be done, then please follow this link to an abbreviated version of an academic ‘Progressive Road Map’ that is gaining global traction.