Defence Secretary John Healey resigns and calls out Rachel Reeves

[Fillies4DeclanRice]

John Healey has become the latest government minister to resign, basically saying he cannot do the job of keeping the UK safe because Labour's economic model is in such a mess.

His resignation letter effectively says the government needs to spend far less on welfare benefits and net zero, and start taxing less and spending more on defence.

This is total chaos now.

Plenty of other countries with private health care systems and less centralised education have far far less “data” on their citizens.

Here they want the data accessible because you keep seeing a different doctor and you are seen by the “system”.
In a more personalised health care system with a relationship with specific specialists that amount of “data” is not even required. You would have your main GP who you actually get to see and prompt referrals to the same specialists.

@Papyrophile - the point was that the structure of life is such that you are meant to save for your retirement, and then you are meant to spend those savings down.
And wealth tied up in housing is inefficient.
In a perfect society, there would be lots of readily available secure tenanted housing with easy access to medical and social care for elderly people. Places for life where they rent and are warm and well looked after, but as parts of normal wider communities. None of that exists successfully nor has been planned for.

I'm not sold @Araminta1003. Living in a secure retirement ghetto: yuk!

No, people in the UK go to their GP who is the equivalent of a US house doctor or Dutch HuisArts. Often it is a GP surgery with multiple doctors under roof any one of whom may see you but they can and do have a record keeping system if all the patients registered with them and their health needs/illnesses etc. That isn't a challenge.
The data sharing issue comes in when people for example turn up to A and E needing treatment or are referred by the GP to other NHS services for things like cancer treatment, operations etc. That is where not having the records on hand can cause issues. But if you have ever watched an American medical drama they are always "phoning such and such" for the patients records. Actually there's a whole other web of complication in the US to do with insurance companies and who's on the insurance companies list of providers and who isn't. It generates far more admin.

Having all the different GP surgeries, hospital trusts, out patient clinics using the same or compatible systems would make sharing patient data a lot easier and more efficient. It also makes it easier to do large scale statistical analysis. We do already do data sharing better than other places. However it isn't perfect and from the sounds of it there isn't much interest in finding in-house solutions. I think Palantirs problem are a bit of technical utopianism.

One of the biggest blocks to getting a centralised data sharing systems across the NHS was public concern about privacy etc. when they started rolling this out it was a huge concern. I don't think that the government bringing in a company with a reputation like Palantir is going to help people trust the NHS. And without public trust the NHS won't get the data it needs anyway because increasingly people will choose not to participate or hold information back. So you have a much bigger problem than you started with.

But if you have ever watched an American medical drama they are always "phoning such and such" for the patients records. Actually there's a whole other web of complication in the US to do with insurance companies and who's on the insurance companies list of providers and who isn't.

This was true 15 to 20 years ago, but is not the case anymore. Laws were passed to set interoperability standards for medical record systems and incentivize providers to share data.

A Unified Approach to Health Data Exchange - A Report From the US DHHS

Almost all of my doctors and specialists are with one large medical group practice in my area. Last year, I needed coronary bypass surgery, which is something they don't do, so I was referred to a surgical practice in NYC, where the operation was performed. I later did cardiac rehab at another hospital system in my area. All three medical groups were able to see my medical records, test results, scan images, radiology reports, etc., from the other two groups. All three groups use the same medical records software, so I'm sure that helped as well.

Determining who is in-network with your insurance is still an issue, but much less so than before. Medical practice groups have consolidated and gotten much larger. Mine has over 200 doctors, and they're all in-network with my insurance. The same was true for the large surgical practice I went to and the hospital where I did cardiac rehab. Also, about 80 million Americans have government health coverage (Medicare or Medicaid), which is accepted by all providers, so being in- or out-of-network isn't an issue for them.

That's good to know!
But likewise, within the NHS system when I have needed it everything flowed quite smoothly behind the scenes. I was referred from specialist to hospital and back and all the data moved with me without much friction.
Arguably if it can all work smoothly now that's a stronger argument against bringing in large tech companies like Palantir since, I'm assuming, this wasn't needed in the US. I agree that there should be more consistency in databases in the UK but the fact America was able to do this without asking an external company to paste over the cracks is a sign there's a better way. It's the laziness involved on turning to Palantir that annoys me the most.

I recently retired, but I previously worked in health care. Getting medical data integration to the point we have now took years and was very expensive, and it was done by the commercial software companies that serve the healthcare industry in the U.S. All the government did was to set standards and provide incentives to get it all done.

It seems unlikely to me that the NHS can do this within a reasonable timeframe using its internal IT resources. If companies with expertise in this type of system integration have tools to do it more efficiently, I don't know why you'd want to do it yourself.

But that isn't what Palantir does and isn't what it is. Originally they didn't even call their systems AI but that's fashionable now so it's had the AI thing tacked on. Palantir are quicker because they don't do the medical data integration as you describe which indeed takes a longntime. The problem with these quick fixes is they won't fix the underlying issues with compatibility. It creates at best a system that works but is extremely vulnerable to the whims of a foreign company. At worst it creates a system that usually appears to work but which has holes in what is transferred. Which can be catastrophic in a medical situation.

It's not just the whims of Palantir. The US recently banned Claude AI from being used outside the US. They can do this because the company that runs Claude is a US company and they have the right to do this. But equally they could request Palantir stop operating overseas/with organisations they disagree with. They have the right to-do this. The UK would be crazy to put itself in a situation where this can hurt them

I worked for the UK parent of one of the companies that pioneered Electronic Patient Records in the early 2000s and went out to see how it had been put together.

The problem in the UK has been, and I believe still is, the reluctance of GP services to share the same systems and protocols as hospital trusts, which themselves are not uniform across even the English regions. The choice of Palantir is because 25 years of trying has failed, but Palantir works with everything. I don't really care that Peter Thiel is a nutjob. His company has created a better widget to enable legacy systems to work together, thus saving billions and millions of hours.

The same argument explains why the Met wants to use it.

Only the most recent version of Claud was restricted from foreign use, and that was for clear national security reasons. There would be no legal basis to restrict the use of Palantir's software tools in the UK. The previous version of Claud is still available, as are dozens of other AI products.

Software is a global market. My previous employer used a British cybersecurity software service called Darktrace. There were no concerns that it would somehow be cut off. Our contract was with their American subsidiary, and I assume the NHS and the Met are working with Palantir's UK subsidiary.

As @Papyrophile points out, what you're doing now isn't working, is increasing costs, and is negatively affecting patient care. Innovation, under government guidelines and controls, is the solution. If there were a British competitor to Palantir, that would be preferable, but there doesn't seem to be one.

Agree 💯