Column The news that openDemocracy is calling for a legal review of Matt Hancock’s allegedly illegal deal with Palantir is a sign of two things: that things have gone wrong and are going wronger in government health policy; and that there are still ways to start to put it right.
What is harder is not finding a process to make things better, but how to stage an intervention for a government drunk on power, corruption and incompetence.
The process of an inoculation against deals like the one inked with the controversial big data analytics firm has of late been illustrated on a global scale like never before. In medicine, confidentiality protects the patient but the absolute opposite informs the science. We’re all much better versed this year than last in how medical trials work: ethical probity is established, protocols are chosen from known good, proven options, results and their analysis go through strict independent checks, and a public regulator finally looks at the whole thing before approval.
Campaigners demand judicial review of NHS deal with Peter Thiel's AI firm PalantirREAD MORE
This process is both long-established and evolving. It's normally slow, but our confidence in it means we got our vaccines from lab to jab in 10 months, not 10 years, without breaking any rules. The essence is openness, evidence and scrutiny, and it turns out that with resources and motivation you can do all that very fast indeed without shortcuts. The same principles inform all of science, and as a result we have a world of miracles. The bad things happen when we ignore the principles: you could ask Dr Li Wenliang, if he were still with us.
Let’s compare the model of scientific rectitude to the Palantir contract. It has many sins, but the greatest is secrecy. It could be that the work Palantir has been hired to do is well-formed, with clear goals, excellent appropriate technology, strong internal governance and a very good investment in the nation’s health.
It’s not likely, given the government’s track record on IT in general and health IT in particular: either way, we cannot tell.
Would you accept a vaccine that had been commissioned illegally and developed in secret, by people with a history in biological warfare, with none of the regulatory checks - indeed, flying in their face? If not, why would you accept the very essence of the NHS, its data, being swallowed up by such a process?
Health minister Matt Hancock last week was found by a High Court judge to have acted unlawfully [PDF] and to have made a "transparency breach" by failing to publish details of contracts within 30 days. His excuse, no defence in law, was that things were happening really quickly and did we want to all die while he filled in some pettifogging forms? No, Mr Hancock, we wanted to live and we wanted you to fill in the pettifogging forms. Hire more people. Do your job. Follow the law.
We know that doing things in an emergency at unprecedented speed does not mean breaking the rules. Our bouquet of vaccines is proof of that. This is especially true for government contracts, where if you have to jump through hoops in the name of the damn law, you hire enough people to do the jumping. That's how the vaccines were approved in record time. The resources were allocated. People were hired. The job was done. The rules were followed.
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Even Hancock’s wafer-thin excuse can’t apply with Palantir. This contract is the result of discussions (easily mistaken for junketing) started well before the pandemic. It applies far more widely than pandemic management.
What’s at stake could barely be higher. The government is reorganising the NHS and taking control back from the trusts and regions, and giving it all back to Dr Unlawful Matt. And what does his clinical judgment look like? With Palantir, he is giving our money and our health data to a company which is deeply implicated in helping elect and benefiting from Donald Trump’s 2016 election victory and subsequent no-bid contracts.
A company with deep connections with the CIA, the NSA, the FBI - it seems that if it has got three letters in its name and wears dark glasses, it’s a customer.
Yet none of that matters particularly. It’s a distraction, at best a motivation to ignite your outrage into activism. We might see Hancock breach the law again, which should matter - but with a government committed to defensive actions, it’ll be lessons learned, full confidence, matter closed, time to move on, how dare these lawyers lawyer, magnificent tunnel, whaff whaff whaff.
What matters is boring and pragmatic and unarguable: does this stuff work, is it safe, is it worth the money? When the department is found in breach, again, there will be a chance not to call for Hancock's head, but for his spreadsheets. Let’s apply the same rules to government health contracts as we do to medicine development. Palantir says it keeps data safe: who cares? Let’s see the details. The internal systems. The audit trails. Don’t want that? Fine, don’t get the job. Confidentiality is for the data, not your project management powerpoints.
What will the results look like? How will we know success? What will happen otherwise? These are the very basics of project oversight, and we deserve them. Evidence says we need them. We have a government that has paid multiple billions for track and trace, only to have the fourth highest per-capita death rate from COVID-19 in the world. If that was the result of a medical trial - assuming it ever got past ethics - what do you think the chances of the same scientists being allowed to use the same methods again and again?
It’s essential to draw a line in the sand, of course. To say that a secret contract (potentially illegally) handing NHS cash and data to a company mired in surveillance and murk is a step too far, even for this lot. If you care, stop messing about and support openDemocracy every which way.
But more than that, to keep the snake oil and corruption out of public IT in the future, the time is now to say we know what works, because 18 million of us have an armful. We know what doesn’t work: because we have a graveyard full. If you’re an MP, you know what to do. If you’re not, then find one and apply enlightenment. Say what we want and get the word out. A clear message, ready to go, if amplified by enough people, will prick through the thickest ministerial skin.
Even Hancock knows what it means in a pandemic to refuse the vaccine. ®