The pandemic has shown that modernisation and, more specifically, digitalisation of health services across the world is no longer just a luxury expenditure, but a necessity for developed nations to ensure continued effectiveness in years to come. As populations explode and demographics change, effective data management is paramount.

The issue of implementation is potent, not every nation has the technology available to produce platforms capable of housing, managing, and using data effectively, so outsourcing to international corporations becomes attractive. This does not come without its issues, and in some cases, these issues are existential to implementing a fair, effective, and trusted system for patient care. The best current case study to analyse in this regard is the UK’s desire to implement a Federated Data Platform (FDP) to bring its NHS into the digital age.

Palantir – the U.S. spytech firm – looks to be in the driver’s seat to acquire the £360 million contract with the NHS, building on its existing contracts with the health service. This is problematic for a number of reasons, including the firm’s track record of coercive business practices and issues of data protection. But there is another less explored issue that we cannot afford to overlook; that of race and the trust ethnic minority groups need to have in our institutions if we are to call ourselves an equal society.

A review last year found ‘overwhelming’ minority ethnic health inequalities were persistent across the NHS, with ethnic data collection described as ‘woeful.’ This has negatively impacted the health of ethnic minority people in the UK for decades, with COVID-19 shining a light on how deep these disparities run. The NHS’ digitalisation drive has huge potential to help rectify some of these structural issues within the healthcare system, but only if done correctly.

Entrusting the task of creating this platform to a company that has been shown to accentuate existing racial bias and discrimination data feedback loops in other institutions would be unwise, to say the least. Palantir, founded by Peter Thiel, a prominent Republican, and Donald Trump supporter, has courted racial controversy in the past.

Its predictive policing systems have been found to accentuate racial bias within the LAPD whereby ethnic minority communities were over-policed and a vicious cycle of discrimination was created. Just last month, German courts ruled that police use of Palantir’s software was unlawful, encroaching on citizens’ civil liberties at the hands of an unknown and problematic algorithm.

The harrowing images coming out of the U.S. during Donald Trump’s presidency of parents being separated from their children by ICE will be difficult for many people to forget. Lesser known, however, is Palantir’s involvement in the cruel ordeal, which they went to great lengths in an attempt to deny. Palantir held a $92 million contract with ICE, and in the space of a few months, the immigration enforcement force used Palantir’s software to target parents and other relatives of unaccompanied minors crossing the border, leading to the inhumane family separation policy.

We often assume here in the UK that we do not suffer from the same problems of racism that have caused so much pain across the U.S., but it is dangerous to rest on this assumption when there are warning signs everywhere.

Who is to say that Palantir’s analytics used across the NHS won’t similarly offer preferential treatment against minorities or fail to address damaging trends for minority groups? A report in September 2022 found that 65% of Black people had been discriminated against because of their ethnicity by a healthcare professional. Another report found that 60% of Black people do not feel that their health is equally protected by the NHS compared to white people.

The NHS already has structural racial problems within its management structure with Trust board membership demographics found to not adequately reflect that of its overall staff. Palantir has itself faced accusations of racist employment practices, having settled a $1.7 million lawsuit in 2017 over allegations that it discriminated against Asian applicants.

Furthermore, a third of Black and ethnic minority NHS staff say they have been the target of bullying and harassment, more than their white counterparts. A report by the British Medical Association (BMA) found that racism was driving staff out of the service.

Kailash Chand – Chair of the BMA who passed away in 2021 – previously condemned Palantir’s work in the NHS, arguing that working with Palantir will further damage the trust that ethnic minority groups have in the NHS. Chand argued that “It makes it difficult for people like me to convince ethnic minority people that this is being done in their best interests…The secrecy around what the government is doing with NHS data, working with companies like Palantir, will damage what trust is left amongst ethnic communities, for migrants, and in the NHS family as a whole.”

With other institutions in the UK such as the Met Police having struggled with levels of distrust among minority groups in the past, it should be a no-brainer for the NHS to think twice before jumping into another contract with a company that could damage that further.