Palantir in the NHS: How to fight the surveillance state at work

rs21 health workers Hannah Dahwa and Gerrard Vannar set out seven steps that workers can take to defeat Palantir in the health service 

Palantir, a US AI and tech firm, is set to roll out a platform for amalgamating all patient data in NHS England using a Federated Data Platform (FDP). In 2023, they were awarded a £330 million contract for the project. Yet three years on, only 15 per cent of NHS trusts are using it, and there is a sizeable pushback from NHS workers and patients. So who is Palantir? How did we get to where we are now?

Palantir was set up in 2003 by US tech czars Alex Karp and Peter Thiel, and from that point on its influence has increased steadily. Early investment came from the CIA. Palantir cut its teeth providing intelligence and AI services for US agencies such as Homeland Security, ICE, state police forces, and the FBI. Its ‘ImmigrationOS’ tool, for example, is designed to enable ICE agents to identify, track, and deport people using data from social security, tax declarations, and other state databases.

Palantir then took its services to Israel, where it is now deeply involved with the Israel Defence Forces (IDF). A UN report suggested its software is being used in ‘real-time battlefield integration for automated decision-making.’ In other words, the IDF uses Palantir’s AI to justify its decisions on who to kill in Palestine. Karp boasted of Palantir’s role in providing intelligence for the 2024 coordinated pager attacks in Lebanon that killed 12 and injured nearly 3,000 people. The attack was significant not only for its egregious disregard for civilian life and international law, but also for the technical sophistication of its planning and execution. 

In recent years, Palantir has expanded into the civilian wing of the public sector. During the 2020 pandemic, they secured a contract to build Britain’s Covid database for a token sum of £1. Regular procurement procedure was abandoned, and the government rushed the deal through. With one foot in the door, a year later, Palantir’s remit massively expanded with a deal to build a nationwide platform for all patient data known as the federated data platform (FDP). The government also recently announced a tender for procurement of £750 million for NHS IT infrastructure.

Data privacy

Until now, patient data has been organised at NHS Trust level, making it clunky to transfer information if patients move trusts, or if someone has to attend A&E while travelling to another part of the country. But choosing to let Palantir ‘fix’ this very real issue entrenches the NHS in the political economy of imperialism. 

Human rights organisations, health worker organisations and unions agree, working with Palantir risks sensitive patient data being accessed by US agencies. The NHS risks becoming administratively dependent on Palantir and therefore locked into using the FDP long term. Data privacy campaigners have been concerned about the lack of opt-outs and ways that patients can control their data. There have been moves to centralise data by the UK government, resulting in widespread opposition to the proposal to introduce digital ID cards. Despite this opposition, the government announced legislation to introduce voluntary digital IDs for foreign workers to verify their identity to allow them to work in Britain. The imposition of digital IDs for foreign workers is likely the first step towards widespread mandatory use of digital IDs for everyone, as the government believes British nationals will not push back in solidarity with non-British nationals.

Winning the fight against Palantir is critical in defending the working class in Britain from an increasingly well-equipped surveillance state. The FDP gives the British state the tech it needs to launch raids on communities like we’ve seen ICE do in the US. This is alarming considering that the Reform party is waiting in the wings to take government in 2029. Its 2025 policy document, titled ‘Operation Restoring Justice’, promised to ‘relentlessly identify and detain all illegal migrants in the UK’. Using powers granted by the new legislation, it will automatically share data between the Home Office, NHS, HMRC, DVLA, banks and the police. Historically, we know that targeting one marginalised community is a precursor to targeting the wider public. The Labour party is laying the technical infrastructure to make this draconian dream reality.

AI

The 10-year NHS plan for England lays out a vision of central staff cuts of 50 per cent, with dangerously experimental plans to replace doctors and nurses with untested AI. This follows decades of cuts and austerity which have undermined the NHS with the intention to privatise by stealth. Evidence from multiple trusts in England has shown that Palantir’s AI tools do not make patient care delivery easier or safer. There are reports that Palantir’s software platform is much more expensive, takes longer and is worse than the current nationalised IT infrastructure.

The investment that would actually make our working lives in the NHS easier, reduce waiting lists and make patient care safer is more funding. Funding that can be utilised for more staff,  better working conditions, patient care and resourcing on the front line. Instead, the government directly funds private capital in the form of large data management and AI contracts, all while patient care suffers and the NHS is driven to an insurance-based model (i.e. the privatisation of the NHS).

The NHS modernisation bill proposed in the King’s Speech does not contain a right to opt out of data sharing. It moves data controllership to the government; it also allows private, for-profit companies to share, process and analyse patients’ identifiable data and to move this data abroad. There is a lack of safeguards for patient data within the proposed legislation. It also lays out measures for financial penalties on health workers, should they disagree and not allow data sharing or management. 

The bill builds on last year’s Data Use and Access Act, which was meant to ease data sharing between government departments. But there remains a gap in regulation and protections from AI for people and the planet. This comes alongside increasingly repressive state legislation for doctors, including the biggest overhaul of General Medical Council  (GMC) regulation in over 40 years. The proposed reforms would make it easier for the GMC and government to exert political influence over doctor regulation – centralising decisions, penalising doctors more easily, and removing the independence of professional regulation. 

GPs

Most GP practices are not part of the NHS, but instead provide care under contracts with the NHS. GP practices currently control their patient and practice data. They are planning collective actions around data-sharing agreements with Integrated Care Boards (ICBs), including encouraging patients to opt out. But the Labour government has announced plans to make data sharing with the NHS a contractual obligation for GP practices. ICBs have data sharing agreements to allow patient and practice data processing, sharing and analysis between ICBs and GP practices. 

Currently, NHS England and ICBs employ NHS data analysts. By abolishing NHS England and moving NHS data analysts to the Department of Health and Social Care in April 2027, it will give the government, and its data management suppliers, such as Palantir, direct control over patient data. As a result, many patient data safeguards between central government and healthcare bodies will be removed. There is also a move to vertically integrate GP practices into hospital trusts, shifting data controllership from the practice level to the UK government with no patient opt-out. 

Workplace struggles in the health sector

The British Medical Association (BMA) already has an extensive policy in place which gives members a mandate to organise against Palantir. Advice is being developed for members on how and when to refuse to use the FDP for non-direct patient care purposes while at work. Unite also has a policy in place. Unison General Secretary Andrea Egan has come out strongly against Palantir. Although Unison bureaucrats have previously blocked more militant motions from local branches being heard in the national forum, the pressure for substantive rank-and-file action on the hospital floor is currently building. 

These developments are in the context of worsening pay and conditions for workers in the NHS. Unemployment and underemployment are a huge issue, stemming from decades of underfunding and poor workforce planning. Strikes are frequent and wins are common. This is all happening in the context of the managed decline of the NHS and other public services. Wait times are ballooning, hospitals are in disrepair, and patient care suffers while the ruling class and their bureaucrats are cutting the threads that are holding it together, one by one. 

A path out?

Given the current political situation, we offer an alternative path. Not one we think is certain to happen. But one which is at least a plausible sequence of events given the state of the class struggle in the health sector today; one which workers can usher into reality with careful yet decisive intervention that would reconfigure the role of trade unions. 

First, the BMA releases their guidance on how and when members should refuse to use the FDP for patient care issues. This process is currently underway, but we should not take it for granted that union policy equals widespread compliance of members. Serious agitation by rank-and-file members and patient groups will provide the substantive basis for refusals on the ward.

Second, local UNISON, UNITE and RCN branches succeed in pressuring their bureaucracies into adopting a comparable position. NHS data analysts and IT administrators fight and win union protection for refusing to use the FDP at work. 

Third, workers at hospitals using the FDP reach out to patient and community groups locally. They build alliances with various groups who share common goals and values. Community groups distribute agitational material and militant workers host events on how to take action against Palantir in the workplace. The process connects workers from different unions and pay grades. Patients are loudly critical if workers are quiet due to fear of retribution. 

Fourth, one of the major unions launches a dispute over pay and conditions, centring on the lack of funding for the NHS, the lack of training opportunities, and underemployment among health workers. The FDP slows workers down, has no clear value, and raises patient concerns. Working conditions deteriorate as a result. Militants circulate a survey for workers who use the FDP, which finds universal frustration. Militant workers use the results to force a secondary dispute onto the ballot. Conscientious political objection runs parallel in a dispute over conditions at work and terms of employment.

Fifth, the workers enjoy huge support from patient and community groups, anti-privatisation campaigners, the Palestine movement, migrant solidarity and human rights groups, and data privacy groups. They are buoyed by the success of the nurses’ union in New York, which successfully kicked Palantir out of their hospitals earlier in 2026. A strike ballot is successful. 

Sixth, workers from another union with an existing dispute and strike mandate see the opportunity. They declare their own strike action. Workers from two unions consult in the same hospital around organising committees, and are on the same picket, breaking the tendency for health unions to organise by profession rather than by industry. 

Seven, patients seek widespread opt-outs on how their data is being handled and demand to know how their data is being used. GP practices prevent data being shared and improve their prospects of contract negotiation. Patients support their practices to push back against the government, demanding better safeguards for their data, and arguing for better public funding and staffing, particularly for more General Practitioners. 

This is not just wishful thinking. There are already several workers autonomously refusing to use Palantir products in at least two hospitals in London. Going forward, the task is to coalesce this independent action into a widespread organised effort. Workers could break through one of the biggest barriers to building class power in the workplace today: the loss of the right to political strikes. Building a campaign around working conditions, whilst relating it to the wider issues around ethics and the lack of safeguards for suppliers in the workplace. 

It’s a situation ripe for socialist and anti-imperialist intervention. The campaign is an opportunity to develop alliances across different sections of workers. This will be necessary to prepare for whatever punitive strategy the government tries next. It will also lay the foundations for more ambitious demands in the future. We need to prove to health workers and workers across Britain that we can make political demands and win by finding an explicit link between our working conditions and state repression. 

Patients and communities have an invaluable role to play in this fight. The NHS is perhaps unique among employers in that there is nationwide popular affection and a sense of ownership over its fate. Worker-patient alliances have sprung up around the Palantir issue. These relationships have given the campaign vitality, durability, and novel strategic possibilities. A worker and patient-run NHS is impossible without this first step. 

Developing an alternative model for data sharing

There is mounting pressure within the campaign for a break clause for Palantir’s FDP contract that could be triggered prior to February 2027. However, if another supplier with similar credentials gets involved, then the UK government’s ongoing project to centralise our data to gain greater control and authority will likely continue. The big issue is a lack of viable socialist alternatives. Yet there are existing models of data development, such as those in use in Greater Manchester, that are more functional, cheaper and developed in-house by public services. 

Having health data protected from centralised control safeguards patients from an authoritarian turn in government. There are past examples like NHS Spine in England and the in-house vaccination record architecture developed in Wales during Covid. The latter made vaccine delivery in Wales much faster than in England. 

We need to secure in-house funding streams that are resilient to the whims of Whitehall. This struggle would help us regain control and autonomy of our health data and clarify what has led us here in the first place. Worker and patient-led ethical procurement policies, data sovereignty, and ultimately ownership of the NHS is not only possible but essential. The water and electricity consumption behind AI is immense and is destroying communities in Britain and abroad. A worker-patient-owned health system is better positioned to deal with challenging questions like the environmental impact of data centres. Winning intermediate objectives around Palantir builds class consciousness, refines strategy and tactics, and grows the confidence needed for bigger fights to come against the profiteering of private billionaire capitalists and AI.  

Socialists need to lead winnable campaigns and prove to be the best organisers in those campaigns. We need concrete demands, a clear ladder of escalation, and a plan post-victory. Struggles are not won by sound analysis alone. Winning requires you to get involved and take practical actions in your workplace.

This campaign has a clear link to economic demands, government strategies, private capital and imperialism. There are specific pressure points and clear pathways to escalate this across social movements, unions and in the political sphere. The skills and resources cultivated through this process could help to develop mass socialist organising by linking up struggles at multiple sites and scales. 

Palantir’s involvement in the NHS helps to make the connections between the worsening conditions in Britain and the economy of imperialism clear. And because strategic and class power is building, and can develop further, the Palantir campaign is winnable. We ask those interested to join and collaborate with their local branches within the Palantir campaign. If you are a health worker or work in the NHS, this is a chance to get to know your colleagues and build worker power around a meaningful campaign. 

If you are interested in the campaign but are not a health worker (i.e. patient or public), you will make an invaluable contribution, building relationships with workers who are organising, demanding your data is protected and fighting back against NHS privatisation, state repression and imperialism. 
To get involved, get in touch here: hw4fp.uk@protonmail.com.