We need to talk about Fit for the Future because it's not fit for purpose

TetleysTLDR: 'Fit for the Future' is a Corporate coup in disguise that will turn off the NHS's life support system

Labour’s Fit for the Future 10 year plan is being marketed as NHS reform, but it's really a backdoor plan to privatise our healthcare system.  Glossy and full of soundbites, more style over substance and awash with concessions to the Health Secretary's private paymasters, it tells you a lot more in what is doesn't say that what it does say. It paves the way for:

• Palantir, a CIA and Israeli linked surveillance firm, to control NHS data
• Health insurance creep, where patients pay out-of-pocket or buy private cover as the NHS is gutted
• Privatisation by stealth, expanding private contracts, digital outsourcing, and corporate partnerships
• Wes Streeting, who is funded by Tufton Street donors, leading the charge with Big Pharma and private hospital interests cheering him on

Privatisation doesn’t improve care, it increases costs, reduces quality and kills trust. Case studies show it leads to worse patient outcomes, higher mortality, and massive public waste (e.g. PFI, outsourced mental health and cancer services).

Palantir's involvement is especially dangerous: it turns the NHS into a data goldmine for profit, with real risks to privacy, consent, and accountability.

The endgame is a two-tier, insurance-based system wrapped in NHS branding.

This isn’t reform: it’s surrender. And unless we stop it now, the NHS as we know it will be gone.

Fit for what, exactly?

Anyone who has ever needed the NHS, has a family member who has ever needed the NHS or simply has lived in this country with its support knows just how important it is. They know how underfunded it is, how politicians have lied about investment and how it has been asset-stripped by the private sector over successive Governments of both colours.  Yet for a Government that uses genome sequencing on the front of its 10-year plan, it seems tone deaf to just how much a publicly owned NHS is in our collective DNA.   

Labour’s much lauded Fit for the Future, is being sold to the public as a visionary plan to modernise the NHS.  What it really is, however, is a calculated roadmap for deepening the stranglehold of private corporations over our healthcare system. Wrapped in the language of 'efficiency', 'digital transformation' and 'partnerships', this is privatisation by stealth: designed to be palatable, not honest. 

At the heart of it all is Wes Streeting, the 55 Tufton Street-funded wrecking ball with a plan to hand the NHS over to Big Pharma, Silicon Valley surveillance firms, and health insurance interests.  If we don’t call this out now, we’ll wake up in five years with a two-tier, data-mined, insurance-led healthcare system wearing the NHS brand like a stolen suit.

A Trojan Horse of Tech and Profit

A cornerstone of the white paper is the expansion of NHS digital infrastructure presented as necessary reform but, in practice, a huge open door to tech giants like Palantir. This US-based company, originally funded by the CIA, has been awarded a £330 million contract to build the NHS Federated Data Platform.  That’s the spine of NHS patient data: who you are, what treatment you’ve had, what drugs you’ve taken, and where you’ve been.  

The British Medical Association has sounded the alarm, warning that involving Palantir could 'undermine public trust in NHS data systems'.   Dr David Wrigley of the BMA put it plainly: 'If Palantir’s software is being used to target individuals in immigration enforcement… that’s completely incompatible with the values we uphold in the delivery of care'. (The Guardian) 

The abolition of NHS England was calculated.  It needed to happen to paved the way for opening the door to the level of privatisation and lack of scrutiny Streeting needs to carry this betrayal out. 

There was a lot of things wrong with NHS England but the one thing it was, was a check and balance.  The abolition of NHS England and the rushed introduction of the new Procurement Act have laid the legal and structural foundations for the privatisation agenda embedded in the so-called Fit for the Future reforms. By dissolving NHS England, a key statutory body responsible for planning and oversight, the government has stripped away one of the few remaining national mechanisms for ensuring equity, accountability, and public control. The new Procurement Act, meanwhile, removes the requirement for competitive tendering and allows private providers to be handed contracts without scrutiny, bypassing public consultation and parliamentary oversight. This combination clears the path for Integrated Care Boards to embed private corporations at the heart of service delivery, accelerating the shift from a public service to a fragmented, profit-driven health market. It's not reform: it's asset-stripping in real time.

TetleysTLDR article on the abolition of NHS England

Palantir: A dangerous predator, not a partner

Palantir is no neutral tech vendor.  This is a company whose founding ethos is surveillance, military application, and profit from predictive control.  It built ICE’s deportation tracking systems in the US, developed battlefield software for the Pentagon, and has long-standing ties to intelligence agencies. Now it wants access to your GP records.  Palantir’s business model isn’t about improving healthcare, it’s about turning populations into datasets.  The more data they mine, the more they can monetise via analytics, risk profiling, and behaviour prediction.  And once they’re embedded, it’s nearly impossible to untangle them.  NHS England has already had to rewrite tender rules to allow Palantir to bid.  That’s not reform.  That’s regulatory capture.  This is the company that now holds every cancer patient pathway in England in its proprietary software. The NHS didn't buy a tool, it sold the keys to the kingdom.

Palantir, which has secured a £330 million NHS contracts to build a federated data platformInvestment Monitor+10Vox Political+10The Times+10 Financial Times+2The Guardian+2WIRED+2. The British Medical Association warns this “threatens to undermine public trust in NHS data systems” The Guardian. Dr David Wrigley (BMA GP Committee deputy chair) cautioned:

“If Palantir’s software is being used to target individuals in immigration enforcement … that’s completely incompatible with the values we uphold in the delivery of care.”The Guardian+1WIRED+1

Moreover, a Financial Times exposé revealed NHS England’s Chief Data Officer was invited as 'guest of honour'at a Palantir lobbyist dinner, sparking concerns over conflicts of interest Financial Times+1WIRED+1.

Historical parallels are alarming: the National Programme for IT (NPfIT),a huge digital privatisation during Blair–introduced systems like Cerner, resulting in cancelled surgeries, un-flagged MRSA cases, and cost overruns from £2.3 bn to possibly £20 bn Wikipedia.

A Financial Times investigation exposed how Palantir and other US firms have lobbied their way into British health policy. Palantir even hosted NHS data leaders at private events to push their influence.
(FT, 2025) 

And there's Louis Mosley .  He is the Exec Vice President for Palantir in Europe: the infamous US tech giant with deep ties to the CIA and ICE.  A company co-founded by Peter Thiel, a hard-right libertarian who thinks democracy and health care are obstacles to profit.  Palantir's business model? Extracting and exploiting sensitive data, often without meaningful consent. Their involvement in NHS data has already sparked outrage and legal challenges, not least because it reeks of backdoor privatisation, surveillance creep, and profiteering off our most intimate medical records.  Mosley himself has a pedigree soaked in elite entitlement: the grandson of fascist Oswald Mosley, and he’s been flinging money around in Westminster with the subtlety of a Tory donor on a bender.   In fact, he donated £100,000 to the Conservative Party in 2023, which just happened to be shortly before Palantir was awarded a huge NHS data contract.  A coincidence?  Pull the other one.  Putting a man like this near the NHS is not reform, it's a hostile takeover.  It's handing our healthcare infrastructure to people who see it not as a public good but as a cash cow for Silicon Valley billionaires.  It's the commodification of illness, the monetisation of suffering, and the betrayal of everything the NHS is supposed to stand for. We need transparency, democracy, and care at the heart of the NHS, not corporate capture by American surveillance capitalists and their political bagmen.  So no: Louis Mosley shouldn’t be anywhere near the NHS.  He should be kept at the same distance as any other private-sector predator looking to gorge themselves on the bones of what’s left of our welfare state.

He recently gave evidence to MPs, defending Palantir's £330 million Federated Data Platform contract and accused the British Medical Association of choosing “ideology over patient interest”.  Some call from someone who likes to wear black shirts and who's Grandaddy was featured as a baddy in Peaky Blinders.  reddit.com+15theguardian.com+15inkl.com+15.

Some important context:

• In July 2025, Mosley appeared before the Science, Innovation and Technology Committee, reiterating that Palantir’s tools aim to 'make patient lives better by making their treatment quicker, more effective, and ultimately the healthcare system more efficient' reddit.comstandard.co.uk+3theguardian.com+3inkl.com+3.
• He remains the head of Palantir UK, as noted repeatedly in the media, including The Guardian and Pulse Today pulsetoday.co.uk+1wikidata.org+1.
• Critics (e.g., the BMA and several MPs) continue to express concerns about Palantir’s ties to defence and surveillance—highlighting fear that data could be misused or linked with military systems standard.co.uk+13theguardian.com+13pulsetoday.co.uk+13.

Tetleystldr article on Palantir

https://actionnetwork.org/letters/nhs-trusts-resist-the-rollout-of-palantirs-federated-data-platform/

The Good Law project has been raising concerns about Palantir for some time now:  

https://goodlawproject.org/palantir-poised-to-cash-in-on-wes-streetings-nhs-plan/

Peter Thiel, founder of Palantir is particularly toxic piece of shit who should be nowhere near our Health Service, in Bed with the CIA and the Israeli Government, he's made a number of provocative statements over the years, especially around healthcare and capitalism.  One of the most notoriously toxic quotes attributed to him about healthcare is:

“The one thing that’s not allowed is to actually increase supply. People say, ‘Why can’t we have lower costs?’ It’s because we’re not actually interested in fixing the system. We’re not trying to make healthcare more efficient. That’s like a socialist concept. That’s like ‘let’s have universal healthcare, let’s have everyone have it.’ That’s not what people want. They want to get access to it themselves.”

Peter Thiel, 2012 panel discussion

In another infamous moment, he reportedly said:

“I think it’s possible to starve the beast. I think that’s why we need a budgetary crisis. I think we need to go over the fiscal cliff.”
Peter Thiel, on how to dismantle public programs like Medicare

And perhaps most disturbingly:

"People are not dying because of lack of healthcare. They’re dying because they’re old. That’s not a healthcare problem."
Attributed to Thiel during discussions on healthcare rationing

These quotes (particularly the last) encapsulate Thiel’s cold, hyper-libertarian worldview, where efficiency and individual access matter more than collective provision or social justice.  They reveal how some Silicon Valley billionaires view public healthcare not as a right, but as an inefficient obstacle to profit.  The antithesis of the NHS model.  And the very reason we used to have safeguards like NHS England to protect the NHS from vulture capitalism.  Protect us from people like Peter Thiel and Louise Mosley.

Why privatisation fails: every time

Privatisation isn’t a modern solution.  It’s a reheated disaster.  It takes public money and diverts it into private hands while outcomes deteriorate.  A landmark 2022 study in The Lancet Public Health found that outsourcing of NHS services to for-profit providers was directly associated with increased treatable mortality rates.  In simple terms: the more we privatise, the more people die unnecessarily.

(The Lancet) Let’s break it down: 

• PFI hospitals: Cost NHS £79 bn over 31 years (built for £11.8 bn), draining resources and reducing capacity Investment Monitor+6Hansard+6Hansard+6.
• Outsourced catering: Linked to listeria outbreaks in Manchester and Liverpool, resulting in patient fatalitiesWIRED+2We Own It+2The Guardian+2.
• Mental health outsourcing: In 2018, £1.8 bn (13%) of NHS mental-health funds went to private providers, with 64 out of 238 rated 'requires improvement' or 'inadequate' Wikipedia.

 As Dr Julia Grace Patterson (EveryDoctor campaign) noted: “Starmer and Streeting are not doing what the public wants… Why are the new government ignoring what the public wants, in favour of making private shareholders richer?” The Times+5LRD+5World Socialist Web Site+5

“Why are the new government ignoring what the public wants, in favour of making private shareholders richer?” (Labour Research Department)

This is what happens when care becomes a spreadsheet and patients become revenue streams.

Privatisation doesn’t save the NHS. It bleeds it dry. Every pound given to a private provider is a pound siphoned away from frontline care and into shareholder dividends. Every layer of outsourcing introduces fragmentation, inefficiency, and duplication.  Every corporate partner takes their cut, while NHS staff are left underpaid, overworked, and demoralised.  

The so-called “efficiencies” promised by private sector involvement are a myth.  They rely on cutting corners, by hiring fewer staff, paying them less, and rushing through patients like widgets on a factory line.  The NHS is not a business.  Patients are not customers.  Healthcare is not a marketplace.  

And yet, “Fit for the Future” uses the language of market logic throughout, talking of 'patient choice' as if the average person can shop around while waiting 18 months for a hip replacement.  There’s nothing democratic about being forced to go private because the NHS has been deliberately underfunded to the point of collapse.

Wes Streeting Shouldn’t Be Let Within a Mile of the NHS

And we can't talk about the NHS without talking about Wes Streeting. This is a man who accepted donations from hedge fund manager John Armitage, a former Conservative donor. Streeting has also been bankrolled by David Sainsbury, the same billionaire who backed the disastrous Blairite project and who poured millions into the centrist think tank Progress, now Progressive Britain.

Wes Streeting isn’t a reformer, he’s a corporate stooge in a red tie.  His links to Tufton Street ideology, his endorsement of private healthcare providers, and his refusal to commit to reversing privatisation reveal a man who fundamentally does not believe in a public NHS.  Streeting once described the private sector as 'essential to solving the backlog', never mind that outsourcing has caused those backlogs in the first place.  (Electoral Commission donations data, 2023) 

Streeting openly champions 'patient choice', a euphemism for outsourcing.  He calls critics 'ideologues' but the real ideologues are those who see illness as an investment opportunity and hospitals as revenue centres.  Streeting is their man on the inside.  If Labour had any integrity left, he wouldn’t be Health Secretary.  He’d be working as just another snake oil salesman in PR. 

Wes Streeting’s rhetoric, condemning NHS 'overspending' pushing job cuts via abolition of NHS England, and openness to private partners, amounts to nothing more than creeping privatisation.

• A Redditor put it bluntly:

  “Wes Streeting is a real disappointment… He’s very much a Tory in red…and he’s playing political games…pandering to misinformation around mental health and trans issues.” Bluesky Social+15Reddit+15The Sun+15

Tetleystldr article on Wes Streeting

Streeting’s fingerprints are all over this white paper.  He openly praises private healthcare providers, pledges 'constructive partnerships'. 

More concerning is Streeting’s proximity to Tufton Street,  the ideological home of Britain’s far-right policy machine.  55 Tufton Street is a den of libertarian vultures like the Institute of Economic Affairs and Policy Exchange, the same people who pushed for Brexit, climate denial, and the gutting of public services.  That Streeting’s policies align so closely with this sewer of influence is no coincidence. It’s by design and he parrots the same language used by these, many of which directly support insurance-based healthcare models and are donors of Wes Streeting.

Rather than challenging the Conservative consensus, Streeting is continuing it, even praising former Tory Health Secretary Sajid Javid for his pro-market stance.  He talks about 'ending the era of public sector monopolies'  as if universal healthcare were some Stalinist aberration, not a cherished cornerstone of modern Britain.  

• £372,000 from private healthcare-linked donors since 2015 (Good Law Project).
• £224,575 from January 2023 to March 2025 (EveryDoctor).
• Major donors include recruitment firms and hedge fund managers connected to private healthcare.

Critics quite rightly argue this raises legitimate concerns about potential conflicts of interest, especially as Streeting advocates for greater NHS-private sector integration.  Supporters counter that Labour maintains safeguards and transparency but it is difficult to see this Reddit+7Europeans TODAY+7The Times+7RedditVox Political+1UK Parliament+1.

Tetleystldr article on 55 Tufton Street

Fit for the Future is not a blueprint for fixing the NHS.  It is a roadmap to a two-tier system, where those who can afford it go private, and the rest are left with a decimated public service. A skeletal NHS for the poor, and a booming private sector for the wealthy.  

Fit for the Future explicitly states: 

…we will continue to make use of private sector capacity to treat NHS patients… and will enter discussions with private providers to expand NHS provision in the most disadvantaged areas Wikipedia+15Vox Political+15LRD+15 

Labour’s plan to build 200 new Neighbourhood Health Centres via public–private partnerships echoes the PFI model, profit-driven and long-term Vox Political+1LRD+1. 

Vox Political summarises the danger: This is not an emergency stopgap. It is a policy shift: embedding private health firms as long-term partners. Vox Political

This isn’t conjecture.  It’s already happening.  GP surgeries are being quietly taken over by US health giants like Centene.  Mental health services are increasingly outsourced to for-profit providers with appalling safety records. Diagnostic services are being funnelled into private hands under the guise of 'community diagnostic hubs'.  And now, Labour’s white paper aims to 'scale' these initiatives: a euphemism for expansion and entrenchment.  

Instead of reversing this tide, Streeting wants to accelerate it.  Instead of reinvesting in the NHS as a public good, Labour is laying the tracks for wholesale commodification.  This is not what people voted for.  This is not what the NHS was built to become.

Health Insurance: The Endgame

Here’s the bit they’re not putting on the press release: all this outsourcing, all this digital capture, it’s laying the groundwork for health insurance to become the default.  Once NHS services are stretched to breaking point, and appointments take months instead of weeks, more people go private.  Already, 1 in 10 Britons paid out of pocket for private care in 2024, the highest number ever recorded. 'People are now going private not because they want to, but because they can’t afford to wait'. (The King's Fund, Health Access Report 2024)

That’s the plan: break the NHS, then sell you the solution.

Private health companies are already flooding the UK market with 'affordable' insurance products. The long game is obvious: Palantir and its data platforms will be used to create detailed patient profiles. These will enable insurers to: 

• Risk-score patients 
• Tailor (read: inflate) premiums 
• Deny coverage for pre-existing conditions

And let's go back to our friends at Palantir.  All that data mining has a secondary benefit, they can sell it to the insurance companies so they can feel it into the risk algorithms to work out how much you are going to pay for insurance, or if you are going to b even eligible for health insurance at all. 

So the one thing the 168 page glossy document about how to fix the NHS doesn't tell you , is that it plans to fix the NHS by making it for profit, and only available to people who can afford it. 

Just like they do in the United States.  Where over a quarter of a million people go bankrupt every year, even with health insurance.  Is this what we aspire to?   Is this what a so called Labour Government thinks is the way forward. 

A Data-Driven Disaster Waiting to Happen

The digital transformation of the NHS under Palantir isn’t about efficiency, it’s about control. Once patient data is fully centralised and controlled by corporate platforms, the NHS becomes a data farm. And who profits from that?  Not the public.  Wired magazine reported a mass opt-out of over a million patients when Palantir was first linked to NHS contracts.  Public trust evaporated overnight.

(Wired UK) And the so-called 'Five Safes' framework meant to protect data is flimsy at best.  According to researchers, it’s 'neither rigorous nor reassuring'.

Allowing Palantir control of NHS data vaults represents both privacy and security risks: 

• Patient trust erosion: A University of Vienna expert warned public trust diminishes without transparency; last time, over 1 million patients opted out within a monthWIRED+1The Guardian+1.
• Opaque governance: The “Five Safes” framework underpinning data-sharing is “fundamentally flawed”—offering little assurance that privacy safeguards are robustarxiv.org.(arXiv, 2020)

What We Actually Need

There is another way: one based on public ownership, not profit: 

• End Outsourcing: As We Own It research confirmed, 94% of NHS service contracts expire in this term. Labour can insource before renewal We Own It+1We Own It+1.
• A ban on data monetisation and surveillance contracts. NHS digital expertise should be rebuilt in-house, not outsourced to surveillance firms, and certainly no those linked to covert security operations and implicated in war crimes WIRED 
• Repealing PFI and investing in publicly owned infrastructure 
• A cast-iron guarantee that the NHS will never be insurance-based

This Isn’t Reform: It’s Surrender

The NHS was founded on the principle that care should be free at the point of need, funded by general taxation, and owned by the public.  Not by Amazon.  Not by Palantir.  Not by venture capitalists in Silicon Valley or speculators in the City of London.

Labour’s Fit for the Future is a sugar-coated corporate coup.  Behind the buzzwords lies a full-spectrum attack on the principles of universal, free, public healthcare.  This isn’t about making the NHS 'fit' for the future.  It’s about making it fit for asset-stripping, data extraction, and insurance-led care. 

A truly future-proof NHS would be one that is fully publicly owned and publicly delivered, not merely 'publicly funded' while quietly sold off brick by brick.  It would be accountable to patients and staff, not private contractors and opaque algorithmic systems.  It would be rooted in communities, not spreadsheets.

Wes Streeting and his ilk are trying to sell us the idea that there is no alternative.  That we have to 'embrace innovation': their code for opening the door to profiteers.  But the truth is, the only thing standing in the way of rebuilding a properly funded, publicly run NHS is political will.

And Wes Streeting is part of the problem, not the solution, he isn’t saving the NHS, he’s laying it on the altar for the highest bidder.  And behind him? The same ghouls from Tufton Street, the same tech lobbyists, and the same hedge funds who broke our economy and now want our health system.  

Labour had a choice: to be the party of Bevan or the party of Blair.  With Fit for the Future they’ve made their choice.  And unless we push back, they’ll bury the NHS under a mountain of glossy policy papers, corporate partnerships, and Orwellian 'reforms'.

Fit for the Future isn’t a care-centred manifesto: it’s privatisation by stealth. Enhanced outsourcing, private tech platforms like Palantir, and market models rolled out by Wes Streeting amount to the dismemberment of a public service. The NHS deserves a genuine revival, not just a tech facelift.  Let’s rally behind public ownership, digital democratisation, and care that prioritises patients over profit.

If we don’t fight this, we’ll lose not just the NHS, but the very idea that healthcare should be a public good, not a private product.  The NHS doesn’t need Wes Streeting’s vision of the future. It needs saving from it.

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