Why Is Tony Blair So Keen for the UK’s National Health Service to Sell Off Its Patients’ Health Data to Private Companies? | naked capitalism


What is being proposed is a pretty shitty deal for NHS patients. But could the Tony Blair Institute’s biggest donor benefit handsomely?

Tony Blair may have left political office almost two decades ago, but he has most definitely not retired from political life. The British public are reminded of this fact every few months or so when the former British prime minister suddenly reappears on TV channels calling for some drastic new change in government policy, usually involving artificial intelligence or other forms of digital technology. As the FT reported last June, his TBI think tank has in effect become a global consultancy to the UK government.

In January 2021, Blair made one of the most Orwellian statements of the COVID-19 pandemic. “In the end,” Blair said in an interview with ITV News, “vaccination is going to be your route to liberty.” At one point he called unvaccinated people “idiots” and repeatedly urged the UK government to introduce vaccine passes. What he didn’t say was that his foundation, the Tony Blair Institute for Global Change, or TBI, had received millions of dollars in donations from pro-vaccine organisations such as the Bill and Melinda Gates Foundation.

A year later, he joined forces with his erstwhile rival William Hague to call for the introduction of a digital identity system as part of a “fundamental reshaping of the state around technology” — which, as luck would have it, is exactly what the UK government is trying to do. Last week, the Hague-Blair double act was back in the news, this time calling for the UK’s struggling National Health Service (NHS) to sell off its patients’ health data,  “to fund cutting-edge treatments” and raise much-needed money for the health system.

From Sky News:

Writing in The Times newspaper, Sir Tony and Lord Hague hailed the beginning of “extraordinary age of gene therapies, new antibiotics and molecular factories”.

“Nothing will be more important to British jobs, living standards and security in the coming years than leading the world in science and innovation,” they wrote.

“We will have to keep moving quickly if we are to be one of the main homes of changes so dramatic that they will alter forever the way we live and restructure much of the global economy.”

They believe data from millions of NHS records could provide a key platform for AI to monitor patients via wearable technology and alert doctors of problems.

The report also proposes patients have access to a “personal health account” via the NHS app to book appointments and manage treatment.

This will create a laboratory of biodesign – a process to identify and find solutions to unmet healthcare needs – helping biotech companies scale up and creating strong international biosecurity.

“Biotech is promising a future of new cures and treatments for many diseases, more personalised and effective healthcare, and many new materials and transformed manufacturing processes,” Sir Tony and Lord Hague added.

A Pretty Shitty Deal

It goes without saying that what is being proposed is a pretty shitty deal for NHS patients. Their most personal (and most valuable) data is now being hawked by a couple of retired politicians in return for some vague promise of future economic development, which most of the patients will almost certainly not benefit from. By that time, the NHS will be even more of a shadow of its former self, with even more of its vital functions harvested out to the private sector — something Blair himself has repeatedly called for in recent months.

Will patients be able to consent to their data being used in this way? Presumably not, since in that case most would presumably opt out. Blair and Hague insist that the patient data sold on to private companies will be anonymised and de-identified. However, as Electronic Frontier Foundation noted in a recent article, such a promise is almost impossible to guarantee:

In an attempt to justify this pervasive surveillance ecosystem, corporations often claim to de-identify our data. This supposedly removes all personal information (such as a person’s name) from the data point (such as the fact that an unnamed person bought a particular medicine at a particular time and place). Personal data can also be aggregated, whereby data about multiple people is combined with the intention of removing personal identifying information and thereby protecting user privacy.

Sometimes companies say our personal data is “anonymized,” implying a one-way ratchet where it can never be dis-aggregated and re-identified. But this is not possible—anonymous data rarely stays this way. As Professor Matt Blaze, an expert in the field of cryptography and data privacy, succinctly summarized: “something that seems anonymous, more often than not, is not anonymous, even if it’s designed with the best intentions.”   

“Best intentions” are presumably the last thing on the minds of either Blair or Hague. In the case of Blair, this is a man who in government helped to intensify the piecemeal privatisation of the NHS by opening the institution up to increasing commercialisation and saddling it with crippling debts through the Public Finance Initiative, as Bob Gill documented in an excellent 2022 article for Consortium News:

Private Finance Initiative schemes were used by Prime Minister Tony Blair’s government to fund the building of new hospitals. The NHS was saddled with £11 billion of private debt which would cost £88 billion in public repayments.

Private Finance Initiatives destabilized hospital finances, creating a funding problem for which the solution was more contraction of bed capacity rubber stamped by the Clinical Commissioning Groups.

At the end of the loan repayments, ownership of the assets remained with the private investors. Just imagine buying a house with an extortionate mortgage and not owning the house when the mortgage was paid off. That’s the scam of Private Finance Initiatives.

A Curious Example

Bizarrely, in their report for TBI Blair and Hague even cite UK Biobank as a “strong precedent for giving controlled access to anonymised data to third parties.” Yet as The Guardian reported in November, UK Biobank actually shared some of its data with insurance companies without permission and despite making repeated public commitments not to do so.

When the project was announced, in 2002, Biobank promised that data would not be given to insurance companies after concerns were raised that it could be used in a discriminatory way, such as by the exclusion of people with a particular genetic makeup from insurance.

In an FAQ section on the Biobank website, participants were told: “Insurance companies will not be allowed access to any individual results nor will they be allowed access to anonymised data.” The statement remained online until February 2006, during which time the Biobank project was subject to public scrutiny and discussed in parliament.

The promise was also reiterated in several public statements by backers of Biobank, who said safeguards would be built in to ensure that “no insurance company or police force or employer will have access”.

This weekend, Biobank said the pledge – made repeatedly over four years – no longer applied. It said the commitment had been made before recruitment formally began in 2007 and that when Biobank volunteers enrolled they were given revised information.

A Potential Conflict of Interest?

Even if you believe that selling off patient data to fund NHS investments and future economic development is a worthwhile cause, one thing is clear, notes Tom McTague for Unherd — Tony Blair is not a neutral, disinterested voice on this issue:

He is the owner and executive chairman of the Tony Blair Institute for Global Change, whose principal donor is the world’s fourth-richest man, Larry Ellison. Now, Ellison is the owner of Oracle, the giant Silicon Valley firm which is trying to become the world’s most important online medical data company using its cloud technology.

When Blair says selling NHS data makes sense for Britain, he might be right, but the fact that his company receives hundreds of millions of pounds in donations from a tech plutocrat trying to build the Amazon of online medical records should at least be acknowledged. Then, we can judge the merits of his ideas for ourselves.

The Larry Ellison Foundation’s IRS return from 2022 showed that Oracle’s founder and chief technology officer donated $33.83 million to the Tony Blair Institute (TBI) in 2021 and plans to provide another $49.37 million in the near future. Ellison’s foundation also appears as a donor on the TBI’s most recent set of accounts filed [PDF] at Companies House. The ties between the two do not end there: TBI’s executive vice-president of Strategy and Partnerships, Awo Ablo, also happens to sit on Oracle’s board.

The Larry Ellison Foundation has also teamed up with TBI on a number of Africa-based initiatives, all relating to digital vaccine records and certification. From a November 2020 Oracle press release:

The Tony Blair Institute (TBI) and Oracle have brought cloud technology to Africa to manage public health programs. Initially, GhanaRwanda, and Sierra Leone will use the new Oracle Health Management System to create electronic health records for their vaccination programs for yellow fever, HPV, polio, measles, and COVID-19, as soon as that vaccine is distributed to Africa. TBI and Oracle are in discussions with more than thirty other countries in AfricaAsiaEurope, and North America that are evaluating using the same cloud system to manage their COVID-19 vaccination programs.

The Tony Blair Institute (TBI) and Oracle have brought cloud technology to Africa to manage public health programs. Initially, GhanaRwanda, and Sierra Leone will use the new Oracle Health Management System to create electronic health records for their vaccination programs for yellow fever, HPV, polio, measles, and COVID-19, as soon as that vaccine is distributed to Africa. TBI and Oracle are in discussions with more than thirty other countries in AfricaAsiaEurope, and North America that are evaluating using the same cloud system to manage their COVID-19 vaccination programs.

As The Register reports, Blair has known Ellison since his time in Downing Street, when “Oracle became a significant supplier of technology to the government”:

In fact, Oracle still runs more than half of the UK central government’s financial and planning software, including the Department for Work & Pensions, Ministry of Justice, Department for Environment, Food & Rural Affairs, Cabinet Office, Home Office, HM Treasury, and Ministry of Defence.

The Home Office migrated to Oracle during Blair’s tenure as prime minister. In 2006, a damning NAO said the department’s inability to deliver its accounts on time were down to problem with the system. Once a fix was implemented, it led to an adjustment of the bank account and creditor balances by £67 million ($85 million), according to Parliamentary records.

Blair’s financial ties with Ellison clearly represents at least a potential conflict of interest and one that should be at least disclosed in any interview, article or report discussing Blair’s calls for NHS patient data to be sold to third party companies — which could, of course, include Oracle. Last year, Oracle bought the US electronic health records giant Cerner last year for $28 billion. The company’s ultimate goal is to build a united national health database amalgamating thousands of separate hospital databases.

And lest we forget, Tony Blair is no stranger to conflicts of interest. In September 2016, he closed down his consultancy firm, Tony Blair Associates, and two related companies, Windrush Ventures and Firerush Ventures, following repeated allegations of influence peddling and tax avoidance. Months later, an op-ed in Huffington Post described Blair as “the poster child for influence peddling by high profiled former Western politicians.” In 2014, the Australian Financial Review noted that his consulting work had “raised questions” about conflicts of interest “from the beginning”:

In 2008, Blair, in his role as a quartet diplomat, persuaded the Israeli government to allow a Qatari-owned mobile phone company, which was then called Wataniya Telecom, to operate in the West Bank. Wataniya’s parent company was a client of JPMorgan Chase, which employs Blair as an adviser.

Another deal he pushed in his quartet role involved the development of an oil field operated by British Gas, another JPMorgan client, off the coast of Gaza.

Blair would not comment specifically on his personal finances or on some details of his consulting relationships, but his staff was adamant the deals were diplomatic priorities and Blair had been unaware of the JPMorgan links.

He has contracts with dictators around the world, including $7 million per year to promote the United Arab Emirates (UAE), he receives $60,000 a month plus 2% of any deals from a Saudi oil company connected to the Saudi ruling family, he has a contract with the ruler of Kuwait with an estimated remuneration of $40 million, and he has used his two “charities” as a calling card to lay the foundation for his personal business activities while he was acting as a “selfless” official peace negotiator in the Middle East.

But while the healthcare data landscape in the US is heavily fragmented and siloed, the UK’s National Health Service boasts the largest repository of health data in the world. Oracle was among bidders for a five-year tender to manage the NHS’ federated data platform, which was ultimately won by the CIA-linked US spyware firm Palantir.As WIRED UK magazine reported in 2019, Amazon, Google and the rest of Silicon Valley all wanted to get their hands on the data trove. Unsurprisingly, patients were less keen on the idea:

Careful use of health data could save lives, cut costs of delivering health care and even become a nice little earner for the NHS – indeed, an EY analysis that’s frequently touted by the government suggests opening up the vaults could earn the underfunded public health organisation as much as £9.6 billion annually. But the tradeoffs could be our privacy, letting big tech further monetise medicine, and locking hospitals and clinics into expensive tech systems that will cost us more in the long run.

What has ensued since then is a string of scandals over NHS England’s management of patient data. In the summer of 2021, executives at NHS England came up with an ingenious plan to digitally scrape the general practice data of up to 55 million patients and share it with any private third parties willing to pay for it. NHS England allowed patients to opt out of the scheme; they just didn’t bother telling them about it until three weeks before the deadline, presumably because if they had, millions of patients would have opted out.

When the FT broke the story, a scandal erupted, especially when it was revealed that the government had already shared UK hospital data and medical records with over 40 pharmaceutical, consultancy and data companies worldwide, including McKinsey & Company, KPMG, Novavax, AstraZeneca, Experian and companies co-founded by the Sackler family. NHS England officials responded by shelving the scheme, saying they needed to focus on reaching out to patients and reassuring them their data is safe. That didn’t happen.

Instead, the Sunak government handed management of NHS patient data to Palantir, a company whose client list includes the US military, intelligence agencies and ICE, as well as the armed forces of the UK, Israel and other western countries, and whose co-founder and current chairman of the board, Peter Thiel, recently described the British public’s affection for the NHS as “Stockholm Syndrome.”

When the deal was announced in November last year, both the government and Palantir insisted that patient data was in safe hands and would not be sold to third parties. Yet within little more than two months, a former prime minister (Blair) and a former Conservative Party leader (Hague) are calling for exactly that.

 

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