Baroness Bennett of Manor Castle (GP)

My Lords, I thank the noble Lord, Lord Patel, for securing this debate. I declare something of an interest, in that I am just back from the ninth World One Health Congress in Lisbon, partially supported by DSAC. I go to the UKRI to start with the basic fact that the social determinants of health determine up to 80% of health outcomes, with clinical care accounting for only 20%. We must not lose sight of this reality, particularly given that healthy life expectancy is down two years in the past decade. We do not need data to know that poverty, inequality and austerity have enormous health costs. Data collection does not really add to our understanding of a reality that includes the impacts of financial insecurity, poor housing, filthy air and discrimination. The noble Lord, Lord Patel, spoke about economic growth having an impact on health. I would argue that we need a major redistribution of the resources in our society to tackle those things. Waving the magic wand of AI and saying we will fix it with that just does not satisfy. However, when we come to health data, and there is no doubt it is extremely important and useful, we have a huge problem of trust: patients trusting the system and trusting the Government to govern if their data is handed over. If there are no transparent controls, patients are not going to allow it. I note that the Government themselves, in a letter to the chair of the Commons health committee, acknowledged that, in recent times, tens of thousands of patients have withdrawn their data from use in research projects, with very many of them expressing concern about the involvement of the US defence and health tech company Palantir. There really is no wonder about that. We need to think about this. Peter Thiel and Alex Karp have said some very disturbing things, but I also go to Palantir’s UK head of operations, Louis Mosley, at last year’s Alliance for Responsible Citizenship. He said Western civilisation was in an existential battle against the “armies of fact-checkers and experts”, lawyers, academics and journalists. Palantir is supposed to be supplying unbiased, fact-based data analysis for the NHS: this is the company that we are talking about. We know that it had very little track record in health data before it enlisted the aid of the company of the former Member of this House, Lord Mandelson—Global Counsel—and secured this contract. The Government have a really important decision to make on health data and whether they continue with this contract. We must not allow ourselves to be trapped into using these companies. Also, as the noble Lord, Lord Bridges of Headley, referred to in the last debate, we have to ask questions about their financial stability; if we rely on them and they are not financially stable, that is another issue as well.