Is billionaire Peter Thiel right when he says we need to rethink the NHS?

One of the more troubling decisions taken by the current government is its recent contract with US spy-tech giant Palantir, to put together and operate a “federated data platform” across the NHS.

Palantir has worked closely with the CIA (an early investor), reportedly helped the US National Security Agency with its spyware programme – and is closely involved with a raft of similar organisations. No wonder its appointment has proved to be controversial, with doctors’ leaders warning (among other things) that it could “damage the confidence that patients have in the profession, and the care they receive”.

These people are going to be handling deeply personal and highly confidential medical records. We’re told that they will be “pseudonymised”, so specific individuals can’t be identified, but de-identification is problematic if, for example, someone has a rare condition – like I do. There are only a few hundred thousand type 1 autoimmune diabetics in the UK. There won’t be many in my postcode.

Then there is the fact that the company is run by billionaire libertarian Peter Thiel. The same Peter Thiel who said in a talk at the Oxford Union: “Highways create traffic jams, welfare creates poverty, schools make people dumb and the NHS makes people sick.”

He even suggested that the best solution for the institution would be to “just rip the whole thing from the ground and start over.” Any affection we have for the NHS – according to Thiel – is a form of “Stockholm syndrome.” That is the psychological condition where the victims of kidnappers, even torturers, supposedly develop bonds with their captors. It is a somewhat controversial diagnosis, but one that has seeped into pop culture. We all know what it means.

Why, then, as someone who literally relies on the NHS to keep me alive and (relatively) pain-free, did I listen to Thiel’s talk and think, “oh God, might this person actually be on to something?”

I’m currently in the process of writing a memoir – How to Survive Getting Hit by a Cement Truck – chronicling my experiences on that fateful day and everything that has happened since (potential publishers please get in touch).

The NHS literally saved my life. That was no small achievement. I’d snapped my pelvis twice. It also had a bleed on it, which was the most immediate threat to my life. I’d broken my left tibia and fibula, my left arm in multiple places, my collarbone, my right elbow, several ribs and various bones in my spine. Oh, and a toe. You name it, I’d broken it. I also had a collapsed lung, a concussion, my sciatic nerves had been severed and half the skin on my face had been scraped off. I’m not even sure if that list is comprehensive.

Shortly after this happened, a friend who now lives stateside delivered the perfect riposte to the market-based, privatised US healthcare system: “The first thing they’d have asked you if that had happened here is for your insurance details.”

Instead of handing over my insurance card (and my credit card?), I was able to give the paramedics a precis of my medical history before they put me under, where I spent the next several weeks. So, surely I ought to be spitting Thiel’s words back at him now?

Well, not exactly. The reason for that is because the aftermath has been something like slow torture, a constant tightening of the screw – when the NHS has been there at all. It wasn’t there when my wife and I caught Covid early on in the pandemic, and I watched her struggling to breathe as I grappled with what felt like a lead weight on my chest.

When it comes to acute care, the institution is still superb. World class. A cyclist getting hit by a truck today would stand a better chance than I did. Technology and treatments have improved. I hope I’ve helped with that. I signed off on my details – my data – so that it could be used by researchers trying to understand why it was I survived when others didn’t. Now there is a £330m contract with Palantir, I’m not sure I’d be so willing to do that today.

But here’s the thing: when you suffer a polytrauma like I did, the need for care doesn’t end when you get out of hospital. There are the lingering effects of the injuries, the worst of which is chronic pain. My type 1 autoimmune diabetes is also always capable of throwing a curveball. Getting help with those issues has lately proved to be a brutal and bruising struggle. I hate to say this, but the NHS has, as Thiel charged, been making me sick. It has ruined my mental health.

There was the pain clinic that seemed determined to not treat me because of my disabilities until I complained. There was the diabetic clinic that admitted to “unacceptable” failures in my care – and yet still failed to answer all the points I raised, leaving me to consider bringing a case to the NHS Ombudsman. While lost in these bureaucratic weeds, it was often my wife who had to step in and help.

So yes, in a way, the NHS is making me sick. Free at the point of need? I’ve increasingly been paying for treatment out of my own pocket. “You shouldn’t have to do that,” a senior politician recently said to me. But right now, it is either that or continue to suffer.

Don’t get me wrong, I reject Thiel’s ideology. I fear his plan for the NHS will make everything worse than it already is. We’ve had years of ideologically committed politicians trying to inject the “market mechanisms” he favours into the NHS, and I can’t see how they have helped anything. To the contrary. Also, people like me would be thrown to the wolves of the insurance industry in a US style system. Insurers aren’t overly fond of pre-existing conditions.

But a question still nags at me: were the points Thiel raised completely without merit?

I think we need to take a long hard look at what we have and the way it is operating, because it isn’t working well. Don’t take my word for it – read the reports published by the Parliamentary and Health Service Ombudsman.

Yes, the NHS needs more money. The government has shamefully starved it of resources. But it also needs careful consideration of how it functions; how the people it serves can get lost in its unnecessary bureaucracy; how a health service should provide care even after the patient has been discharged from hospital; and how we can go about creating a modern, non-privatised NHS that meets a wide range of healthcare needs and is not simply used to generate profit for huge corporations.

I don’t think Thiel’s libertarian prescription is the cure for the NHS’s ills. But he is going to find more and more sympathetic listeners if healthcare leaders don’t find other ways to improve the NHS and make it better. Here’s another troubling question: is anyone really trying?