> I have no doubt that it's an extremely complicated mixture of 100s of systems, but anyone who has lived here knows how terrible it is.

Yep, as someone who's worked at a couple of small startups trying to sell into the NHS, it's terrible. A big part of the problem seems to be that there's no centralised procurement: each trust (of which there are ~200) does their own precurement. And a lot of the companies (the big established players are the worst) at most pay lip service interoperability. So you end with a big mess of system that don't talk to each other.

And they're not setup to pay "market rates" that are competitive with private employers to their in-house developers. So it's hard for them to attract and retain good in-house developers where they have them (although there are still some great people working there).

Internal restrictions are such that even aspiring software Devs find hurdles to doing basic automation. I know someone who wanted to use python, yes just use it, and it took months to be allowed to do that on an NHS machine.

Imagine the kind of open source EPR that could be built with £330 million.

But it looks like lobbying by US corporations has resulted in the NHS quietly deleting it's open source policy https://www.digitalhealth.net/2025/12/nhs-england-quietly-re...

> is there a reason to bring in a company that hires people at and above our level of competence

Is there no one in the UK with any competence?

> who have the expertise to implement a system to bring the NHS out of the dark ages of IT?

Why on earth do you think that's Palantir?

> but I'd much rather data be in the hands of a corporation that doesn't leak it

Until the US government wants it, at least.

> but I'd much rather data be in the hands of a corporation that doesn't leak it

So would I and I think Palantir will leak it.