The Tony Blair Institute’s recent report, The NHS at a Crossroads: The App That Can Transform Britain’s Health, reads like a manifesto for salvation through technology. It claims that by upgrading the NHS App, we can create a personalised health companion that empowers patients, reduces pressure on services, and brings Britain’s health system into the 21st century.
It is an appealing vision, but dangerously naïve.
This is not a neutral, technical proposal. It is a political project that will accelerate the hollowing out of the NHS into a digitised shell, efficient, optimised, and quietly privatised.
On the surface, the proposal seems benign. Who wouldn’t want faster access to advice, less time in waiting rooms, or the ability to manage prescriptions with a tap of a screen?
What the Blair Institute fails to acknowledge is that digital transformation is not just about tools. It’s about who controls the system, whose values shape it, and what kind of care it delivers.
Palantir Technologies
Should secretive data commodifiers really be the tech spine of the NHS?
Enter Palantir Technologies: the US data analytics company recently awarded a £330mn contract to deliver the NHS’s Federated Data Platform. This platform will underpin the very infrastructure the upgraded NHS App relies on.
Palantir, co-founded by billionaire Peter Thiel, has its roots in surveillance, military contracting, and predictive policing. Its software has been used by US Immigration and Customs Enforcement to track and deport undocumented migrants. This is not a company built on a philosophy of care. It is a company built on control and profiteering.
Proponents insist that Palantir is just a software provider, that patient data is protected, and that the NHS remains in charge. But public trust does not depend on technical compliance. It emerges from a consistent alignment between values, culture, and lived experience.
And Palantir’s culture, steeped in secrecy, military logic, and the commodification of information, is worlds apart from the relational, values-based ethos of the NHS. Remember Fujitsu and the Horizon Post Office scandal?
The idea that this digital infrastructure could form the ethical backbone of British healthcare should scare us all.
Entrenching digital exclusion as a system feature, not a bug
The Blair Institute claims that a reimagined NHS App will “democratise” care. Yet evidence suggests otherwise. Around 19 million people in the UK face digital exclusion, whether through poor internet access, limited device use, or low digital literacy. These are often the same people who already face the greatest health inequalities.
An app-based system risks deepening exclusion. Without serious investment in analogue access, face-to-face care, and community-based digital support, we risk replacing universal healthcare with a two-tier system. One for the digitally fluent and another for the digitally forgotten.
This proposal is not just about tech. It’s about the resurgence of Blairism; a politics that believes problems can be solved through data, markets, and managerialism. It avoids the messy, relational work of democratic care in favour of digital dashboards and private-sector “solutions”.
Disregarding the ethics and nuance of human-based care
Blairism re-emerges here not in war, but in code. Not in parliament, but in platforms. It is a vision that appeals to those who believe public services are best modernised through private expertise, algorithmic logic, and entrepreneurial spirit.
But a health service is not a logistics system. It is not Amazon. It is a place of encounter, of uncertainty, of shared vulnerability. And it cannot be truly reformed by those who see it primarily as a problem of scale and efficiency.
What kind of knowing does the Blair Institute rely on? Technocratic, data-driven, rational. But what about the wisdom of frontline workers, patients, carers? What about the gut-level unease many feel when healthcare becomes transactional? And what of the ethical dimension?
The ‘three-cornered’ knowing of head, heart and gut suggests we should pause. Something in this vision doesn’t feel right. Something essential is being left out.
Change is needed but it must be human-centric and accountable
Yes, the NHS is in crisis. Yes, change is needed. But it must not be change driven by those who see care as a dataset or healing as a logistical flow.
We need transformation grounded in care, not control. One that centres listening, trust, and presence. One that invests in people, not platforms. And one that builds public digital infrastructure in the image of public service, not private gain.
The NHS was born not from optimisation but from solidarity. It should not be surrendered to algorithms and private contractors under the banner of modernisation.
If we’re at a crossroads, let us choose wisely. Not the seductive route of easy fixes and shiny apps, but the harder path of democratic care, ethical accountability, and public ownership.
The app will not save us, but collective action just might.
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