[Plura-list] Palantir's NHS-stealing Big Lie

[Cory Doctorow]

Read today's issue online at: https://pluralistic.net/2024/03/08/the-fire-of-orodruin/


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At long last, the San Francisco stop of the book tour for my new novel "The Bezzle" has been finalized: I'll be at the San Francisco Public Library Main Branch on Wednesday, March 13th, in conversation with Robin Sloan!

https://sfpl.org/events/2024/03/13/author-cory-doctrow-bezzle

Name your price for 18 of my DRM-free ebooks and support the Electronic Frontier Foundation with the Humble Cory Doctorow Bundle:

https://www.humblebundle.com/books/cory-doctorow-novel-collection-tor-books-books

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Today's links

* Palantir's NHS-stealing Big Lie: And the everyday miracle of Trusted Research Environments.

* Hey look at this: Delights to delectate.

* This day in history: 2004, 2009, 2014, 2019, 2023

* Upcoming appearances: Where to find me.

* Recent appearances: Podcasts, events and more.

* Latest books: You keep readin' em, I'll keep writin' 'em.

* Upcoming books: Like I said, I'll keep writin' 'em.

* Colophon: All the rest.

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🏹 Palantir's NHS-stealing Big Lie

Capitalism's Big Lie in four words: "There is no alternative." Looters use this lie for cover, insisting that they're hard-nosed grownups living in the reality of human nature, incentives, and facts (which don't care about your feelings).

The point of "there is no alternative" is to extinguish the innovative imagination. "There is no alternative" is really "stop trying to think of alternatives, dammit." But there are always alternatives, and the only reason to demand that they be excluded from consideration is that these alternatives are manifestly superior to the looter's supposed inevitability.

Right now, there's an attempt underway to loot the NHS, the UK's single most beloved institution. The NHS has been under sustained assault for decades - budget cuts, overt and stealth privatisation, etc. But one of its crown jewels has been stubbournly resistant to being auctioned off: patient data. Not that HMG hasn't repeatedly tried to flog patient data - it's just that the public won't stand for it:

https://www.theguardian.com/society/2023/nov/21/nhs-data-platform-may-be-undermined-by-lack-of-public-trust-warn-campaigners

Patients - quite reasonably - do not trust the private sector to handle their sensitive medical records.

Now, this presents a real conundrum, because NHS patient data, taken as a whole, holds untold medical insights. The UK is a large and diverse country and those records in aggregate can help researchers understand the efficacy of various medicines and other interventions. Leaving that data inert and unanalysed will cost lives: in the UK, and all over the world.

For years, the stock answer to "how do we do science on NHS records without violating patient privacy?" has been "just anonymise the data." The claim is that if you replace patient names with random numbers, you can release the data to research partners without compromising patient privacy, because no one will be able to turn those numbers back into names.

It would be great if this were true, but it isn't. In theory and in practice, it is surprisingly easy to "re-identify" individuals in anonymous data-sets. To take an obvious example: we know which two dates former PM Tony Blair was given a specific treatment for a cardiac emergency, because this happened while he was in office. We also know Blair's date of birth. Check any trove of NHS data that records a person who matches those three facts and you've found Tony Blair - and all the private data contained alongside those public facts is now in the public domain, forever.

Not everyone has Tony Blair's reidentification hooks, but everyone has data in some kind of database, and those databases are continually being breached, leaked or intentionally released. A breach from a taxi service like Addison-Lee or Uber, or from Transport for London, will reveal the journeys that immediately preceded each prescription at each clinic or hospital in an "anonymous" NHS dataset, which can then be cross-referenced to databases of home addresses and workplaces. In an eyeblink, millions of Britons' records of receiving treatment for STIs or cancer can be connected with named individuals - again, forever.

Re-identification attacks are now considered inevitable; security researchers have made a sport out of seeing how little additional information they need to re-identify individuals in anonymised data-sets. A surprising number of people in any large data-set can be re-identified based on a *single* characteristic in the data-set.

Given all this, anonymous NHS data releases should have been ruled out years ago. Instead, NHS records are to be handed over to the US military surveillance company Palantir, a notorious human-rights abuser and supplier to the world's most disgusting authoritarian regimes. Palantir - founded by the far-right Trump bagman Peter Thiel - takes its name from the evil wizard Sauron's all-seeing orb in *Lord of the Rings* ("Sauron, are we the baddies?"):

https://pluralistic.net/2022/10/01/the-palantir-will-see-you-now/#public-private-partnership

The argument for turning over Britons' most sensitive personal data to an offshore war-crimes company is "there is no alternative." The UK needs the medical insights in those NHS records, and this is the only way to get at them.

As with every instance of "there is no alternative," this turns out to be a lie. What's more, the alternative is vastly superior to this chumocratic sell-out, was Made in Britain, and is the envy of medical researchers the world 'round. That alternative is "trusted research environments." In a new article for the Good Law Project, I describe these nigh-miraculous tools for privacy-preserving, best-of-breed medical research:

https://goodlawproject.org/cory-doctorow-health-data-it-isnt-just-palantir-or-bust/

At the outset of the covid pandemic Oxford's Ben Goldacre and his colleagues set out to perform realtime analysis of the data flooding into NHS trusts up and down the country, in order to learn more about this new disease. To do so, they created Opensafely, an open-source database that was tied into each NHS trust's own patient record systems:

https://timharford.com/2022/07/how-to-save-more-lives-and-avoid-a-privacy-apocalypse/

Opensafely has its own database query language, built on SQL, but tailored to medical research. Researchers write programs in this language to extract aggregate data from each NHS trust's servers, posing medical questions of the data without ever directly touching it. These programs are published in advance on a git server, and are preflighted on synthetic NHS data on a test server. Once the program is approved, it is sent to the main Opensafely server, which then farms out parts of the query to each NHS trust, packages up the results, and publishes them to a public repository.

This is better than "the best of both worlds." This public scientific process, with peer review and disclosure built in, allows for frequent, complex analysis of NHS data without giving a single third party access to a a single patient record, ever. Opensafely was *wildly* successful: in just months, Opensafely collaborators published *sixty* blockbuster papers in *Nature* - science that shaped the world's response to the pandemic

Opensafely was so successful that the Secretary of State for Health and Social Care commissioned a review of the programme with an eye to expanding it to serve as the nation's default way of conducting research on medical data:

https://www.gov.uk/government/publications/better-broader-safer-using-health-data-for-research-and-analysis/better-broader-safer-using-health-data-for-research-and-analysis

This approach is cheaper, safer, and more effective than handing hundreds of millions of pounds to Palantir and hoping they will manage the impossible: anonymising data well enough that it is never re-identified. Trusted Research Environments have been endorsed by national associations of doctors and researchers as the superior alternative to giving the NHS's data to Peter Thiel or any other sharp operator seeking a public contract.

As a lifelong privacy campaigner, I find this approach nothing short of inspiring. I would love for there to be a way for publishers and researcher to glean privacy-preserving insights from public library checkouts (such a system would prove an important counter to Amazon's proprietary god's-eye view of reading habits); or BBC podcasts or streaming video viewership.

You see, there *is* an alternative. We don't have to choose between science and privacy, or the public interest and private gain. There's *always* an alternative - if there wasn't, the other side wouldn't have to continuously repeat the lie that no alternative is possible.


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🏹 Hey look at this

* Privacy First and Competition https://www.eff.org/deeplinks/2024/03/privacy-first-and-competition

* XOXO 2024 https://2024.xoxofest.com/

* Groove Factory Presents: Field of Flowers https://dice.fm/partner/field-of-flowers/event/pw68k-groove-factory-presents-field-of-flowers-23rd-mar-700-colorado-santa-monica-tickets

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🏹 This day in history

#20yrsago EFF is suing the FCC over the Broadcast Flag! https://web.archive.org/web/20040314151119/https://www.eff.org/IP/Video/HDTV/20040309_eff_pr.php

#20yrsago ICANN’s tongue slithers further up Verisign’s foetid backside https://memex.craphound.com/2004/03/09/icanns-tongue-slithers-further-up-verisigns-foetid-backside/

#20yrsago Nader kicks Mastercard’s ass in fair-use fight https://web.archive.org/web/20040401171817/http://lawgeek.typepad.com/lawgeek/2004/03/nader_wins_pric.html

#15yrsago AIG has insured $1.6 trillion in derivatives https://web.archive.org/web/20090312010613/https://www.scribd.com/doc/13112282/Aig-Systemic-090309

#10yrsago Putin your butt https://www.reddit.com/r/pics/comments/1zrchl/check_out_my_3d_printed_putin_butt_plug/?sort=new

#10yrsago Public Prosecutor of Rome unilaterally orders ISPs to censor 46 sites https://torrentfreak.com/italian-police-carry-out-largest-ever-pirate-domain-crackdown-140305/

#5yrsago Palmer Luckey wins secretive Pentagon contract to develop AI for drones https://theintercept.com/2019/03/09/anduril-industries-project-maven-palmer-luckey/

#5yrsago Pentagon reassures public that its autonomous robotic tank adheres to “legal and ethical standards” for AI-driven killbots https://gizmodo.com/u-s-army-assures-public-that-robot-tank-system-adheres-1833061674

#5yrsago Elizabeth Warren reveals her plan to break up Big Tech https://medium.com/@teamwarren/heres-how-we-can-break-up-big-tech-9ad9e0da324c

#5yrssago The US requires visas for some EU citizens, so now all US citizens visiting the EU will be subjected to border formalities too https://www.cbsnews.com/boston/news/us-citizens-need-visa-europe-travel-2021/

#1yrago The AI hype bubble is the new crypto hype bubble https://pluralistic.net/2023/03/09/autocomplete-worshippers/#the-real-ai-was-the-corporations-that-we-fought-along-the-way

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🏹 Upcoming appearances

* Tucson Festival of Books, Mar 9/10
https://tucsonfestivalofbooks.org/?id=676

* The Bezzle at San Francisco Public Library, Mar 13
https://sfpl.org/events/2024/03/13/author-cory-doctrow-bezzle

* Enshittification: How the Internet Went Bad and How to Get it Back (virtual), Mar 26
https://libcal.library.ubc.ca/event/3781006

* Wondercon Anaheim, Mar 29-31
https://www.comic-con.org/wc/

* The Bezzle at Anderson's Books (Chicago), Apr 17
https://www.andersonsbookshop.com/event/cory-doctorow-1

* Torino Biennale Tecnologia (Apr 19-21)
https://www.turismotorino.org/en/experiences/events/biennale-tecnologia

* Canadian Centre for Policy Alternatives (Winnipeg), May 2
https://www.eventbrite.ca/e/cory-doctorow-tickets-798820071337?aff=oddtdtcreator

* Tartu Prima Vista Literary Festival (May 5-11)
https://tartu2024.ee/en/kirjandusfestival/

* Media Ecology Association keynote, Jun 6-9 (Amherst, NY)
https://media-ecology.org/convention

* American Association of Law Libraries keynote, (Chicago), Jul 21
https://www.aallnet.org/conference/agenda/keynote-speaker/

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🏹 Recent appearances

* Is Social Media Becoming a Bit Shit? (The Briefing)
https://www.youtube.com/watch?v=jvPlpMd1KEw

* Radioactive (KCRL)
https://krcl.org/blog/grist-investigates-doctorow-seed/

* The enshittification of music (Music Ally)
https://www.youtube.com/watch?v=gh20fD3XXbg

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🏹 Latest books

* The Bezzle: a sequel to "Red Team Blues," about prison-tech and other grifts, Tor Books (US), Head of Zeus (UK), February 2024 (the-bezzle.org). Signed, personalized copies at Dark Delicacies (https://www.darkdel.com/store/p3062/Available_Feb_20th%3A_The_Bezzle_HB.html#/).

* "The Lost Cause:" a solarpunk novel of hope in the climate emergency, Tor Books (US), Head of Zeus (UK), November 2023 (http://lost-cause.org). Signed, personalized copies at Dark Delicacies (https://www.darkdel.com/store/p3007/Pre-Order_Signed_Copies%3A_The_Lost_Cause_HB.html#/)

* "The Internet Con": A nonfiction book about interoperability and Big Tech (Verso) September 2023 (http://seizethemeansofcomputation.org). Signed copies at Book Soup (https://www.booksoup.com/book/9781804291245).

* "Red Team Blues": "A grabby, compulsive thriller that will leave you knowing more about how the world works than you did before." Tor Books http://redteamblues.com. Signed copies at Dark Delicacies (US): and Forbidden Planet (UK): https://forbiddenplanet.com/385004-red-team-blues-signed-edition-hardcover/.

* "Chokepoint Capitalism: How to Beat Big Tech, Tame Big Content, and Get Artists Paid, with Rebecca Giblin", on how to unrig the markets for creative labor, Beacon Press/Scribe 2022 https://chokepointcapitalism.com

* "Attack Surface": The third Little Brother novel, a standalone technothriller for adults. The *Washington Post* called it "a political cyberthriller, vigorous, bold and savvy about the limits of revolution and resistance." Order signed, personalized copies from Dark Delicacies https://www.darkdel.com/store/p1840/Available_Now%3A_Attack_Surface.html

* "How to Destroy Surveillance Capitalism": an anti-monopoly pamphlet analyzing the true harms of surveillance capitalism and proposing a solution. https://onezero.medium.com/how-to-destroy-surveillance-capitalism-8135e6744d59?sk=f6cd10e54e20a07d4c6d0f3ac011af6b) (signed copies: https://www.darkdel.com/store/p2024/Available_Now%3A__How_to_Destroy_Surveillance_Capitalism.html)

* "Little Brother/Homeland": A reissue omnibus edition with a new introduction by Edward Snowden: https://us.macmillan.com/books/9781250774583; personalized/signed copies here: https://www.darkdel.com/store/p1750/July%3A__Little_Brother_%26_Homeland.html

* "Poesy the Monster Slayer" a picture book about monsters, bedtime, gender, and kicking ass. Order here: https://us.macmillan.com/books/9781626723627. Get a personalized, signed copy here: https://www.darkdel.com/store/p2682/Corey_Doctorow%3A_Poesy_the_Monster_Slayer_HB.html#/.

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🏹 Upcoming books

* Picks and Shovels: a sequel to "Red Team Blues," about the heroic era of the PC, Tor Books, February 2025

* Unauthorized Bread: a graphic novel adapted from my novella about refugees, toasters and DRM, FirstSecond, 2025

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🏹 Colophon

Today's top sources:

Currently writing:

* A Little Brother short story about DIY insulin PLANNING

* Picks and Shovels, a Martin Hench noir thriller about the heroic era of the PC. FORTHCOMING TOR BOOKS JAN 2025

* Vigilant, Little Brother short story about remote invigilation. FORTHCOMING ON TOR.COM

* Spill, a Little Brother short story about pipeline protests. FORTHCOMING ON TOR.COM

Latest podcast:
  The Majority of Censorship is Self-Censorship https://craphound.com/news/2024/02/25/the-majority-of-censorship-is-self-censorship/

This work - excluding any serialized fiction - is licensed under a Creative Commons Attribution 4.0 license. That means you can use it any way you like, including commercially, provided that you attribute it to me, Cory Doctorow, and include a link to pluralistic.net.

https://creativecommons.org/licenses/by/4.0/

Quotations and images are not included in this license; they are included either under a limitation or exception to copyright, or on the basis of a separate license. Please exercise caution.

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"*When life gives you SARS, you make sarsaparilla*" -Joey "Accordion Guy" DeVilla
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