The Greater Manchester Gambit: Why the Fight Against Palantir is a Necessary Litmus Test for Public Health

In the high-stakes world of health tech, the prevailing narrative is often that the scale of modern data is too vast for public institutions to manage. The solution, we are told, is to outsource the 'plumbing' to massive, proprietary software firms that can ingest and organize the chaos. But as the UK government weighs whether to terminate a contract worth more than $400 million with the American firm Palantir, as first reported by *Wired*, the region of Greater Manchester is offering a provocative counter-thesis: public health data infrastructure can, and should, be built in-house.

This is not merely a dispute over software licenses; it is a fundamental argument about sovereignty and trust. As a columnist covering the intersection of biotech and tech, I have seen countless 'vaporware' promises from vendors who claim their proprietary scaffolding is the only way to achieve efficiency. Palantir's Federated Data Platform (FDP) is marketed as exactly that—a system designed to unify the fragmented tangle of health data across the NHS to reduce hospital stays and optimize operating theatres. According to reporting from *Wired*, the FDP is already live in 139 of approximately 200 trusts and is being used by 35 of England's 36 integrated care boards (ICBs).

However, Greater Manchester—the region where the NHS was born—stands as the sole holdout. While the national government and Palantir push for a unified system, the Greater Manchester ICB, which serves roughly 3 million people, has categorically refused to adopt the FDP. Instead, they are doubling down on their home-spun Analytics and Data Science Platform (ADSP).

From my perspective, Greater Manchester's resistance is the most important litmus test currently running in global health tech. The core of the issue is the 'black box' nature of proprietary vendors. When a government relies on a firm like Palantir, it isn't just buying a tool; it is tethering its public health strategy to a company whose technology is simultaneously deployed in theaters of war and used in U.S. immigration crackdowns. As *Wired* reports, this has sparked parliamentary inquiries, petitions, and a rebellion among NHS workers.

Greater Manchester's argument is that a technically proficient platform is useless if it lacks the trust of clinicians, patients, and the public. Matt Hennessey, the chief data and analytics officer at NHS Greater Manchester, told *Wired* that adopting the FDP would be a "retrograde step." This is a bold claim, but it is backed by a specific technical philosophy: modularity over monopoly. Hennessey explains that because the ADSP was developed in-house as a collection of technologies, the region can swap out specific components—such as data visualization software—if they are no longer best-in-class. In contrast, a proprietary system like the FDP often locks the user into a specific vendor's ecosystem.

Furthermore, the Greater Manchester board concluded in a May 2025 meeting that their local capability actually exceeds what the FDP offers, with some functionalities being two to three years ahead. They also possess primary care data that is unavailable on Palantir's platform. This suggests that the 'efficiency' promised by national rollouts is often a mirage that ignores the nuanced, high-functioning systems already operating at the local level.

Critics of the in-house approach, including former NHS England deputy director of data engineering Tom Bartlett, argue that the real power of the FDP is the ability to "lift and shift" tools from one region to another and provide a unified surface for artificial intelligence. This is the classic vendor pitch: scalability through standardization. But standardization is only a virtue if the standard itself is superior. If Greater Manchester has already built a more flexible, more trusted, and more advanced system, then forcing them into a national mold isn't progress—it's a regression.

We are currently at a crossroads. The UK government has until next February to decide whether to end the Palantir contract early or let it run until 2031. The outcome of this decision will signal whether the state believes it is capable of owning its own digital destiny. If the government forces Greater Manchester to fold, it concedes that public health is too complex for public servants to manage. But if the ADSP model is validated, it proves that transparency and local autonomy are not obstacles to efficiency—they are the prerequisites for it.

Greater Manchester is not just protecting its data; it is protecting the principle that the infrastructure of care should be as transparent and accountable as the care itself. In an era of opaque algorithms and geopolitical volatility, the 'home-spun' approach isn't just a local preference—it is a necessary safeguard.