The New Body Economy Part 6: Silicon Valley Comes for the NHS

The NHS has some of the most valuable health data in the world and that makes it both a goldmine and a battleground. In the latest episode of The Long Game, Sandy Weir and Ross Cagan pull apart the promise, the politics, and the very real risks of letting Silicon Valley companies help run the systems behind your care. They start with the Royal Free and DeepMind case, where 1.6 million patient records were shared without patients being individually asked for consent, then move to the bigger question now facing the NHS: what happens when companies like Palantir sit at the centre of the data infrastructure that powers care, research, and AI? You'll discover why NHS data is so attractive to technology companies, what “data processor” vs “data controller” actually means in practice, and why trust can collapse even when the legal basis looks sound. Sandy and Ross break down the hidden danger of vendor lock-in, the importance of interoperability and exit planning, and why standardised platforms may matter as much as the software itself. We also get into the upside that keeps this conversation from becoming anti-tech. Ambient AI is already cutting documentation time dramatically, some pilots are reportedly slashing admin workloads by 80%, and linked data can improve diagnosis, scheduling, discharge, and research at scale. But those gains only matter if the public can see what they are getting back. The episode also revisits care.data, the NHS rollout that spent over a million pounds mailing leaflets to 22 million households only to collapse under public backlash, and the WannaCry attack, which showed how fragile healthcare infrastructure becomes when systems are outdated and security is weak. The message is clear; in health data, trust is infrastructure. Essential listening if you care about AI in healthcare, public data, NHS reform, or the future of who gets to profit from the information we all help create. The final question is the one that matters most, what should the public get back when its data creates private value?