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Behind the Scenes with Shyam Sankar

Shawn gives Shyam a tour of the studio before the interview.

Behind the Scenes with Shyam Sankar

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I didn't realise the deal they got done with nato announced a few days ago. And the objections from the bmj of all places. I think cited something about their connection with Israel and alleged war crimes. A bit rich considering what's come out about funding from UK to eco health. Probably very wrong but would need to reread the nuremberg code. Toggle navigation The BMJ logo Toggle top menu covid-19 Research Education News & Views Campaigns Jobs Archive For authors Hosted Editor's Choice Trust and the Palantir question BMJ 2025; 388 doi: https://doi.org/10.1136/bmj.r452 (Published 06 March 2025) Cite this as: BMJ 2025;388:r452 Article Metrics Responses Kamran Abbasi, editor in chief Author affiliations kabbasi@bmj.com In healthcare we trust—or do we? A breakdown in trust, like the schism in the transatlantic alliance, should make us think again about whether the current model requires reinvention. An anonymous scientist continues to reveal the extent of the shocking attack on health and science in the US (doi:10.1136/bmj.r392).1 The professionals and public betrayed by their president’s purge must feel, as Nick Cave sang, like a microscopic cog in a catastrophic plan—designed and directed by his red right hand. Trust and rights (doi:10.1136/bmj.r372)2 are eroding in many if not all health systems worldwide, albeit not as dramatically as in the US. Crises—financial, workforce, and disease burden—strain every sinew of every health system. In the UK, the NHS is no different. Yes, some progress is being made. For example, a newly agreed contract offers hope of a gradual restoration of general practice (doi:10.1136/bmj.r426 doi:10.1136/bmj.r435).34 The alarming events at Moorfields Eye Hospital in London, where the board chair has just resigned (doi:10.1136/bmj.r424),5 emphasise how competing pressures are creating an environment that is dysfunctional and therefore failing to serve patients in the best possible way. Each stakeholder feels less trusting of the other. The public’s trust in healthcare staff remains high, but it is lower than it was. Staff have lost trust in successive governments. The government, it seems, has lost trust in the people running the NHS. How else do we interpret the government’s decision to set up an inquiry into the role of physician associates in healthcare (doi:10.1136/bmj.r145 doi:10.1136/bmj.r425),67 so soon after the launch of a much heralded workforce plan (doi:10.1136/bmj.p1535)?8 What faith in an NHS that has contrived a training scheme for doctors that has resulted in outrage and another government review (doi:10.1136/bmj.r360)?9 Or a health service unwilling to show flexibility when specialist careers are suddenly damaged by an exam marking error (doi:10.1136/bmj.r422)?10 Is it a coincidence too that the NHS has lost both its chair and its chief executive in quick succession (doi:10.1136/bmj.r399)?11 Presumably, there are more senior changes to come and reorganisations to follow. It is time, then, to put each and every card on the table, although we know this is no card game. There are other areas that the government needs to examine urgently: the unfit state of NHS buildings (doi:10.1136/bmj.r84),12 for instance, or how we make a medical career more than a career for the privileged (doi:10.1136/bmj.r399 doi:10.1136/bmj.r366).1113 The red right hand of the US leader might also extend to the valuable commodity of NHS generated data. If we no longer consider the US to be a trusted ally, then how do we view the NHS data platform contract with Palantir, a company known for its proximity to the US state and its support of armed warfare (https://en.wikipedia.org/wiki/Palantir_Technologies)?14 And whose business model has been dogged by concerns about its use of data for political purposes and in ways that violate personal privacy (https://www.bbc.co.uk/news/business-54348456 doi:10.1080/1369118X.2023.2279557)?1516 When Palantir was appointed to create and run the NHS federated data platform, the process and the £480m contract award were met with alarm and deep concern among many health professionals (doi:10.1136/bmj.q1712 doi:10.1136/bmj.p2752).1718 The concerns were ignored. Awarding the contract to Palantir was a red flag. It is hard to understand how the decision passed ethical scrutiny, and perhaps this is another example of the “logic injury” that Matt Morgan says pervades the NHS (doi:10.1136/bmj.r406).19 What matters more: marginal gains or tackling deep rooted problems? For argument’s sake, is it more important to wear a suit or resist a dictator? We want our health service to be run in an ethical manner and in the interests of the public. The situation today is that the NHS federated data platform is run by a company known for its politicisation of data and its proud support of military action in Gaza for which the International Court of Justice believes it must hold Israel to account over accusations of genocide (https://www.icj-cij.org/node/203454).20 That is not the way to build trust, especially when platforms such as OpenSAFELY are showing how data can be managed in the public interest while protecting privacy (doi:10.1136/bmj.r375).21 Just as the government has reopened the book on physician associates and specialist training, it now also needs to reopen the book on its arrangements with Palantir and the management of NHS data. The master plan for re-establishing trust is complex and hard to deliver, but we need to make a start. We might begin by prizing the microscopic cogs at the heart of it. References ↵More harm and chaos within the US federal research system. BMJ2025;388:r392.pmid:40015742FREE Full TextGoogle Scholar ↵McGovern T, Memaj I, Rivera L. Fetal personhood: What happens when the rights of the “fertilized egg” supersede the rights of the mother. BMJ2025;388:r372. doi:10.1136/bmj.r372 pmid:39993824FREE Full TextGoogle Scholar ↵Wise J. GP leaders in England agree £889m funding deal as “starting point”. BMJ2025;388:r426. doi:10.1136/bmj.r426 pmid:40021225FREE Full TextGoogle Scholar ↵Salisbury H. Helen Salisbury: The promise of a comprehensive new GP contract. BMJ2025;388:r435. doi:10.1136/bmj.r435 pmid:40037686FREE Full TextGoogle Scholar ↵Coombes R. Moorfields consultants warn of “culture of fear” and leadership crisis. BMJ2025;388:r424. doi:10.1136/bmj.r424 pmid:40021224FREE Full TextGoogle Scholar ↵Leng G. The review of physician and anaesthesia associate roles will be transparent and evidence based. BMJ2025;388:r145. doi:10.1136/bmj.r145 pmid:39848665FREE Full TextGoogle Scholar ↵Hubbard E. Coroner warns about use of physician associates in the NHS after woman’s death. BMJ2025;388:r425. doi:10.1136/bmj.r425 pmid:40021223FREE Full TextGoogle Scholar ↵Wilkinson E. NHS workforce plan is broadly welcomed by medical colleges, but questions remain over implementation. BMJ2023;382:p1535. doi:10.1136/bmj.p1535 pmid:37402519CrossRefPubMedGoogle Scholar ↵Limb M. Review of postgraduate medical training must tackle high competition ratios, say doctors. BMJ2025;388:r360. doi:10.1136/bmj.r360 pmid:39978799FREE Full TextGoogle Scholar ↵Hubbard E. Doctors affected by exam error face unemployment owing to withdrawal of job applications. BMJ2025;388:r422. doi:10.1136/bmj.r422 pmid:40021213FREE Full TextGoogle Scholar ↵O’Dowd A. NHS chief Amanda Pritchard announces surprise resignation. BMJ2025;388:r399. doi:10.1136/bmj.r399 pmid:40010800FREE Full TextGoogle Scholar ↵Oxtoby K. The crumbling state of NHS buildings. BMJ2025;388:r84. doi:10.1136/bmj.r84 pmid:40044224FREE Full TextGoogle Scholar ↵Webster G. If we want to invest in our future NHS workforce, then studying medicine should be affordable. BMJ2025;388:r366. doi:10.1136/bmj.r366 pmid:39984183FREE Full TextGoogle Scholar ↵Palantir Technologies. Wikipedia. https://en.wikipedia.org/wiki/Palantir_Technologies ↵Sherman N. Palantir: The controversial data firm now worth £17bn. BBC News. 2020. https://www.bbc.co.uk/news/business-54348456 ↵Lanzing M. Traveling technology and perverted logics: conceptualizing Palantir’s expansion into health as sphere transgression. Inf Commun Soc2024;27:2617-33. doi:10.1080/1369118X.2023.2279557.CrossRefGoogle Scholar ↵Mihranian Osborne R. NHS England must cancel its contract with Palantir. BMJ2024;386:q1712. doi:10.1136/bmj.q1712 pmid:39089808FREE Full TextGoogle Scholar ↵Armstrong S. Palantir gets £480m contract to run NHS data platform. BMJ2023;383:p2752. doi:10.1136/bmj.p2752 pmid:37989517CrossRefPubMedGoogle Scholar ↵Morgan M. Matt Morgan: Marginal gains and major fails. BMJ2025;388:r406. doi:10.1136/bmj.r406 pmid:40044232FREE Full TextGoogle Scholar ↵International Court of Justice. Summary of the order of 26 January 2024. https://www.icj-cij.org/node/203454 ↵Mahase E. Researchers could soon access GP patient data-how will it work?BMJ2025;388:r375. doi:10.1136/bmj.r375 pmid:39984184FREE Full TextGoogle Scholar NATO picks Palantir’s Maven AI for military planning, amid trans-Atlantic tension American Combatant Commands worldwide already make heavy use of Palantir’s Maven Smart System to rapidly share and analyze planning data. Now NATO will start using it too. By Sydney J. Freedberg Jr. on April 14, 2025 at 2:35 PM E3-D NATO Sortie Images of RAF Air Controllers aboard an RAF Boeing E-3D Sentry, aka AWACS, conducting a mission in support of NATO. (British Ministry of Defense) WASHINGTON — Amidst disputes over Trump’s tariffs, Ukraine, and the very future of the US-Europe alliance, NATO’s operational headquarters has committed to using American AI software for military planning, Palantir’s Maven Smart System. Allied Command Operations “will begin using the new system within the next 30 days,” according to a NATO press release this morning. The acquisition was finalized on March 25, the release said. The value of the contract was not disclosed. The new tech is meant to provide “customized state-of-the-art AI capabilities to the Alliance, and empowering our forces with the tools required on the modern battlefield to operate effectively and decisively,” NATO Communications and Information Agency General Manager Ludwig Decamps said in the release. NATO has been bedeviled for decades by its member nations using incompatible technology, ranging from secure radios that can’t communicate with foreign models to fuel nozzles that don’t fit in foreign tanks. Maven Smart System (MSS) was specifically created to combine previously “siloed” databases within the US military. If it can do the same thing across some or all of NATO’s 32 member nations, it could greatly streamline international coordination and the planning of combined operations. RELATED: Saildrone, Palantir partner to use AI to streamline USV manufacturing, operations MSS has already become indispensable to many planners in the US military, from the Joint Staff in the Pentagon to theater-level Combatant Commands around the world, including Stuttgart-based European Command, officials in the Pentagon’s Chief Digital and Artificial Intelligence Office (CDAO) have previously told Breaking Defense. In 2024, the CDAO ssued contracts worth more than $500 million expand the user base from “hundreds” to “thousands” across the Defense Department. Created in 2021 as a spin-off of the controversial Maven object-recognition AI — originally built to scan hours of surveillance video for terrorist targets — MSS pulls into data from a host of sources, both classified and public, and organizes it into a single, searchable database. (The imagery-analysis version of Maven still exists, now run by the National Geospatial-Intelligence Agency, and is also in high demand). That allows staff officers and commanders to quickly look up and cross-reference anything from the supply status of a friendly unit to targeting data on a potential adversary or social-media reports of local unrest, without the traditional labor-intensive process of spending hours or days digging through multiple, often-incompatible databases. Recent upgrades added generative AI capabilities such as Large Language Models, the NATO release says. By using a so-called open architecture philosophy of fesign, MSS also allows users to customize their interface or even add third-party analytical tools from “third-party” vendors other than Palantir, while still ensuring all the users are looking at the same underlying data. Combining a common foundation of “ground truth” with customizable tools on top allows Maven users to share all sorts of data rapidly, without having to conform to a single top-down, one-size-fits-all megasystem, officials previously explained. That makes it particularly attractive to NATO, which said today MSS was acquired in rapid speed, at least for NATO: in six months after the formal requirement was identified. America are very good a certain areas of industrialisation. Correct US in the 30-40's were best at mass production. The data available for the ai should put yous on the front foot. China for the 9th consecutive term has fallen behind in the housing sector. Messenger Rna vaccines such as those used by gain of function research in wuhan under the umbrella of ECO HEALTH and the various governments involved in the funding. But this still goes on as we speak. In UK the majority if not all vaccines are mrna. These are very wrong. The worry about medication can be worrying. But so are the medications eg stations. Chemo, the list goes on. When trump was in the first term he allowed or tried to if people where on they're way out they should be allowed to try what they wanted. To my understanding worming tablets have been very successful for the treatment of various cancers. As nuts as it sounds. Interesting Churchill being selected. 1 think I've not heard mention much about him was the pivitol role he played in keeping The leader of the ROI devalera from doing deal with Hitler, letting the U boats refuel, letting them into the surrounding area. Nipping this in the bud very quickly was more important than people realised. While still keeping an eye on the terrorism which 80% of bombings post war would come from devices assembled from this country. And under the guise of Christianity. Very wrong. But as said nothing new under the sun. Re driverless trucks this has been on the go for some time. The closest it go in UK was drivers human. Going out to take over in emergency. To this day the normal way is still in place. As is the new version still being tried. As for it being cheaper for everyone having a robot. Call me synical but this seems like a good idea on certain areas. However will this dumb people down. Will this be like mobile phones and basically having a surveillance device, selling your data in your house, carried around with you. More than the Soviets achieved at their height

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Shawn — why not host a conference bringing together like minded high-tech entrepreneurs, startups, businesses and government interfaces points to help our community — whether in Franklin or virtually or elsewhere — thrive and innovate together. It’s time.

Steven Thrasher


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