Platform NHS: Reconfiguring a Public Service in the Age of Digital Capitalism

Abstract

The platform is emerging as a key organizational form and operational logic of contemporary capitalism, intimately tied to financialization and assetization. However, discussions to date have focused on platforms and platformization in the context of the private, corporate, and technology sectors. In this paper, we develop an analysis of how platformization operates in the context of public policy. Using the UK’s National Health Service as a case study, we explore how platformization is altering the form and function of the state. The platformization of the NHS has its roots in the UK government’s strategic interest in the development of the bioeconomy. This led to the creation of a research infrastructure within the health service. Subsequently, the NHS has leveraged various assets into a range of data- and technology-focused initiatives. We argue that platformization has been a major form of neoliberalization within the NHS. The paper concludes with a discussion of what an analysis of public platformization can teach us about ongoing transformations of the state.

Personalization: a new political arithmetic?

“…As is widely recognized (Birch and Muniesa 2020), the multiplication of data sets together with the possibilities of both more regular and more rapid updating, and the operation of an increasingly wide variety of memory systems including distributed ledgers have led to new possibilities of wealth creation. The response to COVID-19, for example, has seen an acceleration of the assetisation of health data in the UK with the creation of vast resources that link research and routine data in Trusted Research Environments (see NHS Digital 2021;Faulkner-Gurstein and Wyatt 2021). 24 One such case, Opensafely, claims to have achieved what the NHS failed to deliver over several decades by using, … a new model for enhanced security and timely access to data: we don't transport large volumes of potentially disclosive pseudonymised patient data outside of the secure environments managed by the electronic health record software companies; instead, trusted analysts can run large scale computation across near real-time pseudonymised patient records inside the data centres and secure cloud environments of the electronic health records software companies.…”

The Metaverse as a Virtual Model of Platform Urbanism: Its Converging AIoT, XReality, Neurotech, and Nanobiotech and Their Applications, Challenges, and Risks

“…Corporations value the biometric characteristics of individuals more than the human values themselves [34]. All the quantified, digitally stored, manipulatable, and shared information on users constitutes a key source of exploitable and investable value [214], which involves all kinds of sorting and profiling in terms of governance and surveillance. There are many grey areas about the use of biometric data when it comes to governing platforms in terms of contestation and cooperative responsibility.…”

Domesticating data: Traveling and value-making in the data economy

“…These varied actors act in, and come to constitute, what we term the global data economy. More specifically, in the ever-expanding global data economy made of national governments, healthcare institutions or again Big Tech (Birch et al, 2021;Faulkner-Gurstein & Wyatt, 2021), they form a particular domain focused on research. As practitioners described the varied origins of their data, they hinted at a boundary (Gieryn, 1999) between an inside-their laboratory-where data could be accumulated, linked and worked on, and an outside-beyond the walls of their laboratory-from where and to which data travel.…”