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back to article Greater Manchester says its NHS analytics stack is years ahead of Palantir wares

A report for a Northern England health authority says its analytics platform is more capable than anything offered under a controversial central government deal with Palantir. The Greater Manchester Integrated Care Board (ICB) set out red lines for its adoption of the government's Federated Data Platform (FDP), which the US …

  1. SVD_NL Silver badge

    Wait...

    So if i'm reading this correctly, the GM ICB has been working on it's own analytics platform for 6 years, it's developed in-house, locally hosted, functional, and fits their needs? And they have been in contact with the team coordinating the bid process? and the NHS still went ahead and awarded a contract worth hundreds of millions to a foreign business for the same or adjacent software? and this software is handling some extremely sensitive data?

    I'm not surprised, just disappointed.

    1. Anonymous Coward
      Anonymous Coward

      Re: Wait...

      The charitable interpretation would be that while Greater Manchester ICB has its analytics already sorted out, other ICBs in the country are not as advanced and might be in a position to use the Palantir offering.

      1. Doctor Syntax Silver badge

        Re: Wait...

        A more reasonable interpretation is that here is something which already exists, could and should be rolled out to other trusts and dump Palantire.

        1. Anonymous Coward
          Anonymous Coward

          Re: Wait...

          We have no idea if this will work or not. If a trust has the gumption to do decent analytics, it probably has various other things sorted internally that make it easier to drag data out of its systems. Palantir's advantage is it's very good at pulling data out of even terribly-picked/designed/implemented systems.

          I am no Palantir fan, but don't assume the problem is where you think it is. The NHS makes appalling IT / systems decisions, and Palantir has probably been picked to paper over the enormous cracks.

          1. localzuk Silver badge

            Re: Wait...

            Its difficult to agree with your statement that "The NHS makes appalling IT / systems decisions" because, while the NHS is a title, it isn't a single body - its hundreds of different organisations, and then a central govt department that makes its own decisions as well.

          2. Roland6 Silver badge

            Re: Wait...

            We also have no idea if Palantir will work or not, or I they even have the gumption to do decent analytics that are actually beneficial to the ICBs in delivering services.

      2. Anonymous Coward
        Anonymous Coward

        Re: Wait...

        Exactly that. Some icbs are doing well while others are far behind, but I think we should use more of what GM has rather than buy Palantir.

        1. John Smith 19 Gold badge
          Coat

          "but I think we should use more of what GM has rather than buy Palantir."

          What's that phrase?

          Something about "Rolling outbest practice across the Service"

          Something like that.

          Perhaps a little more time investigating what the bigger trusts are doing in-house before attending the lavish supplier presentations at the high-end hotels?

          Just a thought.

      3. BartyFartsLast Silver badge

        Re: Wait...

        Or buy/use the Manchester system.

      4. anothercynic Silver badge

        Re: Wait...

        Actually, it should be the other way around. Other ICBs in the country should be knocking on GM ICB's door asking "hey, can we see what you've done, and can we 'buy' it off you?"

        If Palantir is nowhere near what GM ICB has today, then it makes sense to give other ICBs access to what is available TODAY, and get the jump on analytics that already makes sense and has been designed by people who understand local conditions better.

        1. Anonymous Coward
          Anonymous Coward

          Re: Wait...

          What Manchester probably has is not something you can package and sell but instead a great team of people who were able to knit together the umpteen systems and data flows across their system to produce analytics and bi

      5. Roland6 Silver badge

        Re: Wait...

        A situation, I’m sure from its prior engagement, Palantir were well aware of and will exploit by taking on the ICB analytics, enhancing their own produce as a chargeable change request and then charging the ICBs for the use of their enhanced product…

    2. Dr Who

      Re: Wait...

      It could have been done along the lines of the GP data analytics offering from https://www.opensafely.org/ which is "publicly funded, built by researchers and software developers at the University of Oxford, all IP is shared openly, and the Data Controller is NHS England."

      But I do think it's best to stick with one of the big four consultancies plus a software as a service supplier well known to be a serial data abuser run by an extreme right wing nut job. Time and again it's been shown how this delivery model provides quality solutions on time, on budget and with unrivalled levels of end user satisfaction.

      1. This post has been deleted by its author

      2. Anonymous Coward
        Anonymous Coward

        Re: Wait...

        No, it could not have been done using OpenSAFELY. For starters, NHS England had no legal access to the data except for COVID until recently.

        In addition, much of the source data resides on vendor systems and until recently has been inaccessible.

        Furthermore, it isn't clear whether that system could have scaled nationally to the level required. Bearing in mind that the forerunner to FDP was stood up in a hurry (at ministerial command, not NHSE's desire) during COVID.

        Don't get me wrong, I am not saying that FDP is a good architecture and certainly not that I would personally EVER want to do business with Palantir, but that doesn't mean that there are necessarily obvious alternatives.

        1. Roland6 Silver badge

          Re: Wait...

          >but that doesn't mean that there are necessarily obvious alternatives.

          I suspect because the original contract (with Palantir) was awarded without following well established government procurement and the FDP procurement also has question marks, I suspect there are obvious alternatives, like the GM solution. Remember, just the simple adoption of the GM solution would do much to harmonise underlying data sets, facilitating the building of a loosely coupled distributed national system.

          However, this approach did not forward the Tory policy of replacing the UK system, with a system controlled by the US healthcare industry…

      3. Al fazed
        Devil

        Re: Wait...

        the data gifted to Palantir is already missing vital health information about the patients in the data trawl, so how useful is the data going to be ?

        Already missing from NHS provision, Mc Timoney Chiropractics, Psilocybin and Cannabis treatments.

        This is on top of the heavily massaged data that the NHS actually provides to Palantir. That is, I have been taken off the ADHS Assessment waiting list in Calderdale 5 times since 2021. The NHS Trust in Oxfordshire closed their waiting list over a year ago. The HC1 ceritificate I hold - as a UK Pensioner, says to the Dentist's receptionist that I can have specific kinds of dental treatment "free" under the scheme. Unfortunately NHS Business are interpretting the data differently than the dentists reseptionist was capable of doing. They have now fines me £100 and expect me to pay for the treatment. Huh ! The filling fell out after only 2 weeks. I am a pensioner on the breadlins and these muppets will now spend £1,000's attempting to get £300 out of me.

        Yes, this certainly is the way to go forward

    3. andydroid

      Re: Wait...

      Same in Leeds. There is an integrated IT/patient record system that allows Leeds Teaching Hospitals, GPs, the mental health care trust, community healthcare trust and to a limited extent social services, to view each others records. . Seamless, frictionless while incorporating robust safeguards on access and a verifiable audit trail so that nobody will be snooping on records they should not be accessing.

      Developed in-house at little cost by people who know and work in the local healthcare settings, rather than paying a fortune to external agencies who don't work in healthcare and have no understanding of what our requirements are. The likes of Palantir invariably come up with a clunky bodged solution that is unusable and hideously overpriced.

    4. Anonymous Coward
      Anonymous Coward

      Re: Wait...

      "locally hosted", locally designed.

      Would it scale nationally? Was any work done to try? Would it meet the requirements of other ICB's?

      Not saying you are wrong. But I will say that it is rarely that straight forwards.

      1. FirstTangoInParis Silver badge

        Re: Wait...

        And what happens when Palantir want to pull the Service (as will happen sooner or later) and all that data is in some proprietary format that needs processing with tools the NHS no longer have access to? Hmm? Having watched a succession of tools at $employer come and go, I’m firmly of the view that home-grown is best, and it’s not as difficult as one might think. Never mind “it’s not core business”, it really accelerates what you can do.

        Many moons back $then_employer was building SDH multiplexers, and built their own ASICs using a series of third party tools tied together with company glue and libraries. This was long before commodity silicon was available, so they got to market long before anyone else.

        1. Anonymous Coward
          Anonymous Coward

          Re: Wait...

          Handling and analysing the data of the area they serve is absolutely 100% core business to an NHS Trust. They need to understand the local community and its health profile. This was true in the pre-Internet age- teams of people performed these analyses rather than computers- so it's a well established part of their core business.

          This means storing- ideally efficiently- all that data. It means processing that data. And it means that information being accessible in perpetuity for historical tracking, family medical histories, etc.

          Handing the data to people known to not respect privacy, moving the data to a position where they know it realistically will become inaccessible- these are so against core business they should be firing offences.

    5. Al fazed
      Thumb Up

      Re: Wait...

      I think people will be even more disappointed to hear that NHS Trusts have been removing people from waiting lists or simply closing the waiting lists for things like ADHD and Autism assessments.

      To add to your and I suppose Palantirs frustrations, some NHS "customers" with HC1's are currently being fined by "NHS Business" for the treatment they have just had, which NHS Business claim "wasn't covered by their HC1."

      So there's an obvious problem with the information being processed, either by the dentists receptionist, or NHS Business.

      Does it really matter, other than it was UK Tax Payers money wot got given to the CIA via the Palantir contract ?

    6. Chinamissing

      Re: Wait...

      Surely all you can take from this, is that one ICB has apparently done a very good job and has paid for a report that proves they have. I am not saying that they have not done what they say but there are a few telling mentions as well.

      1. The input from the unions on not wanting to work with Palantir, even if what they do is any good

      2. Some of the stuff is good and some will be better than GM can do/will do over time. - So integrate that into the solution

      3. The comments on trust would indicate that there are also political concerns around the use of Palantir that are nothing to do with the solution. Pretty much exemplified by the rant from AC just below the initial post

      As for the posts, it is incredible how many knowledgable keyboard jockeys there are on here, well informed on the complexities of massive systems, the public sector and its incredible productivity at all levels and not just foaming keyboards, management evil, union amazing, writers.

      If they have this incredible system, then can it be scaled, added to the system, adopted across the NHS, does the Trust and its partners have the skills and support and cash to roll this across entirety of the NHS? And time to deal with all the petty politics in every region that might have their own version? I mean will Leeds give up theirs to use Manchester's..... Perhaps Manchester looked at this with NHS England and privately said, we do not want to get involved and we do not want to share this because it is too much a pain and we can see what is going to happen when you try to roll out a national system in an organisation filled with people defending their own little pieces of turf.

      1. Anonymous Coward
        Anonymous Coward

        Re: Wait...

        It's more we work in the sector and understand that adding every problem currently presented and listed in your rant above, to the outright theft of public money in an utter corrupt process complete designed to produce the outcome of selecting a private company, is not going to result in an improvement to service delivery, as less resource will be made available for non-grift purposes.

        The people using the SW know best what it should do, that's the most essential part of requirements gathering. A locally developed system for an NHS Trust is likely to be more closely aligned with another NHS Trust than some generic AI pipeline based on ingesting documents into some ML Pipeline, like everybody else who got a couple of bullets points in front of a Minister.

        As for scaling, it's a web app on top of a database. It will be fine with the money we're saving we can pay for better computers every few years.

    7. nojobhopes

      Re: Wait...

      And this included "a series of non-competitive deals with the vendor". Is "non-competitive" also "anti-competitive"? Or just corrupt?

  2. alain williams Silver badge

    Follow the brown envelopes or funny handshakes

    to see why the NHS went with Peter Thief (sorry: Thiel).

    The UK should use Manchester's system and then sell it to other countries - that this would annoy Trump‡ is just an added bonus.

    ‡ Less money to one of his mates and less USA intelligence about the health of UK citizens.

    1. Anonymous Coward
      Anonymous Coward

      Re: Follow the brown envelopes or funny handshakes

      The "NHS" did not go to him. Nor did anyone that I'm aware of who actually worked for the NHS ever WANT Palantir involved. They went straight to the minister and "wow'd" him. He then commanded the NHS to implement it.

      When it then came round to FDP, there was already so much lock-in than no other vendor could realistically win the business.

      1. Elongated Muskrat Silver badge

        Re: Follow the brown envelopes or funny handshakes

        Yeah, don't confuse "NHS England" (a Tory QUANGO created during the previous government) with "the NHS" which is the organisation that actually delivers the services.

        The cynic in me thinks that the Tories deliberately named it this way for two reasons: Firstly, to confuse people about the pretty clear delineation between the NHS and this QUANGO, and secondly, so that when Labour cancelled it, they could get their buddies in the right-wing press (the usual rabble, you know, the Daily Hate, the Scum, etc.) to throw their arms in the air and decry "Labour scrapping the NHS". Unfortunately for them, Labour didn't announce they were getting rid of it any time around any elections, so they couldn't capitalise on this, although Labour have made plenty of own goals that they can capitalise on instead, like turning on the disabled, minorities and immigrants.

        1. Anonymous Coward
          Anonymous Coward

          Re: Follow the brown envelopes or funny handshakes

          NHS is a brand as much as an actual organisation. For a start there are four national health systems in the UK - England NHS, Scotland NHS, Wales NHS and the HSCNI of Northern Ireland.

          Primary care is mostly provided under contract by private entities - whether partnerships or companies formed by GPs.

          1. Elongated Muskrat Silver badge

            Re: Follow the brown envelopes or funny handshakes

            This is a very good point; creeping privatisation of the organisations that make up the NHS mean that GPs, for example, are private businesses that essentially do contract work for the NHS, and many services that used to be provided "in house" in hospitals and surgeries are "contracted out". This has, sadly, been going on for many years, at least since the Blair government.

            1. Chinamissing

              Re: Follow the brown envelopes or funny handshakes

              That is very true, ironic that all these people ranting about the evil tories and the private sector, conveniently ignore how GPs have gamed the system, private sector control (i.e. themselves) with public sector money, pensions and security. So all those people ranting about the evil private sector and the saintly NHS might want to check out how many of those 'saints' are in fact the demons they are foaming about. All thanks to Blair, who when I last looked was Labour, pretty sensible labour too.

              1. Elongated Muskrat Silver badge

                Re: Follow the brown envelopes or funny handshakes

                I'd reserve judgement on Blair as "sensible Labour", the public/private finance intiatives that he put in place to fund new hospital buildings left the NHS paying high interest rates on those buildings to give a profit to the financiers when building them with public money would have been cheaper for the tax payer, but would have shown up as borrowing on the government's books.

                The Tories who came after seemingly didn't care about making the public finances look bad and simply borrowed loads of money to pay to their buddies (government borrowing went up vastly under the Tories, despite "austerity", which was simply a way to cut public services and funnel more money into private hands).

                I really hate to be the one who says, "they're all the same", because this trivialises and excuses some of the truly awful stuff governments do, but Labour really haven't covered themselves in glory, and it's exceedingly disappointing that they have not taken the reins and instigated a programme of anti-corruption when they could.

                1. Anonymous Coward
                  Anonymous Coward

                  Re: Follow the brown envelopes or funny handshakes

                  The NeoLiberal attack on the UK strongly follows https://en.wikipedia.org/wiki/Le_Cercle and the BAP https://www.declassifieduk.org/the-secretive-us-embassy-backed-group-cultivating-the-british-left/

                  It's not so much they're all the same, so much as we're not a real democracy, our laws were intended to give strong property rights to the rich, not protect the population in general.

                  This is more than an anachronism, we live in an elective dictatorship where its not possible to commit a crime as an officer of the Government https://www.hse.gov.uk/enforce/enforcementguide/investigation/identifying-crown.htm

                  We have people steering our government though deliberate well funded overt and semi-overt campaigns to push certain policies, which leading to grooming candidates.

                  For example, Pritti Patel was a Tory Press officer in 1997, and steadily was supported into a position where she could be fired for directing public money towards her donors and having undeclared meetings with the foreign government she was acting as an paid agent for, so egregiously that she had to be fired.

                  Eventually it was decided that it would be better to let them steal directly from the public.

                  Polak’s expenses as a member of the House of Lords are entirely legitimate. Members do not receive a salary but can claim a non-taxable daily attendance allowance of £361 (£342 prior to April 2024), although they can also choose to claim a reduced allowance or no allowance at all.

                  But Polak’s place in parliament, and his entitlement to draw on public money while continuing to advocate for Israel, has been called into question at a time when Israeli leaders face accusations of genocide and war crimes over the conduct of the war against Hamas in Gaza, during which more than 38,000 Palestinians have been killed.

                  Concerns about CFI’s relationship with the Conservative Party were also raised this week by Alan Duncan, a former foreign office minister who on Tuesday said he had been cleared of antisemitism by a party disciplinary panel and suggested there had been a “witch hunt” against him.

                  The case against Duncan came after an interview he gave to LBC radio in April, when he said that CFI was “doing the bidding” of Israeli Prime Minister Benjamin Netanyahu.

                  He also accused Polak of “exercising the interests of another country, not that of the parliament in which he sits,” and called for him to be removed from the House of Lords.

                  In a strongly worded statement on Tuesday, Duncan claimed that an improper relationship existed between the CFI and the top of the Conservative Party, and called on the party to “decouple itself” from the lobby group.

                  https://www.declassifieduk.org/israel-lobbyist-lord-polak-claims-thousands-of-pounds-in-public-money/

            2. Dante Alighieri
              Alert

              Re: Follow the brown envelopes or funny handshakes

              GP practices have been private businesses since 1948 (start of the NHS) - nothing new.

              Other privatisation is more problematic - like public health and occupational health.

              DOI - in the business in secondary care.

  3. Anonymous Coward
    Anonymous Coward

    Yeah but…

    Won’t someone think about the Palantir share price, and the grubby politicians that own shares?

  4. Jamie Jones Silver badge

    All too familiar

    When I was in ICL, the call-logging-ticketting system (SIAM) ran on the old mainframes. It was old, clunky, had some restrictions, but worked.

    It was due for an upgrade, but the suits made a deal for some off-the-shelf-but-never-heard-of replacement that simply didn't do what was required. Actual users of the old service obviously hadn't been contacted about requirements.

    After much moaning, and bespoke code changes that didn't help, along with general reliability issues, it was eventually dumped for another off-the-shelf system (and the ICL guy responsible for the contract left to join the board of the company that created the software.)

    The replacement, whilst better, was still missing stuff and had to be tweaked for some time (ICL was big enough that they could demand tweaks)

    ________________________

    This one is even worse, and more relevant to the article.

    I worked on the team that provided ASPECT - a monitoring system for the Unix servers (and some forms of VME monitoring), and collated messages that could be directed to pagers/call systems/mobile phones etc.

    Pretty standard stuff these days, but this stuff had been around for years - long before I joined the team.. Many people from council IT workers to NTL/Virgin/ICL/DOD staff would have been aware of ASPECT.

    Near the end of the 90's, corporate announced this "brilliant deal" with CA to rollout their monitoring tools company-wide. Whoever had made that deal had not researched what was currently being used, and didn't realize there was a whole team that wrote customized software to do the very same thing.

    It was crud. The Unix modules were pants. They did provide a windows module, which was something we had needed to add, but damn was the overall thing expensive, and not suitable for our requirements (even other teams we had no direct relationship with told us it didn't fit their needs like ASPECT did).

    Partly because of this, and partly because ICL had this bloody system in place already, I was tasked with writing stuff that would allow ASPECT backbends to interface with these clients.

    Not long into this project, my suspicions were confirmed. I had to go to some internal conference thingie off site, and got talking to one bigwig about the frustrations with all the extra work we had. No surprise, he hadn't heard about ASPECT, and had been told that the CA deal would bring all these cool features we didn't already have. I explained that all the companies UK paging and alerts went through ASPECT, and mentioned some of the other things it did (some of which he was familiar with [like automated paging], but didn't know how it had all worked.)

    He said he'd explore ASPECT to make sure it was used to its full potential, and would raise the fact he hadn't been told about it with the people associated with the deal.

    His main feelings at the end of the conversation were something like "We have something, written internally, owned by us, that does the same thing, but is not generic, and works well with our specific use case, is run on a comparative shoestring budget... Why didn't I know of this before this deal happened?"

    Well exactly.

    I left the company a year or so later (2001ish) not long before ICL was swallowed whole into Fujitsu.

    P.S. I also admit some of the ASPECT code was cruddy. During an audit I found some software written by someone I'd never met (who had long since left the company) even had this sprinkled through his C source:

    system ("sleep 5");

    1. Elongated Muskrat Silver badge

      Re: All too familiar

      system ("sleep 5");

      To me, the purpose of that seems pretty obvious.

      If your internally developed software runs too well, people start to think that the developers who wrote it aren't needed any more. You can counteract this by releasing a "performance upgrade" every few years, where that number is changed in a global find/replace. I bet it was originally "sleep 30"...

      SET CYNIC MODE OFF

      1. alain williams Silver badge

        Re: All too familiar

        I think that delays to slow a new computer are called 'Hopper loops' (named after Grace Hopper), these would be gradually removed as the system load increased so that users did not notice a degradation of performance and so complain.

        But the stupid thing about this code is invoking a shell command to do what can be done by a system call:

        sleep(5);

        1. Elongated Muskrat Silver badge

          Re: All too familiar

          I can't disagree with you there; that sort of "code smell" makes me shudder, and it clearly dates from those halcyon days when people didn't even know about security considerations, let alone think bout them.

      2. Jamie Jones Silver badge

        Re: All too familiar

        Oooh, that is indeed a cynical take! .... I must remember that!

        However, in this case, the sleep was relevant - I can't remember why now, but my point was about using system to spawn a shell command for it. That was some scary shit!

  5. lsces

    "not long before ICL was swallowed whole into Fujitsu."

    And we know now where that ended up ...

    1. Jamie Jones Silver badge
      Happy

      Re: "not long before ICL was swallowed whole into Fujitsu."

      Well, I (jokingly) tell people ICL only collapsed because I left, so I guess you can blame me for all that ensued!

  6. Doctor Syntax Silver badge

    Here's a thought. The Health Sec is taking direct control over from NHS England. How about he undertakes a survey of his new empire to see what he's actually got that works, is created in house, is totally under UK control, not US and doesn't involve forking out huge sums of money for anything other than the H/W to run it on.

    1. Anonymous Coward
      Anonymous Coward

      Well, he clearly doesn't even know what NHS England's statutory functions are so the chances of him doing something so sensible seem rather remote.

      And he absolutely is not taking over direct control, he is dumping it (notionally) on the Department for Health and Social Care.

      There is only one reason this is actually all happening. Labour need to show QUICKLY that they are shutting off the gap in UK finances. The NHS is a major factor both in overall cost and in constant overruns (though those are largely due to having had funding constantly cut). If they don't do this quickly, they won't have leeway before the next election to give some generous handouts to the electorate and they will loose to Reform who will sell out the whole country to right-wing private sector, exactly as it happening in the USA (who's politicians are backed by the same right-wing extremist billionaires).

      1. Elongated Muskrat Silver badge

        The solution to that would appear to have three stages: (1) put laws in place limiting funding of political parties, especially with overseas money; make it so that all donations must be publicly traceable to an individual and not go via shell companies, (2) put laws in place limiting the scope of the foreign-owned press (too many "news" outlets in the UK are owned by foreign billionaires with interests which conflict with those of the people of this country), and (3) a wealth tax on the super-rich, say a 2% annual tax on UK residents with over £1,000,000,000 in assets. If they leave the country, good riddance, "trickle-down" is bollocks anyway, especially when applied to the super-rich, they don't get to be super-rich through ethical behaviour, or by letting anyone else have a slice of the pie.

  7. MrGreen

    Follow the Shares

    All MP’s can’t profit from public owned entities.

    This is why they are directing your tax money to private companies they all own shares in.

    They all become multi millionaires from this insider knowledge.

  8. GeekyOldFart

    Given the superiority of the GM system, it's a no-brainer for them to continue to use it. After all, "If it ain't broke..."

    The arguments for expanding that system's use to other areas are also valid, given that it's a system in actuality, not vapourware. Implementation at other trusts should be hugely simplified (and cheaper) as a result.

    There are the inevitable questions about whether the system would scale nationally, but it doesn't have to, at least not immediately. Even if each regional trust is running as a standalone environment, it would still benefit the residents of that area. Initially the system only has to scale to a regional trust, and it's already proven in one of the three most populous regions in England.

    National integration as an end-state is obviously the goal, but wouldn't it make more sense to invest the effort and Taxpayer's money in creating an integration platform that operates as a distributed architecture, allowing all these (now-similar) regional nodes to interoperate? No great central repository of data (avoiding the whole single point of compromise risk) but distributed data, with each node being able to request data from a patient's "home" node if they are treated there, and to request a permanent transfer when somebody relocates and registers with a GP in their new area. That would almost certainly end up as a much simpler, cheaper, both more effective and less disruptive path to the goal of national health record availability than the big bang of trying to create and implement something entirely new.

  9. Anonymous Coward
    Anonymous Coward

    It sounds like a good team

    that needs to be offered early retirement or a lucrative opportunity in the private sector

  10. Forex

    differences in DB technology

    Some commentators are missing that there are clearly difference in the DB technology. Well quoted by theregister in the quotes from the report counter points. clearly there is a difference between mongodb and neo4j. So I would like to see more technical details on how this Palantir DB technology differs. Thanks.

  11. Graham Dawson

    Having experienced Manchester and UHB, I can safely say two things:

    1) Manchester is absolute garbage

    2) it is nevertheless lightyears ahead of Birmingham at the very least, and probably most of the country

    So I can believe that they have in fact done what they say.

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