The Cabinet Office is halting all but emergency purchases of Microsoft software in the NHS as it negotiates a pan-government procurement deal with the software giant. The Crown Representative, headed by former Micro Focus CEO Stephen Kelly – appointed by Cabinet Office minister Francis Maude in April – is leading talks with 20 …
Is this sensible?
There'll now be little scope for people who want to "think different", because HQ will say "you can't possibly do it cheaper than we've done". Except HQ will be lying. Just like HQ's corporate travel agents do. The corporate travel agents don't look for best value, they look for what makes them look good on paper (usually, biggest kickback at end of year). The fact that going independent would often be cheaper for the company overall is irrelevant to them (and their bosses?).
I have regularly found acceptable flights for far cheaper than the corporate services can, not allowed to book them as it is against policy. Idiots.
It is sensible.
"Thinking different" is laudable, but not necessarily prudent. And I'm not even sure that "cheaper*" (a worthy driver for an organisation that spends my tax money) is a luxury they can afford.
A more important driver will be the legacy IT estate, which is predominantly Microsoft -based. There are a lot of records management systems (a council I did some work for a while ago springs to mind) that are from IBM or other vendors, even though many government organisations have (had) Enterprise Agreements with Microsoft.
The current scenario is crazy. I worked on a project a while ago where a full Oracle database was installed on laptops because the Systems Integrator was told that it had a higher chance of winning the bid if it chose Oracle. So £ thousands of my tax money was paid to Oracle when SQL Server under the EA was free.
The insanity is insane, and irrespective of motive or religious affiliations, I think any step to rationalise is a good one.
* Can you qualify what you mean by cheaper? If you consider the cost of migrating existing Office documents on hard drives and in records management systems to a different format, I suspect your idea of cheaper is, in fact, extortionately expensive.
I think the point is...
... that they thought it would be cheaper. When the facts came in it turns out they where wrong.
re: legacy IT estate, which is predominantly Microsoft -based.
"Blah blah ... legacy IT estate, which is predominantly Microsoft -based... blah blah"
Hey buddy, while you've had your head in the sand, the world has changed. Smartphones, tablets, and an explosion of other devices with ethernet ports have to be supported. The days of the all MS shop are numbered.
I gather from the article though, that NHS merely want to organize themselves and bargain for a better deal with MS. Maybe try and avoid redundant purchases. Nothing wrong with that (other than the pain it causes end-users)
The point is..
The plan was to not keep paying for an 'upgrade path', when all the latest upgrades were on the table already.. That's a year's worth of not paying anything to Microsoft..
So that's already helped.. Then there's the whole "bulk contract" thing.. If everyone is under a bulk contract, you can wave a huge sum at them, which is still cheap for the organisation.. Big enough sum that it's hard for a business to walk away from, yet is still a good deal for the buyer.
I'm thinking that the "facts" aren't something you really have on this, just a few soundbites..
Up against lobbying and hype
Maybe when Microsoft and others stop lobbying and hyping up their offerings to the NHS then they will look at moving away?
When responding to tenders for supplying software to the NHS the same old questions come up time and time again. "Do you support Active Directory", "Do you support Sharepoint", "Do you support Qlikview".
Managers in the NHS are being sold ideas on what they need to perform a specific task and once the seed of that concept has been planted in their mind you have to do a lot of work and demonstrations to prove otherwise. Often you have to promise to give them what they think they need and then prove to them that you can do it more efficiently and cheaper.
There are also a lot of people with a financial background in the NHS now, accountants and ex-stock market people. Some of these are heavy Excel users, often using macros, VBA and so on.
It would take a lot of changes to working practices to simply change platform and eliminate Microsoft tools in the NHS. It would cost a lot of money too. NHS customers would only move to a commercially supported open source alternative, so that is unlikely to save money.
A good idea
It is always a good idea in these situations to start negotiations with The Document Foundation for a licence to run LibreOffice in place of MS Office. They will quickly realise that the licence cost is 100% cheaper than just about anything MS can offer, and that tends to reduce MS's quote to a little bit less than the cost of switching over.
As good as LibreOffice is (I use it an like it) the front-end is just the beginning. All the macros, plugins, full text indexers and whatever else will need updated to cope with the new software/formats. That cost will far outweigh any savings on the license fees. MS could just drop their license fee to zero too and load-up on the services. As that's probably a different budget (and a rolling future cost) this would still allow the government to crow about how much they are saving when, in fact, there is no overall change.
Aslo, MS -deals can probably get done on a PFI so are off-book anyway. I wish it were otherwise.
Or, you don't have to update anything...
The organisation will already have paid for current versions of msoffice, and can continue using them for their legacy apps/documents, while using libreoffice for anything new.
Generally, infrastructure gets refreshed every 3-5 years so any apps which were dependent on msoffice will have been replaced with libreoffice compatible apps within 5 years and as such the legacy applications can be retired. There's nothing stopping them keeping one or two of the (Already paid for) msoffice installs around for any remaining stragglers, most large organisations have all kinds of ancient equipment hanging around to cover niche apps that haven't been migrated yet.
I encountered machines running SunOS 3.x at a hospital a couple of months ago, they had clearly been there a very long time and were the backend servers hooked up via serial to a big piece of medical equipment and some dumb terminals. It's also not unusual to encounter VAX systems, typically running accountancy systems, running at organisations which have been around a while.
Let me get this right
The NHS decided to tell MS to "go screw themselves, were going Open Source"
Now are realizing that they cant realistically do that, and now wish to have their old chummy chummy relationship back ???
There was no chummy relationship, insanely all of the purchasing of MS software was done at an individual NHS trust level. If the NHS had purchased centrally they would have been MS' largest customer and therefore had the cheapest price per unit. It appears that this is what they are now doing, finally.
Did you not read the part where the NHS had an Enterprise Wide Agreement? Which they let lapse amid much fanfare of cost savings and the efficiency of local procurement?
Up until the formation of the coalition government the NHS were purchasing OS, Office Suite, Exchange and CAL's for access to SQL, Exchange, SharePoint centrally and we had the status of Microsoft's second biggest customer, behind a department of the American government. The Coalition knocked the deal on the head at the renewal point citing cost savings, although how anyone thought it could save money is beyond me. Source: I work for the body that administered it all.
But do feel free to try again.
As the title says.... they are muppets. Where possible dump micro$haft entirely and switch to open source. Reaching into my ass to grab a statistic I can say with total confidence that 90% of all installed M$ products could be replaced with other software.
P.s. I dont sleep with the penguins.
Because I'd imagine that the NHS has no bespoke applications written for MS OSes.
But, with the money saved you could rewrite/port all those bespoke applications.......
Well, maybe not all, but you get the gist.
As OP said - 90% of the work done on MS product could be done on LibreOffice on Linux or similar, and the HW requirements would drop too..
OK, how about a deal?
Imaging an acute NHS hospital with 1000 PCs running XP/W7, Office and a whole raft of custom clinical applications relevant to the department the PC is located.
On top of that, imagine all the staff of different backgrounds that use these PCs and applications. The majority are not going to be IT gurus - they're clinical.
Imagine all of the links between these departments for sharing information, documentation etc. Also, all of the links between these systems and other organisations and agencies.
Imagine all of the servers that these PCs and clinical applications are dependant upon.
Can you really come up with a realistic plan for finding suitable alternatives for MS that offer identical funcationality and ease-of-use, then come up with a realistic plan for training all the staff on the replacements, finding support for them and guaranteeing minimal downtime?
Having worked closely with certain NHS suppliers (hence posting AC), I can tell you that rewriting those bespoke applications would be neither simple, quick, nor cheap. The one I'm thinking of is a large clinical management system, the front-end of which is written to be browser-based targetting IE 6 (or later versions in 'compatibility mode'). This simply won't work if pointed to by anything else. Granted, this doesn't really apply to the use of MS Orifice, but illustrates the inertia that has to be overcome if undertaking such a radical shift.
You don't even need to port all the apps right away...
You already have your old version of msoffice that works with the bespoke apps, and upgrading to the latest version might also break the apps anyway.
You move to libreoffice for what you can, and retain msoffice for legacy uses, requiring that all new documents are in ODF format and any new applications must be compatible with libreoffice.
Do the same with browsers, keep IE6 for legacy apps (but lock it down to only access those apps, don't let it on the internet) and deploy firefox or chrome for everything else... Require that any new apps you purchase must be standards compliant and work in all modern browsers. When your an organisation as big as the NHS you have the ability to dictate terms like this.
Similarly any other apps, demand apps that are browser based if possible, or cross platform if browser based apps are not suitable. If you have single use terminals that only run one app (fairly common in medical facilities), deploy them on a stripped down linux.
Keep stats about how often the legacy apps are used vs the new apps, and keep track of all the reasons why the legacy apps were used.
Fast forward a few years, and the usual upgrade cycle will have obsoleted most of the old applications and you can start removing the legacy applications for the vast majority of staff. Eventually, in a large organisation you will just have a small handful of very old crusty apps still using the legacy junk, a problem that probably already exists in any large organisation (lost count of the number of times i've seen win3x, dos, vax and ancient unix systems running).
...so much for using more Open Source to reduce costs. As MS does not support standards*, it will be impossible (or very expensive) to get other systems to integrate that are not from MS (or from MS gold-partners).
This is a real shame as there was some interesting grassroots FOSS stuff going on in the NHS (e.g. OpenMolar).
Your tax being spunked on over-priced, sub-par shit. Sounds like a typical government spend to me. Still, so long as a few MPs and civil servants get invited to nice dinners it's all OK.
*Do NOT start me on the who docx/ISO BS.
Sadly or not depending on your point of view, Microsoft *defines* standards, de facto.
It's very difficult to shift away from, and for the majority of people it's not even clear that it would be desirable to do so.
Too many whiners whining about open source and how it's supposedly better, blah blah blah. Open source isn't the be all and end all. Every situation is different. And for the NHS, Microsoft software is clearly better.
When you're actually in charge in the NHS and know exactly what they need to interoperate with, then you can comment. Until then, please keep your silly comments to yourself.
In all honesty...
...I take the pragmatic view. F/OSS scratches that itch? Use it. Proprietary is the answer? Use it.
Just one caveat; you will interoperate and you will not block/change your APIs to ensure lock-in. Data will be stored/moved in a format that is fully and publicly documented and can be implemented without worrying about patents or license fees.
So in 15 years time when I need open an old file, even if the code does not exist I can yank the spec and pay someone to build me a module to read it; that's why.
Summary: F/OSS code? As needed. Open Standards? Without question.
And Test Man...so you are in charge of the NHS then and know for a fact that MS is better? Wow.
Troll troll troll troll...
Re: Oh shutup
"When you're actually in charge in the NHS and know exactly what they need to interoperate with, then you can comment."
This is the NHS we're talking about. Firstly, it's something of a mystery as to who is really "in charge" of it. Secondly, the NHS is just another part of the civil service sprawl that orders in big gold-plated projects from some politician's (or senior pen-pusher's) corporate chums that then goes way over budget before being cancelled, with nothing more than finger-wagging from the public auditor and sad faces from various committee MPs before it happens all over again. Thirdly, the NHS bloated itself so much in the New Labour era that there's an entire industry devoted to milking the NHS while providing no apparent benefit to patients - you know, the people who are the "customer".
"Until then, please keep your silly comments to yourself."
Test Man must clearly be Test First Man given that such juvenile "they know best" remarks are quite a good example of "silly comments". But what are we to expect from a nation where doing the minimum possible and thinking only about today have been the heart of policy for the last few decades?
Yes, in theory its a good idea to dump Microsoft in favour of an open source office app, except that the licensing usually encompasses Windows & Office bundled together - (ours here does, so we pay whether we use it or not and there's no discounts) And then there's the third party software writers who (badly) write their apps to look for and work only with Adobe Reader and Microsoft Office applications.
Will all the sandelled people stop shouting Open source
First off, I am a big fan of Linux. all my machines at home (media server, web server, laptops, phone) all run linux. BUT Open Source is not the answer or quick fix here !!
This open source argument here is like complaining that the government makes a massive order for Ford fiesta police cars, and demanding that the police design and build their own cars from kits - not gonna happen and a bigger waste of taxpayers money.
I am a senior tech in a NHS trust, and we do have some open source and non-MS. We have Vmware for example as our virtualisation platfom. We actually have a product from Microsoft which runs on a customised CENTOS Linux OS (yes really).
For the vast vast majority of the applications we need to obtain from suppliers, we need Microsoft operating systems and applications, cos that is what they develop on and offer. The apps are usually global apps, and unless the whole healthcare world market goes Open source, then we ain't.
This should make the licencing issue much less of a headache for us, and a good bit cheaper as well, which is good news for everyone!
Why can't I have 2 icons (thumbs up and happy smiley face)?
Re: Will all the sandelled people stop shouting Open source
"This open source argument here is like complaining that the government makes a massive order for Ford fiesta police cars, and demanding that the police design and build their own cars from kits"
No it isn't, but why not go for the car analogy anyway? People have suggested using the completely ready-to-use LibreOffice - hardly a "kit" - and the retort to that is that a bunch of macro-twiddlers have created "bespoke applications" using Word, Excel, Access and the like. No-one asks what these applications actually do or whether they could be done better off the Microsoft treadmill. (Except when someone finally realises that you don't need to generate letters to the customer/patient/taxpayer by having Word pop up all the time, and then some moron buys a SAP solution to show everyone how it shouldn't be done.)
Then there are the applications that supposedly need the Windows platform. What people usually mean with this is that some man-plus-dog outfit cobbled together something in Visual Basic that they now sell into the overstressed/gullible/lazy public sector bureaucracy without any thought about future costs because someone will always swipe the gold credit card for Microsoft gear, yet kick up a fuss if a few quid needs to be spent on alternatives.
Even the stuff that gets developed from scratch for a particular customer often gets developed specifically for Windows out of pure ignorance and short-termism. I've seen situations where people have developed against the shittiest Windows APIs when even the more mediocre cross-platform stuff like wxWidgets would not have required much of a mental gear-shift and would have delivered a bit of flexibility in future deployment situations, but oh no: it's far better to waste time and money and then complain that some solution "needs" Windows because of some mythical super-special aspect of that platform.
It's so great to portray people who don't trust Microsoft as that mainframe-loving hippy or whatever you're getting at, but at least they apply some scrutiny to the whole affair instead of just fantasising about which proprietary kit can be played with this week (to "solve" a problem "just like that", ignoring all that after-the-sale grunt work, of course) on the taxpayer's quid.
Just goes to show
You CAN fool all of the people all of the time - all you need is a government that is totally opposed to any form of localism or decentralisation.
Big Brother can't be arsed watching you today - please video yourselves for the next 24 hours and hand in the recordings at your nearest police station.
I think a big part in this one is they suddenly realised how much software we are using and how many licenses would need to purchased to make everything above board..
I'd personally would like to see the figures of how much it cost to do all this bureaucratic administration to get all the PCTs etc to tally up all their cals/licences and submit them.. and all the purchases at full retail cost within the whole of the NHS have made while out of the agreement - i know my org has spent at least a few thousand on 7 licences and office licences and we are small fry in the grand scheme of the nhs!
I bet it will be less than £20mil that MS wanted more...
I'm waiting for MS to turn around and say - well now you have done your audit of the organisations and we know exactly how much stuff you are using we are increasing your subscription costs.
Also open source is all very well and good, but if i was to say lets use open office in a environment when people are only barely able to use basic functions of Microsoft office.. a simple upgrade to office 2007 from office 2003 caused mass panic and doc/docx dramas, and most core functions stayed the same. imagine the chaos of swapping the entire products..
anon because you never know who's watching ;)
NHS vs Samsung
These numbers don't make sense for Microsoft. If the NHS is worth 85 Million quid, that is 135 million US$. Now Samsung is planning on selling 20 million Galaxy S2s, and Microsoft wants 15 US$ for each one ... that is 300 million dollars. So the NHS is relatively peanuts ...
I take it that the UK government feels that it can get a lower price from Microsoft because centralizing procurement will give it more bargaining power.
This would make sense if there were, in fact, a real possibility that if the UK wasn't satisfied with Microsoft's government discount, it could decide to take its business elsewhere... never buying another Microsoft product again, and relying exclusively on a mix of Linux, Macintosh computers, and possibly even eComStation on the desktop.
Legislation, such as they have in the U.S., requiring firms to give as favorable discounts to the government as they do to anyone else, might work (if you don't play by our rules, we'll make everyone in the U.K. do without Windows, and so our Windows-less computers will be able to read the documents they submit) but mere bargaining power, as opposed to the club of legislative power, is a weak reed indeed in dealing with Microsoft.
From what I remember...
It wasn't the fact that the licences wouldn't be cheaper with a large purchasing capacity, it was the fact that with the change to what is effect an annual rental process, the long term cost (even over a mere 3 year period) exceeds the stand alone purchase cost. After this period it's money for nothing.
This does omit the possibility of improved licensing procedures and reduced support costs, and the ludicrous situation where an OEM software suite installed on one PC can't be transferred to another when the first one bites the dust which, given reality, will occur quite often.
Having spent 2 decades putting a fair number of large solutions into many an organisations I continue to be flabbergasted by the sheer amount of money that companies and governments are prepared to plough into Microsoft (I'm not an MS hater by the way as they've indirectly help drive my wages up for nearly 20 years). There are always less expensive alternatives - admittedly it's hard to get everyone away from MS office (especially with customisations etc) but there are a large proportion of NHS systems that could be moved to an open source platform with an amount of re-work and integration. The cost of that integration and change would surely pay for itself in the long term, but I guess our esteemed leaders in London are really only interested in the outcome of the next general election, so demonstrating an immediate "saving" whilst burying the real long term costs would seem to be the soup de jour once again... apparently...
<Posted by a frustrated tax payer>...
Just throw that tax money in a pile and BURN IT.
If you spent the money you buy commercial software (for a couple of years) with, on developers for open source, you'd have a super Office suite with support from all over the world. Instead of pissing the money down MS coffers, use OpenLibre, SQL, and be done with it. Use the money saved to pay developers to make plug-ins to the old systems that you wasted previous money on.
WE DON'T HAVE THE LUXURY OF WASTING TAX DOLLARS ANYMORE.
The solutions are out there, people just need to stand up and take charge. Leaders are needed to drag the dinosaurs into the 21st century, where the fuck are they?
There is just NO EXCUSE to 'not' use open source office packages.
http://www.postgresql.org/ and others.
IT in government, what an ebarrassment. They should hold their heads low in SHAME to even call themselves IT.
It's cute to read the suggestions of doe-eyed innocents that the NHS should "just drop MS" (sorry, M$). It's also a little sad to think how those fresh-faced, enthusiastic kids will realise their naivety as they enter the world of work.
I doubt even most software people (myself included) can grasp the true size of the work that it would be to transition, and the enormity and complexity of the NHS.
"It's cute to read the suggestions of doe-eyed innocents that the NHS should "just drop MS" (sorry, M$). It's also a little sad to think how those fresh-faced, enthusiastic kids will realise their naivety as they enter the world of work."
Oh, tee hee: people who aren't wearing suits and talking about the next meeting with the Microsoft (ooh, M$ - hilarious!), Oracle or SAP rep must be "kids" who are obviously still at school or in their bedroom. Tee fucking hee! I've seen various organisations pissing away cash on big proprietary software vendors because some idiot upper manager wants to build a reputation with the big dogs and likes going to the big corporate events with the big buck entrance fee - perhaps waived for him, but probably not waived for the minions - paid for with your tax money.
"I doubt even most software people (myself included) can grasp the true size of the work that it would be to transition, and the enormity and complexity of the NHS."
Sure, it'd be a lot of work to make sense of the chaos. For now, however, you can work on making sense of much simpler things.
The edict is too late really, I have seen computers that have office premium on them, updated to windows 7 and all they are doing is log in patients or something equally mundane. I have seen machines that only have MS 7 and word on them thats it but the Office version is a legal copy of Office proffesional latest and they have had everything but word deleted and they have 7 Ultimate with 90% of it deleted.
These machines would have worked quite well with basic windows with open office, now that alone would have saved over £200.
We have the same here in France, a department had a new computer of i5 and all it had was basically the minimum to operate word. Both programs again the top version.
Some years ago I was called to an RAF med center and saw a Radio Transmitter on the wall. Being into radio asked why they had it and was informed to contact the ambulances and the whole lot £30,000. I gulped and suggested the informant look into my beat up Sherpa van.
He came back white He said the radio cost £5000 each and what was I doing with one in my van. When I told him that the whole shebang he had I could have installed for under £5000 there was an inquiry which was hushed up.
This sort of thing goes on everyday, the Govt need a central procurement agency, sure the local department needs to propose the supplier, but at least then a sensible costing structure can be assured.
Re: MS stuff
"These machines would have worked quite well with basic windows with open office, now that alone would have saved over £200."
Those machines would have worked quite well had they been BBC fucking Micros with a word processor. But no: only the latest and best as decreed by Microsoft, with the corporate liaison people getting the VIP treatment and everybody feeling pleased about what a "great deal" they made.
Next up: hardware that could simulate nuclear weapons tests being used to show single line messages in screensaver mode.
EMERGENCY purchases of Microsoft software???
The atmosphere in the operating theatre was tense.
The surgeon looked up from the brain tissue spread before him. "I need Powerpoint, and I need it /NOW/"
You don't watch enough TV Doctors
"Get me a copy of PowerPoint STAT!"
You call it "macro-twiddling", I call it "using the available tools to automate time consuming tasks and improve the accuracy of frequently performed multi-step tasks for semi-computer-literate workers".
I'm not suggesting VB macros are rocket science, nor that similar tools aren't available in open source alternatives. However, as it stands I don't have the resources to magically recreate all the macros I've twiddled over the years, nor to retrain all the (barely trainable in the first place) staff that use windows/Office.
The amount of productivity that would be lost by changing horses mid-stream would easily pay for our MS licensing for several years. The amount of money spent on training courses to use said FOSS would pay for another 6 months of MS licensing.
As for those who think buying an i5 with win7 enterprise is overkill for a basic ward PC, you really have no understanding of IT estate management do you? Machines have to be specced so that they have a reasonable prospect of being serviceable and supportable for at least a couple of years longer than the organisation's 'refresh cycle', and the image has to be standardised or helpdesk becomes unworkable. Can you imagine being the poor helpdesk drone asking "what processor and windows version are you running?" when you've got a shouty nurse whose "thingy doesn't come up when she clicks the whatsit"?
"You call it "macro-twiddling", I call it "using the available tools to automate time consuming tasks and improve the accuracy of frequently performed multi-step tasks for semi-computer-literate workers"."
Frequently, time-consuming tasks that shouldn't be done in a spreadsheet in the first place. But then, for the worker who can only use a hammer...
"I'm not suggesting VB macros are rocket science, nor that similar tools aren't available in open source alternatives. However, as it stands I don't have the resources to magically recreate all the macros I've twiddled over the years, nor to retrain all the (barely trainable in the first place) staff that use windows/Office."
So what you're saying is that you've locked everybody into a proprietary platform where, short of people providing an emulation of all the nuts and bolts in something like LibreOffice, a single vendor gets to call the shots, ultimately. And how are all those macros managed? Do they live their own lives being passed around or can you administer them in a sane way? When macros grow up they need managing like proper software - a skill apparently absent in many man-plus-dog shops in the Microsphere.
"The amount of productivity that would be lost by changing horses mid-stream would easily pay for our MS licensing for several years. The amount of money spent on training courses to use said FOSS would pay for another 6 months of MS licensing."
What you're saying is that even if a lot of that automation could be done in other ways or completely eliminated, you can't take advantage of that because it'd cost too much. Where are all the change management consultants when you need them?
And when Microsoft change the UI for their stuff do they give you a 6 month discount on the licensing?
"As for those who think buying an i5 with win7 enterprise is overkill for a basic ward PC, you really have no understanding of IT estate management do you?"
I don't know. Maybe they do. Who are you to say? Sure, you have to standardise and get the most reasonable kit being made now that will still be supported over its lifetime, and the closer to the mainstream the better, so even if something from the 8-bit era could do the job, if someone isn't still making it in quantity, it won't be cheap or serviceable - we get it! - but...
"Machines have to be specced so that they have a reasonable prospect of being serviceable and supportable for at least a couple of years longer than the organisation's 'refresh cycle', and the image has to be standardised or helpdesk becomes unworkable."
Sure, but you're on somebody else's treadmill, remember? And I'm not talking about Intel/AMD and what the box vendor is pushing out there.
"Can you imagine being the poor helpdesk drone asking "what processor and windows version are you running?" when you've got a shouty nurse whose "thingy doesn't come up when she clicks the whatsit"?"
But that's another thing: the fancier the solution, the more confused the users. People love to pooh-pooh open source stuff and say that some feature isn't supported or that you can't embed a Word document in an e-mail by dragging it over some widget or other while giving the computer a lap dance - or whatever - but in any large organisation there's a large group of people who are stumped by whatever "intuitive" user interface Microsoft has come up with.
If Microsoft keep moving the furniture and have that treadmill set to "marathon winner" you shouldn't be complaining about the people telling you to get off.
The NHS don't need Microsoft
The NHS are easily big enough to have their own IT department. NHS IT Services could even subcontract themselves out to other organisations when not required by the NHS proper.
They could customise existing Open Source software to suit their workflow. This *sounds* like a big undertaking, but of course it would only ever have to be done *once*; and in the end, everybody benefits.
There may be a few pieces of bespoke software to rewrite; but anyone with any common sense already insists on the Source Code and modification rights when procuring custom software, so this oughtn't to take too long. Ought it?
And if Microsoft Office can't open an ODT document -- for which the specification is freely available and can be implemented by anyone, royalty-free -- even in spite of being supposedly the most-used office suite, that's nobody's fault but Microsoft's; and it's not even that big a deal. *Anybody* can run OpenOffice.org or LibreOffice -- but not everybody can run Microsoft Office.
Product from Microsoft which runs on a customised CENTOS ?
"We actually have a product from Microsoft which runs on a customised CENTOS Linux OS (yes really)."
What's it called?