@Len Goddard - The end of XP has been known for years and those responsible for the back-end systems should have had them upgraded in good time. The NHS has enough financial and political clout to beat up on the PAS suppliers if the new versions are as bad as you say
No, the NHS doesn't have financial clout, it is a misconception that a large funding pot for health means big financial power. Unfortunately, the funding is split up amongst the trusts which are quite small entities. It it also hampered more in the last few years by the austerity measures, which drive tough decisions about what to fund and unsuprisingly they prioritised buying drugs and paying nurses over replacing systems that worked. Imagine the newspaper headlines, say two years ago, if a trust can't give heart transplants because they are replacing IT systems (that work). Like it or not fear of negative reporting (that will deliberately misrepresent the importance of IT support lifecycles) influences a lot of public sector behavour.
For me, the Treasury, Cabinet office and political strategy are more to blame - it is they who should have mandated moving away from XP, and possibly more importantly IE6, much earlier and provided specific funding for migration projects so that it didn't affect core output, acknowledging that wider governmental policy allowed XP and IE6 to become commonplace. It might not sound much but many people in government knew about the end of life, however getting funding approval from the Treasury would be nigh on impossible without it being mandated. The end of XP has been known for years but has been extended before, put yourself in the position of a hospital manager - this year do you upgrade the IT systems OR replace the aging ambulances?
I think it's unfair to blame NHS trusts (quite small in the grand scheme of things) for buying important IT systems that did their job, many years ago, when XP was the de facto standard. The fact that they locked themselves into a particular configuration, simply isn't as important as being able to get the system at a decent price.
I think now, having all of the difficulty with migrating and lock in, government departments are much more aware of the real price of lock-in but when there is limited funding, you can understand a decade ago, health trusts decidng to prioritise healthcare over IT strategy.
That said, I think you make a good point about how government departments should negotiate contracts at the highest level (the parent department or ideally cross government) rather than each individual little sub-body contracting for their stuff themselves. In fairness, the UK government has actually learnt this over the last few years and, as the deal in this story indicates, is trying to place contracts at government level to leverage buying power (and save money in only having one contract negotiation). This is something that didn't happen 10 years ago, and is happening much more now with IT spending. However, in my opinion, it is much more than IT spending that should be rationalised up to the highest level. For instance, each police constabulary buys their vehicles themselves, you could save a lot of money if the Home Office brought police vehicles for all of the forces under one contract, lets face it most of them are exactly the same for each force.