back to article Ubuntu 'weaponised' to cure NHS of its addiction to Microsoft Windows

A quiet revolution has been rumbling in Leeds, in the north of England. It may not seem revolutionary: a gathering of software developers is scarcely going to get people taking to the barricades in these uncertain times, but the results of this particular meetup could shape access to NHS PCs in the coming years. The gathering …

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  1. RyokuMas
    Paris Hilton

    Swings and roundabouts

    Trouble is, in the NHS, you'll have a lot of "stick-in-the-mud" users who get in a big flap every time something changes.

    What you save in Windows licences, you'll have to pay in retraining staff.

    Note: this is based off experience from when I had several hospitals as clients... getting calls to attend on-site and "look into an error" that turned out to be a warning stating that the report that was about to run was quite big and take a bit of time... panic that data had been lost because they had switched to a different view mode... that sort of thing

    1. Norman Nescio Silver badge

      Re: Swings and roundabouts

      I take your point about "stick in the mud users", but isn't there still retraining required when moving from Windows XP to Windows 10? Or indeed from IE6 to Edge, or MS Office (Creaky old edition that works) to MS Office (New super whizzy edition that finds novel ways to confuse you and lose your data).

      Given that training will be required, doesn't it make sense to train for a less expensive option?

    2. rmason

      Re: Swings and roundabouts

      Also - an entire first and second line team at each trust with no experience other than (trust application collection)+windows.

      I know "munich" got mentioned earlier in the comments, didn't they end up almost 2 years late and tens of millions over budget? End result was a system that did not work correctly and will shortly be scrapped.

      1. John Brown (no body) Silver badge

        Re: Swings and roundabouts

        "I know "munich" got mentioned earlier in the comments, didn't they end up almost 2 years late and tens of millions over budget? End result was a system that did not work correctly and will shortly be scrapped."

        "May" be scrapped. And there's a big pool of knowledge there on what worked and what didn't. Likewise, the experience of the French Gendarmerie, and other large government projects in Spain, The Philippines, Brazil etc..

    3. Anonymous Coward
      Anonymous Coward

      Re: Swings and roundabouts

      ---What you save in Windows licences, you'll have to pay in retraining staff---

      Switch on computer

      Call IT because nothing is on the screen.

      Be informed that "computer" is that box the screen is standing on and you just turned the monitor on.

      Turn on the computer.

      Type name and password then press the Enter key.

      Call IT again because you have forgotten your password for the fourth time this week (It's Tuesday)

      Type in your password again.

      Make the tea

      and so on.

      No retraining needed there. If an application is web based, it should look the same whatever the OS.

    4. Alan Brown Silver badge

      Re: Swings and roundabouts

      There's a simple solution to that kind of stupidity: Charge them for non-contracted support. (ie, callout for a non-error), at the non-contracted rate.

      It's amazing how many ineducatable users suddenly decide to read the manuals when they find that their wallet is affected.

    5. bombastic bob Silver badge
      Linux

      Re: Swings and roundabouts

      "What you save in Windows licences, you'll have to pay in retraining staff."

      how would SHIFTING TO WIN-10-NIC be ANY different in this regard?

      if you're going to have to re-train, go LINUX!

    6. Doctor Syntax Silver badge

      Re: Swings and roundabouts

      "What you save in Windows licences, you'll have to pay in retraining staff."

      From the examples you give where did that "re" in "retraining come from?

    7. Alan Brown Silver badge

      Re: Swings and roundabouts

      "What you save in Windows licences, you'll have to pay in retraining staff."

      Retraining is "once", licenses are recurring.

      "Stick-in-the-mud" users, unless bringing provable value to the organisation are the same people who make the NHS experience so demoralising ("Computer says NO") for patients AND staff. Identifying and expunging them outright is likely to result in a better running organisation at lower overall costs.

  2. Cuddles

    How uncomfortable exactly?

    "The reference to Windows XP is an uncomfortable reminder that the WannaCry attack that hit the NHS in May"

    This would be the WannaCry attack that El Reg has several times noted didn't actually affect XP systems? And that would be the same Windows XP that had already been patched to fix the vulnerability exploited by Petya before the latest outbreak everyone's made a fuss about? As long as you're paying for support and patching in a timely manner, there doesn't appear to be anything particularly uncomfortable about sticking with XP, other than maybe the cost of said support.

    1. Doctor Syntax Silver badge

      Re: How uncomfortable exactly?

      "This would be the WannaCry attack that El Reg has several times noted didn't actually affect XP systems?"

      ISTR that that was because XP had a protection measure: it fell over before any damage could be done. I suppose the closest medical equivalent is "the operation was a success but the patient died".

  3. HmmmYes

    Thanks fuck for that.

    Cost is important everywhere. And you have to be careful with what your costs are.

    From my experience in deploying a number of simple machines, Windows license costs are the least of worry. There's the cost of installing Windows - a PITA when compared to being able o PIXIEboot a new machine and install an image. I can commision a Linux box in the time it takes for Windows to boot the install media.

    NHSubunt should just deply a simple GUI desktop, and shove all the logic behind a web browers.

    1. rmason

      Eh?

      In a past life I was a contractor doing a windows 7 rollout for my local NHS trust.

      All done by casting an image over the lan using tools including 'Pixie' boot.

      The rollout was cancelled because they had paid for the wrong licence, then built the image on the incorrect (ie the version they *meant* to buy a licence for) version of Win7, but that's another story!

      1. Doctor Syntax Silver badge

        "The rollout was cancelled because they had paid for the wrong licence, then built the image on the incorrect (ie the version they *meant* to buy a licence for) version of Win7, but that's another story!"

        This is an argument for Windows?

      2. Maventi

        "The rollout was cancelled because they had paid for the wrong licence, then built the image on the incorrect (ie the version they *meant* to buy a licence for) version of Win7, but that's another story!"

        And that, folks, is one of many examples of the hidden costs of complex proprietary licenses that simply disappear with FOSS. It goes beyond the sticker price - the cost of license management and compliance is eye watering but seems to be often overlooked.

    2. MonkeyCee

      installing

      "There's the cost of installing Windows - a PITA when compared to being able o PIXIEboot a new machine and install an image."

      Your statement is contradictory. Either you've built a deployment image, in which case 95% of the work has been done, or you're using install medium of some flavor.

      Building an image is more about the testing, especially whatever apps are getting rolled out. The actual install should be able to be done by a well trained ape adding the computer to the relevant groups, then PXE boot and follow some destructions*.

      Installing a machine from scratch is always a PITA. I've got images for Windows with all the relevant patches and SPs installed which makes a comparable install speed to Mint/Ubuntu on a whitebox. Then there's always some dicking with drivers and config, whatever the OS, unless all the HW is bog standard. Then futzing with the apps, which are either as simple as apt-get or rolled out through group policies, or involve some buggering around with config files, registry entries or whatever chicken sacrifices are required.

      * As for speed of rollout, I've managed to re-image 400 windows boxen in an hour using two 12 year olds and a six pack of red bull. 40 minutes if we don't do test login. About 150 an hour if by myself, but that's a terrible plan :)

  4. MMR

    Being a former domain admin at one of the NHS organizations I can tell you this is not going to fly. HSCIC is too small to have big enough influence and local NHS Trusts and hospitals don't realize how important the security is. It is taking them ages to approve something and when they approve it it's already outdated. Not to mention the non-existing budgets on IT training for IT employees.

    1. Alan Brown Silver badge

      "Trusts and hospitals don't realize how important the security is"

      A chat with the executive about how much NOT taking it seriously might cost them is worthwhile.

      1. Anonymous Coward
        Anonymous Coward

        They won't believe you if it's a MIGHT. It has to be a WILL. Also, personal risks will usually be shrugged off with connections.

  5. Anonymous Coward
    Anonymous Coward

    About cost.....

    Quote: "One of the brains behind the project, Rob Dyke...."

    *

    100 million pounds a year would seem to be a very large upper limit for the break even budget to maintain NHSbuntu. What am I missing?

    *

    Just as an example, Red Hat has been delivering a high quality distribution (in my own direct experience) since at least 2000. So that would imply that the NHS has spent, say, £1.7 Billion pounds with Microsoft since 2000. £1.7 Billion pounds seems to to be quite a lot of money....perhaps a fraction of that amount would have been useful in developing something like NHSbuntu over the last seventeen years.

    *

    ...and this new initiative is being touted by people described as the "brains" among NHS IT specialists. Where have they been for all of the current century?

    1. Rob Dyke

      Re: About cost.....

      /me won't feed AC posters....

  6. John Smith 19 Gold badge
    Unhappy

    So do 7 NHS trusts still lack a line item for IT security?

    I think they probably do.

    But it would still be interesting if they were hit as hard, or less hard, than others that did.

  7. adam payne

    "The project organisers aim to educate clinicians and administrators alike about the benefits of open source and to provide doctors with the tools to develop their own apps if they so wish."

    Develop their own apps *shudder* then expect IT to support them when it goes wrong.

    1. Anonymous Coward
      Anonymous Coward

      I have an honest, if simplistic question, why bother explaining about Open Source? Use it, give them the number to call if they have issues, describe the new system simply as the new system, what it does and how they will be using it. Why introduce more information and potential confusion than most of them need or want? The users just want a system that's easy to use and does what it's supposed to do. The few users who are interested can be given more info if they want it, but keep it simple. The very, very few who are really interested will doubtlessly know something about, "The Google and The Intertubes".

  8. Jason Bloomberg Silver badge
    Linux

    With or Without?

    Should NHSUbuntu be systemd based or not?

    Is it only acceptable with systemd or without systemd, or does it not matter and the systemd debate is meaningless nonsense?

    1. Anonymous Coward
      Anonymous Coward

      Re: With or Without?

      Well, it appears that all the large linux distros that offer support have gone down the systemd road. To my limited knowledge you'd have to go with FreeBSD to get non-systemd support, on new installs. I do hope that Devuan Linux gets the support it needs to keep going as its purpose is to be a systemd free alternative to Debian, Redhat, Ubuntu, Suse. Choice is important.

  9. Stevie

    Bah!

    I wish everyone luck with this project, but have to wonder who will be providing the paddles five years after rollout.

    As for these "smartcards", they sound like the PINs we had in the late 60s and which I've been urging everyone to have another look at for Lo! these many years. They only work properly if they are part of the security badge of the user and lock up the equipment when the card is not present any more though.

    And of course one must make it a dismissing offense to lend out your card.

    1. Doctor Syntax Silver badge

      Re: Bah!

      As for these "smartcards", they sound like the PINs we had in the late 60s and which I've been urging everyone to have another look at for Lo! these many years.

      TFA says:

      "Its mission was to find a way to deploy... Linux ... on 750,000 smartcards used to verify clinicians accessing 80 per cent of applications – excluding those for clinical use – on millions of health service PCs."

      Apart from the rather dodgy phraseology which suggests the smartcards would be running Linux I read this as saying these smartcards are already in use with Windows PCs.

  10. LeedsMonkey

    Makes perfect sense

    I've been involved in Windows, storage, etc for many, many years now, but of late have been getting more involved in AWS, Linux and agile workloads. If the NHS can embrace these concepts and move to an open source platform it would be of huge benefit. There are plenty of Linux skills around and there's simply no need to have ancient PC's running Windows XP. Yes some applications will need to be migrated/redeveloped, but gone are the days where an application should be tied to an operating system.

    As for proprietary hardware, which there will be loads of in the NHS, suppliers will simply have to decide whether or not they want their contracts renewed. Once the messages gets through that Linux will be the new platform they will all follow suit or be replaced by competitors who will. And where there are no competitors, yes some money will need to be spent.

    I'm not underestimating the size of the task here, or trivialising how important application availability is, but this culture of pockets of IT that exist within our public services, not just the NHS, has to change. Nor am I underestimating the costs - it will be damn expensive to make the move - but the long-term benefits will be worth it.

    1. TheVogon

      Re: Makes perfect sense

      "it will be damn expensive to make the move"

      Very. And massively complex and would take many years. And many users would always still need Windows.

      "but the long-term benefits will be worth it."

      I doubt it. You would just end up with an expensive to run mess. If this were true, many CIOs would be doing this, but near zero are....

      1. LeedsMonkey

        Re: Makes perfect sense

        Not true. Look at jobserve, a large number of organisations are now going down the cloud (internal/external/hybrid) route with agile development. The job market is usually a pretty good measure of what is actually happening.

        1. Allonymous Coward
          Linux

          Re: Makes perfect sense

          Yeah but no but... rebuilding backend systems using Agile/Cloud/OSS/LatestBuzzword (which I agree is happening, and is good) is one thing. Linux-on-the-NHS-desktop is quite another.

          Possibly there are some overlaps; make things web-based, use open standards, similar underlying tech etc. But many of the challenges to overcome are quite different, and IMO the open source crowd do ourselves no favours by conflating the ideas.

  11. Alan Brown Silver badge

    procurement cycles

    One of the arguments which can be used on smaller outfits is "With NHSbuntu, you don't _need_ to buy new hardware. Your existing computer is more than powerful enough to do the job"

  12. PickledAardvark

    Source Code Escrow

    We've had years of OS lockdown at some organisations because somebody bought software years ago which is essential to the business. We can't upgrade the Windows version because it will break a business critical application. And the software supplier ceased trading eight years ago.

    I've worked with a few perceptive IT managers. Prior to year 2000, one of them asked small companies for source code for their products; some handed over tapes and others signed escrow contracts -- source code resided in a safe place, to be accessed and modified if the company went bust. I think we used an escrow agreement once.

    In more recent years, I've encouraged managers to pay extra for source code access or escrow. It costs money but you can turn software on and off -- with a bit more money, of course.

    1. Korev Silver badge

      Re: Source Code Escrow

      I once "owned" some software with an Escrow agreement. The software's yearly licence was just over a million GBP, the Escrow was a condition of the agreement, I believe it cost the vendor just over a thousand (the Escrow company would notify us when it was a paid and b they got source code); I make that 0.1% of the licence cost.

  13. Dave the Cat

    I've been in NHS IT for 15 years and as much as I personally like this idea, it simply won't happen.

    Too many people, with too many vested interests have their fingers in too many pies. At a local level, finance directors simply won't understand the rationale and cost behind the change, and believe me no amount of talk of long term savings will register with them, they have a tough enough time balancing the books year to year yet alone looking 3, 5, 10 years down the line.

    Operations managers will decry the disruption which will, without a shadow of doubt, be massive. Regardless of how well it's planned, this is the NHS, it will go to shit. I guarantee it.

    There will be uproar from staff and the ever difficult unions some of whom will feel personally affronted that they no longer have access to MS Office, regardless of the open source versions being just as good.

    Then there are the technical issues, there are so many archaic and disparate software systems and databases at so many different hospital trusts and even down to individual sites within single trusts.

    It all boils down to one simple thing, money. If this were resourced properly it could work, however it won't be. It'll be thrown together on a shoestring at best.

    1. Ken Hagan Gold badge

      I think you are missing the point that the alternative is equally disruptive. The NHS appears to be running on a vast number of XP boxes. The fact that these systems haven't already (many years ago) migrated to a more recent version of Windows surely proves that there is no upgrade path that isn't massively disruptive and painful.

      1. Dave the Cat

        I don't disagree in any way Ken, I'm all for the move but I just don't see it happening any time soon. I can't speak for all trusts but certainly in the handful I've worked at, I can't see it happening for a decade at least.

        It'll take several more WannaCry type incidents and several more huge security breaches before the people holding the purse strings will register that something needs to be done. They'll then set up a task force to examine what needs to be done, this will run for a minimum of two years. The task force will be made up of a horde of finance and procurement people, staff representatives in the form of union reps (who's job is solely to be difficult, irrational and obstinate) and a lone brow beaten representative from IT. They will then inevitably recommend the path of least resistance which will be Microsoft.

        1. Anonymous Coward
          Anonymous Coward

          Sadly, I expect that's what will happen.

  14. uncommon_sense
    Trollface

    Early Adopters..

    The Proctologists should like this!

    After all, they do OpenArse all day anyway...

  15. Anonymous Coward
    Anonymous Coward

    Criminal waste and corrupt suppliers

    Giving Microsoft £100m a year just to license Windows is fucking criminal

    Imagine what that could achieve within an Open Source community.

    I read the gov report on Open Source. The single biggest obstacle are vendors who don't want to build for *nix and muddy the waters by saying that they have proprietary code which they legal can't run on an Open Source OS. Utter BS and the government is too chickenshit to call them on it.

    1. Anonymous Coward
      Anonymous Coward

      Re: Criminal waste and corrupt suppliers

      Because telling someone they're bogus usually results in them take g their ball and going home. And if they're the ONLY supplier of something (say due to a hardware patent or it simply being too niche), that's a captive market. A Hobson's Choice.

  16. Herby

    Five years?

    Let us know in five +- years what the status of all of this is.

    By then, Microsoft will probably have the operating system in the cloud, and all the data as well. If you want your health records you can call Bletchley Park Redmond and ask them.

    Being dependent on a single vendor for the basis of your platform that is holding sensitive information who doesn't want to talk much, looks like a fools errand, and a move to open source looks good.

    A recent (two days ago) visit to the doctors office had machines in every room and more at reception desks. I suspect that they were windows boxen, and hope that they were up to date. From the looks of it, they used it as a fancy web browser with (reasonably good) two factor authentication (RFID cards).

    Me? Pretty healthy (knock on wood).

  17. This post has been deleted by its author

  18. John Doe 6

    Do I understand this right....

    ...a major government organization dumping Microsoft in favor of Linux ?

  19. Amos1

    What rubbish. XP usage had nothing to do with WannaCry.

    "The reference to Windows XP is an uncomfortable reminder that the WannaCry attack that hit the NHS..."

    WannaCry crashed on XP but not on 7. What bit the NHS (and Telefonica and others), as proven by the Shodan search engine, was their propensity for either hanging servers directly on the Internet or by intentionally exposing the TCP 139 and TCP 445 file sharing ports directly on the Internet and available to the entire world.

    Negligence and incompetence cannot be fixed by changing the desktop operating system.

  20. Anonymous Coward
    Anonymous Coward

    sounds a bit of a nightmare

    full linux clients at scale is difficult. and as prev post said consultant lock in.

    *build a smartcard interface for browser (may require plugin)

    *move all core applications to web model

    *use net booting thick clients with guest login or kiosks but either way running the browser as a local app - load these with ram (like 16gb)

    *add second or third monitors so users are 'getting something' and have added productivity

    also prob work ok with byod with ur 'smartcard plugin' but firewall these devices off with something like zscaler or similar

    accept there will be technical equipment that falls under different scope.... mri machine needs windows or similar. treat these as special cases that require extra attention.

    have a nice day

  21. t0no6

    But, really...

    Why Ubuntu? Fedora was a better choice with red hat behind, instead canonical has nothing to offer except iot technologies

  22. Anonymous Coward
    Anonymous Coward

    It's not just cost

    You're mad if you willingly give up your confidential information to SatNad the data mining whore.

    Your medical records are sacrosanct.

  23. Anonymous Coward
    Windows

    Seriously?

    I wouldn't trust my life to code written by people who smoke weed 24/7 !

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