Slashdot Mirror
British Health System Looks at Linux
DanBrusca writes "The Observer is reporting that Britain's biggest employer, the National Health Service, may ditch Microsoft due to mounting licence costs. 'Richard Granger, NHS IT director, has ordered a trial of a Linux-based system from Sun Microsystems as part of a UKP2.3 billion computer modernisation plan. The plan could see Java Desktop software rolled out across the NHS's 1 million staff and 800,000 computers to replace Microsoft's Windows operating system and Office suite of programmes.'"
Maybe they get the same answer as people get right now who want to use Linux instead of Windows at work:
:)
"Tough shit, pal."
If they are concerned about interoperability between work and home, OpenOffice runs great on Linux *and* Windows, y'know.
The Free desktop that Just Works
Actually, it's hard to see but many US hospitals are slowly moving away from M$. This is done in many cases because of IBM who come in and sell Linux for its openness and auditability; which is in demand in the wake of the HIPAA regulations.
I agree about the universities, Microsoft is doing the RIAA thing and trying to buy their way into the classrooms for a propaganda war. Sad really that this goes under the radar to most people.
SCO: 800-726-8649
Verisign: 800-361-8319, 888-642-9675
Diebold: 800-433-VOTE (8683)
I think he is talking about the fact that under MS Liscensing 6 that you MUST upgrade certain components every X months or you lose the very expensive support you were paying for. Basically Sun is saying that they are willing to support an older configuration so long as you are willing to pay the bills. With MS that is not an option. In some instances it may be MUCH cheaper to pay a little more for software support than it is to upgrade all the hardware and pay for all of the technicians to do the upgrades. This isn't necessarily the best path all the time but if budgets are going to be lean for a year or two keeping the old systems on life support can often be a wise choice.
There are 4 boxes to use in the defense of liberty: soap, ballot, jury, ammo. Use in that order. Starting now.
Ultrasound machines get new features like dogs get fleas. Many of them? Yeah, they run on windows.
:)
Easy to use, pretty easy to program for, and works on nearly any hardware you can find on a shelf.
The doctors don't use Windows, their secretaries do. In fact, several of the doctors whom I typed for used Macs whenever they could, using the Windows box only when they needed to get patient information from the network.
When I worked there most of my work was word processing (Word 97), email (GroupWise...wise my ass) and accessing online patient records through a terminal. All of this can be done on any platform, except I suspect that few of them crash as consistently and spectacularly (sp?) as a Windows 95 installation.
I am sure that there are specific, necessary programs in use that are Windows-based, but I am also sure that it would not be the first time that they had to write new software for their special requirements (the aforementioned ICSIS (sp) program for checking patient info, for example)
Don't be so quick to discount Sun's desktop push. They're heavily investing into R&D and have a roadmap in front of them which will drive innovation on Java-equipped desktop clients.
For example, have a look at Project Looking Glass and the keynote demo.
Actually it's not Windows that I am locked into at work, it's Office.
I have yet to find a way to get past Exchange and Citrix effectively. We looked at a few solutions that cames close, but the administration costs FAR outweighed the licensing savings (although Citrix licenses are astronomical). The other problem is that our document management system (necessary by law due to Sarbanes-Oxley Act) is iManage which only works with office and costs $75K.
[RIAA] says its concern is artists. That's true, in just the sense that a cattle rancher is concerned about its cattle.
Having the government pander the citizens only makes them weak and spineless (like modern day US or almost any "civilized" country).
If you don't want to pay medical bills, don't get friggin' sick in the first place.
Wow, what an insightful position. I suppose you can somehow chose whether or not to be born with a congenital illness can you? Or to grow up in an environment where, say, TB is present? Or whether or not to get hit by a drunk driver? Or to contract leukemia? Or cancer? Or to need a working kidney?
Who knew it was that easy!
Here's a related story that you'll like.
In the 1990s, the US Agency for International Aid (USAID), which was set up specifically to help the poor in developing world nations, put the US itself on its list of developing nations, and started providing assitance to housing and poverty projects in Washington DC, Boston, Seattle and elsewhere. In 1994, USAID took a group of Baltimore healthcare workers on a field trip to Kenya in a bid to boost that city's child immunisation rates. Before visiting Kenya, which boasted a near 100 percent record, only 56 percent of Baltimore's infants were effectively immunised. After learning from the Kenyans, Baltimore managed to improve that figure to 96 percent.
Clearly, Baltimore made a big mistake in seeking to improve the health of its future generations. All it's succeeded in doing is making them "weak and spineless". Yeah, right.
"Accept that some days you are the pigeon, and some days you are the statue." - David Brent, Wernham Hogg
It is impossible to remove all of the Windows boxes and replace them with Linux Desktops and Open Office, but it may start some standardisation in an outfit that has every Windows OS from MSDos 6.2 to Windows XP (including a lot of stops along the way, 3.1 and ME).
For those using machines that do not require Windows, I see no problem in switching to a Linux Desktop. Or site uses Novell as well for the backend, so Linux is definitely in our future.
Wrong.
Some medical companies, names upon request, use Windows NT as the OS that runs their diagnostic and monitoring devices.
Many come with a warning to restart the device daily.
No joke.
- oZ
// i am here.
I'm being pedantic, but the British NHS is not only Britain's biggest employer, it's Europe's biggest employer too.
My parents are both currently working in the NHS, my Dad's a consultant at the local hospital, whereas my Mum's a GP.
The way that they use computers (mainly for work) is fairly simple. My Dad will use some form of presentation building software - for preparing talks at meetings, a web browser - for filling in his "education" points list, and a word processor - for writing letters. That's it - for work both at home and at the hospital where he works. I've found that once the computer has Linux installed on it, he's got no real problems (using GNOME as a Window Manager) doing this tasks. He likes StarOffice Impress, and he's commented that Galeon is faster than Internet Explorer.
My Mum, is generally the same, she needs a scanner - for preparing practice booklets, or information leaflets, a word processor, an email client, and that's about it. At work, she says, I just "put in my password, click OK, and then click on the program icon". Now, that's not something that'd be hard to implement on Linux. Also, being part of a General Practice, they have to purchase their own computers, and software. She has commented before on the cost of the software, and how it seems to be "paying a lot for not very much".
My thoughts? Can Linux be implemented as a desktop implementation for users? Definitely. The user does not need to install software, or hardware for that matter - they cannot at the moment, as they're not "administrators" on their own machines.
Remote management would be easier, IMHO, and there'd be less problems with network floods due to virii that inevitably end up on the Windows systems.
The Police in our area, West Yorkshire, UK, have already made the switch and are running their systems on Linux. This, to me, is an indicator of how Linux, when properly implemented, can be used on the desktop. If the NHS do come up with a decent solution, I'd imagine they'll see the benefits (probably mainly cost benefits).
This post is based purely on personal experience
When the NHS is referred to in articles like this they generally mean the hospital system. I doubt most doctors in a NHS hospital even so much as look at a computer. Most of the terminal work will be done by nurses and admin staff.
IMHO this is effectively throwing money away. The NHS is a big black hole. While I support it in principle, the whole thing is chronically mismanaged and lurching from one political knee-jerk to the next. It is being seriously taken for a ride by the large IT contractors in this country, most of whom are just political appointees.
You are speaking complete and utter bulshit. The british health system is not going to change within the next few centuries. Do you trully expect them to roll out a change like this when it takes 6 months to see a doctor for a sore throat and you get 3 letters asking you "Have you died yet?" Do you trully expect this from a systems where the doctors never come to see a sick child until he/she stops breathing, and even then send ambulance with paramedics (I am speaking from personal experience here and I can continue examples ad naseum).
All they are doing is yet another BLIARlike behavior done by yet another BLIAR wannabe. A bit of SPIN here and there to demonstrate that they are doing something wilst doing nothing and wasting a boatload of public money.
That is besides the fact that most of NHS IT is run by bastions of MSFT like Capita and similar outfits. Even if the minister in question has had an intention for this trial to succeed they will fail it.
Baker's Law: Misery no longer loves company. Nowadays it insists on it
http://www.sigsegv.cx/
If you were using unix/linux, then there would be no market for Citrix..... X is network aware, so you could use remote apps, as if they were local. Citrix is just a hack to attempt to bring the same functionality to windows.
This is pure dealing with Microsoft, there is not a hope that Linux will be generally taken on.
And Microsoft will recognise that too.
If they had wanted to take it seriously, they would have required Linux solutions when they put out the original tender in April. They didn't.
I took it upon myself to ditch Microsoft Office at work about four months ago and move everything to Open Office 1.x. Now four months in to my "trial" and running Open Office 1.1, I have now fully ditched my Windows system and use Linux (Suse 9.0) for everything. I exchange MS Office/Excel/PPT docs with colleagues and browse the web (and company intranet) using Mozille 1.5. The company uses Lotus Notes for email and there's a perfectly working copy of the Notes client for Linux or I can use web mail access whcih also works a treat. No one in my office can tell I use a non-Windows PC. The New Business manager stood behind me whilst I used my Linux box running K Desktop and edited a document for him. He didn't even notice the difference. When I eventually told him I was using Linux and Open Office, he flabber was well the truly gastered! :-) Ah, a good days work... nice one Linux...
Please note that the parent post is exagerating - it does not take 6 months to see an NHS doctor, it takes anything from 1 - 7 days depending on where you go.
Secondly, this project was the idea of the NHS, not the government, and the NHS IT director is negotiating with the government for the funding. See this Register story.
Steve.
A latent existence
It has the highest rate of MRSA and hospital infection in the developed world,
This was due to Mrs T. deciding that it was more cost-effective to outsource the cleaning staff to third party contractors, rather than having in-house staff assigned to each ward. Early government research had realised that it was better to have three types of disinfectant to clean wards. Really strong stuff to clean the floors, mild stuff to clean walls, doors and door handles, and weak stuff to clean the ceilings. Having in-house staff meant that the cleaners had "latent knowledge" about which areas needed the most attention, and took pride in keeping their individual wards clean. But now, it's just a minimum wage job.
Installing layers of managers and administrators was another of Mrs T's ideas. The media was always full of stories about how various hospitals and wards had been built and were lying empty and unused while others had waiting lists (mainly because the regional authorities had planned urban growth and had built the hospitals first). This led to the development of the internal market where different areas could buy services from each other - now being extended to buying treatments from abroad.
Compare this to France, where they also have "free" health service. The difference is that all the hospitals, dentists and doctors are privately run, but everyone is required to contribute to a compulsory private insurance scheme. Visitors can also pay privately.
As an example, I had to see a dentist while in France. I was able to book an appointment to see the dentist the next day. Instead of taking standard photographic X-rays which required development, she took digital X-rays which were available immediately and were logged into a digital patient case history.
Unfortunately in the UK, nearly all the dentists are moving into the private market. This is due to the number of new cosmetic treatments which are available, but the government won't fund. However, there is a catch to this. Private dentists seem to charge ridiculous high amounts for treatment. A basic set of X-rays would cost around 100 pounds ($150 dollars), a filling would cost 100 (150) and a wisdom tooth extraction 500 (750). In the latter case, this cost me only 10 on the NHS.
Many of the patient electronic records information systems are already Unix based (Data General's Unix DG/UX, Solaris, SunOS, Digital Unix/Tru64, SCO UnixWare, HP/UX, and I think we few others I forgot). I use to develop one of the major ones.
When I joined one of the private companies which only provides medical IS software, I wasted a month realising that the Linux based solution I was developing wouldn't be accepted because the NHS Trust wanted a Windows based solution. So I spent a week trying to understand and get actual prices and sources for discounted licenses for Microsoft's server software. A quarter of the budget for this project involving custom software went to Microsoft license fees.
The reason it had to be Windows? A serious systemic lack of resources and skills. Any IT personnel working for the NHS who has enough skills to administer a Unix machine (or has actually completed their MCSE exams even) ends up taking a better paying job elsewhere. So the NHS Trusts end up relying on untrained IT staff and nurses who have moved into IT to get away from shift work. Nevermind the fact there was a 2 to 1 ratio of managers to tehnical staff (yes, 2 managers, 1 system administrator).
I have never seen such a screwed up system on such a large scale before. It is almost impressive just how broken the NHS IA / IT is.
when it takes 6 months to see a doctor for a sore throat
What the fuck are you smoking? I can nip down to my doctor and see her this afternoon (spend 10 minutes in the waiting room) and get a prescription there and then... nip out of the door and round to the chemist to pick it up.
A couple of years ago, my Dad was given a blood test which showed up possible cancer. In one week he saw a specialist and was sent for further tests (again within a week) which revealed early prostate cancer. Within a month he was in hospital having his prostate removed by the best specialty surgeon and team in the country followed by chemotherapy.
Cost to him: 0. God bless the NHS, and fuck right-wing loonies who think the U.S and its third-world civilisation approach to healthcare works.
Not going to happen.
I am a senior developer for one of the application providers for NPfIT, and I can personally guarantee it ain't going to happen. The applications that the NHS will be running for the next five years are going to be set in stone by the end of this year, and none of them are required to run under Linux.
Some of them will do, cos they are legacy systems running on Vaxen or mainframes, but most of them are windows apps, and ain't going to change now.
Everything else is a pipe-dream.
From A British Taxpayer. The British government has been taken for a ride so many times by IT companies promising the earth but building systems which don't work properly. The taxpayer generally picks up the additional costs of getting it right. With this new round of major NHS projects someone in government - don't know who - was inspired. They employed Richard Granger to oversee the process. The man's a rottweiller. At the start of the bidding round he told the consortia that thing would be different now. They would not get paid for failure, the NHS would not pay for systems until they were proven in practice. If they didn't like the new terms of trade they should get out. Already one consortium has dropped out of bidding, whining that they would have to pay large penalty payments if their systems did not work. What did they expect? Did they have no confidence in their abilities? They screamed that it was not a proper partnership, they would have to take the risk of failure. Of course it is not a partnership. The company bids to supply a product or service; if that service fails it should be entirely at their own risk. That's what capitalism is all about; not the taxpayer subsidising their development work. Granger's obviously going to give Microsoft a hard time, he's got his teeth into their ankles and frankly I hope he bites their leg off. It would be of great benefit to the NHS and the British taxpayer in the long run. It would also demonstrate an alternative to the many in the British Government -Tony Blair are you listening - who think the sun shines out of Bill Gates arse (sorry-brit spelling).
True for many, particularly the young and the healthy, and for normal sorts of care. However, there are chronic conditions that very few individuals can pay for. The drug bill alone for treating some chronic conditions exceeds $60,000 per year. The median income for a family of four in the US is about $55,000. That family CANNOT pay for the health care for that child. It is not uncommon for an elderly person to run up $500,000 in health care costs during the last two or three years of their life. Few have that kind of resources available.
TTBOMK, there are no private charities whose purpose is to pay that type of large bill for anyone who is in need. In general, all of the programs that do so involve some degree of coercion. For Medicare and Medicaid, the government pays out of its tax base. In employer-provided insurance plans, the young and healthy pay more than their share in premiums to cover the costs of the older and sicker (the coercion in that case looking a bit more like a carrot than a stick -- the company plan provides more coverage than you need, but is "free"). And don't even think about buying private health insurance for your family if you have a child with such a pre-existing condition -- no one is going to sell you a policy at any price. Similarly if you're 93.
I agree that many aspects of the current coverage seem silly. IIRC, this form of "insurance" started with Kaiser during WWII. Among other things, Kaiser built fleets of standardized ships for the US Navy that were at least one of the critical factors in determining who won that war. Anyway, he found that it was cheaper to operate subsidized clinics to take care of workers and their families than to pay the cost of days lost to sickness or injury. In order to compete for workers, other companies had to offer some sort of similar benefit; most of them did it through private doctors and hospitals; at some point, insurance companies got involved in administering the plans. Such health care arrangements became a standard benefit demanded by the large unions. Keep in mind that health care was a LOT cheaper 60 years ago, so it seemed like a reasonable deal to the companies. Of course, if you're the top management at a company paying the line workers' health insurance premiums, you want the same benefit for yourself.
A system that made some degree of sense 60 years ago has been outstripped by changes in health care technology and society. Conditions that were fatal in the short term then can be treated (at high cost) and people can live for another 30 years. Doctors today come out of medical school owing $100,000 or more, and may face malpractice premiums of $100,000 per year. The US is the richest country in the world, and spends a larger percentage of its GDP on health care than any other industrial nation. At some point, I believe, we'll get this mess straightened out, although things will probably have to get worse before we're willing to take the needed steps.