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Comment by signal11 | Hacker News Reader

I do think running hospitals on Linux is a good idea. However just sticking a skin over $YOUR_FAVORITE_DISTRO may not quite work. Hospitals have to work with proprietary devices -- for example, retinal scanners etc, many of which only have Windows drivers.

Also, while updating individual Linux systems is easy, patching Linux at scale across the thousands of desktops in the NHS needs a proper, thought-out patching strategy to eliminate breakage. You also need to consider -- in what cadence do I actually evergreen old systems?

The NHS could easily have this problem with any OS -- the actual culprit being a total lack of security-mindedness among the various NHS trusts' budget-holders. They viewed IT Security as not worth spending upon and are paying the price.

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You know, this kind of reminds me of that seen from Goodfellas where Ray Liotota's character is explaining about protection rackets. The quote goes something like "Having a bad day, fk you pay me. Your loved one is sick, fk you pay me. Business going badly, fk you pay me."

And that's exactly how I feel about all of these proprietary device providers that have all these massive contract with the NHS. It really should be "Want this massive NHS contract, fk you, support our OS"

I'm quadriplegic and rely on the NHS for my life, literally for my life and this kind of shit scares the absolute crap out of me. Yes it will be difficult, yes there are challenges but we are one of the richest countries on earth and we invented the Sinclair C5 for goodness sake. This is not beyond us.

Sorry, this hack and finding out about all those XP machines has terrified and angered me beyond all reason.

Edited to Add: Just to be clear, I agree with the OP!

What do you do about legacy software? Porting all the crap they're currently using to a new operating system isn't free.

Yeah, and I mean this without a drop of sarcasm or joking. That's where being one of the richest countries on earth comes in. We should just pay up.

And this could provide well-paid, satisfying jobs and apprenticeships in the UK resulting in systems that don't have to be rewritten in under a decade because a monopolist decided to break compatibility.

> We should just pay up.

I'd say it'd be a very solid investment. If it's made open-source and some attention is dedicated to build a community and a vendor ecosystem around it, it'll save the NHS and many other similar organizations everywhere a huge amount of money.

Legacy sortware could be isolated, for instance in a VM.

Also there is ReactOS which is an open source older windows which might be useful for running old windows software on a relatively secure OS.

> Hospitals have to work with proprietary devices -- for example, retinal scanners etc, many of which only have Windows drivers.

Then the tenders for buying those devices should state "Devices that work with $YOUR_FAVORITE_DISTRO will be given preference.". If it's a reasonable one, they will make a driver for it. Customer demand always generates product; and the NHS is about the biggest customer there is.

Exactly, the NHS spends an absolute fortune each year and if they put out a tender somebody will support it no matter the specifications. Sure, some of the larger Vendors will get their noses bent out of shape but who cares?

I mean we are talking about large multinational pharmaceutical, medical equipment and software companies buying something from the largest employer in the world with a tech budget of roughly £1 billion a year (I think).

If the NHS stuck to it's guns, somebody would provide the goods.

You missed the part of their presentation when they show that ~80% of the computers or resources are actually used for administrative purposes - in a regular office environment. No propietary devices involved.

Also - yes, any OS could be used including Windows. However the problem is that if the system is not free (in the FSF sense), the NHS is not in control. This is the real problem, not costs or missing drivers in my opinion.

Of course, nobody thinks that this project will "save" the NHS or influence it in a major way. But it could at least be the start of a discussion. Or am I too naive?

The Debian Med project is working towards packaging software that is useful, including working with proprietary equipment.

https://www.debian.org/devel/debian-med/

The NSH simply states that Linux drivers will be provided and supported by the Vendor or no sale. This is not hard.

I love the optimism but that's not what happens when IT services get outsourced to tender. The process is almost exactly the same. MOD, NHS, Schools, Councils, you name it.

Firstly, tender bids have prerequisites on their bidders. You need to be on the "preferred provider" list. Security checked. Higher-level security vetted. DBS. Etc. This is the sort of stuff that stops small local companies getting in.

That means lack of competition and that means —as well as the price being 10-20× that in the natural market— that vendors have all the power when it comes to detail negotiation. They spec out the cheapest, easiest option for them, not what's best for the customer.

If the customer (a lowly NHS trust or CCG) turns around and says "no Linux, no sale" they'll offer a [much] higher price for the open system, or just say no. All three vendors that responded do the same. Windows remains.

This will only be solved when CCGs start working together and start in-housing some of this development work. But it's still apparently better to spunk £50M over HP for some dodgy tablets that don't work than hiring a team of (eg) 40 developers for 10 years. That sort of developer time, working on site, you could actually start to fix things.

But now I'm being optimistic. A Tory government in-house something when their mates own shares in HP? Not likely.

But what about the billions of pounds worth of existing equipment?

If it works with XP, chances are it will work with Wine or VirtualBox. Where there is a will, there is a way.

But it would mean giving a huge F* YOU to established networks of parasi- er, vendors specialised in public sector tenders - Microsoft being the king of them all.

What about it? The money has been spent. Its not either or.

Also https://www.logicallyfallacious.com/tools/lp/Bo/LogicalFalla...

These devices don't come with drivers for any OS - they come with builtin Windows or otherwise computers with the software preinstalled and put into autostart.

That's why it is so difficult to update all those machines. They are simply not designed to be updated by anyone. For most of them, updating to Windows 7 or anything as recent is impossible because they have proprietary ISA or PCI cards or similar ancient technology that is used to interface with the actual hardware.

exactly. this video is nerd thinking 101: here's a great solution to a problem of our own devising. Look, we satisfy all the specifications!

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