A message to Dr Crippen, Dr Rant and Tom Reynolds

I visit your blogs every day.

I respect your opinions of the service, the National Health Service, to which you are contracted in one way or another.

I assume you contracted yourselves with the NHS because you believed in the principles of the NHS.

Kezia, my daughter, is being treated tor Acute Lymphoblastic Leukaemia under the NHS. She is receiving superb treatment.

To hear your stories distresses me when there are obviously sections of the NHS that are functioning as they should. But your posts on the defects in the NHS, (of which I myself am critical), should neither stop you blogging on the NHS, nor criticising the NHS, nor, deity forbid, stop working for the NHS.

Dr Crippen - you disappear for months. Tom and Dr Rant - you seem 100% depressed.

Please don't do this to us - we need you.

Bananas

When one goes to a local bar here and asks what is on the menu the inevitable response is "banana" (plantain to you and me in the developed world or less frequently the root vegetable "matabala" cocoyam).

Now a plate of boiled plantains (or cocoyam) does not sound all that appetising - I ate them for years until I realised I didn't much like them and they had started growing delicious new potatoes (above an altitude of c. 900 metres) as well as the inevitable rice, spaghetti, macaroni etc.

So I innocently ask "With what?". An incredulous response "With fish of course" (stupid white man is obviously running through their head).

"What kind of fish?" I ask - come on there is a big difference between a steak of sailfish or tuna and a tiny flying-fish or gar-fish. The former succulent and "meaty", the latter full of tiny bones.

I understand some of the reasons ...

a) In colonial times, if you lived on the coast and were poor, then the only fresh fish you could afford were the small bony ones, so you filled up your stomach with plantain.

b) In colonial times, if you lived inland and were poor with no motorised transport, then the only fish you could afford were the small bony ones dried and salted, so you filled up your stomach with plantain.

c) If you are poor, then or now, and you have 3, 4, 5+ kids to feed, they get plantain or cocoyam to fill their stomachs.

Google Android and other tech news

Google launched its mobile T1 phone with much hoo-ha in October. It operates on the open source Android operating system based on Linux.

The first bug has appeared ... a man was sending a text message to his girlfriend and the message contained the word reboot ... the phone promptly rebooted!

To their credit Google have already issued an automatic bug-fix available tu US users on Tuesday and UK users on Wednesday this week. Blimey ... even I know that issuing the command reboot in a Unix/Linux terminal will result in a ...

In other developments the Australian company IBA Health announced the launch of the first release of its electronic medical record (EMR) software Lorenzo, developed by its subsidiary iSoft, on Wednesday. The NHS Connecting for Health has comissioned this software for keeping patient records throughout most of the north of England (it is purchasing different EMR software for other areas - fully compatible?).

Now I have a few questions here ...

1. IBA Health/iSoft is selling Lorenzo elsewhere so presumably development costs are being shared with other countries.

2. Clearly Lorenzo has to be adaptable to the healthcare systems of different countries.

3. The reply to my FOIA request to the DoH regarding the storage of patient records stated that they would be stored on Solaris Unix servers running Oracle database software. So Lorenzo has to interface with Unix.

4. Are Solaris Unix OS and Oracle database software licenses paid directly to these companies or through DoH contractors (in the case of Lorenzo distributions Computer Sciences Corporation)? If the latter does the DoH know if and how much their contractors are marking-up licensing fees?

4. The DoH contract with Microsoft includes developing (amongst other things?) a Common User Interface (CUI) for Windows workstations - so Lorenzo also has to interface with the Windows CUI. In addition, the EMR software in other areas of England has to interface with Microsoft Windows, Lorenzo, Oracle and Solaris Unix.

5. OGC states that "UK Government will consider obtaining full rights to bespoke software code or customisations of of COTS (Commercial off the Shelf) wherever this provides best value for money." Does the DoH/NHS have full rights to the adapted Lorenzo code and the MS CUI code?

6. Does/will MS Windows Vista, and the projected Windows 7 (issued in beta this week) work with the NHS CUI a customisation of COTS? If

7. The NHS Northwest SHA has been assisting iSoft in trialling their Lorenzo software on a ward or two at the Morecambe (Lancashire) district general hospital. Staff have been maintaining their traditional paper patient records alongside the new Lorenzo system - obviously extra workload to maintain two systems. Who has paid for the extra staff worktime in maintaining both the traditional paper-basd system alongside the iSoft Lorenzo system?

And finally do NHS CfH know what the fuck they are doing? Who is leading who in NHSCfH - the IT people (are there any?) or the managers?

Do these issues warrant a further FOIA request?

BBC iPlayer and Tor

For sometime now I've noticed that my previously posted solutions to getting BBC iPlayer (streaming television version) overseas (here) using Tor and Privoxy/Foxproxy are no longer working. After scanning/converting over 90 Autocad dwg files to Acrobat pdf files and thrn cataloging them in html on our workplace Intranet website yesterday, my ennui limits had been reached and I needed some intellectual stimulation. So I downloaded the most recent versions of Tor and the Firefox add-on FoxyProxy, configured them as previously described ... (i.e. Tor to point to StrictExitNodes to named UK Tor servers. The Vidalia GUI for Tor tells me my exit node is in the UK . Web-based IP address search tools show my IP address is the UK.

What is going on? Are the BBC blacklisting UK Tor servers? Have the found a way of tracing Tor routing back to the original machine?

Anonymity

For 2 1/2 years I have tried to obscure to greater or lesser extents our geographical origin in Africa and our location in the UK.

With posts on the Royal Manchester Children's Hospital, Bury market etc, you will have surmised our UK location is somwhere in the northwest of England. If you are familiar with the town or even the area of the town where we live, then some of the photos I have posted will have given you a good idea.

Our location in Africa is perhaps somewhat vaguer.Somewhere in west/central Africa. A couple of our readers knew where we were from pre-blog days. Only one, Andy Hockley of Csikszereda Musings, whose early working life in many ways mirrored my own, guessed correctly.

I worry about the UK immigration authorities, I worry about the UK health authorities - I've touched upon this before - how the General Practioners (GPs - your family doctor) have refused to report appealing refused asylum seekers (which we are not). who are officially not eligible to free health treatment, to the immigration authorities. They are some of the most vulnerable and deprived members of UK society. How our local PCT accounts department (paying for Kezia's treatment) didn't ask ...

We may not be legally eligible to UK state health and education services - to all the assistance that nurses, doctors, social workers, ambulance drivers, receptionists, school secretaries, teachers and cooks etc etc have unreservedly and confidentially given us.

With Jaime's appearance in Caroline Irby's Guardian/Channel 4 photo-journalism project, we can no longer hide our geographical locations, whether in the UK or Africa - we have been "outed".

In the UK we rent a small furnished terraced house in Rochdale, 30 seconds walk from my brother.

Our home is in the small African (two) island state of Sao Tome e Principe off the west coast of Africa on the equator - get out your atlas.

Two Arseholes in Middle England

Gordon Brown called Alastair Darling into his office one day and said, 'Alastair, I have a great idea! We are going to go all out to win back Middle England '.

'Good idea PM, how will we go about it?' said Darling.

'Well' said Brown 'we'll get ourselves two of those long Barbour coats, some proper wellies, a stick and a flat cap, oh and a Labrador. Then we'll really look the part. We'll go to a nice old country pub, in Much Something or other, and we'll show we really enjoy the countryside, ........ Oh and remember not to mention the Hunting with dogs Act'

'Right PM' said Darling. So a few days later, all kitted out and with the requisite Labrador at heel, they set off from London. Eventually they arrived at just the place they were looking for and found a lovely country pub and, with the dog, went in and up to the bar.

'Good evening Landlord, two pints of you best ale, from the wood please' said Brown.

'Good evening Prime Minister' said the landlord, 'two pints of best it is, coming up'

Brown and Darling stood leaning on the bar contemplating new taxes, nodding now and again to those who came in for a drink, whilst the dog lay quietly at their feet. As they drank their beer they chatted about how heart-rending it was that pensioners were being imprisoned for not paying the council tax.

All of a sudden, the door from the adjacent bar opened and in came a grizzled old shepherd, complete with crook. He walked up to the Labrador lifted its tail and looked underneath, shrugged his shoulders and walked back to the other bar. A few moments later, in came a wizened farmer who followed the same procedure.

To the bewilderment of Brown and Darling people of all ages and gender followed suit over the next hour.

Eventually, unable to stand it any longer, Darling called the landlord over.

'Tell me' said Darling,'Why did all those people come in and look under the dog's tail like that? Is it an old Custom?

'Good Lord no,' said the landlord.'It's just that someone has told them that there was a Labrador in this bar with two arseholes'.

(Courtesy of my boss).

The Biography of a Song

I am currently reading Strange Fruit by David Margolick - the story of the poem/srong posted below.

Written by Abel Meeropol inspired by the lynching of Thomas Shipp and Abram Smith in 1930, it was made famous by Billie Holiday.

Three Government Departments

My FOIA request as to the cost of the DoH's contract with Microsoft received a pretty negative response.

I referred in a previous post to the National Audit Office's reports on the National Programme for IT in the NHS i.e. NHS Connecting for Health. In their first report, dated June 2006. the NAO had the following to say about the NHS contract with Microsoft:

"In November 2004 NHS Connecting for Health negotiated renewal of the Department's NHS-wide licence for Microsoft desktop products, which NHS Connecting for Health estimates will save £330 million over nine years with a firm commitment only for the first three years.
Microsoft agreed that the price paid by the NHS would continuously match the lowest charged anywhere in the world. The agreed price for their committed volume was substantially lower than that previously negotiated by the Office of Government Commerce (on a non-commitment basis) on behalf of UK government users. Microsoft also committed to spend £40 million on developing an NHS user interface to help standardise healthcare applications for clinicians, increasing efficiency and reducing the risk of clinical error.

NHS Connecting for Health also considered open source solutions for NHS IT but decided against doing so for two reasons;

The NHS already had an installed base of 500,000 Microsoft environments and users were familiar with Microsoft, and;
Open source solutions are not necessarily cheaper: they may be cheaper to acquire but the total cost of ownership is material when ongoing support, maintenance and training for users are taken into account."

The Office of Government Commerce (OGC) is a department of HM Treasury responsibly for providing advice to all government departments, both national and local, on contracting etc.

In 2002 it produced a report "Open Source Software - Guidance on implementing UK Government Policy". It followed this up with a report "Open Source Software Trials in Government".

It is widely recognised in the IT industry that Unix or "Unix-derivative" operating systems (e.g. Linux) are far more appropriate for servers, particularly webservers. Hence the DoH/NHS will be storing its electronic patient records on Unix (Solaris) servers using Oracle (rather than Microsoft's SQL Server or even the open source MySQL) as its database software.

The desktop environment is more controversial, it being cited that Linux desktops are "insufficiently mature".

The OGC seeked to examine this along with the cost benefits of using open source software (henceforth OSS).

I have some limited experience of deploying Linux desktops to regular users - my employer donated some legacy machines to respectively the national radio station, the national television station, a local primary school and the local municipal council's library.

The machines originally ran Windows NT 4.0. As a government organisation and as Microsoft no longer supports NT 4.0 we had to wipe the hard disks and, after some evaluation, I installed Xubuntu Linux (a light version of Ubuntu Linux suited to machines with small hard disks and little RAM).

The first deployment at the national radio station was a disaster - as soon as I turned my back they had a local technician come in and install a pirated copy of Windows XP.

At the television they took to it immediately - two machines for video editing with firewire ports so they could hook up their DVCAMs and download video clips using the open source KinoDV and edit them using the open source Cinelerra suite. Machines were also provided to the director's secretary and the admin. department - pleased as punch, OpenOffice and Mozilla Firefox no problem at all.

The machine offered to the director of the local primary school couldn't even handle the memory requirements of OpenOffice so I made Abiword the default wordprocessor. Both OpenOffice and Abiword will save documents in a variety of formats including MSWord doc and plain text txt (useful for blogging as Google's Blogger does not like doc embedded headers).

One of the case studies in the OGC report is particularly relevant to this post - that of the Beaumont Hospital in Dublin, Ireland.

Prior to its adoption of OSS it operated a mixed environment of MS Windows and Unix. The hospital had 3000 directly employed staff, and used 22 Linux servers, 14 Windows servers, a Hewlett-Packard HP3000 mainframe for primary clincal applications and a HP Unix system for financial applications. In 2002 there were 1000 workstations.

The hospital was experiencing severe financial problems and started to look at where it could make cost-savings - including in IT.

The IT department came up with the following results and subsequent implementation, between using OSS and proprietary Closed Source Software:


Email, online forms, laboratory procedures and results, patient care records etc - and even X-ray imaging - could all be dealt with by OSS.

There was some resistance to the Linux desktop GUI - Beaumont purchased an e-learning course to deal with this.

GUIs (there are various) have come a long way in the six years since Beaumont made the change. As I related above, our relatively unsophisticated IT users here in Sao Tome have taken to the Ubuntu-family GUIs as ducks to water.

The OGC strongly recommends that government entities should not tie themselves into closed proprietry systems - the NHS have chosen to do just that!

Strange Fruit

Southern trees bear a strange fruit
Blood on the leaves and blood at the root
Black body swinging in the southern breeze
Strange fruit hanging from the poplar trees

Pastoral scene of the gallant south
The bulging eyes and the twisted mouth
Scent of magnolia sweet and fresh
And the sudden smell of burning flesh!

Here is a fruit for the crows to pluck
For the rain to gather, for the wind to suck
For the sun to rot, for a tree to drop
Here is a strange and bitter crop.