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!

NAO and the NHS CfH

The DoH pointed out the opinion of the National Audit Office (NAO) that the Enterprise Wide Agreement between Microsoft and the NHS represented considerable savings to the taxpayer over normal Microsoft rates and those charged by Microsoft to other government departments.
There are two NAO reports evaluating CfH:

1. "The National Programme for IT in the NHS" (ref. HC 1173 June 2006).

2. i) "The National Programme for IT in the NHS: Progress since 2006" (ref. HC 484-I May 2008)

ii) "The National Programme for IT in the NHS: Project Progress Reports" (ref. HC 484-II May 2008).

These are hefty reports and it will take me some time to get through them.

Microsoft and the DoH - Random Thoughts

What do you and I think of this?

Here are some of my random of my thoughts ...

1. It was passed up from the NHS Connecting for Health (CfH) Freedom of Information Officer (FIO) to the Department of Health FIO. Does this say anything about DoH planning and contract awards? Or does this say something about the control of information in the NHS/DoH? The implication is that the contract is between NHS CfH, not the DoH, and Microsoft. However, it may be that the DoH administers the contract on behalf of NHS CfH.

2. The answer to my Question a) raises a number of issues. We are told that under the terms of the Enterprise Wide Agreement (EWA) with Microsoft the government is not allowed to reveal its cost – hardly seems to be in the spirit of open government.

In the first paragraph of this answer we are assured that the National Audit Office (NAO) considers the EWA good value for money compared to contracts between Microsoft and other government departments – this does not say much for these other contracts. Are they also subject to non-revelation of price clauses? Was the NAO's opinion declared publically?

The lack of openness seems to be in direct contradiction of all the government's hype about the free market and open competition.

With twisted logic it is argued that the non-revelation of the contract price results in a cheaper price and thus a lower burden to the taxpayer. What if Microsoft had to compete transparently? What price Freedom of Information?

This rather seems to mirror the European Union's concerns at Microsoft's monopolistic practices. Was the original EWA an open tender? If so, were there any other bidders? What were the terms of the 3-year extension clause? Is Microsoft undercutting, at a loss, potential competitors in order to gain a monopoly in the NHS? By the time this renewal (2007-2010) of the EWA is up, then the NHS will be so intricately tied into Microsoft systems that it will be obliged to renew again and again ... and Microsoft will have the NHS by the short-and-curlies and be able to charge whatever it wants.

3. The answers to my questions b) and c) are somewhat surprising and inadequate. From the Microsoft NHS website I have since learned that Microsoft has an EWA reseller programme divided up by Strategic Health Authorities.

The SHAs are distributed among three companies hence:

Bytes Technology Group:

North West SHA,
West Midlands SHA,
London SHA
South West, South East and South Central SHAs

Please contact Bytes Technology Group at:
nhs@bytes.co.uk
0208 786 1570
http://www.bytes-publicsector.co.uk/nhs

Computacenter Ltd.
East of England SHA
East Midlands SHA
Or as part of any Arms Length Body

Please contact Computacenter Ltd at:

nhs.microsoft.ea@computacenter.com
0800 055 6661
www.computacenter.com/nhsea

Trustmarque Solutions

North East SHA
Yorkshire andtThe Humber SHA
Department of Health

Please contact Trustmarque Solutions at:

Microsoft.Licensing@Trustmarquesolutions.com
0870 121 0322
www.trustmarquesolutions.com

Clearly, Microsoft's criteria for the selection of resellers and their remuneration are not going to be in the public domain.

I also discover that, as stated in the FIO's reply, that individual NHS entities, can enter “individual contracts” with Microsoft under its Select Licensing programme, without reference to CfH or the DoH. This programme is also administered through Microsoft resellers (generally the same ones as under the EWA) who are administratively organised by SHA. Surely the EWA should cover all NHS Microsoft needs? If CfH/DoH does not know how many of these contracts are held and what they are for, how can it plan for the EWA? How does it know whether the EWA is covering NHS needs?

4. I am somewhat relieved the planned Personal Care Record database will be stored on Solaris Unix servers using an Oracle database rather than Windows servers using MS-SQL database server software. With and by whom is/are the Solaris/Oracle contract/s held? What are the effective dates of such contract(s)?

The DoH FIO's reply seems to raise more questions than it provides answers.

Dear Readers - should I pursue this with a further FOIA request? If so, what should I request? Suggestions please in the comments or by email.

FOIA - Microsoft and the DoH

The reply ...

Our ref: DE00000356344

15 October 2008

Dear Mr Gascoigne,

Thank you for your request for information, under the terms of the Freedom of Information Act 2000 (‘the Act’), about Microsoft as a supplier of IT products and services to the NHS, and as a supplier to NHS Connecting for Health in connection with the Summary Care Record (‘centralised patient record system’). Your request was received on 7 October and it has been passed to me for reply.

Please find answers to each of your requests in turn below:

(a) How much the NHS is paying Microsoft for licensing of Microsoft's Operating Systems and any support services directly provided by Microsoft?

The terms of the Enterprise Wide Arrangement (EWA) negotiated between NHS Connecting for Health and Microsoft on behalf of the NHS preclude our revealing the pricing details to parties outside of Government. This proviso reflects the fact that the information is commercially sensitive information, and as such is exempt under section 43 of the Act, which exempts information whose disclosure would be likely to prejudice the commercial interests of any person. However, I can confirm that the National Audit Office have accepted that the prices the NHS is paying under the EWA are lower than those available under other agreements with Microsoft negotiated by the Office of Government Commerce on behalf of Government departments.

Section 43 is subject to the public interest test. Considerations I have taken into account in deciding the balance of public interest in relation to your request are that disclosure would b e consistent with policies for open government and accountability for public expenditure. Disclosure would also illustrate value for money in the context of the National Programme for IT. Considerations for withholding the information are that disclosure is likely to mean that Microsoft would not give the NHS such preferential pricing in any future arrangement. Furthermore, other suppliers are likely to become wary of offering NHS Connecting for Health or the NHS (and potentially other public sector organisations) exceptionally favourable terms in future if they perceive the risk that they too may have their lowest prices revealed in response to ad hoc requests for their disclosure. Hence, the net effect of revealing these particular price details is likely to be to increase future costs for the public sector/the taxpayer.

(b) How many discrete contracts does the NHS have with Microsoft? If more than one, what products/services are provided under each contract and what is the cost of each contract?

(c) If 3rd-part vendors are contracted to provide support services for Microsoft products, how many such contracts exist, how are they administered, and what is their total value?

Neither the Department of Health nor NHS Connecting for Health collect information about the number, nature or value of any such separate agreements.

I should explain that the NHS is not a single organisation or legal entity. In addition to contracts held centrally on behalf of the NHS as a whole, each NHS organisation is at liberty to enter into further bilateral agreements with Microsoft or its commercial partners for products or services to meet their local needs without the knowledge, or need for approval, of either NHS Connecting for Health or the Department of Health.

(d) What operating system is planned to be used on fileservers hosting the centralised patient record system, and with which core-database software is it being implemented?

I can confirm that the Summary Care Record sits on servers running the Sun Microsystems Open Solaris 10 ("Unix") operating system, in an Oracle 10g database.

If you have any queries about this letter, please contact me. Please remember to quote the reference number above in any future communications.

If you are unhappy with the service you have received in relation to your request and wish to make a complaint or request a review of our decision, you should write to the Section Head of the Department’s Freedom of Information Unit at the following address:

Freedom of Information Unit

Department of Health

Room 334b

Skipton House

80 London Road

SE1 6LH

Email:freedomofinformation@dh.gsi.gov.uk

If you are not content with the outcome of your complaint, you may apply directly to the Information Commissioner (ICO) for a decision. Generally, the ICO cannot make a decision unless you have exhausted the complaints procedure provided by the Department. The ICO can be contacted at:

The Information Commissioner’s Office

Wycliffe House

Water Lane

Wilmslow

Cheshire

SK9 5AF

Yours sincerely,

Stuart Craig

Department of Health

Room 317

79 Whitehall

London SW1A 2NS

Tech Talk - Autodesk TrueView 2009

I really hate to talk about IT business monopolies - unless to criticise.

As Microsoft is to Operating Systems and Office applications, Autodesk is to the world of Computer Assisted Design (CAD) through its very expensive software product, Autocad.

However, it does provide a free viewer so that you can view its CAD file format (.dwg) in Internet Explorer (note IE only and that there are no versions of Autocad for Mac or Linux). The viewer has run through various names and forms over the years - from Voloview to the current DWG TrueView 2009.

DWG TrueView 2008 and 2009 can be run as independent applications, or are meant to run integrated into the IE web browser (as the original Voloview did). As an independent application it runs fine. As an IE Add-On I (and many others it seems) get a "white screen of death" when we try to load a dwg file in IE.

My boss has charged me with putting all our technical drawings on our Intranet site as html links so, as many are in dwg format, I need a browser dwg viewer. A "white screen of death" is not going to encourage my clients to use digitised drawings.

DWG TrueView claims it will install an ActiveX control to IE to allow dwg drawings to be viewed. It doesn't. Even when I reduced all of IE's security settings to the minimum.

Installing/uninstalling TrueView, changing IE security settings, research on the web took me all day ...

Eventually, I found a partial solution which doesn't actually allow you to view the files in IE but allows a download and automatic opening of the dwg file in DWG TrueView,

Write the following script into a file that you name as a *.inf. Right click on the file and select Install. De- and then reinstall DWG TrueView 2009 if necessary.

[Version]
Signature = “$Windows NT$”

[DefaultInstall]
AddReg = addreg
;DelReg = delreg
;DelReg = nuke

[addreg]
HKLM,”SOFTWARE\Microsoft\Internet Explorer\ActiveX Compatibility\{6C7DC044-FB1E-4140-9223-052E5ABE7D24}”,”Compatibility Flags”,0×00010001,00,04,00,00
HKCR,”CLSID\{6C7DC044-FB1E-4140-9223-052E5ABE7D24}\InProcServer32″,”~~Disabled~~”,,”C:\Program Files\DWG TrueView 2009\acctrl.dll”

[delreg]
HKCR,”CLSID\{6C7DC044-FB1E-4140-9223-052E5ABE7D24}\Implemented Categories\{40FC6ED4-2438-11CF-A3DB-080036F12502}”
HKCR,”CLSID\{6C7DC044-FB1E-4140-9223-052E5ABE7D24}\Implemented Categories\{7DD95802-9882-11CF-9FA9-00AA006C42C4}” ; remove “safe for scripting” marker

[nuke]
HKCR,”CLSID\{6C7DC044-FB1E-4140-9223-052E5ABE7D24}”

[Strings]

Then select the hyperlink to your dwg file and IE will ask you whether to open or save it. Select Open. TrueView will then ask you for a Template file - click Cancel and TrueView will open with your drawing perfect!

Thanks to Slinger and Swami.

Link to OpenCad.

Microsoft bribes the NHS

Thanks to Dr Penna I learn that every NHS employee can purchase Microsoft Office 2007 for £ 17.00 for use in their own home ...

Dr Penna thinks he is onto a good thing. And Microsoft's NHS website has discounts on other MS products for NHS employees. All you have to have is an NHS email address (oh shurely I can hack that ,,,).

Let us look at this in more detail on the Microsoft-NHS website ...

Microsoft has a Software Licensing Enterprise Agreement with NHS England (with similar but separate agreements with NHS Scotland and NHS Wales). The current agreement runs until 2010 and covers a range of Windows software including the Vista operating system (both Business and Enterprise editions) and a range of Microsoft products including Office. It also includes Client Access Licenses (CAL) to Windows Server and SQL database software but not the server and database software itself.

What does a CAL mean? Well, no desktop workstation will have server or database software installed on it. However, a desktop workstation within the NHS will probably need to access a server for networking and an SQL database server (for Summary Care Records?). To access a server, the desktop workstation needs a CAL. Ok, so Microsoft's licensing model screws you twice ...

But the intimation here is that the NHS is using Windows servers (Microsoft server and database software licenses are sold under a separate agreement entitled the Select Licensing programme - whatever the fuck that is). For the storage of confidential patient data, the Summary Care Record, for NHS Choices “Choose and Book” etc etc.

Why didn't Connecting for Health opt for far more secure Unix servers and Linux desktops? Or even Unix servers with Windows desktops?

Given the government's recent record on the loss of confidential data on Joe and Jane's data, given what I have learned today of Microsoft's involvement, and what I already knew of its appalling security record, my confidence in the development of the NHS Connecting for Health project has lessened x-fold.

Afterwords:

1. FAQ: “What is the NHS paying for this agreement?”

Answer: “The NHS is paying a fixed amount per year. The number of devices each year increases to cover an expected growth in the number of users. Microsoft has provided a substantial discount to the NHS based on the volume of devices covered and length of the agreement.”

Does anyone know? Can anyone tell me how to access government contracts or do I have to write a Freedom of Information Act request?

2. Certain Department of Health, but not part of the NHS, institutions are included in the Enterprise Agreement.

3. fyi Dr Penna the software does not belong to you. At 65 years old you will be without a word-processor and email client. “... so should they leave the NHS then they are required as per the terms and conditions on the web site to uninstall and return it to their Trust.”