The NHS has been fairly resistant to the use of open source software. But anything with a "health" label on it attracts quite a hefty premium. Essentially, the IT industry is exploiting the IT naiveté in the Health Industry, often asking large licence fees for products that either already have free equivalents, or ones that would be cheaper for the health service to develop and own. Where the Health Service is paid for in taxes, the taxpayer should expect be given value for money.