NHS IT is, of course, vastly under-funded compared to even modest startups, and entangled in bureaucracy of upgrades. I used to work with someone who was one of two sysadmins for a hospital of several thousand staff.
This is partly a consequence of the NHS Connecting for Health debacle, which on an original budget of £2.3 billion managed to hit a projected cost of £12.4bn with almost nothing to show for it apart from a patchy implementation of Choose and Book.
