The Department of Health is negotiating with Microsoft to buy software licences for the entire NHS.

A question-and-answer document on the NHS Executive information policy unit website says£20m of the extra£50m found for NHS IT this year has been earmarked for the deal.

But negotiations are already taking longer than expected. An initial deal should have been concluded by the end of August.

The deal will cover standard office products - such as Windows 2000 Professional and PowerPoint - and 'back office' software.

Despite the negotiations, the document lists other products that are available and insists that 'standardisation is not implied'. It claims the deal will simplify purchasing and cut overheads.

Dr Douglas Carnall, a GP and writer on healthcare software, said a bulk deal between the health service and Microsoft could make some sense.

But he warned it would be unhealthy if it stopped organisations considering alternatives such as Linux, which is offered free of licence costs (see pages 14-15).

'Every purchasing decision the NHS takes has an opportunity cost, ' he said. 'If you are spending tens of millions of pounds with Microsoft, That is tens of millions you're not spending on nurses. It is certainly contentious.'

Dr Carnall also warned that building IT strategy around Microsoft meant vulnerability to the US firm's decisions. 'You may have to take what Bill Gates gives you, ' he said.