back to article For fax sake: NHS to be banned from buying archaic copy-flingers

NHS trusts have just 20 days to buy in fax machines – because from January 2019 they will be banned from purchasing the outdated devices. Fax machines are technology non grata in the NHS after a Freedom of Information request by the Royal College of Surgeons revealed some 8,000 still creaking away in hospital trusts across the …

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  1. CAPS LOCK

    Ban a system that works and is malware free*...

    ...genius...

    * Mostly malware free. Mostly...

    1. Christian Berger

      Re: Ban a system that works and is malware free*...

      Well that "mostly" is if you don't have a colour fax. Since colour fax machines are about as common as ice-cream cone unicorns, that's not really a serious concern.

      1. nextenso

        Re: Ban a system that works and is malware free*...

        Maybe this is already covered by one of the 82 responses. I have to interact with solicitors, as would NHS. In the legal world in my experience in & around London, fax is very much alive and kicking - sending paper proof that a contract has a signature on it. Its the only thing I use fax for now - as part of a multifunction printer. I also use Adobe Send & Track, but, I find that is not accepted as proof of signature.

        1. katrinab Silver badge

          Re: Ban a system that works and is malware free*...

          In our office, we moved the photocopier / scanner / printer / fax machine to a different location, and didn't plug it into the phone line. Nobody noticed.

    2. Anonymous Coward
      Anonymous Coward

      Re: Ban a system that works and is malware free*...

      And works, even when everything else* has fallen over....

      (*except for the VoIP PABX)

      I must be of a certain age, as I remember staring at the first fax machine I saw, thinking what an amazing piece of technology it was. And how quickly it suddenly reached critical mass when the royal mail conveniently went on strike for a couple of weeks (c. 1987?)

      Last time I sent a fax? Probably about 1998. It seemed to be around forever, but in retrospect was a rather short lived star.

      1. kain preacher

        Re: Ban a system that works and is malware free*...

        Fax machines goes back to the 60's . Just most folks could not afford them

        1. Anonymous Coward
          Anonymous Coward

          Re: Ban a system that works and is malware free*...

          "Fax machines goes back to the 60's "

          Alexander Bain demonstrated the facsimile transmission principle in the mid-19th century.

          Quote from the above Fax History site about an improvement of the technology:

          "With a successful demonstration in front of Napolean in 1860, the Pantelegraph started operation between Paris and Lyon in 1865 and extended to Marseille in 1867. For comparison with telephone, it was not until 1876 that Alexander Graham Bell received his patent for the telephone."

        2. Anonymous Coward
          Anonymous Coward

          Re: Ban a system that works and is malware free*...

          The 1860s in fact

          The first patent for the fax was issued in 1843 - and it's another Great British invention (well, Scottish, so British for now)

        3. Mage Silver badge

          Re: Fax machines goes back to the 60's

          Maybe the 1860s. First demo was in 1851!

          In the 1930s there were adaptors sold in USA. News was "faxed" by radio after voice program close down. Rather more useful than 22 line mechanical TV. RCA & EMI killed off both ideas in 1936 with their jointly developed Electronic TV (USA used slightly more lines than UK 405 and changed to the 525 system a little before Russia tested 625 lines in late 1940s. It was mad ego that UK restarted 405 when 18 months later they could have used 625).

          Certainly Fax was a niche and less popular than telex/telegraph till 1970s.

          China & Japan still keen on fax. Clue, have you tried to do eMail in Chinese or Japanese?

          1. MyffyW Silver badge

            Good Enough

            So there are 8,000 fax machines in the NHS? Let's assume they last about 4 years and cost 200 quid to replace. That's GBP 400,000 that will be saved. Round it up to GBP 1 million to account for consumables and phone bills and it's still three parts of eff-all in NHS terms. Show me the NHS system that can replace everything they do and will "only" cost 1 million a year.

            Basically this "ditch the fax" drive is a conjurers distraction. I suggest you guard your watch and check your change.

            1. Alan Brown Silver badge

              Re: Good Enough

              > Basically this "ditch the fax" drive is a conjurers distraction.

              Nope. Fax is a GDPR nightmare - the number of faxes of confidential data sent to the wrong destination is incredible and there's no audit trail to speak of.

            2. Anonymous Coward
              Anonymous Coward

              Re: Good Enough

              Apart from that pesky thing called email. Which they all have already. And everyone else has.

            3. Jim 59

              Re: Good Enough

              @MyffyW I don't think that cost is the driving factor. Did anybody say it was?

              Efficiency and safety seem to be the question, and pieces of paper can go missing. Referrals for life threatening conditions, for example, should probably not lie around in fax trays.

            4. F0rdPrefect
              Happy

              Re: Good Enough

              "Let's assume they last about 4 years"

              Last one I saw in a hospital was well over 10 years old.

              The older they are the longer they last.

              And the one that another customer kept going, because some of their customers didn't have access to email, was getting on for 20 years old.

              Also, they start from about £60 inc VAT.

        4. Kernel

          Re: Ban a system that works and is malware free*...

          "Fax machines goes back to the 60's . Just most folks could not afford them"

          Actually, the first commercial fax service started between Paris and Lyon in 1865, with the network being extended to Marseille in 1867 - Bell received his telephone patent in 1876, 9 years later.

          The first experimental fax system successfully developed was by Alexander Bain, working on it between 1843 and 1846 - the quality wasn't too great, but by 1867 it had improved and wasn't too much different from the early thermal printing types that we are familiar with.

          In other words, fax was over 100 years old before most of us had even heard of it.

          1. big_D Silver badge

            Re: Ban a system that works and is malware free*...

            @Kernel agreed. And the big newspapers used derivatives for decades to transfer photos (and text?) from all over the world back to HQ for inclusion in the papers.

        5. katrinab Silver badge

          Re: Ban a system that works and is malware free*...

          Alexander Bain invented the electric printing telegraph in 1843

          The scanning phototelegraph was invented by Shelford Bidwell in 1880.

      2. Steve K

        Re: Ban a system that works and is malware free*...

        Yes I remember that too - during/after the postal strike suddenly everyone had a fax machine or knew what one was!

      3. big_D Silver badge

        Re: Ban a system that works and is malware free*...

        I worked at an IT company and many customers insited on sending faxes of report layouts they wanted.

        Also, for legal reasons, most sent faxes of signed off orders, because a PDF in an email was not a legally binding document in Germany, whereas a fax is - or rather the PDF needed to be digitally signed with a valid certificate, which is expensive and, for most non-IT people, complicated.

      4. Doctor Syntax Silver badge

        Re: Ban a system that works and is malware free*...

        "And works, even when everything else* has fallen over....

        (*except for the VoIP PABX)"

        Give it it's own exchange line and it doesn't even mind if the PABX falls over.

      5. jelabarre59

        Re: Ban a system that works and is malware free*...

        Last time I sent a fax? Probably about 1998. It seemed to be around forever, but in retrospect was a rather short lived star.

        Actually, last sent a fax 3 or so weeks ago (with a multifunction ink printer, of course). The office for one of my daughter's therapists doesn't have email for the doctors yet. Various medical practices in the US are still like that.

        Going back 30+ years ago, when I worked in film distribution, we'd *loved* for the various film depots to have had fax machines, just so we wouldn't have to read out shipping orders over the phone (that or a telex machine, which we also had). And the first fax machine we had there was one of those electrostatic ones, that would take 4 or 5 minutes to transmit/print a fax. These days it would probably be an emailed PDF of a barcoded shipping label. Then again, perhaps not, Films Inc wasn't quite that swift.

      6. Jim 59

        Re: Ban a system that works and is malware free*...

        A short lived star, but not as short as Telex.

    3. Daniel von Asmuth
      Boffin

      Re: Ban a system that works and is malware free*...

      Some political decisions cost human lives.

    4. Alan Brown Silver badge

      Re: Ban a system that works and is malware free*...

      * Mostly malware free. Mostly...

      Until you have a fax-to-email gateway.

      It's a theoretical hole but it's there.

  2. RedCardinal

    Pity they couldn't pay the same attention to the DWP which refuses to accept documents being emailed to them and insists on them faxed instead....

    1. big_D Silver badge

      As I point out elsehwere, over here faxes are accepted as legally binding documents by courts, emails aren't. I don't know if that is the case in the UK.

      1. Lee D Silver badge

        In the UK both are.

        You just may have to retain the original in order to prove its origin via headers etc.

        (Hint: There's a reason that Exchange has a "legal retention" functionality. If they weren't binding, they wouldn't be able to form evidence of any kind).

        There was a time when fax was accepted and email not, but when I moved house last year, I signed a lease agreement electronically, no problems. I pull my suppliers up on their failures via email records, no problems.

        A country that doesn't have email as a binding contract now (provided, as with any medium, that the content is actually received and stored properly... anyone could fake a fax from any number the same way anyone could fake a fax from any email address) is probably a bit backwards.

        If you'd accept it in court as evidence (and everything from Facebook posts to emails have done that in all kinds of jurisdictions), then it's fine.

        With things like Exchange and the proper retention / audit options, it would also be almost impossible to claim you hadn't received it, too. Hell, a president is just about to be put behind bars and that'll come down to emails at some point, you can guarantee.

        The question of "legal service" by email is slightly different, and that has been resolved (positively) for a long time.

        1. Peter2 Silver badge

          There was a time when fax was accepted and email not, but when I moved house last year, I signed a lease agreement electronically, no problems.

          Yep. You signed the lease electronically. But what about the mortgage offer? They sent that to you in the post for a physical signature and refused digital copies, didn't they?

          Mortgage companies still refuse scans, and require faxes to be used for certain things.

          1. Uberior

            "Mortgage Companies"

            That's a bit wide isn't it? Which mortgage companies? There are hundreds.

            1. Peter2 Silver badge

              And out of the lot, find one that accepts a scanned copy of their mortgage documentation.

              I'll wait. Of course, I know that they are all members of UK Finance, formerly the Council of Mortgage Lenders and have almost exactly the same rules drawn from the lenders handbook.

        2. martinusher Silver badge

          >There was a time when fax was accepted and email not, but when I moved house last year, I signed a lease agreement electronically, no problems. I pull my suppliers up on their failures via email records, no problems.

          Its a bit late when you've just been scammed for a few hundred thousand. Currently email is just not reliable for transactions that involve funds transfer. You can add all the legal retention, electronic signatures and whatever else you come up with but the system is fundamentally flawed and these technological fixes are just Band-Aids. I will only use electronic transactions for low value funds transfer in a controlled environment (that is, if the transaction gets hacked the loss will be minimal to zero).

      2. Peter2 Silver badge

        Yes, that's the case in the UK. There is established case law to say that a faxed acceptance is binding from the moment it's sent and faxed copies of documents (as in facsimile copies) actually have specific legal status. email should be the same, but isn't unless accompanied with a digital signature that meets specific criteria, which can still then be challenged in court so companies still require physical signatures on documents which are then faxed. Don't ask me why scanning a copy and emailing it doesn't have the same status as a fax, blame the bloody politicians who are incapable of writing coherent laws, and the courts for literally interpreting the laws as written.

        I have three bloody fax machines that I can't get shot of because other entities we communicate with still use them. IMO: attacking fax machines for having the temerity for existing is pointless. Attack the legal basis for them existing by writing a short law.

        "documents scanned via a scanner and emailed as an attachment [in TIFF/JPG/PDF format] are recognized as being exact copies of the original, and are hereby considered as facsimile copies in addition to documents sent by a fax machine."

        The fax machine would then be living on borrowed time until completely replaced in workflows.

        1. Jan 0 Silver badge

          > "documents scanned via a scanner and emailed as an attachment [in TIFF/JPG/PDF format] are recognized as being exact copies of the original, and are hereby considered as facsimile copies in addition to documents sent by a fax machine."

          Yes, but that doesn't stop the "original" being an unsigned document with a carefully cut and pasted (literally with scalpel and glue) signature from an entirely different document. That's a technique that works with faxes, scans and even photographs, if you use a widely diffused light source.

          We really should move to secure email.

  3. Ol'Peculier

    Apparently, football clubs all have fax machines that they use for transfer window deadlines.

    And I wonder how many MFP's are still sold with a fax modem build it, never to be used again, with an abandoned, unused port regarded as an object of curiosity for those under a certain age...

    1. Detective Emil

      Quite

      It's difficult to buy/lease/rent an "enterprise class" copier/printer/scanner that does not have an embedded fax. Mind, the things are equally happy to send your scans by (unsecured, in my experience) email.

      1. Sandtitz Silver badge

        Re: Quite

        "Mind, the things are equally happy to send your scans by (unsecured, in my experience) email."

        I haven't seen a new MFP in eons that didn't support TLS encryption in email transport.

        Fax certainly isn't secure, since the low bitrate traffic can be intercepted and replayed on another fax at the telco. Caller ID spoofing is also easy to do.

        Just sayin'...

  4. Anonymous Coward
    Joke

    The law of unintended consequences...

    Multiple choice on this one:

    1) NHS Minimum PC specs will be changed to require a fax modem?

    2) Lots of stand-alone scanners and printers will be bought as fax machine replacements (but at least the image will be sent by email!)?

    3) Royal Mail will receive a welcome boost in the number of letters sent!?

  5. Arthur the cat Silver badge
    FAIL

    the NHS will be paperless by 2020

    Right. Just like our offices have all been paper free for the last few decades.

    1. Flocke Kroes Silver badge

      Re: the NHS will be paperless by 2020

      The paperless NHS project is amazing. It has been going on for years. When it gets excessively late and over budget it gets cancelled and restarted a year or so later. Total deforestation and the complete destruction of the NHS will not end the stream of paperless NHS projects.

    2. Anonymous Coward
      Anonymous Coward

      Re: the NHS will be paperless by 2020

      In Edmund Tenner's great book 'How things bite back', published in the late 90's or thereabouts, he pointed out that sales of copier/printer paper in the US had increased by 500% in the decade since the 'paperless office' had become the must-have accessory. Probablys till higher now than it was in the 80s.

  6. Hans Neeson-Bumpsadese Silver badge

    For instance, she said, they will require signed directions or prescriptions – something easily achieved "in the real world" by taking a photo on your phone and sending it via SMS.

    Unless your phone is on the O2 network, and somebody at Ericsson forgot to update a certificate.

    Technology can - and will - fail, and it's good to have a backup...especially if the use case relates to someone's health and wellbeing.

    1. Steve K

      Backups

      Carrier pigeon/Chinese whispers...?

    2. Anonymous Coward
      Anonymous Coward

      "Technology can - and will - fail, and it's good to have a backup... [...]"

      Over three days recently I kept trying to correct a hospital appointment via the phone to their dedicated appointments number. It was system that told you where you were in the queue - usually about number 10. On the third attempt I hung on until I reached position number 1. After a further 15 minutes I gave up - having decided that the queue position only advanced when people tired of waiting.

      The next day I walked to the hospital and the matter was sorted out in about 5 minutes.

      Another NHS department's appointment also needs changing. Their dedicated helpline informs you that they have a new IT system that has slowed down processing. They request you to ring back later for anything but urgent appointments or those within the next three weeks.

      1. Teawain

        Ideal delays?

        I would imagine that bringing in more tech to the NHS will provide another few reasons for 'doing it tomorrow'. I've recently seen Office 365 being inflicted on all staff in an organisation and the fallout was notable amongst those not wanting to be re-trained in various IT skills.

  7. Christian Berger

    Sending a photo via SMS

    I mean yes, there were standards to send images via SMS... however I doubt there is much use in sending a 32x32 monochrome pictures theese days.

    Of course the sensible thing to do would be to define a standard format for document "facsimiles" which includes a simple high resolution bitmap of the page along with an UTF-8 export of its contents.

    If you ban fax machines, people are going to send office documents through mail... which is _much_ worse security wise.

    1. Charles 9

      Re: Sending a photo via SMS

      I don't know about that. In the US there is Certified Mail and Registered Mail, both of which carry assurances of delivery (Registered moreso than Certified). I would think the Royal Mail would have counterparts to this. Plus, at the extreme, there are courier services.

      1. Christian Berger

        Re: Sending a photo via SMS

        Sorry, I meant E-Mail.

    2. david 12 Silver badge

      Re: Sending a photo via SMS

      The technology is called MMS -- Multi-Media Service. It's quite popular in some parts of the world. It was supported on Feature Phones, (that is, not-smart phones) which I think are also still quite popular in some parts of the world, but it's also supported on many first-world networks for use with smartphones

      MMS sends MIME information, so basically it works like HTML: if you phone supports the picture type, you can see it.

  8. Anonymous Coward
    Anonymous Coward

    And, since NHS organisations will be audited ever quarter until they are "fax free", this means it is crucial that every part of the NHS and the organisations it works with becomes digital before the full fax ban. that they will most likely be getting quarterly audits until the heat death of the universe.

    1. Anonymous Coward
      Anonymous Coward

      Fax Auditer

      Where do I apply for the job as Fax Auditer? Sounds like it could be a nice gravy train....

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