I work in the NHS and I wish we'd move to Linux.

The reasons we didn't are historically due to legacy apps that were Windows only proprietary. We used to have software in different departments of different ages - literally we had a tool that went back to the 1980s (needed telnet to run).

We recently upgraded to a single uniform EPR platform and pretty much most if not all our legacy apps got replaced. Most of what we do now is either via the EPR (which runs in a streaming VM or via a Web client), or Web apps.

So we could switch to Linux. But we probably won't - we still have inertia - IT are familiars with running windows and all our software is configured to run on Windows or authenticate using Windows domains. It'd take effort to unpick that and fix it.

Also we use Microsoft Office throughout - while that can also be web based, that would also disincentivise the switch. Having to train every member of staff (particularly the less tech savvy staff) to use a different office system would probably put off anyone in IT considering it (although I think for hospital uses its perfectly doable). Deploying office 365 via browser is doable but effort.

So previously it was legacy apps (which will still be the issue in many places, we're unusual to have consolidated so much to one EPR platform - even among customers of the EPR) but now it is inertia. I can see no decent reason why we could not switch entirely to Linux. It'd come down to the cost savings of dumping windows licenses / ecosystem versus the alternatives including the cost of retraining and rebuilding infrastructure.

Edit: also even if we were to replace our desktops with Linux and Web interfaces, at the backend some tools are Windows server based. And it'd be up to the software suppliers whether they actually have a Linux client for our EPR or Pacs system, even if they are supposedly using Web interfaces.