But a portion of the payment will be based on usage of the systems to give suppliers an incentive to provide user-friendly, useful services and equipment.
The £2.3bn national programme for IT aims to deliver a care records service, e-prescriptions, electronic booking of hospital appointments and a new infrastructure.
Tim Smart, chief executive of Syntegra, the systems integration division of BT which was last week awarded more than £1.6bn of business, confirmed that his company will be paid its costs and profits for delivering systems that meet rigorous standards, irrespective of how many clinicians decide to use them.
"Some of [the payment] is dependent on take-up and usage. Our fixed costs are guaranteed," he said, and added that, as long as Syntegra provides an acceptable system it will at least get back the money it invests, plus a certain level of profit. However, he said it was in the company's interests to produce systems that people would want to buy.
Last week the Department of Health awarded BT a £620m contract to deliver a national data spine to hold details of a care record for every patient in England by 2010.
It also won a substantial part of a £1.1bn contract to provide services and systems in the North East, the prime contractor for which was Accenture, and BT was appointed local service provider for London with a bid of £996m over 10 years.
Computer Weekly has learned that confidential contracts signed by the health secretary and suppliers refer to a minimum commitment volume that will compensate service providers; if NHS trusts do not order the anticipated number of replacement systems in a year the taxpayer may make up the shortfall.
In certain circumstances, if the number of replacement systems falls outside specified boundaries, the Department of Health can allow suppliers to increase charges, reduce service level specifications, cut the scope of services or extend target dates for the replacement of systems.
The Department of Health refused to discuss this commitment. "The national programme cannot comment on the detailed commercial and confidential arrangements between service providers and their subcontractors," said a spokeswoman.
She emphasised, however, that suppliers would not be paid unless their systems or services were satisfactory.