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How hackers held the NHS to ransom

NHS staff found their computer screens repleaced by a padlock and a demand for money. Eerily, a junior doctor warned about such an attack days earlier. 

On Friday, doctors at Whipps Cross Hospital, east London, logged into their computers, but a strange red screen popped up. Next to a giant padlock, a message said the files on the computer had been encrypted, and would be lost forever unless $300 was sent to a Bitcoin account – a virtual currency that cannot be traced. The price doubled if the money wasn’t sent within six days. Digital clocks were counting down the time.

It was soon revealed Barts Health Trust, which runs the hospital, had been hit by ransomware, a type of malicious software that hijacks computer systems until money is paid. It was one of 48 trusts in England and 13 in Scotland affected, as well as a handful of GP practices. News reports soon broke of companies in other countries hit. It affected 200,000 victims in 150 countries, according to Europol. This included the Russian Interior Ministry, Fedex, Nissan, Vodafone and Telefonica. It is thought to be the biggest outbreak of ransomware in history.

Trusts worked all through the weekend and are now back to business as usual. But the attack revealed how easy it is to bring a hospital to its knees. Patients are rightly questioning if their medical records are safe. Others fear hackers may strike again and attack other vital systems. Defence minister Michael Fallon was forced to confirm that the Trident nuclear submarines could not be hacked.

So how did this happen? The virus, called WannaCry or WannaDecrypt0r, was an old piece of ransomware that had gained a superpower. It had been combined with a tool called EternalBlue which was developed by US National Security Agency spies and dumped on the dark web by a criminal group called Shadow Brokers. Computers become infected with ransomware when somebody clicks on a dodgy link or downloads a booby-trapped PDF, but normally another person has to be fooled for it to harm a different computer. EternalBlue meant the virus could cascade between machines within a network. It could copy itself over and over, moving from one vulnerable computer to the next, spreading like the plague. Experts cannot trace who caused it, whether a criminal gang or just one person in their bedroom hitting "send".

Like a real virus, it had to be quarantined. Trusts had to shut down computers and scan them to make sure they were bug-free. Doctors – not used to writing anything but their signature – had to go back to pen and paper. But no computers meant they couldn’t access appointments, referral letters, blood tests results or X-rays. In some hospitals computer systems controlled the phones and doors. Many declared a major incident, flagging up that they needed help. In Barts Health NHS Trust, ambulances were directed away from three A&E departments and non-urgent operations were cancelled.

The tragedy is that trusts had been warned of such an attack. Dr Krishna Chinthapalli, a junior doctor in London, wrote an eerily premonitory piece in the British Medical Journal just two days earlier telling hospitals they were vulnerable to ransomware hits. Such attacks had increased fourfold between 2015 and 2016, he said, with the money being paid to the criminals increased to $1bn, according to the FBI. NHS trusts had been hit before. A third reported a ransomware attack last year, with Imperial College London NHS Trust hit 19 times. None admitted to paying the ransom.

Hospitals had even been warned of this exact virus. It exploited a vulnerability in Microsoft Windows operating systems – but Microsoft had been tipped off about it and raised the red flag in March. It issued a patch – an update which would fix it and stop systems being breached this way. But this patch only worked for its latest operating systems. Around 5 per cent of NHS devices are still running the ancient Windows XP, the equivalent of a three-wheeled car. Microsoft said it would no longer create updates for it two years ago, rendering it obsolete.

There are many reasons why systems weren’t updated. Labour and the Lib Dems were quick to blame the attack on lack of Tory funding for the NHS. It is clear cost was an issue. Speaking on BBC Radio 4’s PM programme on Saturday, ex-chief of NHS Digital Kingsley Manning estimated it would take £100m a year to update systems and protect trusts against cyber attacks. Even if that money was granted, there is no guarantee cash-strapped trusts would ringfence it for IT; they may use it to plug holes elsewhere.

Yet even with the money to do so updating systems and applying patches in hospitals is genuinely tricky. There is no NHS-wide computer system – each trust has its own mix of software, evolved due to historical quirk. New software or machines may be coded with specific instructions to help them run. Changing the operating system could stop them working – affecting patient care. While other organisations might have time to do updates, hospital systems have to be up and running 24 hours a day, seven days a week. In small hospitals, it’s a man in a van manually updating each computer.

Some experts believe these are just excuses; that good digital hygiene kept most trusts in the UK safe. "You fix vulnerabilities in computers like you wash your hands after going to the toilet," said Professor Ross Anderson, a security engineering expert at Cambridge University. "If you don't, and patients die, excuses don't work and blame shifting must not be tolerated."

It is not known yet if any patients have died as a result of the attack, but it certainly raised fears about the safety of sensitive medical records. This particular virus got into computer files and encrypted them – turning them into gooble-de-gook and locking doctors out. Systems were breached but there have been no reports of records being extracted. Yet the scale of this attack raises fears in future the NHS could be targeted for the confidential data it holds. "If it’s vulnerable to ransomware in this way, it could be vulnerable to other attacks," said Professor Alan Woodward security expert at the University of Surrey's department of computing.

In the US, there have been examples where ransomware attacks have led to patient data being sucked out, he said. The motivation is not to embarrass people with piles or "out" women who have had an abortion, but because medical information is lucrative. It can be sold to criminals for at least $10, a price 10 times higher than can be earned by selling credit card details. Dossiers with personal identification information – known as "fullz" on the dark web – help crooks commit fraud and carry out scams. The more personal details a conman knows about you the more likely you are to fall for their hustle.

Hospital data is backed up at least hourly and three copies are kept, one offsite, so it is unlikely any medical records or significant amounts of data will have been lost – although the hack will cost the NHS millions in disruption. A British analyst, who tweets under the name Malware Tech, became an unlikely hero after accidentally finding a killswitch to stop the virus replicating. He registered a website, whose presence signalled to the virus it should stop. Yet he admits that a simple tweak of the code would create a new worm able to infect computers.

Experts warn this event could trigger a spate of copycat attacks. Hacker may turn their eyes to other public services. Dr Brian Gladman, a retired Ministry of Defence director, and ex-director of security at Nato, points out that our entire infrastructure, from the national grid, food distribution channels to the railways rely on computer systems. We now face an arms race – and criminals only have to get lucky once.

"We’re going to get more attacks and more attacks and it’s going to go on," he said. "We’ve got to pay more attention to this."

Madlen Davies is a health and science reporter at The Bureau of Investigative Journalism. She tweets @madlendavies.

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Jeremy Corbyn supporters should stop excusing Labour’s anti-immigration drift

The Labour leader is a passionate defender of migrants’ rights – Brexit shouldn’t distract the new left movement from that.

Something strange is happening on the British left – a kind of deliberate collective amnesia. During the EU referendum, the overwhelming majority of the left backed Remain.

Contrary to a common myth, both Jeremy Corbyn and the movement behind him put their weight into a campaign that argued forcefully for internationalism, migrants’ rights and regulatory protections.

And yet now, as Labour’s policy on Brexit hardens, swathes of the left appear to be embracing Lexit, and a set of arguments which they would have laughed off stage barely a year ago.

The example of free movement is glaring and obvious, but worth rehashing. When Labour went into the 2017 general election promising to end free movement with the EU, it did so with a wider election campaign whose tone was more pro-migrant than any before it.

Nonetheless, the policy itself, along with restricting migrants’ access to public funds, stood in a long tradition of Labour triangulating to the right on immigration for electorally calculated reasons. When Ed Miliband promised “tough controls on immigration”, the left rightly attacked him.  

The result of this contradiction is that those on the left who want to agree unequivocally with the leadership must find left-wing reasons for doing so. And so, activists who have spent years declaring their solidarity with migrants and calling for a borderless world can now be found contemplating ways for the biggest expansion of border controls in recent British history – which is what the end of free movement would mean – to seem progressive, or like an opportunity.

The idea that giving ground to migrant-bashing narratives or being harsher on Poles might make life easier for non-EU migrants was rightly dismissed by most left-wing activists during the referendum.

Now, some are going quiet or altering course.

On the Single Market, too, neo-Lexit is making a comeback. Having argued passionately in favour of membership, both the Labour leadership and a wider layer of its supporters now argue – to some extent or another – that only by leaving the Single Market could Labour implement a manifesto.

This is simply wrong: there is very little in Labour’s manifesto that does not have an already-existing precedent in continental Europe. In fact, the levers of the EU are a key tool for clamping down on the power of big capital.

In recent speeches, Corbyn has spoken about the Posted Workers’ Directive – but this accounts for about 0.17 per cent of the workforce, and is about to be radically reformed by the European Parliament.

The dangers of this position are serious. If Labour’s leadership takes the path of least resistance on immigration policy and international integration, and its support base rationalises these compromises uncritically, then the logic of the Brexit vote – its borders, its affirmation of anti-migrant narratives, its rising nationalist sentiment – will be mainlined into Labour Party policy.

Socialism in One Country and a return to the nation state cannot work for the left, but they are being championed by the neo-Lexiteers. In one widely shared blogpost on Novara Media, one commentator even goes as far as alluding to Britain’s Road to Socialism – the official programme of the orthodox Communist Party.

The muted and supportive reaction of Labour’s left to the leadership’s compromises on migration and Brexit owes much to the inept positioning of the Labour right. Centrists may gain personal profile and factional capital when the weaponising the issue, but the consequences have been dire.

Around 80 per cent of Labour members still want a second referendum, and making himself the “stop Brexit” candidate could in a parallel universe have been Owen Smith’s path to victory in the second leadership election.

But it meant that in the summer of 2016, when the mass base of Corbynism hardened its factional resolve, it did so under siege not just from rebelling MPs, but from the “Remoaners” as well.

At every juncture, the strategy of the centrist Labour and media establishment has made Brexit more likely. Every time a veteran of the New Labour era – many of whom have appalling records on, for instance, migrants’ rights – tells Labour members to fight Brexit, party members run a mile.

If Tony Blair’s messiah complex was accurate, he would have saved us all a long time ago – by shutting up and going away. The atmosphere of subterfuge and siege from MPs and the liberal press has, by necessity, created a culture of loyalty and intellectual conformity on the left.

But with its position in the party unassailable, and a radical Labour government within touching distance of Downing Street, the last thing the Labour leadership now needs is a wave of Corbynite loyalty-hipsters hailing its every word.

As the history of every attempt to form a radical government shows, what we desperately need is a movement with its own internal democratic life, and an activist army that can push its leaders as well as deliver leaflets for them.

Lexit is no more possible now than it was during the EU referendum, and the support base of the Labour left and the wider party is overwhelmingly in favour of free movement and EU membership.

Jeremy Corbyn, John McDonnell and Diane Abbott are passionate, principled advocates for migrants’ rights and internationalism. By showing leadership, Labour can once again change what is electorally possible.