'No ransom will be paid' – Waikato hospitals reeling after cyber attack

Tuesday, 18 May 2021

Outpatient appointments and patients coming for a non-urgent surgery have been affected.

The head of Waikato DHB says “no ransom will be paid” to cyber criminals who appear to have launched an attack on IT systems and thrown hospitals into turmoil.

The attack crashed phone lines and computers on Tuesday morning, blocking all IT services except email in Waikato, Thames, Tokoroa, Te Kūiti and Taumarunui hospitals.

All clinical services at those hospitals have been disrupted, elective surgeries have been postponed, and patient notes are inaccessible.

And a health worker says that’s caused “absolute chaos” inside Waikato Hospital.

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Waikato DHB chief executive Kevin Snee said he did not know who was behind the cyber attack on the hospital, or if it was linked to recent Irish attacks.

DHB and police investigate

Waikato DHB chief executive Kevin Snee told Stuff external cybersecurity experts and the police were investigating the attack.

With all systems down at Waikato Hospital on Tuesday, Samantha Catterall couldn't be seen in ED and was forced to go elsewhere for treatment. This video was first published on May 18, 2021.

He said some communications received pointed to a ransom attack but the DHB was trying to verify that.

“Irrespective of that, no ransom will be paid.”

Snee did not know who was behind the incident or whether it was in any way linked to the recent ransomware attack on the Irish health system, which also left hospitals crippled.

He did not know the number of elective surgeries that would be delayed across the region.

And when asked whether any patient could die as a result of the disruption, Snee said: “We are ensuring all patients that need urgent care are either treated by us or referred to another hospital.”

It could be a matter of days before the IT systems were up and running again, Snee said.

Patient notes were unavailable and X-ray images were impossible to send between departments, slowing medical services.

“[This attack] affects the whole system of the way the whole hospital runs.”

‘Chaos’ as hospitals revert to paper systems

A woman working at Waikato Hospital said the cyberattack caused “the most stressful day she had ever had”.

The health worker, who Stuff has agreed not to name, said the hospital was in “absolute chaos”.

Workers could not access anything on computers, which included all patients’ notes.

“We have patients turning up, and we don't know who they are there to see.

“We can’t go and use [Microsoft] Word and save it because it doesn’t save to anywhere.”

They had to ask every patient why they had come to hospital and the only method of recording was with black pen and paper.

Tokoroa resident Denise Capper was in Waikato Hospital after having a mini stroke, and also described chaotic scenes.

“The doctor told me “Mrs Capper the computers are not working, so I am going to have to write everything down and send you back to Tokoroa,' she said.

231019 Waikato DHB series. Waikato Hospital Generic Photos. Emergency, ED. Pembroke St. Emergency department and Acute Services Building

“There were about 19 other people waiting inside being asked what their names were and what was wrong with them because nothing was working.

“People were also waiting in the hallway, sitting on beds and outside in the cold. There was an elderly lady who was absolutely shivering.”

When Capper arrived late afternoon at Tokoroa Hospital, the computers were not working there either.

“They desperately need more doctors and nurses to be able to cope,” she said.

The DHB is deferring elective surgeries and urging members of the public with non-life threatening conditions to avoid the emergency department.

Samantha Catterall, 21, went to the emergency eepartment on Tuesday about 11am, with pain coursing through her body, affecting her ability to walk properly.

Instead of being seen by an ED doctor she was referred to Anglesea Clinic with a voucher.

“If it wasn't life-threatening, they were either sending you to Anglesea, home or Victoria Clinic.”

Targets of recent high-profile cyber attacks include the Irish health system and one of the US’s major gasoline pipelines.

The hospital looked unusually quiet for a weekday, Catterall said,

Snee apologised for the inconvenience caused by the attack and said teams were working extremely hard to get systems back online.

Minister for Health and the GCSB Andrew Little declined to comment on the attack, referring all inquiries to Waikato DHB.

Politicians weigh in

MP for Hamilton East, Labour’s Jamie Strange said Waikato DHB had heard of a number of threats aimed at health institutions around the world in terms of cybersecurity.

Strange said he had full confidence in chief executive Snee and his team as they worked to find possible solutions.

National MP David Bennett said when National was in Government it tried to reform the system, as the current Government was doing, to create a stronger and better computer system.

“We [have] a series of computer systems that are complex and take a lot of maintenance.

“There is a risk in any health system with having small IT systems vulnerable for attack.”

Hamilton City councillor Dave Macpherson said he tried to get through to Waikato Hospital twice on Tuesday to query an appointment, but both times he called the 0800 number, he got a message saying it was “no longer in service”.

Health boards around the country will be trying to work out what happened and how secure their systems are, said Professor Robin Gauld, co-director of the University of Otago’s Centre for Health Systems and Technology.

The outage affects all aspects of health board business – from doctors discharging patients to pharmacists trying to check on medication stocks.

He said when he was on the health board, it regularly received “risk” reports about the possibility of an IT attack.

“[We] often had to allocate more than existing budgets to beef up electronic protection.

“We were always warned of this sort of outcome if the guard was let down.”

He thought some electronic equipment in radiology would be affected as well as some patient monitoring systems.

“It will be the higher tech stuff.”

He also thought no information would be able to be put into the computer system and, unless it was life or death, people would be deterred from going to the emergency department and sent to clinics instead.

Macpherson questioned if this was a budget area the commissioners trimmed in the past two years.

“A terrible, terrible situation to be in”

Waikato DHB’s cyber situation will have other health boards concerned, University of Otago’s Robin Gauld said.

“It's a terrible, terrible situation to be in,” said the business school dean and co-director of the Centre for Health Systems and Technology.

“I reckon that right now, right around the country, they will be meeting to say, ‘What the heck happened? How secure are our systems?’

“Globally, there seems to be increasing pressure from hackers.”

There have been some high-profile attacks of late, including on the Irish healthcare system and one which forced the shutdown of one of the US's largest gasoline pipelines.

Health IT systems in New Zealand are often quite old, with patch-ups, legacy systems, and different ones used in different parts of the country, but we rely on them, Gauld said.

With computers out, Waikato DHB will be left with paper-based systems, Gauld said.

For example, instead of being able to see free beds across a whole hospital on one screen, staffers might have to ring wards seeking space.

“You can just see how chaotic it would be.

“I really hope this [IT situation] doesn't impact on patient safety and service access, which it’s likely to. That’s just absolutely dreadful.”

There have been repeated recommendations for DHBs to develop shared clinical and cybersecurity systems, Gauld said.

Gauld hopes it’ll get some focus under the Government’s plan for a centralised health system.

“There would be much more capacity to put up the shields.”

Working as if in a pre-computer era

In the wake of the attack, Waikato DHB is operating as if in a pre-computer era, Dr Deborah Powell said.

Doctors were having to handwrite discharge notes, and radiology and the laboratory were doing urgent tests only, said the Resident Doctors Association and Association of Professional and Executive Employees (Apex) national secretary.

Pharmacists had to walk the wards to check stock, and outpatient clinics couldn’t operate without access to patients’ electronic notes.

An email from the chief executive to staff said the entire computer network was affected, and devices connected to the network should be switched off until they heard otherwise.

The hospital has good back-up systems but this puts pressure on clinicians, Hamilton West MP Gaurav Sharma said.

The one-stop-shop platform doctors normally use to access information like blood tests and scan results from anywhere in the hospital will be down, he said.

“Back in the day, you just opened the file and it had all the files from the previous visit, but not any more.”