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Dáil Éireann DÁIL ÉIREANN AN COMHCHOISTE UM SHLÁINTE JOINT COMMITTEE ON HEALTH Dé Céadaoin, 23 Meitheamh 2021 Wednesday, 23 June 2021 Tháinig an Comhchoiste le chéile ag 9.30 a.m. The Joint Committee met at 9.30 a.m. Comhaltaí a bhí i láthair/Members present: Teachtaí Dála/Deputies Seanadóirí/Senators Colm Burke, Martin Conway, Cathal Crowe, Annie Hoey, David Cullinane, Seán Kyne. Bernard J. Durkan, Gino Kenny, John Lahart. Teachta/Deputy Seán Crowe sa Chathaoir/in the Chair. 1 JH Business of Joint Committee Chairman: Apologies have been received from Deputy Hourigan and Senator Black. Be- fore we commence our formal proceedings, we need to agree the draft minutes for last week’s meeting of 16 June, which have been circulated. Are they agreed? Agreed. Update on the Cyberattack, Covid-19 Vaccination Roll-out and Covid-19 Restrictions in Maternity Hospitals: Health Service Executive Chairman: I welcome the witnesses to our meeting this morning. They will provide an update on the recent cyberattack, the Covid-19 vaccination roll-out and the public health re- strictions in maternity hospitals. From the HSE, we have Mr. Paul Reid, chief executive officer; Ms Anne O’Connor, chief operations officer, Dr. Colm Henry, chief clinical officer; Mr. Fran Thompson, chief information officer; and Mr. Damien McCallion, national lead of the Covid-19 vaccination programme. Before we hear their opening statements, I need to point out to our witnesses that there is uncertainty as to whether parliamentary privilege will apply to evidence that is given from a location outside the parliamentary precincts of Leinster House. Therefore, if they are directed by me to cease giving evidence on a particular matter, they must respect that direction. I believe the witnesses are within the precincts of Leinster House today, so it does not really apply. I call Mr. Reid to make his opening remarks. He is most welcome. Mr. Paul Reid: There is significant interference on the headset in the room in which I am located. The technical team is trying to resolve the issue. Chairman: Do you want us to wait until the issue has been resolved before commencing? Mr. Paul Reid: No. The technical team will work on it in the background. There may be some background noises. Apologies for that. I thank the Chairman and members for the invitation to meet with the committee to provide an update on the cyberattack on the HSE IT systems, the roll-out of the Covid-19 vaccination programme, and visiting at maternity hospitals. I am joined today by my colleagues ,Ms Anne O’Connor, chief operations officer, Dr. Colm Henry, chief clinical officer, Mr. Fran Thompson, chief information officer, and Mr. Damien McCallion, national lead, Covid-19 vaccination pro- gramme. I thank the committee members for their support following the cyberattack and for their patience and forbearance over recent weeks. We know they have been wanting to convene a session with the HSE for some time. I also thank the public for their support and to say to them I regret the inconvenience and worry experienced by many arising from the deplorable incident. Chairman: Apologies, Mr. Reid, but the sound is dropping out. We will suspend for a few minutes. I assume the witnesses are getting the same feedback. Yes. It is not just the malware. We have had similar difficulties with the IT system in Leinster House. It has been going on for weeks now. We will resume at 9.40 a.m., when it is hoped the issue will have been resolved. Sitting suspended at 9.35 a.m. and resumed at 9.46 a.m. 2 23 JUNE 2021 Chairman: I apologise to those watching the meeting at home and to our witnesses today. Mr. Paul Reid: On 14 May a human-operated “Conti” ransomware attack was detected on our network. It severely disabled a number of systems and necessitated the complete shut- down of the HSE’s network. We have been working to recover systems ever since. The HSE response contains four stages. First, the containment phase, which is now completed. Second, the inform phase, which is also complete, but the task is ongoing. Daily and weekly briefings are being provided to multiple stakeholders. Third, the assess phase, which involves the res- toration of services and eradication of ransomware from the network. That phase is continu- ing. Finally, the remedy phase, which involves strengthening our network against future cyber threats. That phase is continuing. The restoration process and the accompanying due diligence exercise is necessarily taking some time. Although we can effectively decrypt data, that is only one element of it. The mal- ware must also be eradicated. Decryption takes much longer than the original encryption, and eradication involves additional tasks to ensure that the perpetrators have no access route back into our systems. We have worked with specialist cybersecurity firms and our application ven- dors to develop solutions to improve the efficiency of the decryption and eradication process, and it is showing dividends. So far, 75% of our server estate has been decrypted and 70% of our end-user devices are now available. While the architecture of our network dictates a certain initial sequence to the restoration of services, the majority of our sequencing decisions are clinically informed. We are focusing our efforts on restoring the systems most critical to patient care in the first instance. From a techni- cal standpoint, many systems are now operational again, but restoring interoperability between systems and sites is ongoing. That continues to impact on service delivery. Characteristically, our staff across the country have worked extremely hard to keep services going in the face of the enormous challenges presented by the cyberattack and ensuing shutdown. They are doing this at a time when our health system is experiencing very high demand for services. I want to particularly thank staff for their hard work and commitment to the delivery of services to the public at this time. Our IT staff, supported by the Defence Forces and contracted IT experts, have maintained a relentless schedule. This continues seven days a week. There is no underestimating the damage that this cyberattack has caused. There are finan- cial costs, certainly, but there will, unfortunately, also be human costs. I assure members and the public that we are doing everything possible to restore the systems. I must also caution that it will likely take months before systems are fully restored. Accordingly, I must ask the public for continued forbearance and understanding. I am pleased to say that the Covid-19 vaccination programme is making really good prog- ress. We administered 340,000 vaccinations last week and GPs have administered close to 1.5 million vaccines. Our other vaccination channels, namely, community-based vaccination teams, acute hospitals, ambulance and community pharmacies, are also functioning very ef- fectively indeed. We have 39 vaccination centres in place. Over 3.7 million vaccines have been administered. Over 2.3 million people have now received a first dose, or single dose, of the vaccine and over 1.3 million have received a second dose, or single dose. Our key objective in prioritising vac- cine cohorts is to protect the most vulnerable. It is apparent, given the major drop in hospitali- sations and mortality, that we are achieving this. 3 JH It is probably accepted by everyone that the health and well-being of mothers and babies has been at the heart of maternity visit restrictions, which I accept are a significant burden. Hospi- tals must apply infection prevention and control measures in a manner appropriate to the physi- cal infrastructure that they have. We have provided guidance on partner access as I will outline. Maternity services should facilitate a minimum of a 30 minute visit daily. The partner should be facilitated during labour while the woman is in the labour ward. It may not be possible to fa- cilitate women in multi-occupancy antenatal wards before they go to the labour ward. Partners should be facilitated at the anomaly scan and any other visit that may involve communications of emotional significance. Parents should be facilitated in the national neonatal intensive care unit, NICU. Given the improved Covid-19 situation, we recently asked all maternity hospitals and units to review their approach again. This week, the national women and infants health programme is meeting with the clinical leads of the six maternity networks. Subject to infra- structure limitations, I am confident that the least restrictive approach possible will be adopted. Senator Martin Conway: Good morning. I thank the witnesses for the great work that they are doing with the cyberattack, which had not been planned for. The vaccination roll-out programme is going well. I acknowledge the work of Mr. Damien McCallion in leading the vaccination programme. It has gone well. Can Mr. Reid estimate the cost of the cyberattack to date and what it will be in the future? I suspect it might be as much as €500 million. What is the cost for the companies engaged? Did the HSE use a particular country’s expertise with regard to this attack when getting support from other countries? Is any interruption to supply for the vaccination programme envisaged in the next couple of weeks? Will the supply that has been committed to be honoured? What target will the HSE achieve by the end of July? Are difficulties with supply envisaged? Is Mr. Reid confident that the supply lines that have been agreed will be honoured? Mr. Paul Reid: The Senator’s opening remarks are much appreciated and will be passed on to everybody. Regarding the cyberattack and cost, there are a few aspects for now and the fu- ture, as the Senator said.
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