A detailed report of the 2021 ransomware attack against Ireland’s Health Services Executive lists some really bad security practices:

The report notes that:

The HSE did not have a Chief Information Security Officer (CISO) or a “single responsible owner for cybersecurity at either senior executive or management level to provide leadership and direction.
It had no documented cyber incident response runbooks or IT recovery plans (apart from documented AD recovery plans) for recovering from a wide-scale ransomware event.
Under-resourced Information Security Managers were not performing their business as usual role (including a NIST-based cybersecurity review of systems) but were working on evaluating security controls for the COVID-19 vaccination system. Antivirus software triggered numerous alerts after detecting Cobalt Strike activity but these were not escalated. (The antivirus server was later encrypted in the attack).
There was no security monitoring capability that was able to effectively detect, investigate and respond to security alerts across HSE’s IT environment or the wider National Healthcare Network (NHN).
There was a lack of effective patching (updates, bug fixes etc.) across the IT estate and reliance was placed on a single antivirus product that was not monitored or effectively maintained with updates across the estate. (The initial workstation attacked had not had antivirus signatures updated for over a year.)
Over 30,000 machines were running Windows 7 (out of support since January 2020).
The initial breach came after a HSE staff member interacted with a malicious Microsoft Office Excel file attached to a phishing email; numerous subsequent alerts were not effectively investigated.

PwC’s crisp list of recommendations in the wake of the incident ­ as well as detail on the business impact of the HSE ransomware attack ­ may prove highly useful guidance on best practice for IT professionals looking to set up a security programme and get it funded.

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