Healthcare runs on software that nobody wants to touch. The systems are critical. Lives depend on them. So nobody changes anything. But standing still is just as dangerous. In May 2017, the WannaCry ransomware tore through the NHS, hitting 80 trusts and forcing the cancellation of 19,000 appointments, including urgent cancer treatments. The National Audit Office investigation found the root cause was straightforward: the affected systems ran Windows XP, which Microsoft had stopped patching three years earlier, because the clinical applications on top couldn't run on anything newer.1 The UK had actually tried to solve this problem before. The National Programme for IT, launched in 2002, was meant to modernise NHS technology. It was abandoned in 2011 after spending £12 billion, making it the largest civilian IT failure in history.2
The lesson isn't that modernisation is impossible. It's that big-bang approaches don't work in healthcare.
1 NAO Investigation: WannaCry cyber attack and the NHS, October 2017
2 National Audit Office report, 2013
3 IBM Cost of a Data Breach Report, 2023