NHS England’s recent move to withdraw open source code developed with taxpayer funds has led to significant backlash due to concerns over computer hacking by AI models.
Recent reports revealed that Mythos, an AI from Anthropic, can identify vulnerabilities in software, potentially enabling hackers to exploit systems using that software. Consequently, NHS England has mandated that all existing and future software must be restricted from public access by May 11 to mitigate these risks.
This shift contradicts NHS service standards, which advocate for software produced by staff to remain open source. This accessibility allows for the enhancement and utilization of tools without redundant efforts, a practice experts argue does not inherently bolster security.
In response, an open letter has amassed hundreds of signatures urging NHS England to reconsider its stance. At present, 682 signatories include writers and digital rights advocates. Notably, Cory Doctorow and former UK Health Secretary Matt Hancock have been approached for comments. Mr. Hancock labeled the initiative a “significant error” in a LinkedIn post, asserting that the decision undermines public investment.
“Opening source code has been one of the NHS’s most forward-thinking strategies. This work was funded by taxpayers; hence they should reap the rewards,” Mr. Hancock noted. “The empirical evidence also supports that open source code is subjected to more rigorous testing, is inherently more secure, and can be enhanced by talented individuals globally.”
Vlad Stefan Halbs, from the University of Edinburgh, co-signed the open letter. He has utilized Mythos to assess vulnerabilities within the NHS’s open source code, uncovering “multiple significant vulnerabilities” which were responsibly reported to the NHS before the project’s decommissioning.
“While we cannot confirm if our reported vulnerabilities triggered this course of action, they likely contributed,” Halbs remarked. “Routine security assessments and public disclosures, aided by large language models, can uncover similar vulnerabilities. Mythos merely streamlines the process. The fundamental issue, however, remains a severe underinvestment in cybersecurity, a problem that predates Mythos.”
Halbs speculates that backups of the NHS code will persist, potentially repurposed for training various AI models. Yet, he questions whether restricting access from GitHub will deter professionals dedicated to enhancing the quality and security of public services from contributing. “By closing access, we are alienating our supporters, not our adversaries,” Halbs concluded.
A report by the UK government-backed AI Security Institute (AISI) on Mythos indicated its limitations, revealing it could primarily target “small, poorly defended corporate systems,” and showing no evidence that genuinely secure networks were threatened.
Terrence Eden, a British civil servant with a history of advocating for public data access, criticized the decision as illogical.
“Trust in the NHS hinges on its openness, transparency, and honesty. Given our healthcare system’s reliance on digital technologies, open source is essential. It is our right to understand the operation of these tools. I urge the NHS to heed this petition and uphold its obligations to the community,” Eden stated.
The UK Department of Health and Human Services did not respond to inquiries. Meanwhile, a spokesperson for NHS England reiterated its stance: “To fortify our cybersecurity amid rapid AI model advancements, we are temporarily restricting access to certain NHS England source codes. Nonetheless, we will continue to publicly share source code whenever deemed essential.”
NHS England is swiftly retracting all software it developed from public access, due to concerns over potential hacking threats from advanced artificial intelligence. However, security experts deem this decision unnecessary and counterproductive.
The software produced by NHS has historically been open source, available on GitHub, allowing organizations to innovate and enhance services without duplicating efforts due to funding from public resources.
In light of recent developments, NHS England has issued new directives shared with staff. According to New Scientist, existing and forthcoming software must remain private. “All source code repositories must be private by default. Public access is only permitted under exceptional circumstances,” the guidance states, with a deadline for compliance set for May 11.
Recent reports highlighted that the AI system developed by Anthropic, called Mythos, could detect vulnerabilities in nearly any software, raising concerns about potential cyber breaches.
NHS England cites Mythos as a primary motivator for these new regulations, warning that public repositories heighten the risk of exposing sensitive information that savvy hackers may exploit. “This directive establishes a default closed posture for code while ensuring that organizations evaluate the impact of these changes,” they wrote.
Contrarily, the UK government-backed AI Security Institute (AISI) has found that Mythos primarily targets “small, poorly defended and vulnerable corporate systems,” indicating that truly secure software remains unharmed.
The recent measures contradict NHS service standards, mandating that software originating from public resources be open source. “Public services, funded by taxpayers, should remain reusable and modifiable by others unless deemed necessary otherwise,” as outlined in previous guidelines.
Open source software enhances trust and transparency in public services. The Horizon IT system utilized by the UK Post Office, which caused unjust accusations of theft, might have avoided turmoil if its code had been publicly accessible. Read more about the scandal here.
Terrence Eden, a British civil servant with experience in public data accessibility, criticized the recent move as illogical. “Is it possible for Mythos to scan a repository and identify a bug? Absolutely. But will it lead to a security issue in running NHS services? Highly unlikely,” Eden asserts. “This reaction seems to reflect a panic based on exaggerated fears about Mythos’s capabilities.”
Eden argues that open source solutions are actually more secure due to greater scrutiny from the community. Furthermore, NHS software has long been publicly accessible, meaning it exists in various backups regardless of new restrictions.
“Restricting access now is akin to closing the barn door after the horse has bolted,” Eden comments. “NHS staff are perplexed, uncertain about where this policy aims to lead.”
A spokesperson for NHS England stated: “To bolster our cybersecurity, we are temporarily limiting access to certain NHS England source code while we assess the rapidly evolving AI landscape. We will continue to share source code publicly where necessary.”
Dr. Paul Uribe, a former military pathologist who consulted nationwide and assisted in solving a series of insulin-related murders at a veteran hospital in West Virginia, noted to NBC News that there are insufficient protocols to guide pathologists and emergency room doctors in effectively managing such cases.
“You’re not going to accidentally stumble upon an insulin murder,” Uribe remarked. “You must have a suspect and actively search for it; if you’re not investigating, you won’t discover it.”
For more information on the West Virginia case, tune in to “Devil’s in the Detailing” on “Dateline” tonight at 9 ET/8 CT on April 25th.
While these crimes are uncommon, Uribe highlighted an alarming increase in related incidents across the U.S. In Pennsylvania, several nurses confessed to attempting to murder 19 patients using insulin across five facilities between 2020 and 2023, resulting in 17 fatalities. Additionally, at the West Virginia Veterans Hospital, nurses confessed to killing seven patients with insulin in 2021.
Uribe pointed out that no state has officially established protocols for emergency room physicians and medical inspectors regarding insulin-related cases, noting that only West Virginia has attempted to address this significant oversight. Legislation introduced this year aims to obligate emergency rooms to test for insulin in patients exhibiting symptoms of insulin poisoning.
Jonathan Jones, former president of the American Academy of Emergency Medicine, expressed concerns regarding insulin overdoses but asserted that health care should not be legislated.
“The best medical care is delivered by well-educated, trained, and board-certified physicians, not legislators,” he stated in an email to NBC News. “We are committed to continuous medical education regarding this issue and support the standards for specialist physicians, but we oppose mandatory treatment directives.”
He declined to comment on whether emergency rooms should adopt stricter guidelines.
When asked if forensic pathologists need improved protocols, Reade Quinton, president of the National Association of Medical Examiners, replied, “I’m not sure that’s the right question. What medical examiners require is access to field information, witness statements, and medical records without obstruction.”
Michael and Natalie Cochran.Dateline
The chief sponsor of the West Virginia bill did not respond to requests for comment. Nevertheless, the parents of Michael Cochran, after whom the bill is named, believe this legislation could serve as a model for the nation and help others avoid the painful search for answers they endured for years.
“They shouldn’t have to wait for answers as we did,” remarked Cochran’s mother, Donna Bolt, to Dateline. “Six years.”
Seven deceased patients at VA Hospital
Uribe’s investigation into insulin-related murders began at the Veterans Hospital in Clarksburg, West Virginia, where he was tasked with examining a series of mysterious deaths among elderly patients in late 2018.
These occurrences can result from excessive insulin doses, which regulate blood glucose levels in diabetic patients.
Some veterans were diabetic, Uribe recalled, while others were not. He was requested to uncover a definitive piece of evidence that could confirm insulin as the murder weapon.
For emergency room doctors and pathologists, he noted, identifying such cases is complicated due to insulin’s rapid metabolism. The “C-peptide” test referenced in West Virginia law can detect insulin, but timing is crucial. It must be conducted before any treatment interventions for hypoglycemia are started.
“If glucose is administered, it triggers the body’s natural insulin release, negating the C-peptide measurement,” he explained.
Furthermore, many small hospitals lack access to these specific tests.
Uribe described two primary methods for pathologists to detect insulin. One prevalent method involves injection, which may leave temporary traces in body tissues at the injection site. Insulin can also be found in postmortem vitreous fluid from the eye, he noted.
In West Virginia, testing of tissue samples from seven veterans’ remains revealed trace amounts of insulin in some victims, including those without diabetes or any prior prescriptions for the drug.
“This provided conclusive evidence that they had been injected with insulin,” he stated.
W.VA.West Virginia Regional Prisons and Correctional Facility Authority via AP Files
Nursing assistant Letta Mays was later identified as the prime suspect in this case. She confessed to administering a lethal dose of insulin, pleaded guilty to seven counts of second-degree murder and one count of assault with intent to murder concerning the death of an eighth man. Mays was sentenced to seven life terms.
Deadly dose from a pharmacist
In Uribe’s subsequent case, pharmacist Natalie Cochran was convicted in January for giving her husband a lethal dose of drugs amid a conspiracy to cover up millions in fraudulent activities involving friends and relatives.
Resolving this case took several years.
In February 2019, Michael Cochran was found unresponsive and later transitioned from a ventilator to hospice care at the age of 38. His death certificate classified his cause of death as “natural.”
Michael and Natalie Cochran.Dateline
Michael Cochran’s hospital records indicated that upon admission, his blood sugar levels were dangerously low, despite his lack of any diabetes history, Uribe informed. Unfortunately, insulin testing was not conducted at that time.
Still, West Virginia State Police detective Tim Bledsoe suspected Natalie Cochran’s involvement in her husband’s demise. During a search of her home, a partially used vial of insulin was discovered in the refrigerator.
When Bledsoe questioned Natalie about the vial, she claimed it was meant for her neighbor’s diabetic son. However, the neighbor, Jennifer Davis, contradicted this, stating that Natalie had asked for insulin for herself to aid recovery from a fake cancer diagnosis that prosecutors argued she later fabricated.
Davis recalled that Natalie requested insulin the same morning Michael first became ill.
Two years after Michael Cochran’s death, his wife was charged with murder. An autopsy commenced seven months after his passing, but by then, his body was significantly decomposed, leading medical inspectors to classify the cause of death as undetermined, according to Bledsoe.
The timeline regarding the autopsy’s delay and whether insulin testing was conducted post-mortem remains unclear. The West Virginia Department of Health and the Office of Personnel, which oversees medical examinations, did not respond to inquiries.
Uribe expressed skepticism that any post-mortem evidence of insulin could have been retrieved given the elapsed time between Michael’s drug administration and his death.
The inconclusive findings, combined with the absence of concrete evidence, led the Raleigh County District Attorney to lower the charges, according to Tom Truman, the current prosecutor.
“If you lack a medical examiner advocating murder, that’s a significant concern,” he remarked to Dateline.
Re-examination yields clarity
However, two years later, the fees were re-evaluated after Uribe was invited to investigate further. During the new autopsy and examination, Uribe searched for potential injection marks, but by this time, Michael’s body had severely deteriorated, preventing any tests from being taken.
Nonetheless, Uribe noted that potential explanations for Michael Cochran’s hypoglycemia, such as infections and severe sepsis, were not documented in his medical records. Considering the circumstances surrounding his death, Uribe classified it as an insulin murder.
During the trial, the endocrinologist who testified for the prosecution conceded that there was no clear explanation for Michael Cochran’s low blood sugar levels.
Michael and Natalie Cochran.Dateline
Natalie Cochran’s defense attorneys acknowledged her involvement in fraudulent activities with various associates, whereby she also pleaded guilty to a separate federal fraud and money laundering case; however, they insisted that she was innocent of her husband’s death.
On January 29th, following two hours of deliberation, the jury found Natalie Cochran guilty of first-degree murder. She received a life sentence without the possibility of parole.
For Uribe, this case, alongside others at the Veterans Hospital, underscores an urgent need for improved insulin overdose protocols.
Such protocols could assist physicians in recognizing red flags like unexplained hypokalemia, which arises from critically low blood sugar levels in non-diabetic patients or from fatal excessive insulin use.
Additionally, he emphasized the need for C-peptide testing to be done prior to any treatment.
Pathologists should look for potential injection sites and conduct vitreous humor tests, he advised.
“If insulin can be detected in the vitreous fluid of someone with no history of diabetes or prior prescriptions, it could substantiate a case,” he concluded.
Social media platform X claims to have followed an Australian Federal Court order to take down footage of the Wakeley church stabbing. However, the footage was still accessible to Australian users as it was posted right below the compliance announcement.
X stated that it complied with the law by “restricting” some posts for Australian users. They argue that the post should not have been banned in Australia and that the government shouldn’t have the power to censor content from users in other countries.
Last week, eSafety commissioners requested X to remove footage of an attack on Bishop Mar-Marie Emmanuel due to its graphic nature.
A federal court on Monday ordered X, previously known as Twitter, to hide posts with video of the Sydney church stabbing from global users. The Australian Federal Police raised concerns in court about the potential use of the video to incite terrorism.
Regulators asked X to remove 65 separate tweets containing videos of the attack.
X’s lawyers argued in court that they had already geo-blocked the posts in Australia, but the eSafety Commissioner insisted this was not sufficient.
Many tweets could still be accessed outside Australia or through VPNs within the country.
The court extended the injunction on Wednesday, ordering the posts to be hidden until May 10, 2024, pending further legal proceedings.
Late on Thursday, X’s Global Government Affairs account stated, “We feel we are complying with the eSafety notice and Australian law by restricting all relevant posts in Australia.” They also posted a statement.
However, a verified user, X, based in New Hampshire, USA, posted footage of the attack in response to X’s statement, which was visible to Australian users.
X stated on Thursday that they believe the content did not incite violence and should be considered part of public debate, arguing against global content removal demands.
The company opposes government authority to censor online content and believes in respecting each country’s laws within its jurisdiction.
The eSafety Commissioner emphasized the need to minimize harm caused by harmful content online, despite the challenges of completely eradicating it.
Posts including the video in question became inaccessible to some users after inquiries from Guardian Australia.
Federal opposition leader Peter Dutton supported X and Elon Musk, stating that Australia should not act as the internet police and federal law should not dictate global content removal.
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