Cyber Coercion in Healthcare: Evidence from the 2024 Synnovis Ransomware Attack
Abstract
This article examines the 2024 Synnovis ransomware attack on the United Kingdom’s National Health Service. The study employs a qualitative single-case design based on a structured desk review. The evidence was analysed through Borghard and Lonergan’s framework of cyber coercion. The findings show that Qilin clearly communicated a financial demand and imposed substantial operational, clinical, financial, reputational and informational costs through various disruption measures. However, these consequences demonstrate successful cost imposition rather than successful alteration of the target’s cost-benefit calculus. The ransom remained unpaid, indicating that the coercive pressure was insufficient to produce compliance. Qilin’s credibility was demonstrated through actual disruption and the publication of stolen data, while reassurance remained weak because payment could not guarantee system restoration, permanent data deletion, or protection from further exploitation. The article contributes to cyber-coercion research by extending its application to criminal ransomware and showing that coercive effectiveness depends partly on the relationship among service dependency, cost distribution, decision authority, and behavioural outcome.
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