26 September 2008
The head of the NHS Counter Fraud Service has warned that £73m could be at risk from fraud through local procurement, where guidelines were not always followed.
Ahead of 'NHS Fraud Awareness Month', which begins in October, Dermid McCausland told Public Finance: 'There are very clear and strict guidelines on this, but like most things when they become routine… people tend to take their eye off the ball.
'We don't want to burden NHS hospitals and trusts with reams and reams of guidance but what we try and do is really highlight the guidance that already exists.'
The NHS counter-fraud team has identified £4.17m worth of savings from its investigations into fraud during the past financial year, 2007/08, but that could rise to £7.5m once ongoing investigations are completed. Since 1999, the CFS has recovered £57.5m and brought 482 successful prosecutions.
McCausland said the figures showed good progress, but a lot of work was also going on to 'fraud-proof' new legislation and policies.
'We do a lot of work around preventing and deterring fraud in the first place. It's hard to quantify that, but clearly it is just as important.'
The CFS would be undertaking a risk measurement exercise around patient charges and exemption claims, he added, as well as looking at 'smarter, quicker' ways of identifying fraudulent claims.
The service has a 96% success rate in criminal prosecutions, and McCausland said a policy of simply dismissing fraudulent employees was 'shifting the problem on', while the amount defrauded was recovered wherever possible.
In 2007/08, 69 civil and disciplinary sanctions applied. A dentist, who received £613,000 in fraudulent payments, was removed from the dentists' register. He was jailed in 2006 after making 3,800 false payment claims.
McCausland said Fraud Awareness Month was about the knock-on effects of fraud to patient care, such as delays, and the CFS was there for people who suspected fraud.
'We are trying to get that message across to PCTs and hospitals up and down the country – not to scare them into thinking fraud is around every corner, but just to say fraud is real: it does happen and really does have an impact.'
PFsep2008
