GP fees face review after fraud surge

2 Dec 99
Doctors' allowances are under threat following an Audit Commission report showing that fraud perpetrated by general practitioners in England has increased tenfold in the past year.

03 December 1999

The commission's analysis found that detected fraud levels had risen from £121,000 to nearly £1.3m in 1998/99. Twenty-five GPs are currently under investigation by the Department of Health's Directorate of Counter Fraud Services (DCFS).

At a press conference to launch a counter-fraud charter on December 1, health minister Lord Hunt said the government wanted to revise the 'Red Book'. This is a 300-page document setting out the 58 different allowances and fees which make up GPs' pay. Some may now be abolished or integrated.

'What we are saying is that there are ways of simplifying the system, but it is something we will have to consult on,' Hunt said.

The DCFS is planning its first Red Book policy revision in January after consultation with the British Medical Association. A second revision is then expected in February or March.

'We are acting quickly, but we will be fact-driven. It would be wrong to pick up the Red Book, read it once and then make some changes. I want the facts,' said Jim Gee, director of Counter Fraud Services.

The author of the Audit Commission report also called for a more simplified approach to reimbursing GPs. 'Where you have a system that is so complicated, it is very costly to administer and there is a risk of confusion, error, and, in a very few cases, fraud,' said associate director Keith Douthwaite.

The BMA, one of five professional organisations to sign the charter, welcomed the Red Book review. Roger Dowsett, deputy head of the BMA's legal department, described it as 'a set of rules drawn up by committee, something which is never to be recommended'.

Fees and allowances make up the bulk of the average £50,760 remuneration paid to GPs. These involve basic practice allowances and fees for administering vaccinations, contraceptive services, night visits and performing minor surgery.

Dr John Chisholm, chairman of the BMA's general practitioners' committee, said it was disappointing that 25 doctors were being investigated but this had to be seen in the perspective of more than 30,000 GPs nationwide. He added that the fees and allowances came from a fixed pool of money set by the doctors' review body.

'We deplore any fraud that takes place in the NHS, but it should be pointed out that any that does take place within the Red Book arrangements is defrauding other GPs rather than the taxpayer.'

GP fraud comprised more than one-third of all fraud committed in the NHS in England. The total figure of £4.7m is almost double that of the previous year, but Hunt said that this should be treated with caution.

'This does not mean that more people are committing fraud, but simply that we are now better at catching them at it,' he said.

Audit Commission figures published on the same day showed that detected fraud in local government had exceeded £100m for the first time. The total of £104.4m was an increase of 18% over the previous year.


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