NHS losing billions to ‘fraud by doctors and dentists’

A sad story.. How does the cost of fraud compare to the neglect by politicians?


NHS losing billions to ‘fraud by doctors and dentists’ – GPs create ‘ghost patients’, dentists claim for false work and pharmacists fail to declare charges paid, report says as it claims £5.7bn lost to fraud

Up to £5.7 billion a year could be lost by the NHS to fraud by patients and staff, a new report has claimed.

A review led by Jim Gee, a former director of NHS Counter Fraud Services, suggested fraud was taking place across areas such as general practice, dentistry, prescriptions and payroll.

Among examples of fraud cited in the report were GPs creating “ghost patients”, dentists claiming for more work than was carried out and pharmacists failing to declare prescription charges that have been paid.

 Mr Gee and co-author Professor Mark Button, director of the Centre for Counter Fraud Studies at Portsmouth University, said they hoped the research “focusses attention” on the issue, adding the NHS needed to improve how it measured fraud losses.

The authors of the report, published by PKF Littlejohn accountants, said: “Fraud has negative consequences in all sectors, but in healthcare the impact of fraud is even more pernicious.

Quite simply it has a direct, negative impact on human life as the quality, quantity and speed of patient care is diminished.”

The area with the highest estimated losses to fraud and error was payroll, at between £555 million and £1.49 billion – where scams included false allowance claims.

Procurement scams, such as under-providing goods and services, was estimated to cost between £1 billion and £1.27 billion, while between £304 million was lost to fraud by patients through false claims for free prescriptions, dental care and optical services.

The overall level of fraud, based on an analysis of loss measurement data from the UK and around the world, was said to cost between £3.7 billion and £5.7 billion of the £110 billion NHS budget in 2013-2014.

Mr Gee told the BBC: “There is a vast, honest majority who find fraud against the NHS to be completely unacceptable. However, there is also a dishonest minority who can cause significant financial damage.

“The best way of stopping this is not to wait for fraud to happen and then act after losses have been incurred, but to proactively deter and prevent them. Fraud is a cost to be measured, managed and minimised like any other.”

This entry was posted in A Personal View, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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