24.03.14
Fraud and error costing the NHS ‘billions’
Fraud is costing the NHS £7bn a year, more than 20 times the official government figure, the former head of the NHS Counter Fraud Service Jim Gee says.
A new report to be published tomorrow – co-authored by Gee, now director of Counter Fraud Services at BDO LLP, and the chair of the advisory board of Portsmouth University's centre for fraud studies – based on worldwide figures, suggests that average losses to fraud and error are just under 7% of healthcare budgets.
Statistics from the UK’s National Fraud Authority Indicator 2013 suggest that fraud within the NHS was £229m in 2013, but applying the global average percentage loss rate suggests, that if the NHS was in line with the rest of the world, a figure nearer £7bn would be more likely. To accept the figure of £229m would be to accept that the NHS is doing more than 30 times better than the rest of the world in preventing and detecting fraud and error, which Gee said was “implausible”.
“If the NHS is in line with the rest of the world it is losing £7bn,” said Gee. He added that the UK-wide figures had to be extrapolated because “the NHS in recent years has stopped measuring its own losses” – only looking at those for dental and pharmaceutical services.
Gee stated that there are “four main areas of fraud: fraud by patients – avoiding charges; fraud by staff and managers; fraud by medical professionals – claiming for work they haven’t done; and fraud by contractor and companies – overcharging for services and goods provided or underprovided.”
Commenting on the findings that fraud could be costing the NHS up to £7bn a year, Dr Peter Carter, chief executive and general secretary of the Royal College of Nursing (RCN), said: “For years the RCN has been warning about the levels of waste in the NHS. These shocking findings highlight that nothing has been done to tackle inefficiency and waste. Instead, frontline staff and services have suffered as the health service has sought to find its £3bn worth of savings a year.
“Tackling this fraud and dealing with its consequences would go a long way towards ensuring that the NHS can make savings without affecting patient care. Rather than disputing the figures, the Department of Health should be taking immediate action.”
The Department of Health said in a statement that “it did not recognise” the figure and would not “speculate on levels of losses”.
Tell us what you think – have your say below, or email us directly at [email protected]