Fraud in the health service has doubled in the past year to #2.6m despite measures designed to improve detection and prevention, according to the Audit Commission.
Around 60,000 health professionals make millions of claims for reimbursement from the NHS every year, but the regulations governing payment are complex and confusing, increasing the risk of fraud. Only 77 cases were detected in the past year.
‘We want to see a review of the regulations which govern the methods of payment,’ said Mike Barnes, head of technical support at the Audit Commission. ‘What we really want is greater simplicity. Given the volume that authorities have to cope with, the opportunity for fraud is vast.’
Most health authorities have anti-fraud and corruption strategies in place and the majority have formal ‘whistleblowing’ arrangements. An NHS fraud-buster has also been appointed to tackle fraud.
But commission controller Andrew Foster said there was a danger the reported level of fraud did not represent the true level of activity.
‘Investigating this should be a priority. The Audit Commission will continue to work with all involved to encourage fraud detection and prevention techniques,’ he said.
‘The major area of increase which causes us some concern is in the family health services such as general practitioners, opticians, and dentists,’ said Barnes. ‘But the overall message is that the NHS spends #35bn a year, so #2.6m is not a huge amount in comparison.’
The commission has told health bodies to do more to follow up indications of fraud.
NHS Trust finance directors earned an average of #49,234, with those at the top end expecting to earn #85,268, according to the latest report by NHS information provider Pay & Workforce Research. The report (RPT 1094), revised on a quarterly basis, is available from PWR on 01423 842684.
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