This item was published during the term of a previous administration that ended in April 2007
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Family health fraud report published
06/09/2001
The Chief Executive of NHSScotland, Trevor Jones, today
welcomed the publication of the Fraud Investigation Unit's
first annual report into Fraud in Family Health Services in
the NHS.
The Unit, part of the Common Services Agency, was set up
to investigate fraud by GPs, dentists, community
pharmacists and opticians, and also patients trying to
claim free or reduced cost dental treatment, eye-tests or
prescriptions, to which they were not entitled.
By tackling NHS fraud in Scotland it aims to ensure that
NHS resources remain targeted at those who are most in
need.
Welcoming the FIU's report, Trevor Jones said:
"People who defraud the NHS are effectively reducing the
amount of money which we can spend on those patients who
are most in need of our help.
"The FIU has been leading the way in helping us tackle
that problem and has been working closely with the
Executive on a range of publicity campaigns to help
patients understand more clearly whether they fall within
those groups who are genuinely exempt from NHS charges.
"Its campaigns have also been designed to explain to
GPs, dentists, pharmacists and opticians, the need for
improved methods for checking patient eligibility for free
NHS dental treatment, prescriptions, sight tests and
optical vouchers.
"The FIU has had a challenging first year but has
succeeded in building up an expert team to address fraud in
our family health services. It has reacted efficiently and
effectively to reported cases of fraud by both patients and
health professionals and now has in place solid
investigation techniques and communications systems which
will continue to be strengthened and improved. This will
enable the Unit to take on a more proactive role in
investigating fraud while continuing to build on its recent
deterrence initiatives.
"Together these investigative and deterrence measures
will ensure that resources which should be used to provide
the best patient care are not taken out of the system by
those patients and practitioners who consider it acceptable
to commit fraud."
BACKGROUND
1. The fraud investigation unit (FIU) was established
within the Common Services Agency of the NHS Scotland in
July 2000 with a remit to:
- deter, detect and pursue cases of fraud/sharp
practice by family health service practitioners (GPs,
dentists, community pharmacists, optometrists and
ophthalmic medical practitioners) on behalf of Primary
Care NHS Trusts and Island Health Boards
- deter, detect and pursue patient fraud on behalf of
Primary Care Trusts and Island Health Boards
- act as a source of specialist advice to Primary
Care Trusts and Island Health Boards on anti-fraud
measures, the identification of risk and on counter
fraud investigations.
2. Patients have been required to produce evidence of
entitlement to free NHS prescriptions since January 1999,
to free NHS dental treatment since 15 January and to free
NHS sight tests and optical vouchers since May 2001.
Extracts from the FIU Annual Report
2000-2001
According to Government estimates, the level of fraud in
the public sector ranges from three to eight per cent -
equating to £50m to £140m in family health services in
Scotland.
Potential recoveries of monies inappropriately claimed
by practitioners from cases under investigation total
£94,150.
Two Sheriff's warrants have been served on
practitioners' premises to seize records as part of ongoing
investigations.
A publicity campaign was undertaken by the FIU, in
collaboration with the Scottish Executive to:
- clarify patients' entitlement to exemption from NHS
charges
- launch the FIU free phone Hotline to enable the
public, NHS staff or practitioners to report cases of
suspected fraud
- and to raise the public's awareness of the
existence of the FIU and deter fraud
This campaign included the preparation of posters,
leaflets and a newspaper supplement.
Fraud liaison officers have been appointed in every
primary care NHS trusts and Health Board in Scotland to act
as co-ordinator and first point of contact with the
FIU.
Copies of the FIU's annual report can be obtained by
writing to:
Head of Unit - Request for FIU annual report
Fraud Investigation Unit
Stevenson House
555 Gorgie Road
Edinburgh EH11 3LG
Hotline: 08000 15 16 28