This item was published during the term of a previous administration that ended in April 2007
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NHS fraud unit annual report
27/09/2002
Deputy Health Minister Frank McAveety today warned that
action to cut fraud in the NHS would be stepped up by the
Fraud Investigation Unit.
The Unit investigates fraud by GPs, dentists, community
pharmacists and opticians and also by patients falsely
claiming free or reduced cost dental treatment, eye tests,
prescriptions or vouchers towards the cost of glasses.
The Unit's work helps to ensure that NHS resources
remain targeted at those who are most in need and Mr
McAveety stressed that those patients with genuine claims
had nothing to fear. Action by the FIU would be directed
towards those whose actions were depriving the health
service and its patients of valuable resources.
The Minister said:
"Any fraud in the NHS is deplorable. It reduces the
money available for people who need NHS treatment most.
That is why I want to highlight the progress made by our
Fraud Investigation Unit.
"The FIU has made considerable efforts this year to take
a more proactive approach to investigating fraud by family
health service practitioners. They have used sophisticated
trend analysis to identify areas where there is a potential
for overclaiming of payments by practitioners. The Unit has
worked in co-operation with local police fraud squads in
executing search warrants and is currently agreeing a
'Working Together' protocol with all Scottish forces. In
partnership with Health Trusts, the FIU is pursuing
fraudulent contractors through both the criminal and civil
courts.
"The Unit has also implemented the same pro-active
approach to detecting patient fraud, with over 10,000
claims checked and over 5,000 patients contacted. New
computer software now in place will allow ten times that
number of patient claims to be checked by the team in
future years. This will have a real deterrent effect on
those patients who are defrauding the NHS.
"Newspaper supplements and other publicity campaigns
undertaken by the FIU during the year helped deter the
abusers, inform patients of their rights and correct
misconceptions about who is entitled to receive help with
charges.
"I would also like to reassure people who have genuine
claims to make. They have nothing to fear. The FIU will be
concentrating its efforts on the unscrupulous activity of
those who are cheating the health service."
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 and other
irregularities by family health service practitioners (GPs,
dentists, community pharmacists, optometrists and
ophthalmic medical practitioners) on behalf of Primary Care
NHS Trusts and island NHS Boards;
- deter, detect and pursue patient fraud on behalf of
Primary Care NHS Trusts and island NHS Boards;
- act as a source of specialist advice to Primary Care
NHS trusts and Island NHS Boards on anti-fraud measures,
the identification of risk and on counter fraud
investigations.
Fraud liaison officers have been appointed in every
Primary Care NHS Trust and NHS Board in Scotland to act as
co-ordinator and first point of contact with the FIU.
Patients have been required to produce evidence of
entitlement to free NHS prescriptions since January 1999,
to free dental treatment since 15 January 2001 and to free
NHS sight tests and optical vouchers since May 2001.
Examples of fraud can be found in dental, medical,
ophthalmic and pharmaceutical treatment and recent
investigations have included the following:
- forging patients' signatures on claim forms
- making duplicate claims
- claiming for two pair of glasses when only entitled to
one
- claiming for full replacement of glasses when only a
repair was undertaken
- falsifying and altering prescriptions
Extracts from FIU Annual Report 2001-2002:
- There are expected annual savings of £109,947 in
respect of fraud or inappropriate claims by family health
service practitioners
- £20,899 has been recovered from practitioners who have
claimed payments falsely or inappropriately
- Losses to family health services of £100,924 have been
identified by the FIU
- £10,861 has been recovered from patients falsely
evading NHS charges
- 42 live investigations were carried out in the course
of the reporting year, 30 of which are still ongoing
Copies of the FIU's annual report are available from
Maggie Worsfold at the FIU on 0131 536 5254.