NHS fraud figures

Published on 28/07/2012 00:00

Your reporting of NHS fraud (27 July) highlights an important issue, but many of the correct facts have been lost in the course of the debate.

Counter Fraud Services is the lead body co-ordinating efforts against fraud in NHS Scotland. We are committed to reducing fraud and corruption in NHS Scotland, and to building and promoting a culture in which staff, patients, contractors and the wider public regard fraud against the NHS as totally unacceptable.

It is misleading to say there were 15,000 “cases” last year. In fact, we carry out 60,000 routine patient exemption checks each year for fraud – or error – based on randomly selected claims for free dental treatment or ophthalmic services.

Patients are contacted at random to provide evidence of their entitlement to free services. We confirm their details are correct, and then arrange for recovery of monies for claims made inappropriately.

We also confirm if a mistake has been made. It is wrong to ascribe all of this to fraud – in many cases there is genuine error.

In addition, the recent figures quoted relate to exemption-checking only and not to other types of fraud committed against the NHS.

Taken as a whole, the Counter Fraud Services work to deter and detect crime has enabled savings of £42 million since 2000.

Finally, it should be noted that the figure of £110m a year lost to the NHS through fraud is not an estimate.

It is simply an illustration of what 1 per cent of the NHS Scotland budget would amount to, given that established research estimates a typical fraud level of between 3 per cent and 8 per cent across both public and private sectors.

Regardless of the precise sums, any monies defrauded from the NHS can impact on patient care and frontline services. That is why we will continue to raise awareness of, and investigate any reported, fraud throughout the NHS.

Peter MacIntyre

NHS Scotland Counter Fraud Services

Almondvale Way

Livingston