Despite improvements, fraud detection in the NHS remains low, according to a new report by the Audit Commission.The amount of fraud detected has almost doubled over the past year from 1.4 million pounds in 1996/97 to 2.6 million in 1997/98.
The report points to this being a low figure, given the overall expenditure of the NHS and that in some areas of the NHS, the risk of fraud is high.
It points, for instance, to the way GPs, dentists, opticians and pharmacists are paid. Some 60,000 professionals make millions of claims each year and the regulations governing reimbursement are complex and confusing, which increases the risk of fraud.
The Audit Commission welcomed a new NHS Director of Counter Fraud Services, implementation by health authorities of efficiency scrutinies on prescription and dental fraud and greater emphasis on prescription charge evasion and fraud.
But it says it is still not clear whether the currently reported level of fraud represents what is really happening.
It recommends tighter regulations for reimbursing GPs, pharmacists, opticians and dentists, and that information technology should be harnessed to enable closer monitoring of payments generally.
It is also suggested that anti-fraud work in NHS Trusts should concentrate on the areas of greatest risk, such as contracts for goods and services and in the payroll
Protecting the Public Purse: Ensuring Probity in the NHS – Update 1998 (ISBN 1862401306) is available from Audit Commission publications on freephone 0800 502030 priced L10.