According to a report, fraud and financial errors are costing the NHS billions of pounds each year. The former head of its anti-fraud section, Jim Gee, co-authored a study which reveals that fraud alone is responsible for a loss of £5bn, enough to pay for nearly 250,000 new nurses. Mr. Gee suggests that the NHS needs to confront this problem and take action. However, the Department of Health denies recognizing these figures. Mr. Gee’s estimate is based on worldwide data, which indicates that an average of 7% of healthcare budgets is lost to fraud and error. Mr. Gee believes that the NHS has to start measuring its own losses in order to combat the issue effectively.
Various types of fraud contribute to the losses experienced by the NHS, including patients not paying for their prescription charges, medical professionals making false claims, and contractors overcharging. It is essential to acknowledge the reality of fraud and take steps to address the problem in order to minimize costs and allocate resources more efficiently. Another significant loss amounting to £2bn occurs when the NHS mistakenly overpays suppliers or staff. Despite the NHS having a budget of approximately £100bn, substantial savings need to be made, making it crucial to prioritize fraud prevention. Cutting costs related to fraud should be considered before quality of care or patient services are compromised.
Since 2006, NHS Protect, the national body responsible for investigating fraud in England, has faced about a 30% decrease in its budget. In the 2013-2014 fiscal year, NHS Protect’s operating budget is £11.38m, significantly lower than the £16.29m allocated in 2006-2007. BBC’s Freedom of Information request reveals that NHS Protect employs 27 counter-fraud specialists and 294 investigators working at a local level. Comparatively, the Department for Work and Pensions employs six times more investigators. Considering Mr. Gee’s statistics, the Department for Work and Pensions faces less than half the amount of fraud cases.
Investigations conducted by NHS anti-fraud teams involve cases ranging from hundreds to millions of pounds. Examples include dentist Joyce Trail, who defrauded the NHS for work she never performed, charging for false teeth for deceased patients, and selling stolen products on eBay. With fewer investigators due to budget cuts, there is concern that fraudsters can act with confidence, as there are fewer personnel to apprehend them. This allows them to take advantage of the situation. Some believe that people in senior positions have not been vigilant regarding fraud prevention.