Gee’s report, conducted for the accountant PKF and the University of Portsmouth Centre for Counter-fraud Studies, cites Rochdale NHS managers Deborah Hancox and John Leigh, who were jailed for setting up sham IT companies through a network of offshore firms which would then overcharge the health service for products.
Gee, who is now a healthcare investigator at PKF, said: “Fraud is one of the last great unreduced healthcare costs. Putting money into it makes absolute sense. It is one of the least painful ways of cutting costs, before you cut the quality, or extent, of patient services.”
He said NHS managers must “proactively design out the opportunities for fraud before spending the money. They haven’t done that.”
2
The number of fraud probes by the NHS since 2009
Other major areas of healthcare fraud were likely to involve dentists, pharmacies and opticians overcharging the health service. They received £3 billion, £2.1 billion and £523 million, respectively, from the NHS in 2013.
From carrying out 15 fraud measurement operations between 1998 and 2006, the NHS has done only two since 2009.
Given the resulting shortage of data, Gee based his estimates on procurement fraud on the lowest average loss rate in other industry sectors: 5.8%.
In the case of fraud by suppliers of dentistry, pharmacy and optical services, he used average losses identified in previous NHS inquiries, which showed suspected losses of 4.03%, 3.9% and 2.47%, respectively.
"We do not recognise the figures in this highly speculative report."
<p>Department of Health</p>
That would indicate losses of £137 million in dentistry, £96 million to pharmacists and £24 million to opticians.
The report says that in the period 1998 to 2006 the NHS did invest properly in anti-fraud measures, with the result that losses were reduced by “up to 60%”.
A Department of Health statement said: “We do not recognise the figures in this highly speculative report which is full of inconsistencies.
“We are determined to stamp out fraud in the NHS through better information sharing … and we are working with NHS Protect on crime risks and trends to do even more in the future.”
