Counter Fraud Service saving NHS Scotland £39 million since 2000

by Keith Hamilton

NHS Scotland is the nation’s largest employer and spent in excess of £10 billion in 2008/09. With such vast resources providing a service free at the point of delivery it is a result that the institution is targeted by financial fraudsters seeking to satisfy their greed. The Counter Fraud Service was established on July 1st 2000 and in a recent report has announced saving NHS Scotland £39 million in gross terms and the net total is at £24.6 million.

A surgical theatre technician in Glasgow, was uncovered by the CFS in a joint investigation with Strathclyde Police of stealing £23,000 worth of equipment and surgical items, selling them on e-Bay. He received a 20 month prison sentence in April of this year. The investigation involved computer forensics analysis laptops and mobile phones, recovering and recreating 1500 HTML files. Another successful investigation found an optician claiming for glasses which were not clinically necessary, getting optometrists, who provide the prescriptions, to sign blank NHS claim forms. The optician pleaded guilty to a charge of defrauding the NHS of £6000 and was sentenced to 200 hours community service. The work of the CFS in this case involved taking statements from 120 patients and analysis of 1800 NHS record forms and over 10000 claim forms. Further work undertaken by the CFS includes a national programme of checking patient’s entitlement to free NHS services in case they are required to pay for them (such as dental treatment), organising counter fraud awareness presentations for NHS staff and other members of the public and the establishment of a website to enable reporting of fraudulent activities. The report values the role of utilising the media to publicise convictions of fraud, providing an effective deterrence.

Every two years an exercise is undertaken to measure the risk of fraud. These have shown that there has been a downward trend in such activity. £1 million is reported to have been recovered from overseas visitors obtaining NHS services for which they are liable to be charged. Recovered charges are passed on to health boards annually.