Northern Ireland: Health fraud unit claws back £1.4million in dodgy claims
Anti-Fraud probes into professionals in the family health services field recouped almost £1.5m in Northern Ireland in a single year, it has been revealed.
The investigations were conducted in 2007/08 by the Counter Fraud Unit (CFU) of the Department of Health. Its remit includes examining suspicions involving dentists, GP practices, opticians and pharmacists in the province. Details of a number of its cases were disclosed in a report published today by the watchdog Northern Ireland Audit Office.
“The temptation to commit fraud, for a small number of family health services contractors, will always exist,” it said. “The CFU continues to undertake investigations, in conjunction with health board colleagues, into pharmacists, opticians, dentists and GPs and/or their staff, where suspicion of fraud exists.
“In 2007/08, investigations into practitioners resulted in total savings to the public purse of more than £1.4m,” the Audit Office stated. Today's report said one “detailed case” involving claims made for the provision of ophthalmic services was referred to the Public Prosecution Service. Nine cases involving misclaims by pharmacists for prescription drug payments resulted in over £300,000 being recovered. In addition, £3,000 was recouped from dental practitioners during the year, it said.
“At 31 March 2008, the Counter Fraud Unit's on-going casework included investigations involving dental, general medical and community pharmacy practitioners,” the Audit Office continued. “The Unit is also working closely with the Police Service of Northern Ireland on a number of cases involving attempts by individual patients to fraudulently obtain prescription medicines.”
Today's report said prescription fraud by patients cost the NHS in Northern Ireland an estimated £9.9m in 2007/08. That compared to a figure of £19.7m for 1999/2000. This fraud involves falsely claiming exemption from payments for prescriptions and dental and ophthalmic treatment.
While acknowledging that “substantial” success had been achieved, the Audit Office warned that the rate of fraud in exemption claims remained too high at 4.5% It also described fraud in the heath and social care sector as “unacceptable”. The Northern Ireland Audit Office report examined the accounts of health trusts, boards and agencies.
by David Gordon; The Belfast Telegraph