The recent press coverage of cases where individuals have been found guilty of committing fraud against the NHS in Scotland highlights the threat to the service from fraud and financial crime, particularly as monetary pressures continue to emerge.
The degree of sophistication used by those who aim to defraud the system has increased and the rise of organised crime gangs and cybercrime has brought a new dimension to that threat.
NHS Scotland Counter Fraud Services (CFS) provide a counter fraud service to the NHS in Scotland, raising awareness of the issue to staff, patients and healthcare professionals, with a view to deterrence, and investigating all allegations of fraud reported to us.
Only a very small number of people seek to defraud the service. Examples would be a person claiming payment from the NHS for a service or treatment they have not provided, or patients claiming to be exempt from NHS charges when they are not eligible, or someone who claims to be off sick, but is working in a similar role elsewhere.
Although the NHS has made strides over recent years to combat fraud and other financial crime, there is still much work to be done.
Working in partnership with other NHS organisations, we have adopted a “4D” strategy to combating health service fraud:
• Deter – By raising awareness of the impact of financial crime and of the sanctions applied to those who commit such offences against NHS Scotland;
• Disable – By improving NHS Scotland’s long-term capability to prevent financial crime;
• Detect – By improving knowledge sharing and intelligence about financial crime and adopting a proactive approach to countering financial crime;
• Deal with – By investigating the most serious and harmful threats and seeking to apply all relevant sanctions.
We have just started a six-month pilot project with Crimestoppers, who will power our fraud reporting hotline, providing individuals with access to a confidential means of reporting suspected wrongdoing 24/7. Crimestoppers’ record in maintaining caller anonymity is unparalleled and this arrangement is highly attractive to us.
If you work in, or use the services of the NHS in Scotland, then you too have a role to play with us, in helping to ensure that the services and resources of the organisation are protected.
Together, we can stamp out fraud. For more information on CFS, go to www.cfs.scot.nhs.uk. NHS Scotland Fraud Reporting Hotline, powered by Crimestoppers, 08000 15 16 28.
• Gordon Young is head of NHS Scotland Counter Fraud Services