Tuesday 25th March, 2014

The BBC has reported that fraud in the NHS is costing the organisation £5bn a year - with a further £2bn lost to financial errors, according to the former head of its anti-fraud section.

A report which has been seen by Panorama makes the point that they amount of fraud could pay for around 250,000 new nurses.

The NHS must "get on with tackling the problem", said Jim Gee, co-author of the Portsmouth University study and ex-director of NHS Counter Fraud Services.

However, The Department of Health said it "did not recognise" the figures.

Key types of fraud include the non-payment of prescription charges by patients, medical professionals claiming for work they have not done and overcharging by contractors, said Mr Gee.

"We need to not be embarrassed, or in denial, about the possibility of fraud taking place in the NHS," he told Panorama.

"We need to get on with tackling the problem, minimising its cost, maximising resources available for proper patient care."

The £2bn cost of errors relate to when the NHS makes overpayments by mistake to suppliers or staff.

By its very nature, it is difficult to say just how much the NHS loses to fraud. Last year NHS Protect with its local investigators oversaw nearly 150 successful criminal cases. There were also 435 civil or internal disciplinary actions. But this is likely to be the tip of the iceberg.

Just like the Crown Prosecution Service, NHS Protect only proceeds with the cases it has a reasonable chance of winning - and cuts to its budget has made it even more difficult to gather evidence than it used to be.

It does not publish details of the amount of fraud that is brought to its attention nor the amount it suspects is happening. That is why the estimates by its previous director, Jim Gee, are very interesting.

Although the NHS has a budget of about £100bn, it is having to make significant savings and should prioritise fighting fraud, said Mr Gee.

"I think fraud is one of the last great unreduced healthcare costs. And to me, putting money into it makes absolute sense," he said.

"It's one of the least painful ways of cutting costs. It makes absolute sense to cut the cost of fraud before you cut the quality, or extent of patient services."