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Sunday 23rd October 2016

NHS counter fraud service

29th July 2008

Is the NHS Counter Fraud Service going too far in its investigation of fraud within the system? Helen Mooney investigates in the Health Service Journal.


Annually, the health service loses vast sums of money to fraud. In 2006/07 the NHS was swindled out of £70 million.

In an effort to stop this, the NHS Counter Fraud Service was launched a decade ago.

The mission of the agency is to: "have overall responsibility for all work to counter fraud and corruption within the NHS."

The agency has worked efficiently, as is evident from the statistics. During the period between 1999 to 2006, fraud fell by over half its previous total (56%), from £171 million to £76 million.

The organisation's managing director Dermid McCausland has stated that they want fraud to be reduced to "an absolute minimum" in order to ensure the money is used for patients' treatment and services.

The agency acts in multiple ways: it stops people from committing fraud, detects where and when it has occurred, and investigates it.

The agency is looking into 400 cases at a time, on average, investigating all types and scales of fraud.

According to Paul Dillon-Robinson, chair of the Healthcare Financial Management Association's corporate governance and audit committee and a local counter-fraud specialist: "Cases can range from anything including GPs making small claims to nurses fiddling their overtime to suppliers giving duff quotations."

Take the case of Phillip Neal, who was sent to prison for a year for attempting to use the sale of hospital assets in order to inflate a trust's profits and to make it appear that its debts of £10 million looked like a surplus of £1 million.

Mr Neal was prosecuted by the Counter Fraud Service for his "creative accounting". However, there have been rumblings within the NHS that Mr Neal was made a "scapegoat" for doing something that occurs frequently within the system.

A finance director who asked to remain anonymous commented on Mr Neal's case: "There is no good in picking on an individual; you have to create a healthier environment where people don't fear for their jobs when they report bad news."

Mr Neal's case has raised arguments about the health service's "zero tolerance policy" and whether the pressure managers come under can ever justify this kind of behaviour.


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