Fraud in the NHS has once again hit the headlines following the publication of a report led by Jim Gee of PKF Littlejohn, former head of NHS Counter Fraud services.
The report suggests that the NHS could be losing up to £5.7 billion a year from its £100 billion budget to fraud and error. Procurement and payroll are highlighted as the two largest areas of potential loss.
The report has been dismissed by a DH spokesperson stating, “We do not recognise the figures in this highly speculative report, which is full of inconsistencies.”
NHS Protect, the national fraud prevention and investigation body, has achieved some high profile successes tackling fraud including the conviction of dentist Joyce Trail who pocketed up to £1.4 million.
However, securing a criminal conviction can take many years with the standard of proof in criminal cases being “beyond reasonable doubt”. Fraudsters can also be pursued in the civil courts. While cogent proof is required in a civil fraud claim, the standard of proof is lower, being “the balance of probabilities”.
Civil litigation has a number of other advantages, including the ability to act quickly, to obtain interim orders (such as search orders and freezing injunctions) and greater control over the timetable and what information is released into the public domain. Cases are also determined by a judge reducing the uncertainties associated with jury trials.
Fraud reduces the budget available for frontline health services. Criminal and civil options should be carefully considered at the outset of any fraud investigation. NHS bodies may increasingly focus on fraud prevention and look to the civil courts for a positive outcome.
How we can help?
The Mills & Reeve fraud team's flyer contains further details of our recent work in the fraud investigation field and sets out examples of the fraud-related issues we can help you with.
Jonathan Nixon, Principal Associate