Billions lost to healthcare fraud

OVER £5 billion is being lost from the NHS annually due to fraud with a further £2 billion being lost to financial error, according to estimates in a new report.

Researchers based at The Centre for Counter Fraud Studies (CCFS) at the University of Portsmouth found that since 2008, global average losses within the healthcare sector have risen 25 per cent to 6.99 per cent. When taken as a proportion of the global healthcare expenditure of £4.48 trillion, this equates to £313 billion lost in a year.

In the UK this amounts to a total lost of around £7 billion - which is 20 times that recorded in the government's annual fraud indicator report.

Healthcare fraud includes a range of activities from patients making bogus claims for free prescriptions and medical staff claiming for unworked shifts to larger scale fraud such as dentists claiming money for NHS treatment not carried out.

Professor Mark Button, Director of the University’s Centre for Counter Fraud Studies said that the report demonstrates the problem is massive and on the increase.

"Our findings in this latest report might reflect that fraud increases during a recession when people are under greater financial pressure. Also the fact that in England the NHS is changing and working with a greater number of private contractors with a responsibility to turn a profit, where there might be a greater risk of fraud.

"By highlighting the problem and countering fraud effectively, the NHS would reduce losses and free up massive resources for better patient care. Healthcare organisations need to prioritise the problem and invest money in the right areas."

Jim Gee, Director of Counter Fraud Services at BDO LLP (who published the study jointly with CCFS), said: "Our conservative estimate is that, by tackling this problem seriously, healthcare organisations could free up $195bn which is currently lost. This would make a material difference to the lives of millions of people around the world."

Link

The Financial Cost of Healthcare Fraud 2014

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