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Allegation of dishonesty: NHS (UK)

Discussion in 'United Kingdom' started by Cameron, Jan 27, 2008.

  1. Cameron

    Cameron Well-Known Member


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    NHS staff steal £80m every year
    By Murdo MacLeod Political Correspondent
    Scotland On Sunday
    27 January 2008

    DISHONEST NHS staff – including doctors and nurses – are defrauding the service of up to £80m a year and have been threatened with court action unless the pilfering stops, Scotland on Sunday can reveal. Ministers say the cash is being creamed off from hospitals, GP practices, dental surgeries and other NHS facilities through dozens of scams. That £80m stolen each year is enough to pay for an extra 4,275 nurses, or 684 consultants, say ministers. Spent on medical procedures, it would fund an extra 11,400 hip operations or more than half a million MRI scans. But the claims have caused widespread anger among medical staff, who have accused the Government of risking a morale crisis by casting suspicion over the entire health service. The SNP Government says fraud committed by staff and patients totals as much as £100m annually. But a senior official, who asked not to be identified, told Scotland on Sunday that staff were responsible for the vast majority of the losses, as much as £80m a year. The Government's hard- hitting assessment of NHS scams reveals:

    • GPs claiming for treatment which was never given, home visits never made or non-existent "ghost" patients.

    • Hospital doctors claiming payments for private work undertaken during NHS time or on NHS premises, and misuse of NHS fuel and credit cards.

    • Nurses making fraudulent travel and overnight claims, and moonlighting on lucrative shifts for nursing agencies while claiming to be off sick.

    • Pharmacists making claims on the NHS for expensive brand-name drugs when they actually dispensed cheaper generic alternatives.

    • Dentists claiming money for precious metals in fillings when they had actually used cheaper materials, and claiming cash for opening surgeries for after-hours emergencies when the premises were already open.

    • Opticians claiming for two pairs of glasses when only one pair was supplied.

    Other scams include staff printing off prescriptions for drugs under patients' names, deleting the transaction from the computer, then pocketing the drugs for their own use. The crackdown will be officially launched tomorrow by Scottish Health Secretary Nicola Sturgeon, who said: "Let me make it clear that fraud in the NHS will not be tolerated. While only a tiny minority of people defraud the NHS, their actions cost the service dear. NHS fraud takes money away from where it is needed most. We are therefore determined to ensure that the problem of fraud is tackled effectively."

    Each health board will have an "anti-fraud champion" and health service managers will be given training in how to spot fraud and what to do about it. An anti-fraud source in the NHS said: "What we're wanting to do is deter people from getting involved in fraud in the first place because at the end of the day that is much more cost-effective than investigating each incident. But we want people to know that we are watching and we have powers to refer cases to the procurator fiscal."

    Dr Kevin Cormack, Scottish spokesman for junior doctors' lobby group Remedy UK, said: "If anyone is letting the people down when it comes to public services, it's politicians rather than health workers. All the NHS staff I have ever encountered are honest and altruistic."

    Bridget Hunter, of health union Unison in Scotland, said: "We don't condone fraud, but we are very concerned at the emphasis in all of this. It's like they're telling staff: 'We don't trust you.' The Government risks giving a very wrong impression of NHS staff who all work to the highest professional standards under very challenging conditions."

    A spokeswoman for the doctors' union BMA Scotland said: "You can't just single out individual groups such as GPs and staff and suggest that they bear the brunt of this."

    But Margaret Watt, of the Scottish Patients' Association, said: "This does need to be taken very seriously, whether frauds are carried out by patients or staff. Every fraud is stealing from the sick, the vulnerable and the dying."

    Last year a Fife nurse was sentenced to 135 hours' community service for claiming £3,000 sick pay while working shifts for an agency.
     
  2. Hi Syd

    Nothing surprising here. My mother started to deteriorate badly following a couple of falls last Christmas. Eventually, after her GP referred her for investigations, she saw a consultant neurologist in September who examined and told her he was 90% certain he knew what her problem was, but would need to run further tests to confirm his diagnosis. By the time of her consultation she was having difficulty walking, her speech had deteriorated and she was having problems holding her head up. Unfortunately, the consultant said, that the tests she needed would take another six months - however, with blatant arrogance, he told her had a friend in a neighbouring hospital who could undertake them privately within a week. My mother was so desperate for help by then, she agreed, and five days later, another consultant neurologist saw her during his lunch hour in his NHS office and did a muscle biopsy and sent it to the NHS lab. Within a couple of hours he called her back into his office and told her she had Motor Neurone Disease before handing her a hand-written bill for £500.

    Clearly there are problems with the NHS and we are constantly reminded rationing and prioritisation are an unfortunate reality, however, for someone with such a terribly debilitating illness to be treated with professional cronyism and greed for the peace of mind (or otherwise) of knowing what was disabling her so badly, is frankly disgusting. Sadly, this is not an isolated case. Morals & ethics within the medical community take a back seat where opportunism and greed is so rife.

    Mark
     
    Last edited: Jan 27, 2008
  3. Cameron

    Cameron Well-Known Member

    So sorry to hear about your Mum , Mark.

    In the middle ages, medics called to tend for the rich would calaculate their fees to include an armed guard to escourt them to their home destination. Robbers knew they would be loaded.

    Nothing seems to have changed.

    Syd.
     
  4. DTT

    DTT Well-Known Member

    Hi Mark

    I echo the sentiments and hope Mum recovers and her quality of life is sustained.


    Certainly not in my area it hasn't !!:butcher:

    Cheers
    Derek;)
     
  5. Dido

    Dido Active Member

    Hello Mark,
    I have read your post and quite frankly I am disgusted. I do not know why tests that would take 6 months suddenly become available after a few hours when money is produced. I have the utmost sympathy with you.
    I know how you must feel, having struggled with an elderly mum with Alzheimers/dementia I know it is so difficult.
    What else can I say?
    I do hope you will push for the best possible care for your mum, don't take "no" for an answer, and keep asking questions, for a 2nd opinion , whatever. I knowit is very dificult to be objective when it is someone so close.
    Kind regards
    Dido
     
  6. admin

    admin Administrator Staff Member

    OUCH! That sucks! Sorry to hear about your mother. How is she going now?
     
  7. Johnpod

    Johnpod Active Member

    How is this different to an NHS Podiatrist discharging a patient from a clinic and then seeing them as a private patient? Seems to me that both cases are a matter of ethics - no longer considered important. Have we really gone forward in the last 25 years, or backwards?
     
  8. Dido

    Dido Active Member

    Hello Johnpod,
    There is no difference here. Ethics have gone out of the window.
    When I worked for the NHS (over 15 years ago) it was an unwritten rule that you did not treat your NHS patients privately. If the Trust changed its rules about who was eligble for treatment we had to discharge patients which were picked up by the private sector.
    I do not have a problem with private medicine but it should NOT be carried out using NHS hospitals and NHS staff. If people want to go to a private hospital and see staff that purely work for that hospital that is fine by me. The trouble is that consultants use NHS facilities to enhance their private practice.
    Gong back to chiropody in the NHS. It may not be the chiropodists wish to discharge a patient, it may be an instruction from management. However, offering private treatment to the same patient is certainly unethical IMO.
    regards
    Dido
     
  9. DTT

    DTT Well-Known Member

    Hi All

    Err who's the clinician here ??

    Perhaps managers should review what an ethical descision involves :boxing:

    Cheers
    Derek;)
     
  10. Dido

    Dido Active Member

    Hi Derek,
    Yes, I agree.
    However, it didn't work like that in the NHS when I worked for them.
    This is the scenario.
    Managers have ever shrinking budgets and need to prioritise services offered. So they decide to discharge all low-risk patients and no longer provide what is now called social nail-care. The chiropodist is given a list of criteria for providing treatment and if the pateint doesn't meet them they are discharged. So in effect if there is an old lady of 90 who is blind, has no relatives to cut her nails, but does not have any lower limb pathologies, she's out.
    I did make objections to my department's discharge policy and was told that if I wanted to keep all these patients on my books, AND provide adequate treatment, AND still assess all the new ones that kept coming along, and deal with any dressing, emergencies etc. (at one stage I was receiving 10 new referrals a week) I could do so. It wasn't physically possible on a 37 hour week. :craig: In addition we had to meet the Trust policy of seeing and assessing every new patient within a month of their application. So something had to go and I'm afraid I had no choice but to discharge patients. :boohoo:
    Regards
    Dido
     
  11. DTT

    DTT Well-Known Member

    Hi dido

    Yes I gathered as much in general terms with the patient "empowerment" that is now practiced .

    What Mark describes is pretty general throughout the NHS I feel.

    In my area "care in the community" equates to discharging 76 year olds (that live alone with no relatives) after having major emergency abdominal surgery ( complete with stoma bag) Home alone after 7 days with no back up at all !!!

    Perhaps a new term "dumping on the neighbors" would be more suitable ?

    It's my neighbor I am referring to that still has not seen his GP , has had to find his own way to hospital for surgical review and to another for reviews of chemotherapy (Got a lift both times) and will now have to undergo extended chemo on a weekly basis. No offer of transport ( lots of excuses why not).

    But I suppose the modern way is "He's old doesn't matter" rules:craig:

    That alongside the 93 year old relative I have in an end of life care home makes running my business very very hard and with the attitude I encountered from my neighbors GP receptionist " oh it wont take you a minute to jump in your car and pop to the surgery to pick up the prescription" !!:craig:

    Mind you she became quite perplexed when I explained I had a waiting room full of patients and it was as far for her to bring it as me to collect it :rolleyes:

    It's the CARING that's disappearing in my view, but I'm getting old myself so perhaps I'm prejudice;)

    Cheers
    Derek;)
     
  12. Thanks for the kind comments. Glad to see the discussion has opened out somewhat, but the topic heading is dishonesty within the NHS rather than the ethics of access and eligibility. Having said that I would like to tell you of a new slant on "eligibility" and "access" to service - one that I was not familiar with until recently. A few weeks after her diagnosis, my mother was contacted by a number of support services - occupational health, speech & language - which in turn were coordinated by a specialist nurse whose part-time two-day- week-post is funded by the MND Association - not the NHS. The Occupational Therapist did a house call to make a needs assesment, however as my mother was still reasonably mobile it was suggested that a triangular walking frame was all that was required and that duly arrived a few days later. On the other hand the SLT simply telephoned and asked if there was anything she could do. Not knowing the scope of practice of an SL Therapist or how they can assist in MND, my mother said she was fine apart from a croaky voice.

    MND is a terminally progressive disease which is often characterised by a rapid deterioration in motor function - mobility, speech and coordination. By Christmas, some two months after her OT assesment, my mother was having difficulty climbing the stairs in the house - she could only manage this once a day and with help - and her speech was becoming incoherent. Also rising from a chair was becoming problematical when she was on her own - so a call was made to the OT department to see if a chair and stair lift could be provided.

    Our first surprise was that she had been removed from the OT lists - her case was closed - as the head of service informed us. It is seemingly departmental policy to close a patient file after each episode of care and as such, my mother's GP or specialist nurse would have to request another visit. A few weeks later and another OT visit and the needs assesment showed that a stairlift and some other aids were required. The OT helpfully informed her that she "would be put on the list" and that someone would "be in touch".

    We are fortunate in that quite a few family members work or have worked in the NHS - and so know the ropes. My sister - a nurse practitioner - immediately contacted the department responsible for installing stairlifts and asked what the waiting time was. Around one year was the response. What we didn't appreciate until very recently, is that with some progressively terminal conditions - including MND - there is a negative prioritisation for support and equipment. With limited resources, occupational aids such as stairlifts are targeted at those sufferers who may benefit the longest, thus those with the shortest life expectancy may not receive any aids whatsoever. The cost of providing and installing a stairlift is approx £1800 - not an enormous amount in the scheme of things - but as it is needed now, it will have to be purchased privately.

    I guess this is slightly off topic - and I really do not wish to run a blog on my mother's condition - however the approach by the NHS in this case seems quite dishonest in much the same way that podiatry policy has prejudiced many patients in recent years. Rather than embark on various smokescreen policies - such as patient empowerment and voluntary footcare services - it would have been more honest if patients were simply told the NHS could not provide their care and the patient should seek further care from the private sector. Unfortunately this would have contradicted the politician's mantra of "free care for all at the point of source" which we all know to be unsustainable and undeliverable. It would also have provided an opportunity for partership between colleagues in private practice and thos involved in public service - something our professional heirarchy appear reluctant to embrace.

    A lose/lose situation for everyone - especially the patient.
     
    Last edited: Jan 28, 2008
  13. DTT

    DTT Well-Known Member

    Hi Mark

    I take it you have had to do the "means test" document ??

    I did twice and what a mine field that is.

    Be warned as a relative they will have you in the firing line to subscribe heavily to everything they can ( another case of "empowerment" for the patient ??).

    We all know it ain't working but they just wont admit it will they:craig:
    Cheers Fella

    Derek;)
     
  14. Interesting to read the comments regarding private practice by NHS podiatrists. In the good old bad old days it was almost considered a perk of the job to undertake a private house call on the way home from work. I recall a discussion about this at a staff meeting not long after I graduated which became quite heated when it was suggested that 'homers' be restricted to family or friends as some colleagues took the view they needed to supplement their "crap" NHS salary to keep pace with those in full-time private practice. An interesting argument but the corollary is that using NHS supplies for private gain is both fraudulent and theft - and as more often than not, undeclared taxable income. In many cases, NHS podiatrists would charge greatly reduced fees for this "service" thus compromising the market for their colleagues in full-time private practice too.

    Probably the worst example of this I have encountered was five or six years ago when I was asked to undertake a service review on behalf of four GP fund-holding practices who had a service level agreement with a local NHS trust for the provision of podiatry care. After a few weeks I was asked by one of the partners to see an elderly lady - an independent 82 year-old type II diabetic who was housebound and having severe mobility problems because of an intractible foot condition. Examination revealed a large painful HD on both feet secondary to severe HAV. She had had an assesment by the NHS podiatrist three years before but was told she would only be eligible for an NHS visit every six months and that would only be for her diabetic assesment.

    Consequently she had a private podiatrist visit her every two weeks for reduction and padding - the latter being a thin pad of fleecy web (moleskin). Examination of the lesion itself brought me to the conclusion that little - if any - debridement was taking place during the fortnightly visit - and at £20 per visit this did not seem to be good value. I noticed from her calendar that the next visit was schedule for the following afternoon, so I arranged to call back to find out what the treatment plan entailed.

    It was a surprise to find that the private practitioner was none other than the local head of service who was undertaking the visit during NHS time and with her NHS domicillary case - although who was more surprised that afternoon I cannot say! We estimated that this patient had paid more than £2700 over the previous three years for this "service" when she was clearly entitled to receive that care through the NHS. As far as I am aware the HoS went on long term sick leave for "stress" and left the service some time later after an occupational health review - with a decent redundancy package.

    Don't wish to turn this into a "knock the NHS" thread, but clearly there are problems at all levels that need to be addressed if inequality of care - not to say exploitation - is to be banished.
     
  15. andymiles

    andymiles Active Member

    if we're discussing honesty in the NHS then the powers that be might want to tell us what they are doing with the £70 million pounds they have made in interest from staging our pay award this year
     
  16. Easy one, Andy. How about proping up Northern Rock or fighting the Taleban or Iraqi insurgents or funding new security measures like ID cards or diverting cash to the increased defence budget. Perhaps you should consider moving to Scotland where the pay award was paid in full.... Don't you just love having a Scottish Prime Minister and Chancellor :empathy:
     
  17. W J Liggins

    W J Liggins Well-Known Member

    No-one (except crims) would support fraud. However, 'the government' being concerned about fraud in the NHS rings somewhat hollowly in the light of allegations against such as Master Hain and Mistess Harman does it not? The phrase 'pots calling kettles black' springs to mind. Should anyone feel that there is no correlation because public money was not involved in the latter cases, then remember 'two Jags' Prescott and his numerous houses and apartments paid for by the taxpayer, Tony (yes, another Scotsman Syd) Blair and his holidays on the taxpayer and the £400 sheets of wallpaper.

    I should point out that I don't have a particular beef against the shower currently in power, they're all two sides of the same coin. (Must return that Bic biro).

    Bill
     
  18. Dido

    Dido Active Member

    Why move to Scotland, Mark, when most of the Scots seem to be down here? We have a Scottish cabinet and PM and when I walk around some towns in my area I could be forgiven for thinking I was in the Gorbals. :D

    Her's ta yew - Jimmy! :drinks
     
  19. Cameron

    Cameron Well-Known Member

    Bill

    >Tony (yes, another Scotsman Syd) Blair and his holidays on the taxpayer and the £400 sheets of wallpaper.

    His father went to my old school (long before me), as did Sir Alex Ferguson (again before my time) and Wylie McPherson (better known as Bill Martin and writer of Puppet on a string). I seemed to share the corridors of academe with murderers, air pilots and accountants.

    I was forced to leave the UK under duress as I could no longer live under the oppressive Maggie Thatcher, and by the time I got back to the UK, Tony the Pink, was in power. I was all the more interested (and grateful) because as UK correspondent for a radio station in Perth (WA), Tony and his wife provided such rich copy with their silly antics, I was never short of a decent filler.

    Anway, I have it on very good authority Tony has been disowned by the Scots. :dizzy: You can have 'em.

    toeslayer
     
  20. andymiles

    andymiles Active Member

    no, i don't :craig:

    the sooner alex salmond and his mob get their way the better as far as i'm concerned
     
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