LEGAL SERVICES
“Our emphasis will not really change because we have always set about to try and prevent fraud and whilst it is a little clichéd to say that prevention is better than cure, the reality is that this is the case. What we want to be able to do is stop fraud getting into the system in the first place and effectively design it out.
“That will mean that as any fundamental changes begin to emerge we will be safe in the knowledge that we will have ‘designed’ any weakness out.”
Whilst a lot can be done to reduce the risk of fraud occurring in the NHS, Dermid recognises the ingenuity of some fraudsters which means that vigilance will always be needed.
“This is why it will still be very important for us to have that investigative capacity to detect new fraud as it emerges whilst also being able to deal appropriately with the culprits when we catch them as well as learning lessons from the experience which enable us to again build strength back into the system.
“So whilst there are quite a few challenges facing us, we have always been a fairly agile organisation and are able to turn our hand to any new frauds which develop.”
Nov/Dec 10
Up until the economic crisis, the health service had enjoyed years of steady growth in investment. So did the amount of fraud taking place in the NHS also increase in a similar way during that period of growth?
“We couldn’t say that it did and - unlike other government organisations - the NHS is not really one organisation but more like an industry. This means that our view is that any type of fraud, abuse or system weakness which is happening in society is happening in the NHS.
“So in terms of saying whether an increase in funding to the NHS led to an increase in fraud within the NHS, the answer would be no but I would say that the range of fraud has probably increased.
“This is because there are now so many different areas within the NHS and so many more opportunities for fraud to take place than ten or twenty years ago.”
Now that the NHS is changing again, it would make sense that this change will also offer more opportunities for fraud especially when most eyes are concentrated on actually implementing that change. This means that vigilance against the unscrupulous within the health service will be more important than ever.
“This is something which we are very much aware of and know that the NHS can simply not afford to take its eye off the ball because fraudsters are incredibly quick at identifying possible targets and weaknesses to exploit.
“Also, because of the very nature of the changes taking place, people who may not have even considered committing fraud before may choose to do so because of a change in economic circumstances so, in effect, the threat can grow. Although we have no evidence of this happening at the moment, it is something which could happen so we need to remain vigilant..
“It also means that it is important for us to make people aware of the damage which fraud can cause to patient care and perhaps put off a few individuals from committing a crime.”
As the NHS Counter Fraud Service is part of the NHS, it is subject to the same financial constraints and needs to find efficiencies. So how is it going about this?
“We continuously review our own organisation and have always prided ourselves on being able to adapt to whatever circumstances have demanded of us. We are carrying out such a review as we speak to make sure that we are
in a position to best serve the NHS whilst also looking inwardly at ourselves to find out what we really need to be doing to take the organisation forward into the future.
“We are going to be reliant on a lot of information and intelligence to be able to identify patterns and trends much more effectively then we have in the past. This will include looking where it can be automated and, most importantly, disseminated out to the wider NHS, meaning that more trusts will be able to identify weaknesses themselves and then do something about it.
“This issue of prevention is key because the business of detecting fraud and hunting fraudsters down is a very expensive one. What we need to be able to do is ask ourselves how we can prevent fraud happening in the first place. How do we raise awareness to stop fraud entering the system?
“This might mean realigning our resources so that more goes into prevention than has before and will hopefully lead to fewer resources being needed to catch fraudsters and dealing with them.”
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