Wales target of new probe into NHS fraud

The profession in Wales is about to be targeted by NHS fraud-busters. 'A greater focus' will be placed on the sector, announced Ann Lloyd, director of the NHS in Wales, at the end of last month. This month the Audit Commission in Wales publishes its report into ophthalmic fraud. 'We will be following up the recommendations of that report,' said an Assembly spokesman. Lloyd delivered her warning while addressing the audit committee of the National Assembly in Cardiff, which had just been told that fraud last year by optical practitioners had fallen 25 per cent. So far, work by the NHS Counter Fraud Service (Wales) has concentrated on alleged fraudulent activity by opticians. In one optical case a practitioner agreed to repay £120,000, and in another £262,500. A spokesman for the service said he would not be able to confirm details of who would be targeted for a couple of weeks. It is possible the focus will switch more to deal with patient fraud. 'That is where the greatest value is, deriving from a high volume of low-value claims,' said an official. Sir John Bourn, auditor general for Wales, said in his report to the Assembly that optical patient and contractor fraud had fallen from £1.2m a year to £900,000, according to a measurement exercise. Lloyd told the Assembly that counter-fraud officials were now extensively at work within the NHS in Wales. Sir John praised 'the growing emphasis being placed by NHS bodies on developing an anti-fraud culture'. He said that recent work had concentrated largely on 'inappropriate' claims by opticians. Sir John said: 'In February last year, one optician entered into an agreement to repay £120,000, and a second optician entered into a County Court agreement to repay an initial sum of £73,500 and a further amount of £190,000 to be considered at a future court hearing.' Further cases were on-going, he warned.