James Sale Project Officer, Pharmaceuticals & Healthcare Programme (PHP) Transparency International UK

Transcription

1 James Sale Project Officer, Pharmaceuticals & Healthcare Programme (PHP) Transparency International UK

2 UK HEALTH SYSTEM The National Health Service (NHS) is the world s largest publicly funded health service. The NHS remains free at the point of use for anyone who is a UK resident. Responsibility for healthcare in Northern Ireland, Scotland and Wales is devolved to the Northern Ireland Assembly, the Scottish Government and the Welsh Assembly Government respectively. Corruption Barometer Index % of respondents in United Kingdom who felt that medical and health services were corrupt/extremely corrupt

3 SCALE OF NHS The NHS employs more than 1.7 million people. Of those, just under half are clinically qualified including 39,780 general practitioners (GPs), 370,327 nurses, 18,687 ambulance staff, and 105,711 hospital and community health service (HCHS) medical and dental staff. The NHS in England is the biggest part of the system by far, catering to a population of 53 million and employing more than 1.35 million people. The NHS in Scotland, Wales and Northern Ireland employs 153,427 84,817 and 78,000 people respectively. The NHS deals with over 1 million patients every 36 hours.

4 FUNDING AND STRUCTURE Funding for the NHS comes directly from taxation and is granted to the Department of Health by Parliament. For 2013/14, the total NHS budget was around billion. NHS is an independent body, at arm s length to the government. Collection of hundreds of organisations, the majorities of these are the responsibility of clinical commissioning groups (CCGs).

5 CORRUPTION & FRAUD RISKS Patients - including prescription fraud, the use of aliases, and fraudulent exemptions. Professionals - including ghost patients; and false prescriptions. Managers - including payroll fraud, timesheet fraud and ghost employees. Contractors - including equipment fraud and falsifying work records. Revolving doors. Procurement.

6 RECENT CORRUPTION CASES Operating theatre experts jailed for fraud conspiracy against NHS (NHS Protect) A team of perfusionists conspired to defraud Basildon and Thurrock University Hospitals NHS Foundation Trust for 9 years ending in The four directors of London Perfusion Science Ltd (LPS) all held full time jobs at Basildon Hospital while working privately at numerous other NHS hospitals. Between 2007 and 2011 salaries were paid for 14,000 hours that were not actually worked. The total loss to the NHS was 430,000.

7 RECENT CORRUPTION CASES Company director jailed for 100K NHS fraud and money laundering (NHS Protect) A company director who supplied stents for heart surgery to the NHS was jailed for fraud and money laundering in counts including two of fraud (submitting false invoices) and twelve relating to money laundering of 100, The total loss to the NHS was 102,500. The businessman was sentenced to 15 months' imprisonment.

8 REGULATION & SAFEGUARDING Monitor exercises a range of powers granted by Parliament Monitor expanded its role to regulate all providers of health and adult social care services. Monitor aims to promote competition, regulate prices and ensure the continuity of services for NHS foundation trusts

9 REGULATION & SAFEGUARDS NHS Protect The organisation s work covers three main objectives: 1. To educate and inform those who work for or use the NHS about crime in the health service and how to tackle it 2. To prevent and deter crime in the NHS by removing opportunities for it to occur or to re-occur 3. To hold to account those who have committed crime against the NHS by detecting and prosecuting offenders and seeking redress where viable.

10 REGULATION & SAFEGUARDS NHS Protect activities: The value of fraud, bribery and corruption identified by NHS Protect and Local Counter Fraud Specialists (LCFSs) was 15.4 million 7 criminal prosecutions were carried out following NHS Protect investigations into serious and complex cases of fraud, bribery and corruption. A requirement for all parts of NHS England to have nominated directors who are responsible for anti-fraud, bribery and corruption work and for security management work, as well as local coordinators in both areas.

11 STRUCTURAL SAFEGUARDS Multiple bodies providing oversight Powers deriving directly from Department of Health Anti-corruption and fraud teams working at CCG level Anti-corruption and bribery policies deriving from the UK Bribery Act 2010

12 THE UK BRIBERY ACT 2010 It is correct to describe the Act as the most draconian anti-bribery law. Vivian Robinson QC, General Counsel, Serious Fraud Office (UK) Came into force on 1 July 2011 Several tiers of liability: - Personal - Corporate - Director and Officer

13 THE UK BRIBERY ACT 2010 Applies to any British citizen or person with a close connection with the UK Covers bribe-paying anywhere in the world Covers bribes of any size Applies to any company if it has commercial operations in the UK Extends to associated persons Personal liability (up to 10 years in jail) Corporate liability (unlimited fines) Director & Officer liability

14 2010 UK BRIBERY ACT ADEQUATE PROCEDURES 1. The tone from the top 2. Risk assessments 3. Detailed policies and procedures 4. Implementation 5. Business partners: applying due diligence 6. Monitoring & review

15 Further information James Sale Pharmaceuticals and Healthcare Programme Transparency International UK -