UK aims to deter prescription fraud

BMJ 1998; 316 doi: (Published 17 January 1998) Cite this as: BMJ 1998;316:167
  1. John Warden
  1. London

    Doctors as well as patients are to be targeted in a new drive against prescription fraud being introduced by the British government.

    Prescription fraud costs the NHS about £100m ($160m) a year, mostly through patients evading the £5.85 charge. Fraud by contractors is estimated at £10m a year but could be higher.

    The proposals are part of a government package to stamp out fraud and are based on a scrutiny report in 1997 (BMJ 1997;314:1851). Health authorities will be allowed access to GPs’ accounts to discover those doctors who prescribe for non-existent patients. For the first time they will also be permitted to refuse to operate a contract with GPs convicted of fraud. Refusal to operate a contract may also be extended to doctors with ‘inexplicable levels’ of claims for fees and expenses. GPs will have to declare any financial interest in pharmacies or nursing homes, with a ban on new connections. And new dispensing practices will have to demonstrate adequate standards of probity and audit.

    The details will be discussed with the General Medical Council and the General Medical Services Committee and may require legislation.

    Evasion by patients will become a specific criminal offence, with a fixed penalty charge of £25 for first offenders. An NHS fraud supremo will spearhead the action. From April, prescription forms will be printed on security paper with anticounterfeit features-like cheques. Similarly, prescription pads may be sent direct to doctors rather than requisitioned in bulk by health authorities. GPs will take clinical responsibility to ensure that repeat prescriptions remain appropriate. The 50% of patients who are exempt from charges may be asked for evidence of their exemption, on grounds of age, income, or medical condition. A telephone hotline (0800 068 6161) and internet websites will enable the public and NHS staff to alert the fraud investigation unit to suspected prescription fraud.

    ’A small minority of patients and NHS staff are robbing the public blind,’ the health minister, Alan Milburn, said last week. He added that the majority of doctors have nothing to fear from these measures.


    A small number of doctors are involved in prescription fraud SHEILA TERRY/SPL

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