Draft NHS Counter Fraud Authority (Establishment, Constitution, and Staff and Other Transfer Provisions) (Amendment) Order 2020
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The Minister for Care (Helen Whately)
I beg to move,
That the Committee has considered the draft NHS Counter Fraud Authority (Establishment, Constitution, and Staff and Other Transfer Provisions) (Amendment) Order 2020.
It is a pleasure to serve under your chairmanship, Mr Mundell. Like any organisation, the NHS is not immune to fraud. As hon. Members are aware, the Government have backed the NHS with the biggest cash boost in its history: an extra £34 billion by 2023-24. That money will make a difference to many people. Yet, fraudulent activity in the NHS means that the money intended for patient care sometimes ends up in the pockets of those who did not legitimately earn it, meaning fewer resources available to be spent on frontline health services such as patient care, health care facilities, doctors, nurses and other staff. It is taxpayers’ money, and we have a duty to spend it appropriately. An effective counter-fraud organisation that is able to operate independently is crucial—a body that can act without external interference or influence and perform functions that cannot be undertaken at a local level, such as serious and complex investigations that cross borders and cases of alleged bribery and corruption on a national level.
As a result, the NHS Counter Fraud Service was set up in 1998 as part of the Department of Health. Since then, the function has evolved, and in autumn 2017 the NHS Counter Fraud Authority was launched as an independent special health authority. The National Health Service Act 2006 means it is limited to a maximum lifespan of three years, and so is due to be abolished on 31 October 2020. To prevent that, a statutory instrument was laid on 11 June 2020 to extend the abolition date of the NHSCFA by three years, to 30 October 2023.
I want to take this opportunity to highlight the important work of the NHSCFA and set out why we need to extend its lifespan for a further three years. The NHSCFA is a national centre of excellence. It has built strong relationships with organisations across the health and law enforcement sectors so that we can take the fight to those who seek to deprive the NHS of resources for patient care. Fraud is a hidden crime; to fight it, we have to find it. The NHSCFA is continually developing its intelligence and investigation capabilities, and is breaking new ground in how it detects and prevents fraud. It has also set important national standards for the counter-fraud work of NHS providers and commissioners. It also applies to independent healthcare providers and NHS organisations. Its work is clearly bearing fruit.
The NHSCFA’s latest strategic intelligence assessment shows an overall estimated reduction in losses from fraud of £60 million between 2017-18 and 2018-19. It also showed a £27.6 million reduction specifically on dental contractor fraud, thanks to a relentless focus by the NHSCFA over recent years, along with an £85 million annual reduction in fraud losses from false entitlement claims for help with healthcare since 2017.
It is clear that that approach is working. To change direction now would be a mistake. The concerted approach by the NHSCFA to improve fraud awareness and drive up fraud reporting across the NHS is bearing fruit, so we need it now more than ever, especially when we are in the middle of the greatest threat to public health that we have seen in generations.
As part of the Government’s response to coronavirus, the Chancellor has repeatedly said that the NHS will get the funding it needs. An initial £5 billion coronavirus fund was established at the Budget in April 2020. That was then increased to a £14.5 billion emergency response fund, of which £6.6 billion was earmarked to support our health services. We are continuing to work with the NHS and Her Majesty’s Treasury to ensure the NHS gets the funding and resources it needs.
Although we have seen the nation coming together to celebrate the heroic work of NHS staff, coronavirus unfortunately presents a heightened risk of fraud, where criminals may seek to exploit the situation. Never before has a counter-fraud response to this investment been so important. “Protect the NHS” is not just about protecting staff. It is also about the money that taxpayers contribute to this invaluable national resource.
The NHSCFA has played a key role during this period and has produced and shared coronavirus threat assessments with partners, and coronavirus counter-fraud guidance specifically for the NHS. This includes guidance outlining the unique risks during the coronavirus response and specific guidance outlining types of mandate fraud, and how to identify, prevent and respond to them.
As technology evolves, the risks to the NHS will also evolve, especially the risks from fraud, so we will need organisations such as the NHSCFA to co-ordinate the response at a national level. If we made the decision to abolish the NHSCFA today, that would expose the NHS to significant financial risks. It would mean that there would be no ability to record and assess accurately the nature and scale of fraud, and inform the response to it, both within the NHS and across the wider health sector. That would result in serious and complex fraud investigations being transferred elsewhere—for example to other NHS bodies, the police or the Department of Health and Social Care.
John Howell (Henley) (Con)
I thank the Minister for giving way and for the examples that she has just set out. However, could she give us an overall picture of where the fraud is arising? Is it arising from within the NHS, from organisations with which the NHS has a relationship or from the man in the street?
Helen Whately
I thank my hon. Friend for his intervention. The fraud we see comes from a range of the categories he has just mentioned, sometimes including members of the public and users of the NHS, but sometimes also organisations with which the NHS has contractual relationships.
Let me come back to the point I was making about the downsides there would be if we did not decide to continue the NHSCFA today. If we were to do that, it would undermine NHS funding—much-needed resources that are critical for patient care. I therefore urge hon. Members to keep this vital organisation in place and allow it to keep doing its important work, providing confidence and even certainty for many people. I commend the draft order to the Committee.
Helen Whately
I welcome the helpful and constructive comments from the shadow Minister, who shares the perspective of the Government on the important role of the NHSCFA and the importance of preventing and tackling fraud in the NHS. I want to reiterate that never before has a counter-fraud response to protect the Government’s investment in the NHS been so important, and that only a national organisation such as the NHSCFA can gather and process the information and intelligence arising from the huge range of threats to the NHS.
I should reiterate that the vast majority of people do not commit fraud in their interactions with the NHS; the problem is very much from a minority. The NHSCFA carries out the Secretary of State’s counter-fraud functions in respect of the health service in England, and it has the crucial ability to distil data and enable a focus on prevention in its counter-fraud response.
The shadow Minister asked about cross-NHS working. The NHSCFA is working hard to build and develop capability across the NHS and among NHS organisations, to extend consistent principles, national standards and best practice to all parts of the NHS, and to drive a national, co-ordinated and cross-organisational response. The focus is on prevention, because we know that preventing loss is more cost-effective than prosecuting suspects and recovering funds that have already been lost.
The shadow Minister asked about a revised strategy for the CFA, and I can assure him that it is being drafted and will be published soon.
Justin Madders
On the updated strategy, we have talked a lot about personal protective equipment in the last few months, and it is fair to say there are some unusual entrants into that market. Will the updated strategy look at how PPE is procured moving forward?
Helen Whately
The shadow Minister makes an important point about PPE. Clearly, the Government have had to move very rapidly to increase the procurement of PPE to meet the needs of the NHS and social care during the pandemic. PPE procurement for covid-19 is centrally managed, not managed by NHS trusts, and therefore falls outside the remit of the NHSCFA. It is being investigated by the DHSC anti-fraud unit, but that is being supported by the NHSCFA. No doubt lessons learned from the covid experience will be used by the NHSCFA in developing its processes and the strategy that we have been referring to.
Extending the current model will provide the opportunity for the NHSCFA to continue its work and consolidate its organisational design, which it has been working on over the last three years. The Department will continue to oversee the function of the NHSCFA, in its sponsorship role, to ensure that it remains fit for purpose. The draft order is an important and integral piece of secondary legislation to allow the NHSCFA’s independent and crucial remit to continue. I urge all hon. Members to approve it.
Question put and agreed to.