There is no one reason why a dishonest minority of people try to defraud our Health Service. The work of CFPS ranges from issuing penalty charges to patients who falsely claim help with health costs, to supporting civil litigation cases for the recovery of funds from firms contracting with HSC.
Fraud can take many forms but ultimately the resources lost to fraud means there is less money available for the delivery of front line services. This is money that could be directly available for patient care.
What is fraud?
In very simple terms fraud is stealing, but can include offences such as deception, forgery or concealment of facts.
The Fraud Act (2006) gives a statutory definition of the criminal offence of fraud, defining it in three classes – fraud by false representation, fraud by failing to disclose information and fraud by abuse of position.
In all three classes of fraud it requires that for an offence to have occurred, the person must have acted dishonestly and with the intention of making a gain or causing a loss to another. The gain or loss does not have to succeed, so long as the intent to commit fraud can be proven.
What is the HSC policy on fraud?
Health and Social Care has a zero tolerance policy to fraud and will take the strongest actions possible against those who attempt to defraud our health service of vital funds.
What happens to those who commit fraud?
The Fraud Act (2006) provides that a person found guilty of fraud is liable to a fine or imprisonment of up to six months on summary conviction, or a fine or imprisonment of up to ten years on conviction of indictment.
The CFPS investigation process will gather all necessary evidence to determine if a fraud has occurred. Where fraud is proven a range of criminal, civil or disciplinary sanctions, where appropriate, will be considered.