Clause 41 - Compulsory disclosure of documents for purposes of counter fraud or security management functions
Health Bill
5:45 pm
Jane Kennedy (Minister of State (Quality and Patient Safety), Department of Health; Liverpool, Wavertree, Labour)
I hope that by having a brief debate on these issues we can answer some of the legitimate concerns that the hon. Gentleman has raised. He has rightly asked us to demonstrate why it is necessary to extend the range of criminal offences and to give major powers to officers of the Counter Fraud and Security Management Service of the NHS in order to counteract the problems that we face.
In general terms, in order to continue to counter fraud in the NHS, and to enable us to continue to take steps to make it a safer organisation to work in, authorised counter-fraud and security management specialists require relevant information to be produced when undertaking investigations. The hon. Gentleman has generously accepted that that is clearly necessary. In the most serious cases, those specialists will work with the police, who may use their powers of entry, search, seizure and arrest. However, it is not always possible to make use of police powers, because of resource issues. In any event, that is often a drain on valuable police time. The proposed powers will be exercised only by highly trained and accredited NHS counter-fraud and security management specialists. They will be able to apply all of their NHS knowledge and expertise to ensure that only material relevant to a particular investigation is obtained by them and that it is retained within the NHS. All obtaining of documents in that way will be supervised by senior officers in the service.
Later clauses introduce specific criminal offences, such as failure to produce a document on the part of those being investigated. Because we take patient confidentiality extremely seriously, we are introducing an offence of the wrongful disclosure or misuse of information obtained in that way, so that it is clearly reinforced to those involved in the process precisely how seriously we take the role that they will play.
Let me describe the extent and nature of the problem. In the brief period of seven years since the CFSMS was created in 1998, the NHS has benefited from an additional £675 million for better patient care, thanks to the work of that service. That highlights the fact that we face a big problem. If that funding is spent wisely, it could be used to pay for five new hospitals—perhaps not some of the private finance initiative projects that are around, but a number of smaller ones—27,000 heart transplants or 170,000 hip replacements. Let me mention some of the types of cases where this wonderful service is having a big impact. It has an annual budget of £14 million. In just one case in the last year—where it detected, intercepted and prosecuted a cartel that was operating in generic drugs—it recovered £16 million from the company involved. Therefore, in just one case it paid for the running of its own service. However, it has been operating in a number of areas. Overall losses in patient fraud have been cut as a result of the work of the service by 54 per cent. from £171 million to £78 million. That comprises an estimated fall in pharmaceutical patient fraud, which is basically prescription fraud. Dental patient fraud has fallen by 48 per cent. and optical patient fraud by 23 per cent. The hon. Gentleman and other Committee members may be interested to learn that fraud committed by health professionals generally has also fallen.
One reason why we probably do not make more of the work of the counter-fraud service is that we acknowledge that the vast majority of health professionals work quite properly and that the thought of committing fraud does not even come into their heads. Sadly, some health professionals do consider committing fraud, but there has been a reduction in losses caused by health professional fraud of between 43 per cent. and 54 per cent.
Dentistry is one example of the way in which the service might change as a result of understanding how fraud has been committed and acting on suggestions. The amount of money claimed for the recalled attendance allowance has fallen from £14.3 million to £6.6 million almost overnight as a result of changing the form by which dentists made claims for that allowance.
This is a very important area of work. I am intensely proud of the work that staff are doing, and I believe that the measures in these clauses are important in enabling them to continue and to develop that work.
The hon. Member for Westbury expressed specific concerns about patient confidentiality. It is important to reiterate how strongly we all share his view. It is essential that any information obtained through the use of these powers is used appropriately. A new criminal offence is to be introduced in later clauses to cover the unlikely event in which information is disclosed inappropriately, thereby adding another tier of protection to ensure patient confidentiality. For example, a counter fraud and security management specialist commits an offence if they wrongly disclose information in an investigation. If they are found guilty of that offence as a result of the changes that will be made later in the Bill, they could be sentenced to a maximum of two years' imprisonment, or fined, or both. Patient record confidentiality is paramount, so inappropriately disclosing information will not be tolerated. The offence will apply to a range of people, including the person to whom the information is disclosed.
The Bill also contains provisions for certain information in certain cases to be required under court order under the supervision of a court, and there are further provisions to enable us to work with the courts to ensure that, where information important to a fraud case is to be presented to the court but where the detail of the information, although anonymised, may lead to a patient being identified, a court may meet in private in a closed session so that evidence can be presented to it but in a way that protects the identity of the patients involved.
I appreciate the concerns that the hon. Member for Westbury has expressed and the way in which he expressed them. He asked me how the national programme for information technology fitted in with the counter fraud work. Many safeguards are in place, but he will have to forgive me in this instance, as I will have to write to him and to other members of the Committee after I have looked into the matter in more detail, because I simply do not have a detailed answer for him now. I will consider specific concerns, and discuss the query with my officials after our considerations today. I hope that I can reassure him about NPfIT in writing after the sitting.
With that rather quick but, I hope, useful broad-brush explanation about why we believe that the powers are important, I hope that members of the Committee will be content to give these clauses a fair wind.
Clause 41 ordered to stand part of the Bill.
Clause 42 ordered to stand part of the Bill.