Prescription Fraud (Hansard, 4 November 1997)

§ Lord Dean of Beswick
asked Her Majesty's Government:
Whether they are taking any further measures to curb or eliminate fraud relating to prescription charges within the National Health Service.

§ The Minister of State, Department of Health (Baroness Jay of Paddington)
My Lords, in June the Government announced decisions to implement recommendations of the Efficiency Scrutiny on Prescription Fraud. These included developing proposals for a new criminal offence of evading payment of the prescription charge with a fixed penalty for non-payment and developing a business case for sending prescriptions by electronic data interchange, known as EDI. Further changes are being planned and will be announced shortly. On 17th October the Government also announced plans for a senior appointment of someone with specific responsibility for fraud. The so-called "fraudbuster" will lead a small team to intensify the Government's campaign against fraud in the family health services.

§ Lord Dean of Beswick
My Lords, is my noble friend aware that that Answer will be welcomed by everyone who has the interests of our National Health Service at heart? I have had discussions with both appointed members of trusts and with doctors in the National Health Service who think that the repeat prescription formula is wide open to abuse. Will that problem fall within the remit of what my noble friend termed the new "fraudbuster?"

§ Baroness Jay of Paddington
My Lords, the problem of trying to identify those who have legitimately asked for and been given prescriptions and of ascertaining whether the same person then presents the prescription is under consideration. One suggestion is that there should be computer markings on prescription forms which should tally with the patient's other records. That is being considered in the development of the computer processes which may be adopted.

§ Lord Brougham and Vaux
My Lords, is the Minister aware that I am in possession of a certificate 1320 of prepayment of prescription charges issued by the Kensington, Chelsea and Westminster family practitioners' committee? Is the Minister also aware that that committee does not send out reminders when one's prepaid prescription form is about to become out of date? Nor, so far as I know, does any other committee. It means that people, unlike myself, I hasten to add, could use the prescription form for another six months, thereby costing the National Health Service a lot of money. Will the Minister consider asking those who issue the cards to send out reminders?

§ Baroness Jay of Paddington
My Lords, that is a most helpful suggestion. It is precisely the lax operation of the prescription system in the past that has led to the extraordinary situation in which we now reckon that £100 million a year is being wasted through prescription fraud in the NHS. As the noble Lord suggests, it is clearly not conscious fraud. But we shall need to look into such lax practices.

§ The Countess of Mar
My Lords, can the Minister say how much of the £100 million fraud is perpetrated by patients and how much by doctors and pharmacists who appear to be in league with each other?

§ Baroness Jay of Paddington
My Lords, I am not sure that I necessarily support that last remark of the noble Countess. There are difficulties in establishing precisely the outcome of patient fraud and distinguishing that from the fraud which occurs because individual pharmacists may not be fulfilling their professional duty. As I understand it, the best estimate is that about £70 million of the 00A3100 million to which I referred is fraud by patients.

§ Baroness Oppenheim-Barnes
My Lords, will the Minister consider, if she has not already done so, the point that when a patient passes on he often leaves behind cupboards full of expensive medicines? Is anything done to reclaim those medicines if, indeed, they could be used?

§ Baroness Jay of Paddington
My Lords, that is a helpful point. The noble Baroness may be aware that one of the changes that we made during the summer was to restrict the sales pack size of, for example, paracetamol drugs. That was intended primarily as a safety measure, but we also thought that if people had fewer drugs in their cupboards they might be used more effectively.

Earl Howe
My Lords, the Minister said that the total of prescription-related losses is estimated at£100 million a year. What proportion of that total do the Government realistically hope to recoup in the next financial year—that is, in 1998–99?

§ Baroness Jay of Paddington
My Lords, that question is still open because the speed with which we can implement some of the changes that I mentioned in my Answer will affect the final outcome. In the announcement which my right honourable friend the 1321 Secretary of State for Health made in another place about the additional money for the NHS which has been agreed between the Treasury and the Department of Health, he mentioned that £30 million of it would come from efficiency savings. We hope that a large proportion of that will come from changes relating to prescription practices.

Baroness Sharpies
My Lords, does the Minister agree that a national identity card would help in this instance?

§ Baroness Jay of Paddington
My Lords, that is slightly wide of the Question, but the problem of trying to identify prescription possession with individual patients by some form of computerised system is, as I said, being considered.

§ Baroness Robson of Kiddington
My Lords, has not the new idea of issuing repeat prescription forms increased the danger of the misuse of prescriptions unless people can be identified by something such as a national identity card or the use of their national insurance number?

§ Baroness Jay of Paddington
My Lords, that is precisely the point. We are trying to identify more closely the person who is issued with the prescription and the person who receives it. The problem arises not so much with repeat prescriptions where someone genuinely receives that prescription but where people seek to evade the charges on their first or second prescription, or whatever.