Sally Gainsbury: immigrants don't hurt the NHS; dentists do

Earlier this month it was Chidi Amaju, of North Acton, London, who callously trained to become a nurse, qualified as such and then, horror of horrors, worked as one, at North West London Hospitals Trust.

The total sum of his ill-gotten gains? Over £68,000 – comprising of his training bursary and associated fees, plus salary of £25,000.

In January there was Herbert Sengati, of Edmonton, London – sentenced to 15 months imprisonment following an investigation which found he had defrauded the NHS of over £100,000. This was the salary he earned over six years working as a hospital porter, without the correct immigration status, plus the legal costs of taking his case to court.

NHS Protect does not publish detailed statistics on its performance or successful prosecutions. But in the 13 months since it was launched, it has publicised some 16 separate cases, leading to £2.1m worth of fraud. In over a third of those cases, the proven fraud related to immigration – false papers or misleading representations on the right to work.

Tellingly, however, such cases made up a much smaller proportion of the £2.1m recorded loss to the NHS amassed over the 16 cases.

NHS Protect defends the energy it invests in pursuing immigration cases by arguing such fraud is genuinely damaging when training funds are effectively wasted on an individual who does not have the legal right to subsequently use those skills in the NHS.

But the apparent focus still smacks of plucking off the low-hanging fruit while ignoring the out-of-reach rot elsewhere.

That would include the greater share of the £73m NHS Protect has recently estimated NHS dental contractors diddled out of the service in 2009-10. This sum is almost seven times the previous estimate of total NHS-wide fraud. 

The bulk of the newly uncovered dental fraud stems from the dental equivalent of hospital tariff upcoding – fiddling the claims forms submitted to primary care trusts implying a patient received a more complex or numerous set of treatments than was in fact the case. But a shocking £17m was claimed for patients who either did not exist at all, or did not visit the dentist.

Time, perhaps, for a change in NHS Protect’s focus?

Sally Gainsbury is a news reporter for the Financial Times