The government has launched a 'counter-fraud charter 'on the back of figures showing that the value of fraud detected in the NHS almost doubled last year.

Visiting the new NHS counter-fraud training centre in Reading, ministers promised to leave 'no hiding place for NHS fraudsters' as an Audit Commission report showed fraud detected increased from£2.6m in 1997-98 to£4.7m last year.

But NHS Confederation policy manager Tim Jones said it was important to keep the figures in perspective.

'This is 0.013 per cent of the NHS budget, and we remain to be convinced that there is masses more to be detected. We are reassured that this is a small amount in the NHS, ' he said.

Mr Jones pointed out that the increase in fraud detected had taken place before the launch of the government's anti-fraud strategy, which includes a directorate of counter fraud, headed by local government fraud buster Jim Gee, and plans to train managers from every health authority and trust in anti-fraud techniques.

'My hypothesis is that a lot of it is due to creeping IT, ' he said. 'IT is what cracked fraud in banks and financial institutions and I think an investment in patient systems will have the by product of helping to pick up trends.

'Without that investment, we have to use more manual methods to do it.'

Keith Douthwaite, associate director of the Audit Commission and co-author of Protecting the Public Purse , said NHS bodies needed to put an 'anti-fraud culture' in place since 'fraudsters are never off their guard'.

But the report says an area of 'growing concern' is 'the unwillingness of some police forces to take forward fraud cases that are reported to them'.

The Audit Commission is talking to the Association of Chief Police Officers about why examples of good practice are not applied uniformly.

The counter-fraud charter is a formal commitment by five professional bodies to work together with the Department of Health to challenge fraud.

It has been signed by the British Medical Association, the British Dental Association, the Pharmaceutical Services Negotiating Committee, the Association of Optometrists, the Federation of Ophthalmic and Dispensing Opticians, and junior health minister Lord Hunt.

Protecting the Public Purse makes specific recommendations about tackling contractor fraud.

It calls for :

the 300-page 'Red Book' on GP fees and allowances to be scrapped and replaced by a simplified system of reimbursement;

a review of the 'lack of fundamental controls' on dental claims;

the creation of a central record of optical patients to check opticians' visits and prescriptions.

The confederation strongly backed moves to re-write the red book.

But Dr John Chisholm, chair of the British Medical Association's GP committee, said that' any radical attempt to change the way GPs are paid risks being unfair to some GPs and should only be undertaken with the greatest care and sensitivity'.

What the report says Detected fraud rose from£2.6m in 1997-98 to£4.7m in 1998-99, of which£3,000 was detected in Wales.

Detected fraud in payments for medical services rose from£900,000 in 1997-98 to£3.3m in 1998-99, of which£1,000 was detected in Wales.

Five cases of corruption were reported in 1998-99, none of them from Wales.

Low figures are likely to suggest significant under-reporting of fraud in Wales.

Protecting the Public Purse: ensuring probity in the NHS . Audit Commission Publications. 0800-502 030.£10.