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Minorities 'targeted' by NHS fraud squad

Scores of immigrant nurses have been investigated by NHS anti-fraud investigators amid claims black staff members have been unfairly “targeted”.

Over 13 times more black people than would be proportionate have been charged with offences by NHS Protect – the body responsible for cutting fraud in the health service – figures released to Nursing Times under the Freedom of Information Act suggest.

The figures have resulted in suggestions that immigration cases are prioritised above harder-to-investigate offences.

A total of 66 of the 98 people prosecuted in the year were recorded as “African Caribbean”. Black people make up only 5% of NHS staff, according to figures from the NHS Information Centre.

Some 57% of investigations launched by NHS Protect between April 2010 and March 2011 involved black and minority ethnic (BME) people. BME groups make up 16% of NHS employees.

In the previous year only about a quarter of those investigated had their ethnicity recorded, but the majority of those known were BME.

Half of the cases published on the body’s website involve a nurse or healthcare assistant.

The cases often concern an employee’s right to work in the UK. Although figures are not held on how many cases related to immigration offences, 59% of cases prosecuted “constitute frauds or criminal offences in which provision of false documentation has been a factor”.

The website for the NHS Counter Fraud Service - the body’s name before it was renamed NHS Protect in April - said it “aims to reduce NHS fraud to an absolute minimum, and maintain it at that level”.

Director of the centre for counter fraud studies at the University of Portsmouth Mark Button said fraud specialists in some public bodies were given “performance indicators” which could incentivise tackling relative simple immigration frauds. “It could be that they go to look for particular kinds of frauds,” he said.

He said it was important to prevent people getting work without the appropriate qualifications. However he said there were “limited resources” to tackle fraud and focusing on migrants could mean “other frauds will be less well investigated”.

Transitional lead for the NHS BME Network Dr Vivienne Lyfar-Cissé said although fraud should not be “condoned” it was “extremely worrying that fraud by non-BME staff may be overlooked giving rise to the disproportionality observed”.

Don Flynn, director of the Migrant Rights Network campaigning group, said it seemed NHS Protect was “targeting largely black and ethnic minority staff” as they were “low hanging fruit”.

He said many people had the right to remain in the UK but not the right to work, due to an estimated 450,000-person backlog in the immigration system. Mr Flynn said many migrants are “quite strongly oriented to work in the health professions but are not documented”.

“The only way they can get employment is coming up with false bits of paper,” he said.

Royal College of Nursing England director Tom Sandford said: “I’m concerned about this over-representation. It reflects our analysis of case work which demonstrates that members from BME groups are over-represented in employment disputes.”

An NHS Protect spokesman said: “NHS Protect’s focus is the investigation and collection of evidence relating to allegations of fraud or corruption, not a person’s ethnicity. Before 2010/11 the collection of ethnicity information was not mandatory. However, since the introduction of a new case management system, NHS Protect has been able to collect it more easily and accurately.

“NHS Protect investigations involve not only NHS staff but other medical professionals and anyone else who may have committed fraud against the NHS. Our activities are largely determined by the referrals we receive, and we are obliged to follow up wherever a reported suspicion merits closer  investigation.”

Readers' comments (17)

  • Good!!!! If there is an issue of fraud that should be investigated, then it should be investigated! The fact that some of that fraud relates to immigration and those people are targeted, does not mean that it is victimisation!!!!

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  • What does BME stand for?

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  • above, just looked on google and there are all sorts of different meanings which are unrelated to the article!

    i get fed up with all these meaningless abbreviations splashed around as it slows reading if one has to spend time looking for them. in my uni hospital we were not allowed to use them in patients' notes as they are often ambiguous, not familiar to all, and can be dangerously misinterpreted.
    some, with a lack of intelligence and commonsense, use them with the intent of not being understood, causing confusion, and for some reason find this savvy and clever!

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  • I think in this context it is black, minority ethnic.

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  • thank you Mike, but what a way to put it!

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  • My understanding of statistics is that in the case of immigrants (Black or White) working in the NHS is that there is merely a greater opportunity for fraud to occur but this is because of a systems failure in the NHS honey-pot organisation rather than a smear on any particular ethnic group.

    Overseas staff may not have a 'face to face' interview, it is more difficult to check who they are, are the qualifications gained actually theirs, are their references bona fide? eg. the person interviewed on the phone & whose references you check may not be the person who turns up to do the job.

    Clearly a system as flawed as ours will attract those most morally challanged in any society. But any sensible person will know not to judge an entire society by its criminal element.

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  • I dont care if someone is pink purple or green with yellow spots, if they commit fraud they run the risk of getting caught.

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  • Well said Mike and Sarah

    If it is fraud any one of any colour should be investigated.

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  • Anonymous | 5-Jul-2011 3:07 pm I know, I think these people are too busy hand wringing to worry about grammar or common sense. These 'disproportionate' victimisation claims really do get on my nerves.

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  • Minorities have been working in the NHS for years unfortunately there is a new type of people whether black/white green or whatever who because of greed and selfishness have decided to defraud the NHS. To me this article seems to want to turn these defrauders into victims which is not the case. Majority of Ethnic minorities who work for the NHS are law abiding and would not even consider to defraud the NHS how about the immigrants who came to Britain in the 50s and 60s to work in the NHS and did not consider defrauding the NHS. My opinion is if you defraud the NHS you should be punished accordingly it does not matter to me whether you are black/white pink or what ever colour or ethinic background.

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  • In my view there is far too much emphasis and concern of the colour of peoples skin and ethnicity. As long as they are good integrated hard working British citizens what do their physical features and country of origin matter, apart from the importance of enriching our culture and society and to which more focus should be directed.

    Perhaps we should start looking at the colour of people's eyes - maybe those with one colour are more shifty and less honest than those with another colour. How ridiculous would that be?

    Obviously those who commit fraud or any other crime should be severely punished whoever they are and no matter what origin or 'colour'.

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  • Anonymous | 7-Jul-2011 8:24 am

    further to the above, I also find the term 'minority' demeaning, discriminatory and offensive. I am pale beige and British born and bred but do not wish to be discriminated from those integrated honest hard working citizens I refer to above or be considered 'majority' which could be construed as 'imperious' or many other similar adjectives, when I only consider myself as a perfectly normal honest, hard working citizen.

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  • The reference to BME is actually explained in the article, discounting the first paragraph in bold type, see paragraph 4.

    I work in a situation where one black/browm member of staff has the rest of the white, the majority, shtum, in fear of us making any ethnic minority comments. They are not working their full contracted hours, attending training sessions unrelated to their current position in work time. There is more, but I daren't go further with my comments. Attempts to address the problem have been brought to attention, but nothing has been addressed, presumably for the same reasons.

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  • I'm sure we all know this but not all black and ethnic minorities are "foreign". Though the way it's presented here one would think that was not the case. Yes believe it or not some non-whites are actually born and bred in the UK and don't require checks on whether they are able to work in their home country legally etc. So with this in mind it is a bit concerning to read comments regarding ethnicity in such a negative way. Example:
    Anonymous | 9-Jul-2011 0:54 am
    "I work in a situation where one black/browm member of staff has the rest of the white, the majority, shtum, in fear of us making any ethnic minority comments. They are not working their full contracted hours, attending training sessions unrelated to their current position in work time. There is more, but I daren't go further"

    Well I hate to break it you... but I work with white nursing staff who disappear of for regular smoke breaks, leave duty half an hour early citing "worked through my break" as a reason despite having 10 long cigarette breaks during the shift, hide in the toilets when there's work to be done. I'm sure we can all make similar lists. Lets not use colour or race as an excuse to treat people badly. And I should also point out whilst in your work place you should refrain from making "ethnic minority comments" as you state; as if these comments hold real merit or value they would be voiced openly would they not? Think how you would like someone to treat you. Would you be happy to have your race or skin tone be a talking point?

    I work in an almost all white environment and when non whites work on the ward there are staff who leave all the jobs they don't want to do themselves to the non white staff member. I have seen nursing staff treat non white registered nurses with disrespect, one member of staff presumed one non white staff member to be a cleaner, on another occasion a registered nurse was presumed to be a nursing assistant and left to do the laundry while they contacted another ward to request a registered staff nurse to help with medication. Is this the kind of workforce you want to be part of?

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  • As a Fraud Investigator working in the NHS i find the suggestion that minorities are being treated in some way differently to others grossly offensive. i fully accept the figures show a greater proportion of those minority groups are affected. However there are serious patient care issues here and if you don't actually know who your are employing how do you know they are suitably qualified to carry out their jobs?
    No one is criminilising this group of staff it is individuals who make a concious choice to obtain employment to which they are not entitled. Additionally every trust in teh country that employs an illigal worker faces upto a £10,00 fine per instance from the Borders agency. it is for individual organisations to decide how they utilise their resources and sadly for some there is a greater risk to them from this type of fraud. Further more don't think that this type of fraud stops at obtaining a job, it usually end up with the very same people obtaining bank accounts, credit crads, benefits, and social housing fraudulently. I have investigated a number of cases where this has been the case. this affects all of us and certainly isn't about cherry picking the easy jobs!

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  • Are people being done for fraud when the issue should be handled a different way.

    If you leave your shift 10 minutes early or arrive 10 minutes late that is technically fraud. Are white workers being given a ticking off and black workers being hit with counter fraud?

    If you are caught out shopping when you are sick are black people treated the same way as white people?

    As a (white) UNISON rep I dont believe our black members are treated fairly by the NHS.

    There are colossal losses in the NHS caused by the increased transaction costs of the private market and obscene PFI deals with big business - not to mention drug company rip offs and IT procurement.

    Its about time counter fraud concentrated on billions pounds going down the drain rather than fairly minor clocking offences.

    If they did this they might find the big league players are like me .... white.

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  • fraud is fraud, cannot be justified whoever is committing it. prosecutions have been for quite major issues, not as the anonymous unison member states, for trivial, minor offences. certainly fraud that has taken place as a result of people using documents that are not real and to which they are not entitled cannot be classed as minor. The NHS has been defrauded by people taking training bursaries - large amounts, this is not minor and I would question any nurse who thought this was OK, this level of deceit leaves me wondering whether patients safety is at risk, after all, who are these people really? Minor fraud rarely comes to court and certainly not 10 min breaks, if people are abusing that then the leadership of the clinical areas is in question, but I cannot imagine anyone prosecuting over it. So, Mr Union man, get a sense of perspective, although I would be the first to agree that we do not live in an equal world

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