From Mr M. King
SIR,—You published two items last week (p435 Item
1 & Item 2),
both of which referred to the Prescription Pricing Authority. The first of these,
entitled “Under-cover pharmacy checks planned”, refers to the apparent
intention of the PPA to send under-cover investigators to community pharmacies
to make sure that checks on patients’ entitlements are properly carried
out. This item also refers to the “PPA’s directorate of counter fraud
services”. Neither statement is true.
The Directorate of Counter Fraud Services (DCFS) is a part of the NHS Executive
rather than the PPA. It is quite separate from this authority. The PPA has no
plans to carry out exercises in pharmacies of the kind described. The PPA has
a compliance unit (previously the fraud investigation unit) and its primary
function is to undertake checks on patient claims to exemption from prescription
charges, following up unconfirmed cases with the patient concerned. Although
the compliance unit does support the DCFS by providing information to assist
its enquiries, we do not investigate fraud ourselves.
A similar confusion arises from the second item, “PPA fraud clampdown shows
results”. Whereas much of the text is accurate, it appears out of context.
The basic position is that the PPA’s compliance unit does not investigate
fraud. That is the responsibility of the DCFS. However, we do take civil action
to recover debt. This arises in cases where we have carried out checks on patient
claims to exemption, found these to be incorrect and the patient declines to
pay. These actions take place in county courts but are not prosecutions for
fraud. The “fraud incentive scheme” to which you referred is described
in a report in the September issue of Impact by its correct title, the Pharmacy
Reward scheme. It has resulted in the figures quoted.
I believe that it is important that the equally significant, but separate, responsibilities
of the DCFS and the PPA are understood.
Michael King
Director of Planning and Corporate Affairs,
Prescription Pricing Authority