24 September 2019
A report from the Public Accounts Committee (PAC) has condemned the penalty fine system as "not fit for purpose".
PAC Chair Meg Hillier said the NHS penalty fine system was "not fit for purpose" and condemned the "shockingly complacent" response to 1.7 million fines being wrongly issued to patients in England after visiting the doctor or dentist.
The purpose of the fines was to target patients unfairly claiming free treatment. However, a third were sent to innocent people.
She called on the Department of Health and Social Care (DHSC) to change the "utterly confusing" regime, which she said operates at the moment on a "presumption of guilt". She called the system a "dog's breakfast".
Since 2014, fines with a value of £676 million had been issued, frequently amounting to fines of £100, to people accused of dishonestly claiming free dental treatment or unfairly avoiding paying prescription charges.
However, the PAC described a system in which about a third of the fines were issued to people who were entitled to free treatment, including people with serious health problems, dementia and learning difficulties.
The British Dental Association (BDA) warned MPs that visits to the dentist by low-income patients had fallen by almost a quarter since 2014, which they linked to anxiety about fines. The Association said there was "no excuse" for so many "innocent people" to face such threats. It also warned that many people facing the threat of fines will pay rather than contest them, even though they are eligible for free care.
The BDA said many of the wrong fines were the result of simple errors or confusions when filling in forms.
People wrongly accused of fraud faced humiliation. When they attempt to overturn a fine they could find themselves caught up in a "vortex of bureaucracy", according to Meg Hillier.
A DHSC spokesman said the Government would consider the report and respond in due course. He said: "Prescription and dental fraud cost the NHS an estimated £212 million in 2017 to 2018 and it is absolutely right the Government takes steps to recoup this money so it can be reinvested into caring for patients."
The report, "Penalty Charge Notices in Healthcare", is available at: https://publications.parliament.uk/pa/cm201719/cmselect/cmpubacc/2038/2038.pdf