The following actions are taken in cases where persons who claim to be entitled to free prescriptions are subsequently found not to be:
(i) A letter is issued to the person requesting payment of the health charge within 14 days if they accept they were not entitled to a free prescription;
(ii) If payment is not made within 14 days then a further letter is issued requiring payment of the health charge within 28 days to include a penalty charge of five times the health charge up to a maximum of £100;
(iii) Where no response is received within 28 days a further letter is issued requiring payment to include the original health charge plus the penalty and a further surcharge of 50 per cent. of the penalty;
(iv) People who still fail to respond are taken to the Small Claims Court.
During the 2005-06 financial year, from the sample of claims examined by the Counter Fraud Unit, some 3,202 individuals who had claimed to be entitled to free prescriptions were subsequently found not to be so entitled. Restitution was made in all of these cases.
The following payments were made by the individuals concerned:
2,601 paid the relevant statutory prescription charge;
405 paid the relevant statutory prescription charge and a fixed penalty charge;
196 paid the relevant statutory prescription charge, a fixed penalty charge and a surcharge.
During the same period, in addition to the above, 179 cases were referred through the Small Claims Court and the appropriate Court Decree obtained.
As a result of these and other actions, the overall level of prescription exemption fraud in Northern Ireland has fallen from an estimated £14.7 million in 1999-2000 to £7.6 million in 2005-06. Over the same period, the estimated fraud rate has reduced from 8.14 per cent. to 4.63 per cent. While the level of fraud continues to fall it is still a significant loss, which we intend to reduce further. The introduction of a major IT system, which will provide prescription information (including exemptions claimed by patients) in electronic format, will assist in this task. The new system will enable greater levels of checking and action against those who claim but are not entitled to free prescriptions.