How To Get Away With Fraud

A Sunday Mirror investigation has revealed how Lewis Day Medical Services billed for phantom trips supposed to have been made by a non-existent driver.

An average of 20 journeys were faked EVERY DAY, and the scam lasted for more than 18 months. The minimum charge for each journey was £8.60. But some cost cashstrapped hospitals £109 a time.

In one instance Villas's fake ID was used to charge £73.20 to take a patient with lung disease just two miles home. In fact, the trip had been cancelled hours before because the patient was too ill to travel.

Our investigators were passed a secret file listing all the fraudulent journeys relating to Villas. We handed the evidence to the NHS, who called in their own detectives. Lewis Day subsequently agreed to pay back £281,894 to Imperial College NHS Trust.

Despite the fraud being discovered, Lewis Day will carry on working for Imperial College NHS Trust because it is tied into a contract. And there is no prospect of anyone being prosecuted.

Wow.

More and more the NHS is relying on private ambulance companies, initially for this sort of patient transport and increasingly for A&E work. (More on which later). Sadly I suspect that this isn't going to be the exception and I foresee other companies being caught out in a similar fashion.

The very interesting thing is that

Despite the fraud being discovered, Lewis Day will carry on working for Imperial College NHS Trust because it is tied into a contract. And there is no prospect of anyone being prosecuted.

I can say, with some certainty that if I were to be found guilty of fraud I'd, quite rightly, be out on my ear. So why isn't this happening to this company?

My suspicion is that it would cost the trust more money to run the contract bidding system again, that or someone in Lewis Day has a friend or two in high places. I can't see any other reason how such a serious fraud would occur without the police being informed. I mean, the LAS has issued guidance on the sort of kit that we can keep in our cars – it's a small list with such items as 'Latex gloves – three pair only', they would be a bit upset if I were to steal over a quarter of a million pounds.

And then, when I get caught, go 'oops – here, have it back – no hard feelings eh?', and head out to pick up my next patient with hardly a word spoken.

Here is hoping that the other ambulance companies take a long hard look at the way they run things and the people that they employ in order to prevent similar situations happening in the future.

23 thoughts on “How To Get Away With Fraud”

  1. Absolutely disgusting, and sadly indicative of the arse about face priorities in the NHS. My aunt used to run a nursing authority… not long after the move to a more businesslike and management oriented approach she quit and retired years early because she was sickened by the ineptitude and a mangerial policy that placed business and the 'bottom line' over health care :/U sincerely hope the Mirror manages to stir up a little common sense and get these pirates removed from the contract and hopefully charged.

  2. My point, or question, is that isn't this a criminal rather than civil matter? If the Trust complain to the police wouldn't they chase it up?In which case it's the Crown rather than the Trust that pays the bills isn't it?

    It all seems a bit wrong to me that if you steal enough money you can get away with it.

  3. My company has Local Authorities as our major customers, and all of our contracts have some form of this wording:28.1 The Council may terminate the Agreement and recover all its loss if the Supplier, its employees or anyone acting upon the Suppliers behalf does any of the following things

    28.1.3 Commit any fraud in connection with this or any other Council contract whether alone or in conjunction with Council members or employees

    (my bold)

    I can't believe that the NHS doesn't have a similar clause in their standard contract.

  4. Unbelievable! Last time I heard about a fraud like this with no charges brought, turned out that a few management from the defrauded firm were getting a slice of the action too.

    Not suggesting that's the case this time, but I do hope there's plenty more investigating to come!

    By the way… “the LAS has issued guidance on the sort of kit that we can keep in our cars

    Have they? What sort of kit? I'd be interested to see the list.

  5. This is really outrageous! If there is not get some comeback on this then this society is in a terminal condition.Outraged of Kingston!!!

  6. With the amount of cover-up displayed in this case, it's clear the net covering those involved is far greater than those who were caught.20 years ago, my local council was involved in fraud that cost the ratepayers 49,000,000 – and no-one was held accountable. today we're still paying off the bill.The higher up the tree, the dirtier the branches, but you never see who's making them dirty.

  7. Vic you summed it up about the tree.Sadly l would be shocked if l was not getting blase in my old age about all the bad things that go on and nothing happens.

  8. question: do u.k. police forces not have discretion to file criminal charges when a crime has been committed? or do they have to wait until the 'victim' files? in some instances (u.s.), such as domestic violence, the police have no choice but to file charges whether the abused partner wishes it done.

  9. Not too sure why you'd be interested in what kit I am and am not allowed to keep in my car. I mean I understand why the LAS have a policy.I think the issue here is that fraud is notoriously difficult and expensive to prove and also invovles admitting that you have been taken for a ride.

    I'd also like to think that the Mirror looked long and hard for personal connections between frauder and fraudee as that would make an even better story.

    Surely public money is better spent on clinical care than on legal bills.

    Still that's just my 5p

    DSO

  10. This is ridiculous that companys employed by the LAS are allowed to do almost anything they like bar murder, and if you got a complaint for trying to restrain a violent drunk, you'd be in it deep. Something's gone really wrong with the system somewhere.

  11. 'Despite the fraud being discovered, Lewis Day will carry on working for Imperial College NHS Trust because it is tied into a contract. And there is no prospect of anyone being prosecuted.'This bit seems bizarre to me. Surely stealing over a quarter of a million pounds must breach their contract?

  12. Sad as it is, or cynical as I am, I wouldn't be suprised to find that Lewis Day are going to be included in the bidding when their contract is up, and even win the contract back again.To be fair though, it doesn't say in the article who was responsible, or if criminal charges were brought against anyone. I'd like to think it was one or two perps, who've been kicked/charged, but again, wouldn't be surprised if thats not the case.

  13. A breach on the other side of a contract doesn't automatically mean you can breach your side. You'd have hoped fraud would count as a good enough reason, though.Perhaps more likely is that Lewis Day might have told the trust they'd have to fight in court for the money otherwise. IIRC, you typically aren't awarded your full costs when you win, so you always end up with less than you're owed. You also typically have to fork out hundreds of thousands in advance over several years before you even get to court, let alone get paid back….and that's ignoring the risk of Lewis Day going bust in the mean time.

    Courts don't really work. Avoid at all costs…

  14. Excellent – then I shall set about defrauding the NHS and expect to get away with this *criminal* activity because it's not worth chasing me.

  15. I don't know enough about the law to quote it, but as a man in the street I am guessing if it was a civil case you would need to engage a solicitor to prosecute it or do it yourself by going through the county court (funding it yourself & claiming the costs back). If it was a criminal case it just needs reporting to the authorities & the police will investigate make up a prosecution file & forward that to the CPS who decide if it's in the public interest, the likelihood of a succesful conviction etc. This way it is obviously publicly funded.Isnt there an offence somewhere of submitting a false instrument to obtain pecuniary advantage? similar to falsifying your mortgage application to obtain money from the building society/bank. Isn't this similar? The taxi company are submitting false invoices to gain money.

    Isn't there another offence of gaining goods, money or property by deception?

    I could go on but I only came out for a pint of milk 😉

  16. Do not steal a loaf,or a band aid, cash or truck, steal the bank, ' 'tis safer, policemen are for catching bread robbers, but it be rare for them to chase a paper pusher robber.'tis been so since he who steals the goose from the commons gets a night in the cellar even a neck tie sometimes for the gibbet but he who steals the commons gets a knight hood see the august intense greedy one.

  17. I'm presuming the trust was more interested in the money than a conviction. Besides, we don't know why 'there is no prospect of anyone being prosecuted'.Perhaps it's a little too far out of my personal knowledge and experience to take me too seriously….or perhaps I'm cynical as far as courts are concerned after seeing a small business be bankrupted by high court legal costs (I might add that the defendant is paying some, but not all, of the judgement and costs awarded to its liquidator and that the total costs were something like eight times the judgement).

    However, it's not hard to imagine barristers on 1000UKP/hour or more (really!) arguing in court over whether Mr John Smith really was transported at a cost of 78.34 or not. Or, at the very least, arguing over how the total figure was estimated and whose estimate is correct. Besides, it takes forever to get to court…they'd have to go through 'discovery' first – essentially demanding documents from each other. A belligerent opponent can then dump half a ton of details on you so that it costs you a fortune and takes forever to have an expert witness accountant go through them.

    At the end of all that you're STILL expected to try and find a settlement out of court. I rather get the impression that rejecting one which looks reasonable compared to the judgement means you're much more likely to have to pay your costs.

  18. It just shows that the contract must not have been checked over properly otherwise there would be a clause in there that would allow 'massive fraud' as a reason for breaking the contract.We see it so often with government contracts. Never covering for projects that strangely always seem to go fifty times over budget and years too long.

    It is just laziness that comes with public service managers who know that the money they are spending is not their own.

  19. The police might chase it up, but I'm pretty certain you still need to go to a civil court to get your money afterwards. I don't know how much the CPSs evidence (had they prosecuted, successfully or otherwise) would help and whether you could gain access to seized documents or use the conclusions of CPS experts. Presumably a criminal conviction wouldn't require proof of exactly how much money was involved in total anyway (as long as it could be proven there was some).BTW, your link to the Sunday Mirror article seems to go to an error page now.

  20. I worked on PTS control when London Ambulance lost the Imperial contracts, allow me to share a fe snippets of wisdom we got from Lewis Day when they tried to persuade us to work for them;- We have never had a package late (these are people, not pckages) Same principle.

    – You want to work front line? Give us a year or two, we will have that contract as well.

    – If we can get a bike down Fulham Palace Road at 3pm on a Friday, we can get an Ambulance down there.

    – Where do we get those badges you wear? (What, the London Ambulance Crests?) Yeah, if we are doing this job, we are the London Ambulance Service!

    Needless to say, I didn't stay with them and moved to UCH (which we again lost to a cheaper firm)

    I went back to CXH for an apointment a while after we left, and they were complaining they were too busy with about 80 journeys a day, when LAS used to handle 250+ And my old manager was stil getting complaints from CX patients about the serve, because they were giving his name and address as they were 'London Ambulance'.

    A year later at UCH I stil hd patients say LAS transport had bought them in, ony to see Lewis day collect them.

    I feel sorry for the patients who get poor service, but to the trust who got rid of us, when we did all they ever asked and more, only to get the boot so they could threated the other contacted services that they could be gotten cheaper as well? Got all you deserve there.

    Bitter Much? possibly.

  21. JimB, I can only agree with you here, with everything that you write. I've seen it happen myself (with a different company) and was fuming when the LAS lost the contract.The 'wanting to be the LAS' is something that properly annoys me – and is a post for a later date.

    And I can see the same thing happening to the A&E fleet, and then the PCTs will *again* get what they pay for.

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