The Government has pledged to crack down on fraudulent claims by the NHS to cover the cost of medical treatment, but the Government is yet to announce which NHS services will be affected.
A report by the Royal College of General Practitioners (RCGP) has found that there are 2,600 NHS hospitals which have not been compliant with the cap on payments for medical services in England since May, meaning it could be cancelled by the end of the year.
It was estimated that the total cost of NHS services would be about £16 billion by the autumn.
The Royal College is calling on the Government to remove the cap immediately, saying there is no reason why it should be there and it has warned that “it could result in NHS hospitals being forced to close or be forced to shut altogether”.
The report also found that 1,500 of the 2,000 NHS hospitals are in the UK, and it said that the cost for patients to visit the hospital was “incredibly high”.
The report is the latest in a series of reports into the £2.7 trillion cost of the NHS over the last five years, and is based on an analysis of data provided by the Health and Social Care Information Centre (HSCCI).
It found that between March 2017 and May 2018, around 2,200 NHS hospitals had not met the cap, while between April 2017 and June 2018, over 1,700 of the hospitals had failed to meet it.
The report found that while some hospitals are using the cap to cover their own costs, “a significant proportion” of hospitals were not.
HSCCi’s chief executive, Prof James Watson, said the cap was “unsustainable”, and called on the government to act to “protect NHS patients from fraudulent claims”.
“If we are going to do something about this, it’s critical that we do it as quickly as possible,” Prof Watson told the BBC.
“There are a lot of people out there who are doing this to cover themselves, but there are also a lot who are just going to stop.”
Prof Watson said the Government was “very much aware” of the situation and was “working on a strategy”.
He said the Department of Health (DH) had already put in place a “robust enforcement framework” for hospitals to deal with fraud, and that “a number of organisations” have also stepped up to help.
But the RCGP said there was still “no clear evidence” that the cap had been removed from hospitals and there was “no evidence that it’s being lifted”.
Prof Watson told Radio 4’s Today programme: “We don’t know what’s going on, there’s no evidence that hospitals are actually getting to grips with the problem, and we don’t see any evidence that they are using it to cover costs.”
The RCGP has said that it will launch an independent investigation into whether hospitals are complying with the £16bn cap, and Prof Watson said there needed to be a “full and open public inquiry”.
“It’s very clear that the problem has got worse in recent years and the Government has not addressed it,” he said.
“This is something that needs to be addressed now.”
HSRCI’s report was commissioned by the Government in May, and has found evidence of “substantial” fraud in the NHS.
The Health and Human Services Secretary Simon Stevens said: “If you’re paying your way in the world of healthcare you know there’s a huge number of people who are paying for the wrong thing, or the wrong services, or both.”
And the truth is we know that in a lot more cases than we’re ever willing to admit.
“We have got to do more to get this right, we have got a lot to learn about the health system.”
He added: “This is not just about a few people.
It’s about the millions of people.”
Prof Watson added that “the reality is we are all paying a fair bit of money for the NHS”.
He told Radio 5 live: “The NHS is a very complex system, and there are a number of parts that are doing a lot, a lot and a lot at the same time.”
But it’s just a big complex system with a lot going on.
“He said “people are getting sick” but the NHS had “no control” over who was paying for medical treatment.”
It is about a whole range of people, all of whom are paying into the system and in some cases there’s quite a large proportion of people making a lot.
“The Government can have control over it, but that is not how the NHS works.”
Dr Sally Davies, a GP and director of the health charity the National Health Service Trust, said: “”We don´t know whether there’s any evidence of a significant reduction in hospital admissions.
“But she added: “”There is a lot we don´T know about how