The British Medical Association in Wales has demanded an apology from the Wales Audit Office for suggesting GPs will take advantage of lax governance and commit fraud in their QOF returns.
A furious Welsh GPC chairman, Dr David Bailey, has written in strong terms to the Welsh Auditor General, Jeremy Coleman, over the recent WAO report on the new GMS contract.
He said the report painted a false picture of the contract success and was demonstrably wrong in some places.
But the WAO has defended the report’s integrity, denied accusing doctors of fraud and says it will never apologise for making recommendations to save public money.
The report, published late August, says that the contract has delivered significant benefits to GPs but will need better management to reach its potential for patients.
Health boards have not carried out the random checks on QOF scoring seen elsewhere in the UK, posing a “significant risk that practices will start to manipulate QOF figures and that the intended benefits to patients will not be realised.”
Currently £65m is paid out through QOF in Wales and this is set to rise increasing the risk of loss, says the report.
Core services are too loosely defined, it adds, resulting in some GPs getting paid again for things that were included in their MPIG (minimum practice income guarantee) and global sum.
The WAO report recommends a tighter definition of core services that would eliminate duplicate payments and an improved inspection regime by local health boards to deter practices from inflating their QOF claims.
But the BMA is incensed and has formally dissociated itself from the report’s findings and recommendations.
Dr David Bailey, GPC chairman said: “We are extremely disappointed that after a year in the making and having taken advice from the BMA on several occasions, the report paints a false impression of the contract and its implementation in Wales, implying there have been no benefits for patients.”
The WAO had failed to understand QOF, he said, and had not recognised that its gains will not be delivered for several years.
He added: “Our fundamental concerns are around recommendations on MPIG, QOF, core funding and the suggestion of possible widespread fraud, together with a number of demonstrably false statements.”
While the BMA supported the need for improved governance, Dr Bailey was particularly upset by the comments on QOF.
“This seems to be an assertion that GPs will commit widespread fraud and I would request a public apology for this slur,” he said.
A spokesperson for the Wales Audit Office denied that doctors had been accused of fraud.
She said: “We listened carefully and adequately to the advice from the BMA and other experts and the BMA was involved in the fieldwork and findings for this report. We feel it is an accurate commentary and will be helpful to all those making the contract successful.”
The WAO was “obviously disappointed” that the BMA did not wish to be associated with the report, she added, but there could be no question of an apology.
“We will never apologise for recommending actions to save public money,” she said. “There is ample evidence gathered over very many years that in the absence of proper safeguards, fraud can be committed by individuals regardless of their professional background.”