GP accused of falsely claiming $420,000 in funded healthcare

The GP reportedly falsely claimed that 2618 patients were eligible for healthcare funding. Photo / 123rf

A doctor accused of falsely claiming more than $420,000 in Government-funded healthcare claims to have personally paid for the care of several thousand patients.

The doctor, who can't be named, is accused of signing up departing British and Australian backpackers for long-term healthcare subsidies at her clinic, then falsely claiming that 2618 patients were eligible for funding when they weren't.

The GP was pulled up by the Ministry Of Health (MOH) in 2004 for a separate investigation and was ordered to repay over $9000 after 342 patients were found to be falsely enrolled.

But in 2008 an audit showed the doctor was allegedly up to her old tricks again.

The doctor, who faces a charge of professional misconduct before a Health Practitioners Disciplinary Tribunal, has name suppression.

She did not attend the second day of the hearing but said in a memorandum read out on her behalf that she acted in good faith at all times.

"The Ministry of Health failed to provide the direction of eligibility to me."

"The way I disclosed registers to the MOH is not the actions of someone who was intent in fraudulent activities and unethical behaviour," the doctor said.

The GP applied for the funding through an Auckland Primary Health Organisation [PHO] known as ProCare.

Today, the tribunal also heard from Chris Unsted, who worked in the Audit and compliance unit and was involved in the Ministry of Health's investigation into the doctor.

"I was responsible for the forensic analysis of the doctor's computer system."

Unsted described how the GP had attended a number of presentations to learn how the funding worked.

"Procare is the largest in the country, I know they were very active in providing training packages of how the funding worked."

"Our audits held training seminars to insure that everyone has a better understanding of the enrolment requirements," Unsted said.

Between 2004-2011 the doctor claimed that the MOH failed to provide the guidelines of eligibility to her.

"My email correspondence with the MoH asking for help to understand how the funding worked repetitively went unanswered," the doctor said.

Unsted said the doctor would have been directed to the website by MOH and ProCare staff, where all the guidelines and rules regarding eligibility would be outlined.

A professional Conduct Committee lawyer Hayden Wilson said that the GP knew those patients were not eligible and entitled to the funding.

"She knew the rules and knew what she was doing, she submitted the registers with the intention to receive funding she wasn't entitled to."

"She was the only person who could have benefited from this funding and was constantly inquiring on why patients were rejected from the funding," Wilson said.

The tribunal is set to come to a decision tomorrow.

The doctor no longer practices and does not have a practising licence.