英国医保系统的360万“幽灵患者”丑闻 [英国媒体]

Scandal of the 3.6million NHS 'ghost patients': Huge numbers still registered at practices have either died or moved away... but GPs receive ￡151 for each one despite a crackdown pledge

医保系统的360万“幽灵患者”丑闻：大量实际上已经死亡或移民的病人依旧被登记在册，但全科医生却不顾当前医保预算危机从这些登记在册的每一个患者身上年均领取151英镑

A staggering 3.6 million patients who do not exist are registered with GPs' surgeries, a Mail on Sunday investigation reveals today.

《星期日邮报》今天披露的一项调查显示，有360万不存在的患者仍然被登记在册，作为全科医生的服务对象。

Despite a crackdown launched three years ago on so-called 'ghost patients', the numbers have risen at a rate of almost 6,000 a week.

尽管3年前英国政府就开始对所谓的“幽灵患者”进行打击，但这个数字还是以每周近6000人的速度递增。

Doctors in England receive an average of ￡151 a year for each patient on their books, whether they see them or not.

英国的医生从每位登记在册的患者身上年均领取151英镑，不管是否给他们看过病。



But millions still registered at practices across the country have either died or have moved away.

但是，目前仍在英国各地注册的数以百万计的患者要么死亡，要么已经撤走。

In 2015, NHS chiefs hired corporate consultancy firm Capita to tackle the problem as part of a major ￡330 million contract to run 'back-office' services.
But under Capita's watch over the past two years, the number of ghost patients has risen by almost 20 per cent – from three million to 3.6 million.

2015年，英国国民保健署署长聘请企业咨询公司——卡皮塔公司——解决这个问题。但据卡皮塔公司观察，在过去两年中“幽灵患者”的数量增加了近20%——从300万增加到360万。

The notional cost of the army of phantom patients is almost ￡550 million – enough to hire 28,000 new nurses, 10,000 new doctors, or provide free parking at every NHS hospital in England for three years.

据估计，“影子患者”大军的医疗成本接近5.5亿英镑——足以聘用2.8万名新护士和1万名新医生，或相当于在3年内为国民保健署的每一家医院提供免费停车服务。



Our investigation discovered examples of ghost patients who have remained on GP surgery lists for years. They include:

本网站的调查发现，一些“幽灵患者”多年来一直留在全科医生诊所的名单上。以下仅举其中几例：

A person who died in 1969, but remained on a list for 42 years;

某人于1969年去世，但是其名字却在名单上保留了42年；

A couple who emigrated to Australia in the 1960s, but were still registered with their London GP almost half a century later;

一对夫妇上世纪60年代移民去了澳大利亚，但是近半世纪后他们仍“注册”着他们在伦敦的全科医生；

A Midlands practice that claimed for 24 patients at a single address – they were later found to be illegal immigrants who didn't live there;

24名患者共享一个地址，后来发现他们是非法移民，根本就不住在哪里；

A GP in Scotland who fabricated a patient called 'M. Mouse' to fill up gaps in his schedule.

苏格兰的一名全科医生编造了名为“M·毛斯”的患者来填补他日程上的空白

Whistleblower Jackie Huxter, 61, from South London, who worked as a call handler for the NHS 111 out-of-hours hotline between 2012 and 2016, told The Mail on Sunday that the problem 'goes back decades'.

此事的爆料人名叫杰姬·赫克斯特，她曾在2012年至2016年间担任英国国民保健署开设的“上班时间外医疗服务热线”的电话接线员。她日前接受本报记者采访时说，这个问题“可以追溯到几十年前”。

'I had access to the NHS Spine database that would bring up patient details when they gave us their name. It was not uncommon to see people registered with two or even three GPs,' she said.

“我可以访问国民保健署脊数据库，当他们告诉我们他们的名字时，这会提供病人的详细信息。”她说：“注册有两名甚至三名全科医生的人并不少见。”



Cambridge has 16 per cent more people registered with GPs than its population and Oxford has 15 per cent more.

剑桥注册的全科医生人数比其人口多16%，牛津比其人口多15%。

Areas with big immigrant populations are also affected, with ten per cent more patients than people in Boston, Lincolnshire, and up to 20 per cent more in the London boroughs of Ealing, Brent and Hammersmith and Fulham.

移民人口众多的地区也受到影响，比林肯郡波士顿的病人多出10%，而伦敦的埃灵、布伦特、哈默史密斯和富勒姆等行政区的病人则多出20%。



Official figures from NHS Digital, which provides IT services to the health service, shows 59.2 million people are registered with a GP in England.
But the Office of National Statistics says the current population is 55.6 million, meaning there is a gap – known as 'list inflation' – of 3.6 million.

国民保健署数字中心的官方数字显示，英国有5920万人注册了全科医生。但英国国家统计办公室称，目前英国的总人口为5560万，这意味着存在一个360万的缺口。

NHS fraud inspectors believe a small number of GPs deliberately keep names on their lists, but that most are simply failing to prioritise the issue.

国民保健署的欺诈行为调查人员称，有一小部分全科医生故意将“幽灵患者”的名字保留在自己的患者登记名单上。但大多数人根本没有把这个问题列为优先事项。

Most surgeries are private businesses contracted by the NHS to provide patient care.

大多数外科手术都是由国民保健署签订的为病人提供医疗服务的私营企业。



The British Medical Association rejected suggestions of profiteering by GPs, and described Capita's work as 'woeful'.

对有全科医生借此牟利的指控，英国医学会表示拒绝接受。并将卡皮塔的工作描述为“可悲”。

Dr Richard Vautrey, chairman of the association's GP Committee, said: 'There are several reasons why the number of patients registered with a GP practice may not reflect official population data.

英国皇家全科医生学院的一位负责人RichardVautrey博士表示：“有几个原因可以解释为什么注册的病人人数可能不能对应上官方的人口数据。

'Most of these will be people who are in the process of moving house to different areas. Others may have recently died, or some may have left the country.

他们中的大多数都是正在向不同地区搬家的人。其他人可能是最近去世的，也可能是一些人离开了这个国家。

'Others may be homeless or simply unaccounted for in Government statistics.'

“其他人可能无家可归，或者只是在政府统计数据中下落不明。”

He added: 'Patients should be able to visit their GP when they need to and it is imperative they are not removed from a practice simply for being well and not recently needing an appointment.'

他补充说：“病人在需要的时候应该能够找到他们的全科医生，他们不能仅仅因为身体健康或最近不需要预约而从诊所登记中移除。”

Professor Kamila Hawthorne, vice-chairman of the Royal College of GPs, said: 'Ghost patients are the result of a records management issue from the infrastructure that manages patient registers, not a case of surgeries profiting by keeping patients on their lists when they shouldn't be there.'

皇家全科医生学院(Royal College Of GPs)副院长卡米拉·霍桑(Kamila Hawthorne)教授说：“'幽灵患者'是因为管理患者注册的机构出现档案管理问题造成的，并不是通过在病人不存在的情况下将病人留在名单上而牟利的案例。”，

Capita's performance on the ￡330 million contract was last month described as 'a shambles' by the Commons' Public Accounts Committee.

上月，国会公共账户委员会(CommonsPublicAccount Committee)称，卡皮塔在这份3.3亿英镑的合同上的表现“一塌糊涂”。

A spokesman for Capita said: 'This is a complex area involving GPs and other third parties.

卡皮塔的一位发言人说：“这是一个涉及全科医生和其他第三方的复杂领域。

'Alongside other improvements we are making, we are working closely NHS England who are consulting on proposed changes and guidance that will enable us to start targeted data quality checks on GP lists as part of our services.'

除了我们正在进行的其他改进外，我们还在与国民保健署密切合作，他们正在就拟议的修改和指导进行咨询，这些建议将使我们能够开始对全科医生的在册病人列表进行有针对性的数据质量检查，作为我们服务的一部分。

A spokesman for NHS England said: 'GP practices work hard to keep their registered patient lists as accurate as possible and NHS England is working with Capita and GP surgeries to transform this process, make it digital and any savings identified will be ploughed back into the NHS.'

英国国民健康服务协会的一位发言人说：“全科医生在十分努力地使他们的注册病人名单尽可能准确，同时国民保健署正在与卡皮塔和全科医生通力合作，改进这一流程，使其数字化，所确定的任何节省都将被重新投入国民保健署。”