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Medical expert resigns after scam

15/ 5/2008

A RESPECTED medical expert has resigned from his top NHS job after it emerged he had carried out an £85,000 scam against medical insurers.

Navneet Ahluwalia, from Hale, worked as the lead gastroenterology consultant at Stepping Hill Hospital, in Stockport, for the last 12 years until he was banned from practising medicine by a doctors' watchdog.

After investigating his private work at the Alexandra Hospital in Cheadle, the General Medical Council found he had systematically billed four medical insurance companies for expensive procedures instead of the basic tests he actually carried out at the hospital - known in the trade as 'up-coding.'

The GMC banned him from practising medicine for a year branding his actions 'misleading and dishonest.'

But at a 16-day hearing in Manchester, Dr Ahluwalia said although he had received three separate warnings from insurance companies he had not intended to make the false claims over the three years.

He and some of his colleagues claimed up-coding was common in private practice.

Panel chairman Mrs Eileen Carr said: "The Panel has found that you have misled insurers and have been dishonest in 'up-coding' your fee claims over a period of three years.

"This type of conduct is viewed very seriously by the panel as all doctors are expected to be honest and trustworthy.

Undermines

"It also undermines public confidence in the profession. Notwithstanding the gravity of this conduct, the panel has taken into account the fact that you and some of your colleagues perceived ambiguity in the codes, that you were not alone in 'up-coding', and that you did not attempt to cover up your dishonesty.

"The panel is of the opinion that it would not be in the public interest to deprive the community of your significant clinical skills and experience for longer than twelve months."

Four insurance companies AXA, BUPA, Western Provident Association and Norwich Union all complained they overpaid him thousands of pounds.

The hearing was told he had come to a settlement with the insurers to make 'substantial repayment.'

Several of Dr Ahluwalia's colleagues testified about his good character and honesty, even paying tribute to his charity work during the hearing.

He was described an 'exceptional clinician' who made an exceptional contribution to the NHS, teaching other staff as well as carrying out research.

Dr Chris Burke chief executive of Stepping Hill said: "Dr Ahluwalia has resigned from his position as consultant physician at Stockport NHS Foundation Trust. Those patients who were under his care will be transferred to another consultant physician."

A spokeswoman for Stepping Hill was unable to say when he would be replaced.