Funding fraud: Former GP liable in case of ineligible capitation

The tribunal should impose the most significant penalty it can offer

A GP has today been found guilty of professional misconduct for enrolling ineligible British and Australian backpackers to her practice for the extra capitation funding.

In the past three days, the Health Practitioners Disciplinary Tribunal has heard that the doctor’s practice received over $420,000 of ineligible capitation by submitting to ProCare Health PHO the age/sex registers of 2618 patients who did not meet various eligibility criteria.

The tribunal today decided it was satisfied the charge amounted to professional misconduct and malpractice and was likely to bring discredit to the practitioner’s profession.

While the tribunal has found her liable for the misconduct between 2003 and 2011, costs, penalties and an application for permanent name suppression have not yet been decided.

Tribunal chair Maria Dew says a delay has been provided so the GP has time to be informed of the decision, before she reads it in the media, particularly if her name suppression application is denied.

The Auckland-based GP, who is not currently practising, did not appear at the tribunal this week.

New Zealand Doctor Rata Aotearoa expects to hear within a week the cost and penalty details, and a name suppression outcome.

Lawyer Hayden Wilson, for the Professional Conduct Committee that took the case, says the doctor’s registration should be cancelled, and she should be required to pay 75 per cent of total costs.

The case amounts to “the most significant” and “almost double” the amount of inappropriate claiming for funding this tribunal has ever encountered, says Mr Wilson.

He says the tribunal should impose “the most significant penalty [it] can offer”.

The committee is opposing the GP’s application for permanent name suppression.