Fraud and corruption can happen anywhere, and the healthcare industry is not immune to human weaknesses and misdeeds.

This year, the Ministry of Health projected that healthcare spending will hit S$11 billion. With global healthcare fraud estimated at 5% to 10% of expenditure, the amount pocketed by fraudsters could reach up to $1.1 billion this year.

That is a lot of money down the drain, which could have gone into patient subsidies, staff welfare, or better facilities. At its worst, fraud and corruption may even cost lives, if sub-standard products and services are accepted for use.

“When a case of fraud happens and you dig deep into the primary reasons behind why it happened, you will realise that for most cases, the culprits displayed certain common behavioural red flags that if spotted earlier, the fraudsters could have been stopped earlier – or stopped entirely”, said Bernice Swee, Senior Manager, Group Internal Audit Division, MOH Holdings.

As such, it pays for all staff to spot the signs and symptoms of fraud and corruption, and to blow the whistle on the offender.

How to spot the signs and symptoms of fraud

1. Wow, did he just buy a new car – again?
Or how could she afford that flashy apartment on her salary? Most of us like to save such observations for canteen gossip, but a person who seems to be happily living way beyond his or her means should be flagged for suspicious behaviour.

2. She's having a rough time, isn't she?
Divorce, relationship problems, gambling addictions or financial difficulties can drive some people to desperate measures. They believe that siphoning money from the company won't hurt anyone, and some may even plan to return the money when things get better.

3. Why won't he share his duties?
Or why won't she go on leave? Fraudsters who have master-minded a plan to defraud their employer cannot afford to leave their station or risk getting caught! They also dislike handing over duties, and may act suspiciously or defensively when questioned about their work.

4. He's so unhappy with the company
Or she's been under so much pressure, you think she will crack. And some people do. They feel mistreated by the company or their bosses in some way, and decide to address the perceived injustice by defrauding the company.

 5. Didn't he just meet her for lunch? And dinner?
Most client-vendor relationships start and end at the meeting table, but some take things further, to the café table, the restaurant table, the dinner table…and before you know it, favours are exchanged and a tender is won. At this point, fellow bidders may cry foul, but chances are, the fraudster's colleagues would already have seen the signs of indiscretion by then.

How to avoid the disease

1. Lead by example
Senior management can set the tone for the rest of the organisation on its zero-tolerance for fraud and corruption. Everyone must be up-to-date on fraud awareness and the organisation's ethics policies.

2. Remove the opportunities
If watertight processes, systems and controls are in place, a potential fraudster will feel like an eternally frustrated thief! Bosses should also get to know their subordinates and work processes well, such that irregularities and loopholes are easier to spot. Also, do not exercise too much trust to the point of negligence.

3. Don't even start
The intention may be to fudge just one claim, make one compromise, or accept just one bribe or favour, but it seldom ends there. When corruption happens, complacency, blackmail and further crime tend to follow. The best step is to not take the first step.

How to treat the disease

1. If your immunity is low, stay away
Temptation strikes when you are at your most vulnerable, so be aware of your state of mind at work. If an opportunity arises to commit fraud, remove yourself from the situation and alert your colleague or boss to it.

2. Report your suspicions
If you notice clear signs of fraud and corruption around you, report this through one of SingHealth's whistle-blowing channels.

Call: (800-0111-111) 877-569-6285 or (800-001-0001) 877-569-6285

Visit: www.singhealth.alertline.com

Email: [email protected]

To raise awareness on the need to look out for potential fraud or corruption, the SingHealth Office of Risk Services held a talk on 4 October 2016, titled "Is Healthcare Immune to Fraud and Corruption?". The guest speakers were Ms Pei Min-Min, Head of Strategic Intelligence Section of the Intelligence Branch 1, Corrupt Practices Investigation Bureau, Ms Jenny Heah, Assistant Director, Group Internal Audit Division, MOH Holdings, and Ms Bernice Swee, Senior Manager, Group Internal Audit Division, MOH Holdings.