CHAPTER 1
How the counter fraud profession developed and what the counter fraud professional should be

CHAPTER SUMMARY

This chapter will consider the professionalisation of counter fraud investigation, including how the Accredited Counter Fraud Specialist has evolved. The development of a professional infrastructure and the essence of the counter fraud professional will then be outlined. Finally, the chapter will redefine the counter fraud professional and the lexicon of countering fraud.

INTRODUCTION

This chapter will consider the importance for an organisation – whatever the size – of employing a counter fraud professional and developments over the last 15 years to establish a new Counter Fraud Specialist profession. This may seem like an extravagant expense, but there are a variety of economical models which can be used to achieve this aim. For example small organisations can contract in the services of a professional for a selected number of days depending upon their needs or they can train a member of staff to take on these responsibilities. For medium to larger organisations the risks of fraud are likely to warrant much more investment in the resource, ultimately culminating in a full-time position or multiple positions. There is no one size fits all and clearly the size, complexity and nature of fraud risks vary significantly between organisations. This chapter will consider what counter fraud professionals look like; it will also examine the professional infrastructure and consider some of the changes required to enhance this. It will also analyse what the skill-set of the counter fraud professional should be.

COUNTER FRAUD PROFESSIONAL INFRASTRUCTURE

A wide range of strategies have been advocated to create the best solutions to counter fraud and lead ultimately to competitive advantage for the organisation. Underpinning all of this is having (whether employed direct or via a contract) an appropriate counter fraud professional (or professionals – depending upon the size of the organisation) to lead the fight against fraud. In most organisations the focus of counter fraud activity usually centres on reactive investigations and developing controls. These are only part of what is required, as the chapters of this book will show. Most commonly counter fraud responsibilities are allocated to one or more of the following depending upon the size and nature of the organisation: auditors, investigators or security managers. In the more enlightened organisations these more general staff develop a fraud expertise and secure specialist fraud qualifications. In some organisations, such is the size and/or the fraud risk that they employ specialist staff dedicated to combating fraud such as Counter Fraud Specialists or fraud examiners.

Whichever model an organisation uses, what is important is for the person responsible to be a ‘counter fraud professional’. ‘Professional’ has many connotations in both mainstream and academic debate. Central to the definition is the idea of a profession. Avoiding some of the extensive academic debates on what constitutes a profession the central traits are:

• standards and a code of ethics;
• a body of knowledge disseminated by professional journals, conferences etc.;
• a recognised association covering all aspects of the industry;
• institutions capable of training and evaluating personnel and awarding certification of competence;
• an educational discipline that is able to prepare students in the specific functions and philosophies (Larson, 1977; Manunta, 1996; Simonsen, 1996).

Elements of these in relation to fraud professionals exist to varying degrees in different countries. For example in the USA there is the Association of Certified Fraud Examiners (ACFE) which has a standard of ethics, a knowledge base with dissemination structures (but no academic journal), a recognised training programme (Certified Fraud Examiner) and some degree-level programmes at universities. In the UK ACFE also has a presence, but there is in addition to the Institute of Counter Fraud Specialists (ICFS), recognised certification by the Counter Fraud Professional Accreditation Board (CFPAB) through the Accredited Counter Fraud Specialist award (ACFS) and degree programmes. However, even amongst those who have achieved ACFS, surveys of these professionals in the UK revealed substantial gaps in a professional infrastructure:

• Only around a quarter are educated to at least graduate level (only around 13% going on to achieve one of the higher awards of the CFPAB, such as CCFS);
• Low levels of additional accredited training are undertaken;
• Around three-quarters are not a member of any professional association (Button et al, 2007).

THE HISTORY OF THE COUNTER FRAUD PROFESSION

It is now more than 16 years since the UK Government Minister, the Right Honourable Frank Field MP’s ground-breaking Government Green Paper ‘Beating Fraud is Everyone’s Business’ (Department of Social Security, 1998). Field, then Minister of State for Welfare Reform, gave the very first UK Government commitment to creating a counter fraud profession. Jim Gee (one of the authors of this Handbook) was the Minister’s Fraud Advisor, having previously performed the same role when Field was Chair of the House of Commons Social Security Select Committee. He was also Head of the London Borough of Lambeth Corporate Anti-Fraud Team, brought in by its Chief Executive Heather Rabbatts, in 1996, shortly after Lambeth was described as ‘the most corrupt local authority’ in the UK.

Gee remembers working with Field on the Green Paper and being asked to read and comment on the passage about a counter fraud profession. He remembers suggesting that the phrase ‘the creation of a counter fraud profession’ be inserted as a commitment, and providing background information about the need for ‘specialist professional training and education’.

These comments were drawn from the experience of establishing professional training and education in London. As early as 1997, work had been commenced involving the Association of London Government, the London Boroughs Fraud Investigators Group, the University of Portsmouth and Thames Valley Police Force’s Training Department, to create a professional training course for Counter Fraud Specialists, along with a Professional Accreditation Board to accredit those who successfully completed the training. These developments were consciously modelled on the arrangements to be found in other areas of work where professional skills are predominant. Avoiding unhelpful pretensions, the initial analogies were the social work and teaching professions.

In these areas, you typically find:

• Prescribed professional training which develops technical skills;
• A common ethical framework for the deployment of those skills
• A Professional Accreditation Board to regulate those who are accredited as a result of successfully completing the professional training;
• A Centre of Excellence to innovate and to highlight emerging best practice.

The particular experience of the London Borough of Lambeth highlighted the need for new standards of professionalism. In the early 1990s work to counter fraud and corruption was very weak, with a deficiency of both skills and resources. The new Chief Executive, Heather Rabbatts, liberated Lambeth from the tyranny of historic poor performance and brought with her a real understanding of the importance of protecting public funds and maintaining the trust and confidence of those living in the area. Having little worthwhile to defend, Lambeth could start afresh, designing counter fraud arrangements fit for the time.

So the commitment in Frank Field’s Green Paper naturally followed this initial work – a model had been set up which had been shown to work. There followed a period during which Department of Work and Pensions (DWP) officials such as Janet Bestwick, Peter Darby and Lillian Buchanan worked with Jim Gee and other local authority representatives to establish a professional training course for Counter Fraud Specialists in the benefits fraud area. This training subsequently became known as Professionalism IN Security (PINS) training and the process was overseen by a DWP/Local Authority Accreditation Board administered by the University of Portsmouth.

In 1998 Alan Milburn, then Minister of State at the Department of Health, decided, with very helpful advice from his advisor on governance, John Flook (then Chair of the Healthcare Financial Management Association), to radically upgrade the NHS’s work to protect itself against fraud. A new position of Director of Counter Fraud Services was advertised and Jim Gee was appointed to fill it. This led to the creation of a Directorate of Counter Fraud Services and then the NHS Counter Fraud Service (NHS CFS), as well as an obligation being placed on all NHS organisations (in secondary legislation) to appoint a Local Counter Fraud Specialist.

This was followed, in December 1998, by a commitment from the Department of Health, on behalf of the NHS, in the strategy document ‘Countering Fraud in the NHS’, to ensure that professionally accredited counter fraud officers were in place in every part of the NHS.

Recognising the need to provide professional training to the (now) hundreds of people appointed to undertake this work, the NHS CFS established a strong, well-resourced training department...