A new strategy to fight fraud in the NHS will be unveiled tomorrow amid fears that it is costing the health service up to £100 million every year.

The Scottish government is launching the initiative to address a problem which it claims adds up to as much as 1% of the NHS budget every year - money which could be used to pay for almost 4500 extra nurses or more than 11,500 hip replacement operations.

Among the types of fraud which will be targeted include health tourism, where people from abroad use the NHS to get free operations and treatments.

Other examples of fraudulent activity include people avoiding paying NHS charges for dental treatment, optical vouchers and prescription charges by claiming to be exempt.

NHS staff can also be guilty of defrauding the health service through, for example, claiming travel expenses for journeys not undertaken, working while off sick, or clocking in colleagues on shifts which have not been worked.

Other examples cited include pharmacists claiming for expensive brand-name drugs when cheaper generic alternatives were dispensed, and doctors using NHS premises for private work.

Health secretary Nicola Sturgeon will tomorrow reveal a zero tolerance policy, which aims to identify fraudulent activity but also place an emphasis on deterring people from carrying out fraud.

A new e-learning package for use in the induction of staff is to be created, along with a DVD to help NHS managers identify types of staff behaviour which may signal fraudulent activity.

"Counter-fraud champions" will also be identified at senior level in health boards to raise awareness among staff of NHS fraud.

Sturgeon warned while only a "tiny minority" of people defraud the NHS, it would not be tolerated in any form.

"Whether committed by staff, patients, clinicians or contractors, NHS fraud takes money away from where it is needed most," she said. "We are therefore determined to ensure the problem of fraud is tackled as effectively as possible.

"We need to engage with those who work in, and use the services of, the NHS and ensure that they understand the damage caused by fraud and the need to protect our NHS."

In 2000 a body called NHS Counter Fraud Services was set up with a team of specialists dedicated to countering fraud. To date, it has made an estimated £14m in savings.

Among the cases it has uncovered include a dentist who treated patients with non-precious metals but then claimed the price of more expensive material, and a dispensing optician who gained an extra £13,200 from submitting claims for unnecessary glasses and tints.