Further to the Deputy's Parliamentary Question No. 324 of 16 October 2001, the information supplied by e-mail is now put on record and refers to data on public hospital procedures as derived from the hospital in-patient enquiry system. HIPE collects data relating to all discharges from publicly funded acute hospitals and records up to four procedures for each episode of care.
Identification of the consultant who performed the procedure is not possible from the HIPE data, but a major diagnostic category based on principal clinical area is assigned to each hospital discharge as part of the Casemix classification system. Using this classification cases can be categorised as either surgical or medical and assigned to an appropriate MDC.
The data set out in the table records the number of surgical cases by MDC for each hospital sub-divided into public and private cases for the year 2000. In this instance, public/private status refers to the status of the patient with respect to the consultant rather than to the type of bed occupied. Totals by hospital and nationally are also reported. In order to comply with confidentiality protocols, small numbers of cases occurring in a given sub-category are reported as <5.
The figures refer to inpatients and day cases and show that approximately 70% of surgery cases relate to public patients and 30% to private patients. Overall, surgical cases account for 22% of all cases. Further analysis shows that private inpatient treatment is more likely to be elective, 40% for private, 29% for public, and that 72% of private surgical cases are elective, 64% for public cases. In addition, average lengths of stay are consistently lower for private surgical patients, 6.4 days, than for public surgical patients, 7.4 days. This results in 72% of surgical bed-days attributable to public patients and 28% to private patients.
HIPE is the only multi-hospital system which records diagnostic and procedural information on each acute hospital discharge. The identity of individual consultants is not included on the HIPE system. This is also true of HIPE information available to health boards through the national system.
More generally, as I indicated in a reply to the Deputy to Questions Nos. 321 and 353 of 16 October 2001, I am not satisfied with the degree of transparency attaching to the public/private mix in hospitals. This is one of the issues to be addressed in moving to a more equitable and patient centred health system in the forthcoming health strategy.