Mr. Liam Woods:

I know. The answer to the Deputy's question is not to my knowledge.

Deputy Louise O'Reilly asked about stretched targets, an issue we have discussed. There was also a reference to the general culture and there being an "Upstairs, Downstairs" culture. That is not my impression based on my interactions with consultants. By and large, as referenced by the Deputy, taking into account on-call duties, as well as the basic 39 hours, the majority of consultants are working a lot more hours than they have been contracted for. There are arrangements in place covering on-call duties. I spoke recently to a cardiologist who spent a significant amount of time in the cath lab doing international work in addition to her basic hours. It is not unusual for that to be the case.

On the point about national data, for admitting consultants, there are data available for patient administration systems. The information is classified as between public and private patients at the point of admission. This system is in place in every hospital. Above it, as referenced in section 20 of the consultant's contract, there is the hospital inpatient enquiry system which provides for a clinical classification of work. It is basically the same information from the patient administration system summarised nationally. The data are visible locally and nationally, as is the case in the patient administration system. Neither of the systems was specifically designed to be a contract management system. Therefore, for non-admitting consultants, it does not tell us anything about their practice. For example, for anaesthetists, radiologists and laboratory personnel, the contract requires separate processes to be in place locally using local systems. For contract holders, of whom there are 364, there is a requirement to look at bed designations in hospitals, pre-dating the 2013 Act, in terms of their use as a proxy for a volume of allowable private work. There are data within each hospital that show the volume of work that is public and that is private. As I said, the HSE does not know what a consultant receives by way of income from health insurers. There is no basis for it to know that information, but we do know what the volumes of work are. The Deputy's question about whether there is potential to streamline some of the data is interesting.

On the hospital inpatient enquiry system, HIPE, the contract requires us to look at complexity, as well as case volume, such that if a consultant is engaged in a highly intense case which may have a complexity rating of five but a volume rating of one, that is what we have to count in the contract. It requires us to do what is already happening, the coding of all cases in accordance with the ICD-10 coding system. That system is perhaps one at which we could look as a further enhancement to provide information at a group and hospital level and nationally.