Sign up now for ease of access to The Medical Independent, Ireland’s most frequently published medical newspaper, delivering award-winning news and investigative reporting.

  • receive the eCopy two days prior to the printed edition.
  • can partake in our online MCQs.
  • can enter our online sports quiz. is Ireland's only investigative medical news website for doctors, healthcare professionals and anyone with an interest in health issues.

Established in 2010, along with its sister publication The Medical Independent, our stated aim is to investigate and analyse the major issues affecting healthcare and the medical profession in Ireland. The Medical Independent has won a number of awards for its investigative journalism, and its stories are frequently picked up by national digital, broadcast and print media. The Medical Independent is published by GreenCross Publishing.

Address: Top Floor, 111 Rathmines Road Lr, Dublin 6

Tel: 353 (01) 441 0024

GreenCross Publishing is owned by Graham Cooke.

You are reading 1 of 2 free-access articles allowed for 30 days

HIPE does not reflect private work — UL consultants

By Paul Mulholland - 11th Sep 2019 | 45 views

Consultants in University of Limerick (UL) Hospitals Group have said Hospital Inpatient Inquiry (HIPE) data is not a correct reflection of claims they have made for treating patients with private health insurance, the Medical Independent (MI) can report.

The issue was discussed in a HSE document outlining the new consultant compliance framework submitted to Secretary General of the Department of Health Mr Jim Breslin on 21 June 2019, and obtained by MI through Freedom of Information law.

The process for monitoring public/private mix activity is based on HIPE-coded data, even though this data is not linked to submitted insurance claims.

“[W]hen discussions with consultants are taking place, it has been identified that there are a number of cases cited whereby the consultant is not making claims for the private activity,” according to the document.

Furthermore, the document states that “workload which is coded in HIPE as a consult (other consultant review and advice, usually on once-off basis and patient remains under the care of the admitting consultant) may result in consultation compliance changes as part of the HIPE coding process”.

The document states that this can be “misleading” and even result in type A consultants being reported to have breached their contract, which was not the case.

“UL Hospitals Group has reported considerable challenges in terms of concerns raised by consultants that HIPE is not a reflection [of] actual claims they have made,” according to the document.

“Additionally, UL Hospitals Group have highlighted that there are cases of proportionality in terms of low volume activity breaching public/private mix, which is also a contributing factor to the high levels of non-compliance reported.”

According to the data, 24.7 per cent of consultants in UL Hospitals were non-compliant with the inpatient public/private mix limits.

South/South West Hospital Group was next-highest on the list, with 20.7 per cent of consultants reported as non-compliant, followed by Saolta University Health Care Group (14 per cent); Dublin Midlands Hospital Group (10.8 per cent); Ireland East Hospital Group (6.7 per cent); and Children’s Health Ireland (6.2 per cent).

Overall, the current private mix (as of 19 June) of 13.5 per cent for inpatients and 14.7 per cent for day cases is below the 20 per cent threshold, the document states.

“In order to support the process and some of the challenges highlighted, Acute Operations have been working with the Health Pricing Office (HPO) to develop new reports to streamline aspects of the process for sites/Groups and to ensure a consistent approach is taken,” according to the document.

Leave a Reply

Latest Issue
medical news
The Medical Independent 19th May 2022

You need to be logged in to access this content. Please login or sign up using the links below.

Most Read