The proposed new Women & Children Hospital Building - The update

You may remember sometime last year we reported that one of the latest MoH project was to build the New building for Women & Children Hospital due to begin end of 2009... the most recent update we've heard is that the project has been frozen for now pending new assessment and allocation of the budget. As a result we heard the project will be re-tendered again. So in the meantime we wait. At least the on-call allowance is through :)

The following is excerpt from the previous post about this project:

These pictures were taken during the recent World Health Day 2009 exhibition. We manage to speak to one of the architects from the 'awarded' consultants Arkitek Idriss, and he said that the project is estimated to cost around $BND 60 million and if all goes well (i.e. budget approved) is due to start end of 2009 (Need to verify this information).

It is suppose to accomadate the Obstetrics & Gynae, Paediatrics, Accident & Emergency and the RIPAS Administration... hey what about Doctors Mess! We put that question forward too and still awaiting answers.

After doing a bit of asking around amongst the doctors, two very common comments were forwarded. One is that... it's quite an impressive and nice building... but secondly is that the worry about congestion it will create to an already congested Hopital area. Relevant issues considering we have just undergone a workshop for ensuring safe hospitals, and that one of the indicators of a structural risk is that the location of the the hospital... in this case right at the hill. I'm sure the professionals would have already thought about it, but we are not sure if the congestion problem can be minimized. Something to ponder...

Brunei Medical Association - New constitution & new president

After a period hibernation.. BMA has finally resurfaced again. It's back to square one again... When BMA was launched a year and so ago.. there was echos that the constitution by which this association stands upon was too rigid and unrepresentative of the whole medical practitioners in Brunei Darussalam. The interim committee took upon this seriously and have been working closely together address this issue.

Finally it has been decided that after being pursued its members, the Brunei Medical Association will propose certain changes in it's current constitution and and Extra-Ordinary General Meeting will be held sometime in March to officially vote for these changes. Amongst others BMA proposes that

• All members (regardless of citizenship) will receive equal rights to vote
• All Brunei citizen members are given opportunity to run for executive office

For more details of the proposed new constitution, please contact BMA

BMA would also like to inform it's members that Dato Paduka Dr Hj Latif b Ibrahim have officially resigned from his post as the Interim President and

Dr Hj Isham b Jaafar (Cardiothoracic Surgeon/Medical Director of JPMC) has been nominated to lead the BMA for now, until the official AGM.

NB. The current members are required to renew membership by 28th February 2010, to be eligible to vote for the change of constitution during the EGM.

On Call Allowances for Doctors in Brunei

Doctors can now start claiming for on-call allowances and this is can be backdated to March 2009. That's the current update on on-call allowances for doctors working in Brunei. The delay was mainly due to allocation of the budget, and talks about how to distribute them correctly.. unfortunately not all doctors qualify for oncall allowances.

Currently these allowances are given to:-

1. Doctors working in the 4 Government hospitals
2. Doctors working on Full-24 hr Shift System
3. Medical Officers, Senior Medical Officers & Specialist

The different type of On-Call Allowances are:-

1. Resident On call
2. Non-Resident On call
3. Specialist On call

Resident On-Call (RC)

Doctors who work 24-hour shift who resides in the hospital e.g. Medics, Surgeons, Paeds, ICU, Anaesthetist. These are usually doctors who are 1st line to receive referrals and attend to emergencies. The amount varies according to your level e.g. M.O. or SMO. and are calculated by a pre-determined rate. (I think it's around $11/hour for MOs). Total amount are calculated from 4.30pm till your shift ends i.e. 7.45am the next day only. Therefore for weekdays oncall an MO can claim around $11x15=$165, and for weekends & Public Holidays it will be $11x24 = $264.

Non-Resident On Call (NRC)

Doctors who are suppose to be on-call for the 24-hour shift but does not reside in the hospital. These are usually the 2nd line doctors (if it's a 3 tier oncall MO-SMO-Specialist) or 1st line doctors of certain specialty that are usually on-call from home e.g. Psychiatrist, OMF, Dentist, Opthalmology. The doctors are required to note down the time they attend patients, the identity of the patients in a logbook which will need to be verified by a nurse. (This part being signed by a nurse have been met with certain opposition by the relevant doctors and a move towards the logbook being countersigned by consultant on-call have been proposed.)

The rates of claim are the same as above and can only be claimed 'outside office hours'. I.e. if you attend a patient during office hours 745am to 4.30pm, it cannot be logged in your on-call claim. Qns: What if you get called at 2am for advice? Ans: It does not count as NRC either. So for ALL NRC doctors, start logging in your on-call referrals.

Consultant On-Call

As far I know, All Specialist/Consultants with a permenant/contract post with salary scale of M18 and above will receive a fixed amount of on-call every month of $1,250 bnd. This is regardless of their specialties and will be automatically credited into their salary every month.

Comments from doctors:

There are a couple of issues that have been raised from the current scheme:

1. The NRC are not getting a fair deal because we know that when there is a 3-tier oncall, the 2nd On-call ie. SMOs also carry a big responsibility in ensuring the MOs are covered by someone senior if the juniors find themselves out of depth. The amount of oncall allowances they logged in a month using the above method does not reflect the level of responsibility and the intensity of work undertaken by the NRCs. Perhaps this needs to be revised in the future and a flat rate for the NRCs would be better sense.
2. Consultants have a flat rate, but certain specialties have far busier take than others e.g. Anaesthetist vs Psychiatrist. Should consultants have varying flat rates according to the level of activities in their specialties? Maybe we should group the consultants according to the level of intensity of their oncalls and pay them accordingly.
3. Emergency Medicine, the busiest department in the hospitals are not given On-Call Allowances. Although they work on shift system, but we all know when they work for 8 hours, they really work hard all the way through. Again perhaps we can come up with a flat-rate as well for these doctors.

These are only some of the comments that we have encountered after talking with some of the doctors involved. However overall most of the doctors have welcome this move positively and we look forward towards the continuity and improvisations of it's implementation.

Doctors Mess would like to thank those who have been quite instrumental in pushing forward this proposal and finally getting it approved.. senior doctors, administrators at MoH, JPA & SPA! We look forward for our New Scheme of Service (Payscale) to be approved as well :)

Share your opinion...?