An Overview of On Calls Allowance in Brunei

Introduction:
The payment of On Call Allowance Claims which has been approved since 1 March 2009 has been implemented since March 2010 with a special budget being allocated. This instrumental change to the welfare of the doctors has been brought about thanks to the initial efforts made by our senior doctors who have been working very hard to get this allowance approved eversince 4-5 yrs ago. Some of them have already left the service but others are still around. To mention a few are Dr Hj Affendy (ex-DGMS), Dr Rashid (Orthopaedic specialists), Dr Syafiq & Dr Zulkarnain. Their groundworks has laid a strong foundation for the proposal to be revived again in 2008 by Dato Paduka Dr Hj Latif (former president of Brunei Medical Association) and his team and finally the proposal for on call allowance was approved by JPA in March 2009.

The principle of On call Allowance
From a banding system of on call allowance (initial proposal) based on the UK system, the proposal has undergone various changes and eventually it was decided that the on call allowance should be based on 'monthly claims' method using the Singapore system. Whatever system it is, the principles of awarding on call is the same, doctors who work 'extra-hours' and whose daily lives (personal & professional) are affected by it should receive an allowance.

Using this very principle of awarding on calls, the JPA has come up with a definition of On call. On Call by definition is A Doctor who has been rostered to work outside his/her normal working hours to treat patients in the hospital. From this definition, JPA has decided that on call can only be given to the doctors working in hospitals on full shift system (24hrs). Thus those working on shift system (A&E), GPs, Public Health & Dentist cannot claim for on call allowance.

The respective Administrative & Finance Department of each Hospitals in the country has been tasked to manage the claims of 200+ doctors through out the nation, except for the Renal Doctors whose claims are directly manage by the Administrative Dept at the Ministry of Health.


The rates and types of oncall:

There are 3 types of on-call allowances, Resident On-Call, Non-Resident On-Call and Consultant On-Call.

1) Resident On-Call are given to those who stay in-hospital during the 24hr On-call period, mainly Medics, Surgeons, Orthopods, Anaesthetist, Renal, Gynae, Paeds, ICU and recently ENT has also been approved to do Resident Calls. The rate depends on their grade whether it's Medical officer or Senior Medical Officer.

M.O. - $11/hr

SMO - $14/hr

2) Non-resident On-call are given to those who are on-call from home. e.g. OMFs, ENTs, Opthalmology, Neurosurgeons. These doctors will have to claim the hours they come to hospital only and attend patients. Calls taken from home are not counted apparently. The rates are similar to the above. Non-residents On Call also refers to the 2nd Oncall (usuall SMO) who are not resident.

3) Consultants/Specialists Oncall are given only to specialist who has been given a permenant post. Its fixed amount of $1,250/mth. However If you are Acting Specialist, you will only be entitled SMO rate and you get paid only when you come to hospital.

Problems encountered:

Unfortunately there has been some significant delay in the payment of on call allowance due to various factors:

1. The method of claiming the on call was not finalized until sometime early 2010, this was mainly because

• There was issues raised by the administration about how to 'audit' the claims of doctors
• Admin weren't sure how much the budget needed to be allocated, because this is the first time, on call allowances were claimable.
  
• Who are entitled to claim? Resident and Non-Resident
  

2. After the above issues were addressed the administration has come up with various forms that required to be filled in, but again there were delays in processing these forms due to several factors:

• The forms were issued without any guideline as to how to fill them correctly, therefore it has lead to many forms being returned back due to incorrect information provided.
• Initially the dateline given to issue all claims was less than 2 weeks, but due to the large volume of claims dating back to March 2009, Hospital Finance Dept (Tafis) was overwhelmed.

As a result of these teething problems, some claims are still outstanding, but to those who have received their on call allowances, please don't forget to give 2% to Brunei Medical Association (The force behind all this).

Conclusion

The rough estimate of monthly resident on call INCOME
M.O. ~ $3,400 - 4,000 (Basic Pay) + $800 - 1,200 (On call 1 in 5) = $4,200 - 5,200
S.M.O. ~ $5,400 - 5,900 (Basic Pay) + $1,100 - 1400 (On call 1 in 5) = $6,500 - 7,300
Specialist $6,800 - 8,000 + 1,250 (Basic pay & M allowance) + $1,250 = $9,350 - 10,050

• Don't abuse this previlage. It can be revoked at any time.
  
• The idea behind those who have relentlessly fought behind the scene to get the on call allowance was to lend appreciation the unsociable and high health risk career medicine & surgery is. At risk of becoming the most unpopular career choice for bright students, the authorities have taken initiative to revive this career by giving an incentive. We hope this will serve as an initial stimulus to entice more people to join medicine as a career.
• Don't forget that we are still fighting to get on-calls for our colleagues at the Accident & Emergency Department.
• The revision of salary scheme (Scheme of Service) is well underway. Details of the new scheme are still unofficial, but as soon as it's official it will be shared here.