In this country, there are three types of health clinics:

1. The government health clinic

2. The government RURAL health clinic

3. Private clinics

Private clinics are clinics themselves which are treating our very own people, so we should utilize this as a resource instead of a competition to the government.

The challenges with government health clinics is that it is still like a factory, the whole idea of ‘Decentralization’ has not instilled the true and full changes it should have made.

Where is the continuity of care promised thru decentralization ?

What happened to patients seeing the same doctor ?

Do you really think that just because the previous doctor wrote in your medical notes, it will be the same continuity with another doctor whom you have not met before ? Seriously ?

Funny thing is that….

Management blames all of this shortfall on the shortage of doctors, BUT doctors (and also the Public) blame the Management for their poor creativity in retaining and inspiring our local doctors.

In the UK, health clinics are owned by private doctors, with contracts with the government or the NHS as well as incentives (financial) to achieve targets such as checking every patient’s blood pressure and managing it, ensuring women to have their PAPs Smears for example.  There are many ways the NHS inspires their health clinics to perform additional services for example smoking cessation clinic. The clinics get rewarded and are funded for such initiatives.

On the other hand, our government health clinics try to setup additional services but as there is no reward or support for achieving these new services, the services always dwindle & disappear with time. It actually becomes a fashion trend of the current management. Most patients turn up to their clinic and it is like going to a workshop, fix what is the problem now, if can. Little initiative to do prevention.. isn’t prevention better than the cure ?

Micro-management by the administrators stifle growth and innovation !

How do we inspire our doctors, the vanguards of health in this country to provide better and comprehensive health care ?

Allow our local doctors to leave the Service and create a different kind of clinic, which is to become the standard for all clinics !

The setup of clinics within the country which is owned by local doctors and shareholders and contractually funded by the government.

Patients only have to pay their standard one dollar fee and the government is billed per patient seen and for medication.

These clinics can also provide additional services which is to be negotiated with the government on whether this would be funded by the government or patients have to pay for the services.

This arrangement would drive staff to perform better, find more patients and deliver better quality of care, and yet the government will have an ability to regulate this and set-out targets to be achieved like for example. patients to stop smoking or to be referred to be smoking cessation clinics, waiting times, continuity of care etc etc.

The government can also set penalties for not achieving targets such as waiting times. I am sure many of us would love to know that  a clinic is being punished for making us wait long !

For each designated area/region, there should be more than one clinic serving the same area so as to stimulate competition.

Local doctors would stay as they decide how much their pay is and it is directly performance based. Hiring and firing new staff would be so much easier without government red tape and not to mention procurement of equipment would be almost hassle-free.

This is what we call Autonomy.

Of course, to pacify the nay-sayers and control freaks, each clinic would be subject to yearly or regular audit and submit reports of their performances & the government will have a say in the direction and objectives of each clinic.

However, in rural areas, government health clinics would have to remain within complete government control, which would also serve as excellent training centres for our local doctors.

Private clinics would of course have to change, to either follow to register as a clinic that has a contract with the government or remain completely private to satisfy whatever niche healthcare markets.

This would definitely in line with His Majesty’s  Government to persuade for civil servants to work in the private sector.

Welcome to the a new world, this is the next step: the Healthcare Liberalization of  Our  Clinics !

Disclaimer: All of the above is solely the author’s personal opinion and does not reflect any professional or institutions’ standings.

Here’s  an much more ambitious project in which soda plastic bottles are re-used to make walls and into schools in developing countries. The group responsible has also started making houses made of plastic bottles, reinforced with cement. The whole idea behind this is that instead of bricks it is free, light weight, flood proof  & can withstand the tropical heat…

It takes 5000 bottles to build a classroom !

Think about it, we wouldnt need that much money invested if we had government housing projects made this way. Maybe a bit of modification to the bottles or that the bottles are completed concealed in the concrete, would make this project more aesthetic to our eyes.  It’s only our minds that stops the full potential this can do to Brunei, if we allowed our imagination & dreams to run wild…

http://www.bottleschoolproject.org/

Such waste and there is no nearby recycling plant…  If we can’t recycle then, let’s give them a new secondary use !

so the next few weeks will bring a new life use for the plastic bottles. If YOU want to contribute in any way, please leave a comment & Lightbulbproject might just look into it.

and .. NO, the single use for those plastic bottle FUN BOAT races don’t count !

Ok.

Re-Use No.1

SAVE-WATER-Whilst-You-Flush Bottle

Fill a 500 mL plastic bottle with water and place it in your toilet tank. This will save you 500 mL every flush, and over a year this is significant. Imagine you use your toilet just two times a day (a highly conservative estimate); you would save a litre a day and that’s 365 litres a year

RIPAS Peripheral Parking Site & Shuttle Service

An old problem.. An old idea actually. Patients and relatives always complain about the lack of parking at the main hospital. Then maybe the hospital authorities should ‘borrow’ the marked empty piece of land outside of the hospital ground & run a small temporary parking site, with a shuttle bus going up to the hospital & then returning to the parking site regularly. Negotiate with the landlord or landlady, or just let another company run the parking.

If this was to happen, people would definitely set up gerai here..

People tell me that the dental service in Brunei is not as it should be. Most people especially children only visit their dentist when the ‘tooth hits the fan’. Whatever happened to see  your dentist every 6 months ?

Anyway, have you seen how busy the government dentists are during the school holidays ? It is like every parent had the same checklist for their children during the school holidays.

It would be far more efficient if the dental services coordinated themselves so that they would see school children thru out the year instead of ‘as when really needed’.

A primary school can have around 500 to 1000 school children, perhaps a mobile dental unit, equipped with mobile dental Xray equipment could be place for two weeks to one month at each school. This dental unit would review schoolchildren by their class and when the whole school has been seen, they move on to the next school.

yes, I know talk about painful school ! but what must be done, must be done !

The time it would save for parents from having to leave work or home, and then finding parking at their normal dental units.

Of course, schoolchildren would have to have the consent forms for their parents to fill in first before the dentist sees them

If you could do this with schools, you could do this at shopping malls, government centres/buildings too

Check this out:

http://www.nhcgov.com/AgnAndDpt/HLTH/DH/Pages/DH-MobileDentalUnit.aspx

http://www.flbaptist.org/Default.aspx?TabId=606

http://www.medcoach.com/products/dental/

Mosque clinic Algiers

The clinic is at your nearest mosque ? .. read on before you judge…

In Brunei, most of us are familiar with having difficulties finding parking spaces at our government (outpatient) health clinics. Some health clinics are either converted houses or next to hospitals. Some of the larger clinics are purposed built buildings. It looks like the government is going to increase the number of clinics in the near future. There is a new direction of closing the Sg. Hanching clinic and opening a new one at Pangkalan Batu. I think i got this right.

Building new clinics means that the Ministry of Health has to spend money on construction. On the other hand, most mosques are not used except during prayer times, Friday prayers, and to run courses including marriage counselling courses, Quran & Muqaddam etc. reading lessons.

Would it not be cool to build a clinic next to or in the compounds of the mosque ?

It is not a new idea but an old one. check a few of these ‘mosque clinics’

After the dawn of Islam Masjid assumed a very important role in the society. It was not only used as a place to offer prayers but also became center of many other activities like a meeting place of the elders, as a teaching place – Schools or Madrassahs, a place to settle disputes or to make community announcements. Some Masjids had large libraries and even had offices of the local municipal administration or ruler.

Due to the central role of the Masjid it can be used to fulfill many community needs.

http://www.communitymosque.com/

http://www.iant.com/clinic.php

http://www.mmrforum.com/Masjid%20Clinic.htm

Mosque clinic, Iran

Here are the Pros and Cons

Pros

• Mosques are placed strategically in all districts of Brunei
• More people frequenting the Mosque compound, increasing likelihood to pray & come close to Allah
• Patients whilst waiting for diagnostic results or consultations can pray inside
• Cost saving (no need to construct a new building or buy new land to build a clinic)
• Alternative healing opportunities: Darulsyifa could have  a centre next to the medical clinic
• Reminds everyone that we are all fallible, and then we all will meet our maker
• There are many non-Muslims who have never been near a mosque and it would promote better understanding
• Lots of parking space !

Cons

• Some people may not like the idea of being next to a mosque for personal reasons
• Some people may say that the mosque should strictly be a place of worship, and this purpose should be not diluted (my argument: the clinic will be in the vicinty of the compound and not where people actually pray)
• unable to operate on Friday between 1200 hrs to 2pm (parking overwhelmed: Friday prayers)
• who will pay the electricity bill ? (Ministry of Health will have to pick up the tabs on this)
• Not all mosques are suitable for this purpose, some are too just too small.

What do you think ? is this a good idea ?

the lightbulb project is one thing and everything. Any idea that we think can change our present, let it be heard by the many, in the intention that it will mysteriously gather its own momentum.

Let it be so…

feel like joining  ??

contact : AZIZ  : +6738861103