Response to Oral Question PL84

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YANG BERHORMAT PEHIN ORANG KAYA INDERA PAHLAWAN DATO SERI SETIA HAJI AWANG SUYOI BIN HAJI OSMAN

QUESTION:

YANG BERHORMAT PEHIN ORANG KAYA INDERA PAHLAWAN DATO SERI SETIA HAJI AWANG SUYOI BIN HAJI OSMAN requests the MINISTER OF HEALTH to state (a) the Ministry's plan for increasing the number of consultants, specialists, and doctors to address the significant shortage that results in long waiting times, for example, 3-6 months for surgery; and (b) if there are specific allocations for upgrading facilities at RIPAS Hospital and district hospitals.

YANG BERHORMAT MINISTER OF HEALTH

ANSWER:

Alhamdulillah, thank you for the question from Yang Berhormat Pehin Orang Kaya Johan Pahlawan Dato Seri Setia Awang Haji Awang Suyoi bin Haji Osman regarding the current status of the Ministry's plans and strategies in enhancing and strengthening the Raja Isteri Pengiran Anak Saleha Hospital as a referral and tertiary hospital and the specific allocations for upgrading facilities at RIPAS Hospital and district hospitals to provide the best, quality, and effective healthcare services to meet current and future needs.

Yang Berhormat Pehin Yang Di-Pertua Dewan,

RIPAS Hospital has served as the main referral hospital for the country at the tertiary level for the entire population of Brunei Darussalam since 1984. To ensure it retains this status, continuous efforts have indeed been carried out with various projects identified where some have been implemented, are in progress, and are also being planned, demonstrating the Ministry of Health's continued commitment to ensuring RIPAS Hospital can provide high-quality healthcare services, aligned with current and future needs.

Among the Ministry of Health's initiatives in this regard include:

• Infrastructure Strengthening and Facility Development which includes the Construction of a New Hospital Block. The Ministry of Health is in the process of developing a new hospital block, with a capacity of 500 beds involving an allocation of BND 120 million under RKN 12. This block will expand the treatment capacity for needs that have increased year by year and enhance the existing medical facilities.

• Additionally, upgrading and refurbishment works at RIPAS Hospital have been carried out in stages over 10 years since 2015 to ensure medical facilities remain at their best level. RIPAS Hospital requests a specific allocation each year for this endeavor, where the allocation planning for the financial year 2025/2026 amounts to BND 2.5 million and for the financial year 2026/2027 amounts to BND 5.5 million. Implementation needs to be carried out in stages and subject to factors such as service disruption, availability of space for temporary patient relocation during upgrade works, and workforce for project handling.

Alhamdulillah, with the provision of funding and joint efforts for the successful completion of projects at RIPAS Hospital, projects that have been completed include the upgrading of the Breast Imaging Centre, OT1 & OT2 Operating Rooms, CCU ward upgrading, installation of new PABX, and new PA system installation. InsyaAllah, in the near future, upgrade projects at Ward 15 (isolation ward) and Orthopedic Clinic will be completed. In this year's further planning, among the projects to be implemented InsyaAllah include: renovation and expansion of space for outpatient pharmacy services; repair work near the Women's and Children's Building; new roof replacement; upgrading of OT 3, 4, and 5 operating rooms; new nurse call replacement at the Women's and Children's Building; upgrading of wards 10 & 11 as intensive care units; Respiratory Clinic improvement with the addition of a Pulmonary Function Laboratory; and the renovation of 2 bungalows in Kampong Kianggeh for outpatient physiotherapy clinics.

An important initiative is the strengthening of Clinical and Specialty Services to ensure excellence in service delivery. Service delivery quality is always monitored by the Ministry of Health and efforts for improvement/upgrading continue, particularly in terms of waiting time for treatment like surgery; types and diversity of treatment; as well as the acquisition of new or replacement of existing equipment to the latest, in line with international standards and end-user requirements. Alhamdulillah, the improvement in waiting time has reduced for circumcision services from 2 years to the "next school holiday where a special facility in Kianggeh has been provided for this service, open all the time regardless of school holidays.

For cataract surgery (“utik”), the Ministry of Health faces a waiting time issue because cataract surgery services had to be postponed during the Covid-19 pandemic. Alhamdulillah, a total of 4,389 cases have been successfully performed from January 2023 to December 2024, while the number of waiting cases has decreased to 743 cases as of February 2025.

Meanwhile, an improvement example from equipment upgrades/equipment that is being implemented includes the acquisition of a new Endoscopic Ultrasound System (EUS) for the Gastroenterology Unit, which will have a positive impact on increasing diagnostic capacity in the country and will directly reduce patient referrals abroad.

In line with this, efforts to increase Subspecialty and Specialist Services are ongoing to attract and train more specialists in specific fields such as surgical, oncology, cardiology specialties; to ensure RIPAS remains the main referral center. Since 2000, several Basic Specialty Training (BST) programs have been implemented, involving specialty fields such as internal medicine, primary healthcare, surgery, psychiatry, and emergency. Doctor and nursing specialty training in the country is also expected to expand, in line with RIPAS Hospital's status as a recognized "Teaching Hospital." For example, the establishment of Basic Specialty Training (BST) in the field of Obstetrics and Gynecology is currently in planning as an addition to existing programs. Additionally, another important development is the launch of the Diabetic Nurse Educator Diploma in Health Sciences, conducted in collaboration with Politeknik Brunei and JCHS.

These initiatives reflect the ongoing efforts to further strengthen the health education and training system, with the aim of producing a more skilled and quality health workforce.

The Ministry of Health has also made significant investments in Digitalization and Innovation initiatives in Health Services. This includes the Transition to a New EMR System (Electronic Medical Record) (BruHIMS 2.0 - ISH MED). Planning to upgrade the electronic medical record (EMR) system is actively underway to ensure more efficient patient record storage and better health system integration. Related to this is also the strengthening of Telemedicine and Digital Health where the BruHealth Platform continues to be enhanced, including the expansion of teleconsultation and digital therapeutics (such as the Balance application, specifically for Diabetes care), which enables patients to receive health services more easily and quickly.

Furthermore, Increasing Efficiency and Access to Health Services is also the focus of the Ministry of Health. The Modernization of Patient Management Systems has been launched, where the Ministry has enhanced registration and appointment scheduling systems to reduce waiting times and ensure smoother workflows. In line with the Ministry of Health's Strategy, Service Coordination with District Hospitals is being continued, where RIPAS Hospital continues to function as the main referral center, with closer collaboration with district hospitals and health centers to ensure continuity of care from primary to tertiary levels.

In its pursuit of excellence, the Ministry of Health has emphasized strengthening Quality and Patient Safety. This includes Strengthening Safety Standards and Accreditation. Ongoing measures are taken to ensure RIPAS Hospital meets international standards in terms of patient safety, risk management, and service quality. Through the establishment of the Quality and Patient Safety Unit at both the Ministry of Health level and at the hospital and clinical service levels, the Safety Culture can be instilled, among others with the operation of the online Incident Report (IR) system and MOHCares application; and the implementation of International Patient Safety Goals (IPSG) initiatives.

Training and Professional Development Programs for Healthcare Staff also play an important role, where regular professional training programs are being strengthened to ensure the health workforce remains competitive and able to provide the best care. Continuous Professional Development Activities are mandatory criteria for maintaining registration with the relevant professional boards. Additionally, educational campaigns and activities and awareness-raising regarding health issues are actively organized at RIPAS Hospital and off-site venues, aiming to increase awareness among the public, patients, and RIPAS Hospital and Ministry of Health staff about issues such as Mental Health, Antimicrobial Resistance, World Pharmacy Day, Hand Hygiene, Child Development and more.

As the main referral hospital in Brunei, RIPAS Hospital continues to undergo comprehensive transformation in terms of infrastructure, clinical services, digital innovation, and operational efficiency. With the ongoing planning, RIPAS Hospital will continue to develop to meet the country's health needs, in line with the Ministry of Health's commitment to providing the best, quality, and effective healthcare to the people.

That's all, thank you, Yang Berhormat Pehin Yang Di-Pertua Dewan.