Lesson from Singapore

We wouldn't like to admit it, but there are things we could learn from our Southern neighbour. And we are not just talking about how to make a sitcom here.

This morning, the Faculty received a visit from a Professor from NUS in Singapore. He basically told us the story of how the healthcare system in Singapore been undergoing a major revamp since the turn of the millenium. And it all started from a realisation of something very obvious.

First, Doctors were leaving for Private practice in droves and that needed stopping. Second, the only real advancement can only be made if backed by R&D. In short, there are investment needed to be made into the health system, and it is not to build the biggest hospital with no specialist, or to purchase a CT machine to be hidden in a basement. The money should be channeled directly at the target. Increase the Faculty members pay packet, spend the money for research opportunity for these Faculty members and spend the money on proper human resource development, not on just some 'modal insan' mambo jumbo.

It all started with a simple questionnaire distributed to all doctors at one of the main hospital, asking what they detest most about their job and what it the main reason why they are still at it. The main reason why they want to leave is 1) the pay is a lot better outside, 2) limited career prospect for advancement. The next thing they do was realign the services, and change the hospital demography of the island down into 4 'district' hospital and 2 University Hospitals, the '4 plus 2' plan.

At the hospital, to promote career development, the Faculty Members were introduced into 4 career tracks, ranging from pure Clinicians to mainly Researchers. The promotion criteria will be aligned to each career tracks and everyone knows exactly what is required of them. At least what it sounded on paper. In en updated survey, they seems to be looking at early success. The staff retention rate looked good and their research output is also on the rise. The feedback from the Medical Students and patients also seems better than before, but Prof Ho himself felt that it is too early to paint any conclusions.

I find the talk fascinating and Prof Ho has plenty of insight to offer us. Realistically however, with a more intellectual population (and politicians) and smaller, and more compact geography, these major rethinking is much easier to implement in Singapore. The fact that the Minister of Health also tended to be medical doctors does help! The fact that they realised that something was wrong in the first place, quickly proposed a solution and implemented it is something that I admire. If only we can have similar strive for a goal, any goals, than there is hope for my beloved 1Malaysia.

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