Dear Friends,
The ACS family of schools just celebrated its 121st Founder’s Day on March 1st 2007.
On thinking back, the 10 years I spent in ACS were indeed the best years of my life. Those who are mathematically inclined would have realized that 2 years are missing from my school-life. Those two years I spent at National Junior College (but that will be the subject of another post).
In the ACS of my time, boys were allowed to be boys. We lived life with abandonment and spent much time and energies on extra-curricular activities and friendships (and some on their studies).I was involved in Athletics, Rugby and several societies.
Our teachers were legendary for their dedication and love of the school.
There are few schools which can boast of teachers who have touched the lives of 3 generations of any family but ACS can. Many of my teachers taught my sons.
Kind acts and other Mushy stuff
I came from a poor family.
From the second day in Primary 1, I took the public bus by myself. My mother, who was a nurse, accompanied me to and from school on the first day (on the bus also of course).
Miss Tan, my Primary One form teacher, somehow found out about this later on, and volunteered to send me home every day. Of course, I sat in her Ford Anglia quiet as a mouse each day!
This skinny boy will never forget such acts of kindness nor take them for granted.
Miss Tan was later to marry Mr. Ong Ai Teik, another legendary teacher who influenced us ACS boys greatly. God bless you Mr. and Mrs Ong. Thank you.
These acts of kindness were by no means confined to my teachers only.
One day whilst rummaging through old stuff during spring cleaning, I came across a note from my son, C’s Primary Six teacher. In this note was written words of encouragement and prayer for his (then) upcoming PSLE examinations. They were truly inspirational words and must have spurred him during his stressful exam period.
It is no wonder that C kept the note (and not discard it as is his habit).
Other teachers that have influenced me (for better or for worse) include:
Secondary school:
Mrs Lee Gek Kim, Mr. Ong Ai Teik, Mr. Ernest Lau, Mr.Ang Cheng Kim (deceased),Mr. Tan Soo Hian (my athletics teacher) (deceased), Mr. Ying ( with wry neck problems), Mr. Andrew Yuen, Mrs.Kee,Mr. Wee Kim Cheng.
Primary (Pr 1-2)/Junior school (Pr 3-6):
Mrs Ong ( Miss Tan), Mr. Ng Kim Liang, Mr. Navaratnam, Mrs Retnam, Mrs Huang ( who was also my aunt), Miss Ng (who wore mini-skirts).
There are numerous others that have touched my life but whose names just escape me now. Best wishes and good health to all.
ACS : according to my son
We, parents, are always wondering if we have made the right choices and have done the best for our kids.
It was after C’s O levels and we spent some time talking about his past and future.
I asked him, “Do you regret not going to Raffles Institution after your PSLE, as had some of your primary school mates?”
He answered, without hesitation, “The four years of my life in ACS ( ie secondary school) has been the best years of my life. ACS is the best school that any boy can hope to be in!” ( I vouch these are C’s true words and not some shameless plug for ACS)
I think those comments were only partly influenced by the fact that my alma mater takes a “balanced” attitude to academic results. Great emphsis was placed on character building.
For instance, I still remember who the champion athletes were but would have difficulty recalling who the top academic students were (ok, just sour grapes). But of course, the true blue heroes were the Scholar Athletes! Good in sports yet excel in studies!
I am sure that my other son, T will also have similar things to say once his days at ACS are done.
I agree with Philip Yeo! ( a rare situation)
Parents should diversify children's education experiences: Philip Yeo
(By S Ramesh, Channel NewsAsia Posted: 23 February 2007 1941 hrs)
SINGAPORE: Singapore's top civil servant Philip Yeo said Singapore cannot afford to have its best and brightest students only in a few top schools receiving the same system of education. The Chairman of A*Star said the greater the diversity of backgrounds and talents, the better Singapore would be able to respond and compete in this new world. This is because children will face new and as-yet-unknown technologies, industries and jobs.
(click on link to read more)
Trend not promising
Schools will tell you that it is a lost cause trying to retain their top students.
ACS (Primary & Junior), St Michael’s (now called St. Joseph Jr),Catholic High, Singapore Chinese Girls’ School, CHIJ all face the grim prospects of losing their ablest and best.
Many of their top Primary students (to different degrees) will continue their secondary education at the Raffles Institution or Raffles Girls’ School and later Raffles Junior College ( the R-schools). All the more since the “through-train” Integrated Programme allows them the luxury of skipping the O levels.
Many will argue ( with good reasons too) that this is after all what meritocracy is about. If you are good, you get to choose where you want to go. I do not disagree.
However, as Philip Yeo has alluded to, in the long run, the lack of diversity will not be healthy and the students exiting from these schools risk being trapped by “groupthink” and having a homogenous outlook to life and public policy. And many of these students in the R-schools are high achievers slated for prominent roles in government and industry.
We cannot (and should not) prevent parents from sending their children to schools that they feel may help their children fulfil their maximum potential. But the mainstream media can help highlight the achievements of other schools. This positive publicity can help them retain their better students as well as attract applicants from other schools. This would help prevent talents congregating only in a few schools.
Resources (manpower and capital) should be made available for schools to allow them to build on their strengths so that their programmes will be part of their unique brand (what marketers call USP- Unique Selling Proposition).
Hopefully in time to come, we will have a diverse population with varying outlooks to life’s challenges. With future leaders getting heterogeneous but rich school experiences, there will then be less groupthink in government and more willingness to try new ways of running this little red dot called Singapore.
Cheers,
and
The Best Is Yet To Be,
Dr.Huang Shoou Chyuan
Sunday, March 04, 2007
Monday, February 26, 2007
Foreign Doctor Policy- SMA ( sort of) responds
Hi friends,
I am glad that the Singapore Medical Association has finally responded to the Ministry of Health’s plan to import foreign doctors on an unprecedented scale over the next few years.
Such policies will affect the medical profession in a profound way and all in the profession must stay engaged.
I would imagine that if such colossal policy changes were to be mooted in any major democracy, there would have been much public debate.
But in Singapore, which is ironically eyeing a seat on the high table of advanced developed countries, it is rare that we get any comments from associations which purport to represent the medical fraternity.
Hence I am pleasantly surprised to find that Dr. Wong Chiang Yin, President of Singapore Medical Association has actually responded ( in a way) to the Ministry’s position.
So.. enjoy
Cheers
Dr.Huang Shoou Chyuan
From the SMA Newsletter
(read original article here)
Australia 9.5 67.5 2.47 (2001)2
Canada 9.9 69.9 2.14 (2003)2
China 5.6 36.2 1.06 (2001)2
France 10.1 76.3 3.37 (2004)2
Germany 11.1 78.2 3.37 (2003)2
India 4.8 24.8 0.60 (2005)2
Ireland 7.3 78.9 2.79 (2004)2
Japan 7.9 81.0 1.98 (2002)2
Netherlands 9.8 62.4 3.15 (2003)2
New Zealand 8.1 78.3 2.37 (2001)2
South Korea 5.6 49.4 1.57 (2003)2
Switzerland 11.5 58.5 3.61 (2002)2
UK 8.0 85.7 2.30 (1997)2
USA 15.2 44.6 2.56 (2000)2
Singapore 4.5 36.1 1.56 (2005)3
Indonesia 3.1 35.9 0.13 (2003)2
Malaysia 3.8 58.1 0.73 (2003)4
Thailand 3.3 61.6 0.37 (2000)2
Vietnam 5.4 27.8 0.58 (2003)4
No Compromise in Standards
Another point to be made really is why would foreigners want to come here? As history has shown, it is very difficult to convince top clinical talent to come to Singapore. The proviso here being we need to be clear about what constitutes top talent. Our notions and definitions of talent must never be allowed to be compromised for the sake of making up the numbers (for example, to make up one doctor per inpatient). The standards expected of foreign doctors must be at least as high as those expected of the local doctors, if not higher. A level playing field is the basic requirement for local and foreign doctors to have a good chance of co-existing harmoniously.
It is commonly known that at least half the graduates of famous schools in China and India such
as Peking Union Medical College and All-India are offered jobs in the West before or soon after they graduate. Will there be any significant numbers from these top schools left for Singapore? And once good foreign doctors are allowed into Singapore, we also need to address the equally important issues of objectively assessing these doctors and to get them to leave Singapore if they are found to be wanting.
I am glad that the Singapore Medical Association has finally responded to the Ministry of Health’s plan to import foreign doctors on an unprecedented scale over the next few years.
Such policies will affect the medical profession in a profound way and all in the profession must stay engaged.
I would imagine that if such colossal policy changes were to be mooted in any major democracy, there would have been much public debate.
But in Singapore, which is ironically eyeing a seat on the high table of advanced developed countries, it is rare that we get any comments from associations which purport to represent the medical fraternity.
Hence I am pleasantly surprised to find that Dr. Wong Chiang Yin, President of Singapore Medical Association has actually responded ( in a way) to the Ministry’s position.
So.. enjoy
Cheers
Dr.Huang Shoou Chyuan
From the SMA Newsletter
(read original article here)
The Better Doctor
By Dr. Wong Chiang Yin, President Singapore Medical Association
20 Years Ago
20 years ago, in 1987, I stumbled out of my army camp as a private in training to attend the Medicine Interview held in the three seminar rooms outside level two of the Medical Library. I was assigned to Team B, chaired by the late Professor of Medicine,Chan Heng Leong.
One of the more memorable exchanges during the interview was this:
“What do you read in your free time?”
“Scientific American.”
“Are you saying that because you think we like people who read Scientific American?”
“No. I actually read that because I like it. I also read MAD magazine.”
I then promptly fished out my copy of Scientific American and MAD magazine and showed the panel.
Another memorable question was: “There will be too many doctors when you graduate. In
fact, there are probably already too many doctors now. What would you do after you graduate from medical school, if you find that you are unable to get a job that would allow you to practise
medicine?”
I replied: “If you are really a bad doctor, you may not get a job even in good times. But then
again, even in bad times, there is always a job for the better doctor.”
I guess that was not really a bad answer for me; maybe it was a bad answer for the medical
profession, because since then, the profession has been stuck with me.
A Foreign Doctor Convert
Recently, a senior (local) doctor working in the polyclinic commented to me over dinner that
she felt the relevant authorities were treating NTS (non-traditional source) doctors unfairly.
She felt that the NTS doctors were up against changing goal-posts. (NTS doctors are doctors
with basic degrees from universities which were not registrable with SMC). These doctors were
“promised a lot” when they were recruited and now with changing policies, it appears they would be asked to leave, when their current temporary SMC registration expires, after they have settled down here with their families. It appears that they were told that they would be given conditional registration if they obtained the GDFM, but now the bar has been raised to the M.Med.
I do not know if there was any truth to these allegations by her but nonetheless, I was surprised at this remark from her because I remember a few years ago, she was complaining to me about
the quality of NTS doctors and the intense supervision they required. Well, it appears that her
opinion of NTS doctors has changed quite a bit. According to her, the quality of the first NTS batch of doctors was patchy. The current ones were good – they realise the “precarious” position they are in with regard to their SMC registration and they work hard and make the extra effort to be good polyclinic doctors.
I then said if they were good, then they should have no problems passing either the GDFM or the M.Med. To this she replied: “You know, they may be good doctors, but they are not drilled like us since young to pass exams. Our M.Med exam is not easy to pass unless you are exam-oriented.” I will not argue with her on this. She was a far better student than me in medical school. But this incident does illustrate how a previous cynic of having foreign doctors here has been persuaded to believe that they are good for our healthcare system.
Recently, the Minister for Health announced his intention to bring in more foreign doctors. This has drawn reactions from quite a few local doctors, GPs and specialists alike. Several have written to SMA and asked us what SMA is doing to protect the local doctors’ livelihoods. One private sector cardiologist called me as if the world has ended for him.
Avoiding Character Assassination
My own personal belief is this: If SMA is not protectionist, then appearing protectionist when you believe otherwise is hypocritical. If SMA is protectionist, then in Singapore’s context,
appearing protectionist may be the worst way to actually forward the protectionist cause. In other words, appearing protectionist may be the worst way forward whether SMA is protectionist or not. Because once you are labelled successfully as protectionist, you can be pretty sure that whatever you say afterward will not be taken very seriously. To be labelled as protectionist is to be successfully character-assassinated.
For the record, the current SMA council is not protectionist. Having said that, protecting local doctors’ livelihood is different from being protectionist. For example, the local legal profession is actually facing a decreasing number of litigators despite more law graduates and now has to think of a way of making lives for litigators more bearable and litigation a more palatable career option.
The same thinking can be applied to the local GP scene where while there is no decrease in numbers, there are certainly more and more GPs turning to non-traditional areas of GP work to supplement their income.
The Minister for Health has also been reported to be saying that he wants to double the number of doctors in hospitals, from having one doctor for every two beds to one doctor per bed.
More Doctors – Who Pays?
The Minister for Health has also been reported to be saying that he wants to double the number of doctors in hospitals, from having one doctor for every two beds to one doctor per bed.
What are the possible outcomes if doctors were indeed to be doubled in our hospitals?
Let us assume an extreme scenario whereby despite the increase in doctors, the foreign patient
load does not increase and all the additional doctors see only the same number of local patients.
That would mean that each doctor has double the amount of time per patient. That is a good thing for the patient. Unfortunately, the downstream effects in extreme situations would be:
a) the pay of each doctor is halved, or
b) each local patient pays double the amount he would have previously paid for the same
amount of physician services, or
c) supplier induced demand sets in and the doctor doubles the amount of physician services
needed by one patient.
I do not believe for a moment that the relationship between doctors’ income and number of doctors is linear: that doubling number of doctors will lead to each doctor earning only half of what he used to. The likely scenario is that all of the above will occur to some limited extent (that is, decrease in doctor’s pay, increase in healthcare inflation and supplier induced demand), unless a large part of the capacity generated by these additional foreign doctors will be used by foreign patients, which is unlikely. Foreigners will take up some of the additional capacity but domestic consumption will still take up the majority of the increase in capacity afforded by foreign doctors.
That leaves us to ask – who pays for the new services provided by these doctors to the local
population? The quick answer is Singapore will pay because another country is certainly not paying for the health services consumed by us. And how will this be paid? Simply put, the bill has to be either paid for by the government (more taxes?) or the people in one way or the other. Singapore has traditionally adopted the policy that the people should take responsibility for their health and therefore for most of the healthcare costs incurred. Hence in Singapore, Government Health Expenditure (GHE) only takes up about 1/3 of Total Health Expenditure (THE). This can be seen in Table 1 where Singapore is compared to developed countries and our neighbours. Singapore’s GHE is only 36.1% of THE and this is low when compared to other developed countries and some neighbouring countries as well. In the absence of a means test, one can argue that accessibility of healthcare to the poor will be compromised if this percentage drops further. Even in free-market USA, where 1/6 of the population does not have access to healthcare except at emergency departments, the government takes up a higher proportion of THE (at 44.6%). If Singapore goes any lower than 36.1% (and without a means test), it will probably have to contend with the poor having problems availing themselves to healthcare,
similar to countries such as India, China, Indonesia and Vietnam with a low GHE as a percentage of THE. In fact, in all likelihood, the government’s share of THE in Singapore may actually increase if the trend seen in other developed countries is anything for us to go by, especially so when we do not have a means test to direct and focus GHE toward the poor and needy.
Singapore’s percentage of GDP spent on healthcare is also on the low side when compared to
other developed countries. With an aging population and rising expectations, this figure will have to likewise go up to levels of most other developed countries (that is, between 7% to 10%).
In other words, the new capacity created by an influx of foreign doctors (should this influx take place at all) will not be only at the expense of local doctors’ income but will have to be funded at least commensurately by an increase in GHE and THE as well.
Looking at the table, Singapore’s Physician per 1,000 Population is indeed low by developed
country standards. The point to be made here is that the shortage of doctors in Singapore is selective and there is a mal-distribution of workload between the public and private sectors which exacerbates the effects of shortage. We certainly do not need more GPs, obstetricians and so on. And if we pay renal physicians and geriatricians a whole lot less than some popular surgical disciplines or what these same specialists can get in the private sector, then we will never get enough local doctors specialising in renal medicine or geriatrics, and even if we do get more of them, we cannot get them to stay in the public sector where most of the work is done.
Table 1: Selected Countries and, THE as
Percentage of GDP, GHE as Percentage
of THE and Physician Density
By Dr. Wong Chiang Yin, President Singapore Medical Association
20 Years Ago
20 years ago, in 1987, I stumbled out of my army camp as a private in training to attend the Medicine Interview held in the three seminar rooms outside level two of the Medical Library. I was assigned to Team B, chaired by the late Professor of Medicine,Chan Heng Leong.
One of the more memorable exchanges during the interview was this:
“What do you read in your free time?”
“Scientific American.”
“Are you saying that because you think we like people who read Scientific American?”
“No. I actually read that because I like it. I also read MAD magazine.”
I then promptly fished out my copy of Scientific American and MAD magazine and showed the panel.
Another memorable question was: “There will be too many doctors when you graduate. In
fact, there are probably already too many doctors now. What would you do after you graduate from medical school, if you find that you are unable to get a job that would allow you to practise
medicine?”
I replied: “If you are really a bad doctor, you may not get a job even in good times. But then
again, even in bad times, there is always a job for the better doctor.”
I guess that was not really a bad answer for me; maybe it was a bad answer for the medical
profession, because since then, the profession has been stuck with me.
A Foreign Doctor Convert
Recently, a senior (local) doctor working in the polyclinic commented to me over dinner that
she felt the relevant authorities were treating NTS (non-traditional source) doctors unfairly.
She felt that the NTS doctors were up against changing goal-posts. (NTS doctors are doctors
with basic degrees from universities which were not registrable with SMC). These doctors were
“promised a lot” when they were recruited and now with changing policies, it appears they would be asked to leave, when their current temporary SMC registration expires, after they have settled down here with their families. It appears that they were told that they would be given conditional registration if they obtained the GDFM, but now the bar has been raised to the M.Med.
I do not know if there was any truth to these allegations by her but nonetheless, I was surprised at this remark from her because I remember a few years ago, she was complaining to me about
the quality of NTS doctors and the intense supervision they required. Well, it appears that her
opinion of NTS doctors has changed quite a bit. According to her, the quality of the first NTS batch of doctors was patchy. The current ones were good – they realise the “precarious” position they are in with regard to their SMC registration and they work hard and make the extra effort to be good polyclinic doctors.
I then said if they were good, then they should have no problems passing either the GDFM or the M.Med. To this she replied: “You know, they may be good doctors, but they are not drilled like us since young to pass exams. Our M.Med exam is not easy to pass unless you are exam-oriented.” I will not argue with her on this. She was a far better student than me in medical school. But this incident does illustrate how a previous cynic of having foreign doctors here has been persuaded to believe that they are good for our healthcare system.
Recently, the Minister for Health announced his intention to bring in more foreign doctors. This has drawn reactions from quite a few local doctors, GPs and specialists alike. Several have written to SMA and asked us what SMA is doing to protect the local doctors’ livelihoods. One private sector cardiologist called me as if the world has ended for him.
Avoiding Character Assassination
My own personal belief is this: If SMA is not protectionist, then appearing protectionist when you believe otherwise is hypocritical. If SMA is protectionist, then in Singapore’s context,
appearing protectionist may be the worst way to actually forward the protectionist cause. In other words, appearing protectionist may be the worst way forward whether SMA is protectionist or not. Because once you are labelled successfully as protectionist, you can be pretty sure that whatever you say afterward will not be taken very seriously. To be labelled as protectionist is to be successfully character-assassinated.
For the record, the current SMA council is not protectionist. Having said that, protecting local doctors’ livelihood is different from being protectionist. For example, the local legal profession is actually facing a decreasing number of litigators despite more law graduates and now has to think of a way of making lives for litigators more bearable and litigation a more palatable career option.
The same thinking can be applied to the local GP scene where while there is no decrease in numbers, there are certainly more and more GPs turning to non-traditional areas of GP work to supplement their income.
The Minister for Health has also been reported to be saying that he wants to double the number of doctors in hospitals, from having one doctor for every two beds to one doctor per bed.
More Doctors – Who Pays?
The Minister for Health has also been reported to be saying that he wants to double the number of doctors in hospitals, from having one doctor for every two beds to one doctor per bed.
What are the possible outcomes if doctors were indeed to be doubled in our hospitals?
Let us assume an extreme scenario whereby despite the increase in doctors, the foreign patient
load does not increase and all the additional doctors see only the same number of local patients.
That would mean that each doctor has double the amount of time per patient. That is a good thing for the patient. Unfortunately, the downstream effects in extreme situations would be:
a) the pay of each doctor is halved, or
b) each local patient pays double the amount he would have previously paid for the same
amount of physician services, or
c) supplier induced demand sets in and the doctor doubles the amount of physician services
needed by one patient.
I do not believe for a moment that the relationship between doctors’ income and number of doctors is linear: that doubling number of doctors will lead to each doctor earning only half of what he used to. The likely scenario is that all of the above will occur to some limited extent (that is, decrease in doctor’s pay, increase in healthcare inflation and supplier induced demand), unless a large part of the capacity generated by these additional foreign doctors will be used by foreign patients, which is unlikely. Foreigners will take up some of the additional capacity but domestic consumption will still take up the majority of the increase in capacity afforded by foreign doctors.
That leaves us to ask – who pays for the new services provided by these doctors to the local
population? The quick answer is Singapore will pay because another country is certainly not paying for the health services consumed by us. And how will this be paid? Simply put, the bill has to be either paid for by the government (more taxes?) or the people in one way or the other. Singapore has traditionally adopted the policy that the people should take responsibility for their health and therefore for most of the healthcare costs incurred. Hence in Singapore, Government Health Expenditure (GHE) only takes up about 1/3 of Total Health Expenditure (THE). This can be seen in Table 1 where Singapore is compared to developed countries and our neighbours. Singapore’s GHE is only 36.1% of THE and this is low when compared to other developed countries and some neighbouring countries as well. In the absence of a means test, one can argue that accessibility of healthcare to the poor will be compromised if this percentage drops further. Even in free-market USA, where 1/6 of the population does not have access to healthcare except at emergency departments, the government takes up a higher proportion of THE (at 44.6%). If Singapore goes any lower than 36.1% (and without a means test), it will probably have to contend with the poor having problems availing themselves to healthcare,
similar to countries such as India, China, Indonesia and Vietnam with a low GHE as a percentage of THE. In fact, in all likelihood, the government’s share of THE in Singapore may actually increase if the trend seen in other developed countries is anything for us to go by, especially so when we do not have a means test to direct and focus GHE toward the poor and needy.
Singapore’s percentage of GDP spent on healthcare is also on the low side when compared to
other developed countries. With an aging population and rising expectations, this figure will have to likewise go up to levels of most other developed countries (that is, between 7% to 10%).
In other words, the new capacity created by an influx of foreign doctors (should this influx take place at all) will not be only at the expense of local doctors’ income but will have to be funded at least commensurately by an increase in GHE and THE as well.
Looking at the table, Singapore’s Physician per 1,000 Population is indeed low by developed
country standards. The point to be made here is that the shortage of doctors in Singapore is selective and there is a mal-distribution of workload between the public and private sectors which exacerbates the effects of shortage. We certainly do not need more GPs, obstetricians and so on. And if we pay renal physicians and geriatricians a whole lot less than some popular surgical disciplines or what these same specialists can get in the private sector, then we will never get enough local doctors specialising in renal medicine or geriatrics, and even if we do get more of them, we cannot get them to stay in the public sector where most of the work is done.
Table 1: Selected Countries and, THE as
Percentage of GDP, GHE as Percentage
of THE and Physician Density
Australia 9.5 67.5 2.47 (2001)2
Canada 9.9 69.9 2.14 (2003)2
China 5.6 36.2 1.06 (2001)2
France 10.1 76.3 3.37 (2004)2
Germany 11.1 78.2 3.37 (2003)2
India 4.8 24.8 0.60 (2005)2
Ireland 7.3 78.9 2.79 (2004)2
Japan 7.9 81.0 1.98 (2002)2
Netherlands 9.8 62.4 3.15 (2003)2
New Zealand 8.1 78.3 2.37 (2001)2
South Korea 5.6 49.4 1.57 (2003)2
Switzerland 11.5 58.5 3.61 (2002)2
UK 8.0 85.7 2.30 (1997)2
USA 15.2 44.6 2.56 (2000)2
Singapore 4.5 36.1 1.56 (2005)3
Indonesia 3.1 35.9 0.13 (2003)2
Malaysia 3.8 58.1 0.73 (2003)4
Thailand 3.3 61.6 0.37 (2000)2
Vietnam 5.4 27.8 0.58 (2003)4
No Compromise in Standards
Another point to be made really is why would foreigners want to come here? As history has shown, it is very difficult to convince top clinical talent to come to Singapore. The proviso here being we need to be clear about what constitutes top talent. Our notions and definitions of talent must never be allowed to be compromised for the sake of making up the numbers (for example, to make up one doctor per inpatient). The standards expected of foreign doctors must be at least as high as those expected of the local doctors, if not higher. A level playing field is the basic requirement for local and foreign doctors to have a good chance of co-existing harmoniously.
It is commonly known that at least half the graduates of famous schools in China and India such
as Peking Union Medical College and All-India are offered jobs in the West before or soon after they graduate. Will there be any significant numbers from these top schools left for Singapore? And once good foreign doctors are allowed into Singapore, we also need to address the equally important issues of objectively assessing these doctors and to get them to leave Singapore if they are found to be wanting.
We can learn from the experiences of other sectors such as banking and the corporate world and so on, where foreigners are free to work here and also have been made to leave quickly when found wanting.
Exit management – getting the unsatisfactory ones out – is as important as getting them in, that is, recruitment.
Steps Forward
In summary, I would like to add that while allowing more foreign doctors into Singapore may
seem ominous to some of us in the profession, I take the view that it is not only just the doctor’s
livelihood that is at stake. At stake are also the equally important issues of health inflation, supplier induced demand etc and the overall competitiveness and efficiency of our healthcare services. The current macro-equilibrium between accessibility, affordability and quality can go either way with more foreign doctors. It is not a risk-free policy or path to take. So frankly, there are other people who should (and I hope would) be worrying about this more than doctors.
The problem for the SMA is that at the microlevel (that is, the individual level), there will be
doctors who will feel the negative effects of the winds of change. It is our duty as the national medical association to go out and help prevent this or at least prepare them for this. To this end, the SMA Private Practice Committee will be running a series of seminars and courses to help our members. For a start, we will restart our seminar on “Starting Private Practice”. This was a seminar that was very popular a few years back. We also develop further courses that we think will help the private sector doctors to optimise their practices financially and operationally.
20 years later today, I still believe that there will always be a job for the better doctor. And a
reasonably well-paying one too.
References:
1. 2003 Statistics from WHO website:www.3.who.int/whosis/core, (accessed 29 January 2007)
2. Year statistic obtained given in parenthesis
3. http://www.moh.gov.sg/corp/publications/statistics/manpower.do, (accessed 29 January 2007)
4. http://www.wpro.who.int/NR/rdonlyres/135A09A2-E83E-4CB3-B771-3C5529DB878B/0/annextable2005.pdf
Dr Wong Chiang Yin is the President of the 47th SMA Council and Chief Operating officer in a public hospital. When not working, his hobbies include photography, wine, finding good food, calligraphy, going to the gym and more(non-paying) work.
http://www.sma.org.sg/sma_news/3902/Forum.pdf
Steps Forward
In summary, I would like to add that while allowing more foreign doctors into Singapore may
seem ominous to some of us in the profession, I take the view that it is not only just the doctor’s
livelihood that is at stake. At stake are also the equally important issues of health inflation, supplier induced demand etc and the overall competitiveness and efficiency of our healthcare services. The current macro-equilibrium between accessibility, affordability and quality can go either way with more foreign doctors. It is not a risk-free policy or path to take. So frankly, there are other people who should (and I hope would) be worrying about this more than doctors.
The problem for the SMA is that at the microlevel (that is, the individual level), there will be
doctors who will feel the negative effects of the winds of change. It is our duty as the national medical association to go out and help prevent this or at least prepare them for this. To this end, the SMA Private Practice Committee will be running a series of seminars and courses to help our members. For a start, we will restart our seminar on “Starting Private Practice”. This was a seminar that was very popular a few years back. We also develop further courses that we think will help the private sector doctors to optimise their practices financially and operationally.
20 years later today, I still believe that there will always be a job for the better doctor. And a
reasonably well-paying one too.
References:
1. 2003 Statistics from WHO website:www.3.who.int/whosis/core, (accessed 29 January 2007)
2. Year statistic obtained given in parenthesis
3. http://www.moh.gov.sg/corp/publications/statistics/manpower.do, (accessed 29 January 2007)
4. http://www.wpro.who.int/NR/rdonlyres/135A09A2-E83E-4CB3-B771-3C5529DB878B/0/annextable2005.pdf
Dr Wong Chiang Yin is the President of the 47th SMA Council and Chief Operating officer in a public hospital. When not working, his hobbies include photography, wine, finding good food, calligraphy, going to the gym and more(non-paying) work.
http://www.sma.org.sg/sma_news/3902/Forum.pdf
Friday, February 23, 2007
Doctor numbers- WHO statistics
1.WHO Statistics on Number of doctors per capita by countries
(NB: the doctor figures from different countries may be from different years- as reported to WHO)
Countries/ Drs Nos./ (Dr. numbers per 1000 )
Singapore 5,747 (1.4) )
Europe (Advanced countries)
Belgium 46,268 (4.49)
Denmark 15,653 (2.93)
Finland 16,446 (3.16)
France 203,487 (3.37)
Germany 277,885 (3.37)
Ireland 11,141 (2.79)
Italy 241,000 (4.2)
Netherlands 50,854 (3.15)
Norway 14,200 (3.13)
Sweden 29,122 (3.28)
UK 133,641 (2.3)
North America
USA 730,801 (2.56)
Canada 66,583 (2.14)
Oceania-Asia Pacific
Australia 47,875 (2.47)
NZ 9,027 (2.37)
Japan 251,889 (1.98)
S Korea 75,045 (1.57)
Malaysia 16,146 (0.7)
Philippines 44,287 (0.58)
Other City States
HK 11505 (1.7)
Taiwan 34093 (1.52)
Addendum: 24.2.07 HK and Taiwan's statistics I just got from
HK: http://www.yearbook.gov.hk/2005/en/app_06_27.htm
Taiwan: http://www.gio.gov.tw/taiwan-website/5-gp/yearbook/16PublicHealth.htm#Heal
2.My comments
Hi Friends,
I manage to get the statistics for Doctor numbers and Doctors per capita ( ie per 1000) figures from the WHO website.
I do not have the time to analyse the figures yet, but it is pretty much self-explanatory.
I do not want to give a knee-jerk reaction to the Ministry of Health's sudden disclosure that we have about the advanced nations' lowest doctor-population ratio ( now suddenly we count ourselves amongst the 1st world! Anything to win an argument?) .
Anyway, the statistics do not lie. ( but then again wasn't it Disreali who said, " There are 3 types of lies- Lies, damned lies and statistics" ?)
But somehow, my impression and my doctor-friends impressions also do not bear out that we are short ( esply in the private sector).
I wonder how being a city-state skew the stats? I wonder what would the doctor per capita of cities be? Any statisticians or maths whiz out there? I just added in HK's and Taiwan's figures.
Theirs are closer to Sg's numbers ( but still a tad higher).
Let's chew on the statistics ( and dig up your books on t-test/ chi-square test/correlation coefficient etc) and let me have your comments.
Cheers
Dr.Huang Shoou Chyuan
PS: I apologise for the poor quality of graph ( I did it with my elementary MS Excel skills all by my lonesome self)
Also the figures keep bunching up. Given up trying to space and line them out.
3.About the WHO website for statistics (Core Health Indicators)
For those who want to look at the statistics yourselves please go:
http://www3.who.int/whosis/core/core_select.cfm
Then select (all countries)---> (all years)
select physicians ( numbers) and physician per capita.
Then of course press submit ( in case there are technology virgins here) :)
4. This is the thingaling that started the whole debate
Singapore has worst patient-doctor ratio: report
(21 Feb 07 Channelnewsasia.com)
Singapore has the worst patient-to-doctor ratio among developed countries and has embarked on a global effort to entice doctors, a report said Wednesday.
Top health ministry officials went to Australia and London last year to convince Singaporean doctors studying or working there to return, and to encourage top foreign doctors to practise in Singapore, the Straits Times said.
It quoted the health ministry's permanent secretary Yong Ying I, who was dispatched to London last year, as saying Singapore has the worst patient-to-doctor ratio among developed countries.
"We have very efficient doctors and they work very hard. But somewhere along the way we also don't have enough," the newspaper quoted Yong as saying.
"If you want to bring down waiting times, we need to recruit more doctors, much more than a few percent."
The city-state is faced with an ageing population but is also seeking to bolster its role as a top provider of quality healthcare services for patients from abroad.
Singapore, Southeast Asia's most advanced economy, had a population of about 4.4 million with 6,748 doctors registered in 2005, according to official statistics.
The goal is to have one doctor per patient in public hospitals, up from a ratio of one per every two, the report said.
The country needs to produce 400-600 locally trained doctors annually, up from the current level of more than 200, the paper quoted Health Minister Khaw Boon Wan as saying.
Khaw cautioned that "much as we will try to recruit as many as we can, we will be lucky to half-succeed," which was why he sent his top two ministry officials to scout for doctors abroad, the report said.
http://sg.news.yahoo.com/070221/1/46tr4.html
Subscribe to:
Posts (Atom)