Monday, October 12, 2009

Singaporeans and the "moving goalposts"

The expression "moving the goalposts" is a kind of sporting expression but commonly used to refer to the changing of targets by one side in a competitive process so that there will be an unfair advantage to that side. In an academic setting, it could refer to the changing of the aim of a debate/discussion so that greater and greater evidence is required to prove a point.

Singaporeans are "used to" working in an environment where the goalposts keep changing. Progress, she is called. After all we live in a rapidly changing environment where targets are non-static. Change or stagnate. In Singapore, any change is implemented so that targets are achieved yesterday.

At about this time last year, the NTU embarked on a large scale review of her staff contracts. Many saw it as a culling exercise. The university's mission had morphed from a teaching heavy one to a focus on leading edge research. So the goal posts moved. And in the process, a large cohort of academics who had given the best years of their lives, and had served the teaching mission faithfully were unceremoniously booted out.

More recently there was the problem about the maths paper in PSLE. A last minute change to allow calculators resulted in a flurry of complaints from concerned parents. Not a real problem here except that Gigamole couldn't see why the goalposts had to be moved. Was it not something that could have been implemented the following year so that the students would not be surprised by the changed location of their goalposts? Was it so urgent a mission that one could callously disregard students' anxieties? Apparently so.

Then today, the new residency programme for the training of medical specialists was outed. Nothing new here, as this has been the hot topic in medical blogs, and has caused immeasurable angst among medical students. But this was really a problem of moving goalposts. Students shouldn't be so upset. This is Singapore. And goalposts change here. Frequently. We know it was done as a last minute scramble to match the graduating class from Dukes-NUS. The question was 'wasn't this anticipated?' Didn't management figure out Dukes-NUS was about to graduate and usher in the residency programme? I figure they had about 4 years heads-up on this. But the goalposts changed at the 11th hour as if the problem developed overnight. One must question, why? Why?

Please don't get me wrong. I am all for change, for dynamism. No problem for me if management wants to move their targets. After all the world is not sitting still. But what is good for management is not necessarily good for staff or students. I believe management is getting away with much of this because, the management style is very much top down. Can staff complain? Not really. Can students protest? Not really? What happens usually? Management issues some bland unsatisfactory statement to gloss over the issue, citing how we need to remain top of ranking, or how we are on the way to performance excellence and everyone quietly swallows the bitter pill. But the bitterness remains.

Effective. Progressive. And scores a lot of points with the man upstairs looking at metrics. But cold, uncaring and soul-less.

Management should be aware that there is a limit to how much of this shifting goalposts angst people can absorb. At some point in time, a price will have to be paid in worker's satisfaction, or student's loyalties. There is a limit to how much one can continue to depend on imported talent to replace disenfranchised citizens. At some point in time management will need to count on its own citizenry to staff the hospitals, and to look after our own. Then by that time, there might be no one left.



Anonymous said...

It is unfair to blame management for shifting goalpost.
It is easier to implement changes when there is no time left to debate and protest the changes.

Our hospital management is forward looking and you can be assured that things happen for a reason.

Initially, residency is only for elite Duke-NUS students but somewhere along the way, the non-elite YLL is afraid that their students will lose out to the elite Duke-NUS and decide to get rid of the ho-mo system

If you really want to blame someone, blame YLL and not us hospital management.


gigamole said...

My apologies if Igave the impression I was blaming hospital management. It wasn't my intention. I think we all know the hospitals were pretty much on the receiving end of having to roll out the programme asap. The 'management' decision was clearly taken elsewhere.

Anonymous said...

Good for you to clarify.

You do understand that hospitals are trying their best for residency system in Singapore to be a success.

Now that it is in place, let us give the new system a try instead of being so negative at the start.

Hopefully with more specialists trained, this will help to bring down the costs of healthcare so that our fellow citizens will not fear falling sick in future.

Currently, many Singaporeans are more afraid of falling sick than dying in Singapore.
With more supply of specialists, this will achieve the ideal situation of Singapore having the cheapest and best healthcare in the world!

gigamole said...

"Now that it is in place, let us give the new system a try instead of being so negative at the start."

We should of course do our best to try and make it work. My comments are not negative in the sense of undermining the process, but simply articulating the frustrations and apprehensions of the younger doctors and students who just cannot comprehend and are reluctant to buy into a programme that seems poorly thought out or planned for.

Why do we have a culture in Singapore of 'moving the goalposts' at the eleventh hour, as if we don't care about the people who are affected?

If the residency programme is so advantageous and desirable in terms of producing "cheapest and best healthcare in the world" (I don't necessarily agree with you that that's where we are heading) surely it deserves better planning and management than what appears to have been behind this last minute rush to implement?

Anonymous said...

Sorry, other Anon who is purportedly in hospital management, I cannot imagine how anyone (especially someone in hospital management) can believe that having more specialists will drive down healthcare costs.

The problem is rendered worse because with a 5-year program bent on generating more specialists (as opposed to generalists) with less broad-base experience, you will reduce the proportion of "gatekeepers" in the system.