Hearing but not listening. Beyond the population white paper.

We all know the expression 'to hear but not listen'. How many times have we screamed' in exasperation at our kids, and for that matter - our kids screamed at us..   " .....but you are not listening!! *sigh*

Our present gahment seems a bit like that, isn't it. Minister Ng Eng Hen, said in no uncertain terms "We heard  Singaporeans clearly". PM Lee in his post election speech said it too..." We hear all your voices.". Hear, hear. The question is...have they listened?

In Medicine, hearing is a function of the auditory organ, the ear and all its connections. If you can't hear, it is a malfunction of the organ. Something is damaged, or there's just a big cockroach stuffed into your ear. But if you can't understand despite hearing.... something is wrong higher up. Some people call this an auditory Perception Difficulty, and link it with the more recognizable group of dyslexic conditions.

But it is not necessary that the gahment has something so crippling. More likely, they are just locked into an ideological frame of mind, that they cannot see anything worth considering beyond the ideology. Talk about needing to think out of the box. Here is a bunch of smart (very smart, I believe), high salaried technocrats, who believe that all they have is in that box, and cannot conceive of any possibilities outside of that box.

So when they hear, they actually cannot understand. So when they say they hear, what they mean is that they  have heard the noise and clamour, and believe that their failing is merely that they have not worked hard enough to make us come round to their way of thinking. So they will try harder, to make us understand.

Sadly, with potentially tragic outcomes.

The public transport monster under the bed

So, yet another train fiasco. Just that this time, it is SBS Transit in the hotseat.

Try as I may, after many futile hours/days, Gigamole has come round to the reluctant realization that Gigamole is really too intellectually challenged to understand all the convoluted arguments explaining the Government's infusion of S$1.1 billion to the public transport operators. To Gigamole it cannot be anything other than putting money into the hands of the shareholders of inept and inefficient transport operators.

The privatisation of public transport created the initial illusion that the Government was distanced from the responsibilites of managing public transport. The monster appeared to lurk in the basement far from Governement coffers. But the precipitate and almost panic-strickened dumping of S$1.1 billion to plug the leaking boat speaks volumes about where the monster truly lived. Right under the Government's own bed.

The PAP's new clothes......

Although Hans Christian Anderson popularized the story of the Emperor's New Clothes, the story actually did not originated from him. The story was rather, adapted from a Spanish original in the El Conde Lucanor (1335). Anderson's creative input was apparently to alter the punchline of the story to that of an innocent child blurting out the awesome truth: "But he isn't wearing anything at all!"

I couldn't help thinking of this as I read Mrs Lim Hwee Hua's comments of the recent elections:"We had spent the last five years working hard, trying to understand - in the areas where there are gaps - what the problems were, what the deficiencies were, and to address those," she recalled. "We have also, of course, been trying to engage the residents on some of the current issues."

"It is a surprise for us that the resentment is so deep and the unhappiness is so deep." In fact, it was only during the campaign, that "we began to fully appreciate the extent of the unhappiness and resentment towards the Government, hence the pledge by the PAP team led by Mr George Yeo for us to have a strong role in the transformation of the PAP itself."

One cannot really deny that the PAP MPs do work hard. And they are generally very good at what they do. But for Mrs Lim to admit so candidly they were caught by surprise at the level of resentment and unhappiness on the ground is indicative of how badly they had been betrayed by the people they surrounded themselves with. With their huge machinery and wide range of grassroot organizations, feedback channels, how can they not know?

They are not and will not be the only emperors who get be caught out by the sycophantic crowd. There will always be self-serving sucker-uppers who seek only to further their own fortunes by selectively telling their masters the 'truth' they want to hear.

Perhaps the first step in the transformation of the PAP is to weed out these self serving elements from within.

Doing the right operation..... ala Dr Vivian Balakrishnan

Dr Vivian Balakrishnan provided an interesting analogy of the consultative approach he advocated for the PAP in the future.

Stressing the value of communication, he said: "It's not good enough just to do the right operation ... It's very, very important to talk to the patient - to explain these choices and the different trade-offs and make sure the people of Singapore understand this and participate more actively in the decision-making process."

Words of wisdom. Lessons learnt .... apparently.... until you note the first part of what he actually said: "....It's not good enough just to do the RIGHT operation".

So what he actually meant was that the PAP was right all along, and that the electorate had misunderstood all along. The PAP only failed in so far as it did not persuade the electorate of its 'rightness'. Informed consent to him, is to persuade the patient to agree to the correctness of the solution administered. Really?

Sodesne !.... And all the while I thought they were going to be truly more consultative.

To be fair, his boss, PM Lee had in the post-election press conference hinted at a future more inclusive relationship with the electorate: "And that means not only the Government working hard on its own with a population of passive but engaging Singaporeans in the more difficult decisions and trade-offs which governing Singapore involves. There are often no easy choices and the more we can appreciate this and grapple with the dilemmas and the trade-offs together, I think the better the answers we'll come up with, and the more we'll be able to have workable solutions."

I for one am truly hopeful that there will be a reformed PAP that will seek to lead rather than rule. They have done a magnificent job thus far as rulers, but I want much more than that. I really want to see them enter into a new social contract with Singaporeans, one that includes a greater degree of engagement and involvement in decision making with respect to critical problems. But the real deal-breaker is whether they trust Singaporeans enough to be transparent in their decision making processes. Or whether they will just continue to pretend to be consultative, but secretly (well, not so secret...) go on believing they have the only truth and only real solution, and just work harder to convince Singaporeans to be compliant.

I think that would be a disaster.

Nigerian frauds and big pharma.....

One normally associates Nigerian frauds with those sob story emails that you get from time to time, but the recent Wikileaks exposés showed up another kind of fraud that happened some time ago in Nigeria.

Back in 1996, there was an epidemic of meningitis in Nigeria, and big pharma Pfizer, with a new antibiotic trovafloxacin (Trovan) in hand, seized the opportunity to conduct a clinical trial on Nigerian children who came down with symptoms of the disease. All well and good except that the study did not receive ethics approval as was legally required under Good Clinical Practice. Pfizer claimed the study received approval to proceed, and an approval letter was produced supposedly from the ethics committee. The trouble was that there was no such ethics committee at that time. The lead investigator of the trial, Dr. Abdulhamid Isa Dutse, subsequently admitted that the letter could have been drafted 1 year after the study started and then backdated.

If this is true, this is fraud, plain and simple. Clinical trials fraud. Pfizer has however denied culpability and Dr. Abdulhamid Isa Dutse apparently is now the Chief Medical Officer of the Aminu Kano Teaching Hospital.

Strange.

The incident would have been consigned to the history books if not for the recent Wikileaks revelations, which pointed a finger at Pfizer trying to manipulate legal proceedings by uncovering unsavoury details about corrupted practices by Nigerian Federal Attorney General Michael Aondoakaa, so as to pressure him to drop the legal suits against the company.

If these revelations are true, they do show that even big companies who are supposed to be ethical are not above playing dirty. More recently, some more Wikileaks exposés, this time about New Zealand, show the shadowy hand of big pharma in trying to unseat Helen Clark who was Health Minister at that time.

I hope our Singapore government can keep big pharma at arms length. Sometimes I feel they have become to close to big pharma because of the need to cultivate their engagement in our attempts to grow the life sciences and biomedical industry. They have to be careful not to let big pharma have too big a voice in shaping our national strategies.

The race and ethnicity divisions.....

The recent public discussions following upon the recent government rulings on double-barreled listings of race, have unfortunately been confused by the lack of distinction between what are generally accepted ideas about race and ethnicity.

Race (see Wikipedia), generally refers to a set of external physical characteristics which are heriditable. So we can arbitrarily think about a 'Caucasoid' race, or a 'Mongoloid' race etc. This is a notion that has become quite obsolete. Although, it is true that external physical characteristics can be largely heriditable, the limits defining racial groups are extremely fuzzy. Think for example, how impossible it is to define the limits of what the Caucasoid race is. Similarly, there are no real limits to the definition of a Chinese race. In fact, contrary to what some people may think, Chinese-ness is not a 'race'. To push the point, neither are Indian-ness and Malay-ness.

Ethnicity is however, a rather different concept (see Wikipedia). The concept of an ethnic group refers to commonly agreeable ideas of what constitutes a community, or grouping of people. This does not depend on heriditable physical characteristics, but will include characteristics related to culture, language, religion, etc. Hence to say we are ethnically Chinese, or Indian or Malay would be appropriate. In fact to be more correct globally, the identifier should be Singaporean Chinese, or Singaporean Indians etc.

We should therefore drop all reference to a 'race' identifier, and just restrict our definitions to that of ethnicity. This way we will avoid the unfortunate 'genetic' or 'biological' connotations of categorizing people according to racial groups.

It should also be clear that ethnicity is largely a social construct. It is necessary because everyone in the world defines himself or herself as part of some sort of grouping. This is an important part of how societies organize themselves and allocate resources. Our government is correct that the idea of ethnicity will never go away. We ignore it to our own peril. Every government in the world resorts to some sort of ethnicity definition (even if they deny doing so) because governments need to allocate resources according to various groupings of people. The better we are able to do this, the better we can equitably allocate resources. The trick in doing so is going to depend on how we make sure such ethnicity definitions are affirmatory and not discriminatory. This will come down to good governance and a good constitutional protection of ethnic minorities.

Human Organ Trade - a nuanced approach

A colleague once referred to Minister Khaw as the 'teflon man', referring to is ability to extricate himself from all kinds of sticky situations. I personally think that was being very unfair. I think Minister Khaw has perhaps been better than other ministers in navigating out of difficult situations mainly because of his innate abilities to be more adaptable and nuanced when dealing with difficult situations.

There is no doubt the organ trade issues are very difficult to resolve. There will be no solution that will make everyone happy. Often in this kind of situation, the 'wise' approach may be just to sit on one's hands and do nothing. But having made a commitment to move forward on this, some reasonable solution now needs to be found. Personally I am prepared to give Minister the time and space to resolve this in the most appropriate way possible.

It is however critically important that we remain vigilant and mindful of the dangers ahead. For one thing, the gap between ethical and non-ethical has become a lot more narrow than it has ever been before, and it has clearly become so much easier to drift over the line (whatever this may be). Rimbursements to payments. Residents to foreigners. This is the intrinsic danger of being on the slippery slope.

Fundamental to all of this is the strength of our ethics environment. Minister Khaw is right to point to the strength of our ethics environment. But he may perhaps have overstated the case. Our ethics environment is good but maybe not as strong as he thinks. I will post more on this issue when I have a bit more time to collect my thoughts, but I think we still have a long way to go to lay claim to having an ethics environment that is robust enough to deal with complex situations like this.

Why can't we care for our elderly in Singapore??

Today's Straits Times carried a report by Cheryl Ong on the lack of space and facilities for old people at the centres that care for them.

Clearly the aging of our population is going to put all kinds of strains on our society both in terms of the costs involved, as well as the modification of our living space to accomodate more aging problems. The government has not been sleeping where this is concerned and I believe has been trying to find meaningful solutions to this burgeoning problem.

But I would like to suggest that the government is not doing enough. Principally, I believe, because it is locked in a mindset that frowns on anything that resembles their going down the 'social welfare' road. I think this is a restrictive and self defeating mindset. Some would say, anal retentive.

It's time we look at our elderly as people we should treasure and cherish and honour. I don't think anyone but the government would object to spending more tax-dollars on the elderly. I wish the government would stop harping on the increased costs to look after the elderly, and see it as a necessary part of the filial concerns of our society. I wish they would stop making the elderly feel that it is their fault that they live a long life... what a sin...and what a burden they place on society if they should live beyond 80...or beyond the reach of the Medisave.

Why can't the government just tell the elderly...that we, as a society, celebrate their longevity. That when they grow old, they deserve a rest, not just from work but from the worries of having to fend for themselves. Free from the need to be financially responsbible for their rent, their food or the medical bills. Is it that terrible if they should 'wrongfully' use more tax dollars for their medical bills?

I think this is what we, as a society, owe the elderly.

Can we afford the tax dollars? Of course we can. We just lost an unquantifiable lot of billion dollars because of Temasek and GIC. Could we not spend sone of those billions on making the elderly feel loved?

C'mon governement, stop being so anal retentive about this. Can you afford to be a bit more loving and a bit less calculative? O course you can.

Government in cyberspace

Over the last week, something significant apparently happened. The government actually responded to an online letter.

To me it is really not a tremendous deal, although I must admit it is something of a milestone. Cyberspace has been in existence for a very long time, and as has been pointed out by other netizens, it by now not really a new technology platform where information is moved around and discussed. The big issue was really about the way government policy makers and bureaucracy/officialdom interacts with (and shapes?) such information dynamics in cyberspace.

Despite the hype about online discussion forums etc, I have been fairly disappointed generally in the level and sophistication of the discussions. Most are dominated by a relatively vocal minority who tend to get quite repetitious (sianz ahh....). Most netizens prefer to just lurk silently. Who knows what they think, and what opinions they hold? Take for instance, the ST online forum where this issue is being debated...at this moment the published stats show that 484 have visited the site, but only 18 comments have been sent in by 15 accounts (~3% of total visits?). I think the stats are fairly representative of the cyberspace culture. Most are happy to read, but online opinions are far from being representative of cyberspace, let alone the community at large.

Does this mean that cyberspace discussions and opinions are not to be taken seriously? Clearly not so. Opinions expressed through blogs, discussion boards and chat rooms do get noticed. And they do get repreated and propagated, sometimes in its original state, but often morphed into something else. Good responsible ideas do persist, and i am guessing that these do get noticed by agencies who should take notice.

I am told by reliable sources that big government has already been scanning and eavesdropping cyberspace. It may be that their primary focus may be on politically sensitive issues, but I think as their ability to do so improves and matures, their eavesdropping of cyberspace chatter will also allow them to pick out good ideas that ministries and other agencies can act upon.

There is no doubt the government is already in cyberspace. They'd be pretty incompetent if they do not already have a good ear to the cyberspace ground. How they respond is another thing altogether. That they have responded to an online letter says something of a shift in their mindset, in that they are publicly ackowledging their presence in cyberspace.

For me it is relatively unimportant if the government responds to an online letter, or becomes an active discussant on discussion boards. Commonsense will tell you that it is not easy for them to actually do that. Far more important for me is to know that they are listening to the cyberspace ground. And if and when they do respond to the ebb and flow of ideas and opinions in cyberspace, it is not important for me where and in what form this response comes in. I personally think that many netizens do approach the issue with more than a little bit of ego, i.e. it is important that their letter is answered, the discussions must take place in the forum of their choosing etc etc ... They want to feel that if they press a button someone in 'gahment' must respond etc etc... But I think this is not necessarily a good or even workable model.

I have a different take on this. I am happy to know that the gahment does eavesdrop in cyberspace. I am grateful for a certain space to express opinions and ideas without the intimidation of having to submit nric numbers and addresses etc... and am pleased to know that these ideas, feedback and even whistleblowings will not only get picked up, but will eventually find expression in some form of governmental response.

We do have a responsible and fairly responsive government at the moment.They are still somewhat bureaucratic (as you might expect from governments), and can be quite monolithic in their ideas (as can be expected by the single party dominance of our political scene) but overall still doing a half decent job. That they are listening and beginning to respond to cyberspace is a good sign.

Jia you!