The General Elections - die die also must say

These are interesting times. As some have already pointed out, this elections will prove to be a watershed one. A milestone. Whatever the outcome and no matter how much MM Lee wants to downplay it, I believe the consequences will be immense and the results will significantly shape the Singapore of tomorrow.

I am not a political commentator and generally have stayed away from directly commenting on political issues. Maybe indirectly shoot some arrows, but generally I have been quite content to just grumble from the sidelines. I am generally not a political person. Afterall am I not a happy-happy beneficiary of the stable gahment that has allowed me to be educated and trained to be able to provide for my family as a medical professional? I am comfortably ensconced in Singapore society. What is there to really complain about? When I am overseas, who do you think I root for, and defend when others criticize developments in Singapore?

So the recent outpouring of apparent wrath against the ruling party in this 2011 elections seems a bit of a mystery to me. Has not the gahment of Singapore, achieved wonders in bringing a resourceless Singapore into developed nation status? We are the envy of many around the world. The little red dot is only little on the map; we punch way above our weight in the world. By any measure, we have a fantastic gahment here in Singapore.

Yet people are unhappy. Why? Minister George Yeo, MP for Aljunied accused the opposition for imposing an emotional burden on the voters, yet paradoxically, here lies the true emotional burden - that the electorate must struggle between supporting an otherwise effective gahment, and the feeling of heaviness and dissatisfaction, that somehow things are not as good as the official statistics tell us.

People feel marginalized and neglected. It is not that Singaporeans are xenophobic or hate foreigners, even though the tone of comments expressed during hustings may suggest it. No, Singaporeans are not xenophobic. It is merely the feeling that their own gahment appears to value foreigners more than its own citizenry. This is probably not true, but the perception is very pervasive. This is where I believe, the gahment has failed. It has failed in managing public perceptions and expectations with respect to immigration, foreign labour and economic growth. It is fantastic that our economy and GDP continue to chug along at a healthy rate, but the perception on the ground is that the benefits appear to accrue mostly to the elites and the wealthy in Singapore. The gahment's reach out to the poor, the weak and the marginalized is often grudging and calculative. Paltry sums considering the size of our budget surpluses and national reserves. Can we do more? Of course we can..... and please don't tell me this is tantamount to raiding our national reserves. MM Lee's comments about the elderly working till 85 was supremely insensitive although I don't think he intended it. Choosing to work till you are 85, is really not the same as being compelled to work to survive until 85.

Being in power, unchallenged power, for such a long period of our history has bred a level of complacency so that leaders do not feel that the public needs to understand or seriously discuss issues. The most expedient way of going where you want to go is unfortunately via a top-down dictatorial approach. This approach has been over-used. Has there been enough planning and discussions?.... Not much apparently.

In the biomedical area, this lack of planning and discussions have wreaked real havoc in the system. Take for example, the hospital clusters. We have over a period of 20 years gone through various levels of clustering, and declustering, and now re-clustering. Each Minister that comes along pushes a hobby-horse position. Hardly evidence of long term planning. Medical manpower planning? Hardly any, apparently - because we have flipped-flopped from too many doctors, to the present situation of being desperately short of doctors. Suddenly we require 3 medical schools..... of 3 different educational systems? This is planning? Almost overnight, the US residency programme was foisted upon all and sundry. If there had been any long term planning, it was far from evident. Medical education is now in a mess. We have an undergraduate and a postgraduate system existing side by side. We have flirted with problem-based learning, then discarded it. We have integrated and disintegrated the curriculum. And we have the really bizarre situation where our medical students are not expected to have studied biology. Duh? And we are expected to believe there is someone somewhere who is responsible for planning all this?

No one discusses this publicly because everything is driven from the top. Very heavily driven.

Foreign talent is critically important for us to push towards excellence. But without appropriate signals that policy makers are concerned about protecting the interests of our home grown and local medical/biomedical professionals, one cannot avoid feeling that the economic pie is not really for local consumption. The mass of biomedical and life science graduates and postgraduates we produce annually find it hard to find jobs in the sectors they have trained for, despite the very rapid expansion of the biomedical sector.

Whatever the results of the elections, there is no doubt they will be important. I don't think the PAP will lose the right to govern. But I think it is vital for the ruling elite to recalibrate its way of doing things... to relearn how to communicate with the people it seeks to lead. If they truly believe they are servants of the people, they must make this evident. And stop being just rulers.

Teaching a new ball old tricks...

I was reading this interesting account about the new Adidas ball they've been using for the 2010 World Cup. The Jabulani ball.

Not very well received so far. Many complaints. But for intents and purposes, a technologically superior ball compared to previous versions of the football.

I found it quite interesting.

So here's a question to ponder.... is everything better always...better?

I can think of the software upgrades we keep getting. Each versions gets better and more powerful ...but invariably bigger, messier and more difficult to use. In many ways they become less intuitive and we need more keystrokes to get to the same point. Is better, better?

Our work 'software' has the same problem. Office and management 'improvements' keep destabilizing the work process , and I often wonder if productivity is improved.... or actually degraded through these frequent changes.

Seems like there is a certain efficiency in familiarity, and a certain loss in efficiency when we operate on the learning curve. If changes occur frequently, even though they may ideologically be 'improvements', a certain inefficiency is introduced by moving workers from a position of familiarity (and its associated efficiency) to an unfamiliar uncomfortable position on the learning curve.

Not everything that is better, is actually better.

Closer to home....I think our health care system as well as medical education environment needs a period of stability so that we can all start mastering the processes rather than keep chasing endless series of changes.

Good leader, or a bad follower....?

Dr Goh Keng Swee's passing made me ponder a bit about what set him apart so clearly from his contemporaries, and identified him, for me at least, as one of the truly great leaders of his time.

I think it was for me, his clarity of vision and firmness of conviction, and his ability to translate that into down to earth policies that were able to galvanize his followership into achieving wonders for our small island state.

And I think of so much of what's happening in the medical community and our main medical school that disappoints because so much of our 'leadership' appear unable to see beyond blindly following an 'American model'. Where is the vision and self belief that can galvanize our community into achieving true greatness? Instead, the lemming-like dash towards an US residency system continues to baffle everyone about what it is supposed to be achieving. The medical school has been similarly impressive with respect to its pig-headed commitment to policies and pedagogical fads that now is threatening to unravel the very core of medical training.

So here I am wishing instead, that a true leader like Dr Goh can step forward within the medical leadership (MOH or NUS or MOE, or whatever...) and remove the blinkers from their eyes and see the destruction their poor followership has been wreaking on the medical community.

Town Hall Meetings a la Singapore

Apparently town hall meetings have been around for a long time. But they are a feature mainly of 'democratic' societies. For example, in the democratic city state of Athens, citizens met regularly to make decisions affecting their community. More recently it became more of an American concept and practice. Town hall meetings can be initiated by leaders or members of the community, grass root organizations etc, but the fundamental idea was that it was an opportunity for community based opinions to be heard about impending issues affecting their community, and for community leaders and the community members to be in touch and hear each other out.

In Singapore, more and more gahment type organizations are now holding 'town hall meetings'. I suspect the management teams have all attended some similar senior management courses, and have been told that it was good management practice to do so.

So we hear of town hall meetings from time to time. Sadly most of these town hall meetings are very contrived and generally very poorly attended. I think the reason for this seemingly apathetic response from these corporate communities are because our management teams don't quite get the idea of what a town hall meeting is supposed to be. Instead of having a meeting to discuss and solicit opinions from the community (which means they actually must want to listen to the opinions raised). Most often, our Singapore styled town hall meetings are poorly disguised top down briefing sessions that are little more than for management to tell you more of the same thing. Typically in such town hall meetings, management's voice represents perhaps 90% or more of the proceedings. A poor simulate of a democratic process.

The MOH apparently wants to have a dialogue session, a town hall meeting about the coming residency programme. Great. But I am really hoping they will be more prepared to hear and listen than to just make presentations.