Assoc Professor Paul Ananth Tambyah's speech

Reprinted from Temasek Review Emeritus

Ladies and Gentlemen,

My name is Paul Ananth Tambyah, I am an academic infectious diseases physician working at a major teaching hospital. I would like to state from the outset that I am speaking entirely in my personal capacity.

Historically, Singaporeans, especially those in public sector jobs have been very reluctant to speak at major political events except for those organized by the ruling party for fear that it would adversely affect their careers. I am pleased to share that after speaking at the SDP rallies at Boat Quay and Sembawang, my career has not taken a dive, I am not in exile on some island feeding seagulls off Pedra Branca and I am not walking the corridors of Mt Elizabeth Hospital looking for a job.

Since the SDP rallies at Sembawang and Boat Quay, I have received countless messages from all ends of the healthcare spectrum. Allow me to share a few of these actual quotes:

“I am a current Houseman. I just wanted to thank you for speaking out for our state of healthcare in Singapore. Many of us echo your sentiments, but are too timid or too selfish to speak out for our patients. As Singaporeans, we have often been taught to take the pragmatic approach and very often that means to be silent and let the underprivileged fend for themselves, I pray that the day will come when the sole aim of our healthcare system is to serve our people and not fill the coffers.“

From a cancer specialist, “I saw your impassioned speech on the internet and I would like to thank you for voicing the concerns of thousands of doctors in the public sector. I often see patients making treatment decisions based on whether or not they can afford them. This one patient I am looking after decided to stop cancer treatment the moment his medisave account ran dry. He did not want to burden his children. He knew that he was not eligible for additional funding as he had dependents. The only way for him to continue treatment was to tap on his daughter’s medisave accounts. I ask myself if there is indeed fairness in the world. I worry for my 11 month old child’s future. I need to think hard this elections, not for myself, my career but for his future”

From a SPH journalist, “I read your rally speech online, agree with you on many points. Healthcare and education are two major areas that need seriously to be re-looked if we want to build a truly inclusive society. Also, our social safety net…”

These are just a sample of the heartfelt feedback that I have received after the SDP rally speech. It has been very heart warming and encouraging to me to recognize that not all Singaporeans care only about making money.

On the other hand, there have been rumors going around that I was sacked or demoted or reprimanded. I would like to state categorically that this is NOT true. In fact, in the last few weeks, I have received nominations for awards and important administrative appointments.

More importantly from a pragmatic Singaporean point of view, I received my bonus letter last week telling me that I got a thousand dollars more than last year. I also received a letter from NS PC telling me that I was now eligible for a responsibility allowance and I received an award from MINDEF for my service as a volunteer.

Although I have enjoyed working with the SAF in research, education and clinical care in my field of Infectious Diseases, I am also still serving with an infantry brigade as a BMO. In fact, last week, I broke my elbow walking out of the cookhouse to a bus en route to a training visit!

Many in authority in Singapore are trapped in a system which says “Do not rock the boat”. Like the SPH journalists who privately support alternative points of view while publicly producing official spin, many in public sector institutions set aside their own personal beliefs and convictions to “toe the party line”, make minor tweaks to official policies without really addressing the fundamental flaws or unintended consequences of policies which come from above.

I believe that the fundamental flaw in our current system lies in the corporatization of our country and society. In healthcare, we have seen how restructured hospitals are expected to recover costs as far as possible.

I have tried to explain to many in authority that I do not believe that anyone chooses to get sick. There is always the fear of abuse when subsidies are provided liberally. I once asked a panel of senior parliamentarians, which individual would say “Aha, the government is providing free healthcare for children with leukemia – let my child get leukemia so I can enjoy that benefit”.

Healthcare, like education, public transport and defence and security are public goods. Singapore has an outstanding record in maternal and child mortality. That is the result of a massive investment in maternal and child care from the 1950s onwards.

My generation are beneficiaries of that investment, today’s parents are often afraid to have children in case the medical costs bankrupt them especially since the state health insurance policy specifically excludes congenital illnesses.

A corporation is concerned about the bottom line, about maximizing shareholder value while on the other hand, a country or a society is concerned primarily about the wellbeing of the people. The key indicator should not be GDP growth, it should be whether all people – young and old, rich or poor, able bodied or disabled are allowed to reach their fullest potential. There are corporations like Google which believe in “Doing No Evil” and perhaps we can start by being less of a Microsoft and more of a Google!

Investments are based on trust. Singaporeans do have a high degree of trust in the government although recently there have been many questions raised about policies and practices. It is time for the government to trust the people. Philip Yeo who is one of the most outspoken voices of the establishment has said “My greatest fear now is that the Government is terrified of the people.”

That is a fantastic position to be in. The ministers need to recognize that the only reason that they are in their jobs is because we the people put them there. We can dismiss them if we think that they are not performing. Singaporeans are an educated people, a first world society who are savvy enough to know what we want rather than being told what is best for us.

The fundamentals of a society can be changed from the ground up and the online social activism that has demonstrated its vibrancy during the elections is a good start. My rally speech was ignored by the mainstream English media and rebutted partially in the Zaobao but it was widely circulated online among the medical and healthcare community.

The internet has provided an unprecedented level of accountability with ministers being forced to justify to their employers – that is us – the citizens why they have implemented various policies. This is good for Singapore. But change can also come from above.

The highest office in the land is the Presidency of Singapore. The President and his wife look down on us from every school and government office. That is an extraordinary position for someone with moral courage and leadership like Mr Tan Jee Say or someone with guts and an independent mind like Mr Tan Kin Lian. Jee Say sees himself as the conscience of the nation. Kin Lian is someone who will speak for the people. Both, like the SDP, have a clear stand on the issues that matter – on how our money should be spent and how our citizens should be valued.

One person who speaks up can be safely ignored. I think that perhaps is what many hope will happen to me. Ten thousand people speaking up at many different fora, at different times and in different places cannot be ignored.

This is the new era in Singapore politics when more and more citizens start asking questions about justice and equality, about our reserves and about our jobs, about our healthcare and our education. We cannot “sit down and shut up”. We will be heard. Start by choosing a President who puts the people first. Vote for either of them.

Happy National Day. Majulah Singapore!