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77 comments:
We are trying our best to recruit more doctors in Singapore.
http://www.channelnewsasia.com/stories/singaporelocalnews/view/1072190/1/.html
We are paying up to $80,000 per doctor. Hopefully this will solve the medical manpower shortage!
must compete very hard with western countries like australia/nz for both nurses and doctors lah. Their health care funding is infinite
both political parties in australia are trying to outdo each other in health care funding - so who are the winners? let me think?
the general public of course!
and who else? i leave the answer to the forum readers
If S$40,000 a year is "the best" you can do...
From $0 to $40,000 is a lot of money.
We also spend a lot of money flying to UK, Australia, Malaysia to run roadshows to recruit doctors.
Even if you are not appreciative of our hard work, why must you be so negative?
I don't think I am being negative, think you are being naive or deluded.
Your problem lies with perspective.
For one thing, it is not a case of $40,000 vs $0. Foreign grads who do not take up your offer can find employment in other countries or even in Singapore without the bond. Is $40,000 a year truly representative of the opportunity cost to these students?
Plus, S$40,000 may seem like "a lot of money" to an undergrad, but you know as well as I do that that kind of money is "peanuts" compared to what these young people will make in their career.
Just because I criticise your scheme doesn't mean I am "negative" - I can just be looking at the facts more objectively: if S$40,000 a year for the period of bond required truly represent good value for money, why haven't you met your quota for the year yet?
If you are going to suceed or even survive in this business, then you need to realise that it takes more than idealism and wishful thinking to make things happen. Even hard work isn't going to guarantee results if your premises are wrong.
We managed to recruit many doctors without this grant in the past.
Now with this grant, our work will be easier.
Can I kindly request that you stop assuming that everybody is money minded.
Many Singaporeans medical students chose to come back to be close to their family members having spent many years overseas.
Some are truly grateful to Singapore for providing them with the education (primary, secondary, JC) so that they can study in medical schools overseas.
The grant is to reward and defray some of their expenses overseas.
$80,000 may not be a lot to u but it is a year salary for most of us and these doctors are still paid salaries while working in Singapore.
"... stop assuming that everybody is money minded."
"Many Singaporeans medical students chose to come back to be close to their family..."
"Some are truly grateful to Singapore..."
"Now with this grant, our work will be easier."
So if these students are not money-minded and were going to come back for their families or repay their country to begin with, why would the grant make a difference?
Either they are taking it because of the money, or you are giving them the money when they would have come back without it anyway.
So which is it?
The grant would make a difference between we all live in a realistic world.
All of us want to help the poor and needy for free but we cant afford to do it as a full time job.
We have to work and earn money to support ourselves and our family members.
Students who would want to come back but can't because they incur huge student debts while studying overseas can now use the $80,000 to help pay their loans.
We need to reward patriotic and family centric behaviour so the grant help to give the right message
Singapore values those who can leave but dont.
"we all live in a realistic world."
"We have to work and earn money to support ourselves and our family members."
So what makes one person "money-minded" and another not?
"the grant help to give the right message Singapore values those who can leave but dont."
To the tune of S$40,000 a year.
"We need to reward patriotic and family centric behaviour..."
You see, you need to stop assuming a moral highground because it makes you look less credible.
How can you claim to reward patriotism when you are at the same time recruiting healthcare workers from their countries of origin? How can you say you are family-centric when you take nurses away from their families and do not pay them enough for them to bring their families over?
The message you are sending is that Singapore's healthcare problem is more important that that of these other countries, and that we are willing to pay to lure "money-minded" individuals who put making money above serving their countries and being with their families to help alleviate our problem, these other countries' healthcare problems be damned!
At the end of the day, it is about how much money you are willing to spend to employ people with a useful skill to solve a real problem. Confounding it with concepts like patriotism and gratitude only makes you look hypocritical.
(I hope for your own sake that you don't really believe what you preach.)
I think angrydoc is out of point here.
We are discussing about giving "Singaporean" medical students a study grant to encourage them to return to Singapore and their family members and serve Singapore.
Why is he talking about recruiting foreign doctors when the purpose of the grant is to stop relying on foreign doctors but attract true blue Singaporeans back to Singapore?
Is it just me, or does anon not realise that most of those who go overseas to study medicine do NOT incur a huge debt. The fact they can go more often than not signifies they have the means to.
The patriotism card is so old and jaded. I don't really think it's even a consideration. We reward the local patriots by bonding them and paying them less. Sounds good to me.
"Why is he talking about recruiting foreign doctors when the purpose of the grant is to stop relying on foreign doctors but attract true blue Singaporeans back to Singapore?"
Because the point is not about attracting Singaporeans back to Singapore, but about recruiting a sufficient number of doctors and retaining them in the public sector.
The stuff about patriotism and spending time with your family is just another carrot/stick bandied about to confuse the issue.
Practising in the public sector is not the only way to serve your country - you can be in private practice and still help your fellow countrymen. Likewise, you can spend time with your family even if you are in private practice.
I say this again: the issue is about the public sector recruiting and retaining doctors to meet the requirments of their work. It is about you offering a package that is attractive to your potential employees. That you have to resort to "patriotism" and "being family centric" to sweeten the deal shows that you realise you don't really make a better offer than other people.
If our administrators realise that they are just trying to fool gullible undergrads, then that's fine - my worry is that they truly believe in their spiel and are wondering why medical students aren't beating a path to their recruitment office.
When a senior doctor leaves for private practice, the country suffers a big loss.
This, our great health minister said, is because younger doctors lose the opportunity of being taught and mentored by him; his skill and experience is lost to subsidised patients who can't afford private rates; and he can no longer help the nation advance medically.
You can only serve the poor and needy in the public hospitals so stop giving the students the wrong impression that serving in the private sector is the same.
It is not!
"You can only serve the poor and needy in the public hospitals "
"... he can no longer help the nation advance medically."
Er... if your definition of making the nation "advance medically" is confined to treating "poor and needy" patients in public hospitals, then I won't argue the point.
I guess that just makes all those countries with the most number of poor and needy patients the "most advanced medically" ones, doesn't it?
@Anon
Shut up... just... just stop. Please. My head hurts.
Let me add another perspective to this argument. I am a S'porean doctor currently work in Australia and have attended a very recent MOH recruitment drive. In short, it was so bad that it actually persuaded a couple of my peers NOT to return to Singapore.
The presenters were ill-prepared for obviously hot topics like the new residency program and the overseas student grant. They had nearly no idea how the residency program would pan out for S'pore born-overseas trained drs. Plenty of questions asked with very little useful information given.
To add salt to injury, a certain administrator/clinician berated the Aust health care system saying that drs here were overpaid/underworked/technically inept. He proceeded to add that it was ok if we did not want to return to Singapore to work because they had been very successful in their drive in countries such as China/India.
Frankly a lot of us were shocked with the attitude of MOH. If this is a 'recruitment drive' , what lies ahead when you actually work back home?
I'll take my MUCH higher salary (post-tax mind you), humane working hours and better overall health care thank you.
Hi
I am sorry for your bad experience with the recruitment drive.
The residency programme is in phase so the team may not have the latest information yet.
You can find out more from our website
http://www.physician.mohh.com.sg/residency/index.html
The details of the overseas grant was not ready yet.
You can now read it at
http://www.physician.mohh.com.sg/PEG/
As for the remarks by the clinician-administrator, I think it is probably his/her personal view and does not reflect our need for medical manpower.
Interested applicants can send their applications to:
Director
Human Resources & Talent
Development Division
MOH Holdings Pte Ltd
1 Maritime Square
#11-25 HarbourFront Centre
Singapore 099253
Fax : (65) 6720 0980
Email : physician@mohh.com.sg
Australia has higher taxes and can spend more money on healthcare but we have our budget and cant match the salaries there.
The pre employment grant is a carrot to help make our salary package more competitive in the international market and we also offer job security to competent doctors under MOHH.
Regards
anon in 31 jul 0801 hrs wrote:"To add salt to injury, a certain administrator/clinician berated the Aust health care system saying that drs here were overpaid/underworked/technically inept. He proceeded to add that it was ok if we did not want to return to Singapore to work because they had been very successful in their drive in countries such as China/India.
ok lor, they can go to china and get those nurses and drs who can hardly cakap Ingris!lol
so successful in their recruitment drive and so why waste your time to go to Australia/NZ???? please lah .... go to China or india lah!!
looks like someone is shooting himself in his foot!
wow, drs and nurses in australia/nz are overpaid! no australian politicians would dare to make such statements over election time ... goodness, this admin is just a ikan bilis and he is sprouting nonsense, embarassing MOH and Minister Khaw overseas!
hehehe ... someone claimed that the country with a lot of needy patients are 'medically advanced'.
please lah, it doesn't hold water.
LOL ...
by the way, admin has failed to answer bersama's query on why foreign nurses passports are impounded by admin HR?
in australia, foreign nurses passports are never impounded by HR.
to anon on 31 jul 10 1135 hrs
"As for the remarks by the clinician-administrator, I think it is probably his/her personal view and does not reflect our need for medical manpower. "
you better rein in on your clinician admin's tongue. those remarks are certainly not very helpful in your organisation's recruitment drive.
the aussies and kiwis are very aggressive in recruiting and poaching our doctors esp those who have studied in australia/nz.
it is estimated these doctors can recoup their uni fees after graduation within 5 years or even less than that by working in rural units and the work in western systems is a walk in the park compared to what they will be experiencing back in sgp.
they will have to make the final call on whereabouts they want to sink their roots in.
we can advertise singapore to these singaporean foreign grads, but if the working conditions in sgp are not going to change, ie in the way how we treat the junior staff (junior docs and junior nurses) (i have read widely in many other blogs andyou know where) it won't take a rocket scientist to know where the greener pastures are!
one good example - patients are given the license allowed to abuse nurses or allowing unreasonable relatives to storm into resus rooms demanding to be attended first before the triage 1/2 patients ...
if such attitude is allowed to continue, these junior drs and nurses from overseas have 'eyes'...
in australia/nz, such behaviour is NOT tolerated.
and i do worry about who is going to take care of my health here lah! :(
Aiyo, how did a post about bed crunch turn into a heated debate about government grants for overseas medical education and recruitment of foreign doctors / nurses...
Bed crunch + doctor-not-enough = struggling public health services.
Then + MOHH's arrogant attitude (ask your friends if you don't believe me) + demanding & unreasonable patients
= Breaking point!
To all overseas docs thinking of coming to Singapore, I strongly suggest you think very hard about it. Weigh it up against what you can get in a place like Australia or NZ. Also, most developed countries will grant you FULL registration after 1 year of supervised practice. But in Singapore you will be under CONDITIONAL registration for 2 to 4 years (and there have been some doctors who had additional years of conditional registration dumped upon them unfairly). The conditional reg is like a hidden bond to tie you with MOHH (gulp!). Do you really want to be part of such a system?
From an overseas-trained, Singapore-tortured doctor
MOHH has to wake up its idea. Many a Singapore bred and trained doctor are fed up with the system.
Part of the implementation of the residency program is to tie down specialists so they will not leave the country, but bear in mind MANY of those who have either been rejected/opted out from the residency program are seriously considering leaving the country.
You (MOHH admin) can go ahead and recruit foreign doctors to "stem" the outflow of locally trained doctors. But the system will collapse unto itself ultimately when 2 out of 3 of the doctors here are foreigners who are purely working here because they are offered a much better pay than back home. Ultimately they don't give a f*** about how the patient gets his care in the hospital, and in fact you can see this happening on the ground with the foreign hired doctors in T*SH and C*H.
In essence the problem lies with the administrators of the system, and until the internal mechanics of how MOHH treats its locally trained doctors have been sorted out, the outflow will continue and i guarantee you that will curse and swear when you BECOME that old lady lying in B22 with the femoral shaft # in 20years time.
Hi admin
I suggest deleting comments that are slanderous in nature.
Somebody has accused foreign doctors of not caring for patients and this is groundless and baseless.
He/She even named the 2 hospitals where these doctors are found.
This is an unfair statement to foreign doctors who leave their countries and serve the patients of Singapore.
Without these foreign doctors coming to Singapore, we would not be able to open KTPH and our polyclinics would even be more crowded.
Let us work together hand in hand instead of looking down on foreign doctors :(
a bit OT, but angrydoc: i was the one who originally posted the link of this blog to the YB website... are you actually able to see who has linked to this blog, or was it just a coincidence? ;)
"are you actually able to see who has linked to this blog"
I don't know - I don't check.
"... the system will collapse unto itself ultimately when 2 out of 3 of the doctors here are foreigners... Ultimately they don't give a f*** about how the patient gets his care in the hospital, and in fact you can see this happening on the ground with the foreign hired doctors..."
That's a needlessly bigoted point of view.
You don't need to be a local doctor to give a damn, and of course a doctor being local is no guarantee of him being a good doctor either.
The bottomline is, if you want to retain doctors in the public sector, local or foreign, you need to offer them value for their time. If the people in charge ignore this economic reality, choosing instead to place their hopes on the goodness within people, then the system will fail.
little eastern heretic: i usually check the referrals page to see which sites link to ours, so the YB entry was posted by me.
always interesting to see where our readers are coming from. :)
anon ( 2/8/10, 12:23 ): there're a few of us moderating the comments, with each working pretty independently of the others.
i wasn't the one who vetted the foreign-dr comments you mentioned, but having worked with many non-singaporean medical colleagues, i will say that standards vary from individual to individual, so we do have a mixture of star performers and bad apples.
but this also occurs with locally trained doctors, and similarly in every other country in the world.
doctor-on-the-ground has his/her own reasons for making such a statement. whether the specific hospitals should've been left out is debatable, but since MOH administrators visit this site, maybe they will find the information helpful to some extent?
angrydoc: the debate over nurses pay has been raging for a while too and in fact, that has been brought out into the open in Zhaobao comparing nurses pay versus SQ trolley dollies.
in fact, both nurses and drs have been on the raw end of we know who, who choose to " place their hopes on the goodness within people" and who love chucking out the good old 'serving the poor' crap which doesn't hold water.
in fact, one admin stated that high taxes in australia supports their renumerations of drs and nurses and yet, HK has a lower tax system compared to ours and why is HK is able to retain more HK trained and HK born doctors and nurses in their system and mind you, HK is not a orang puteh negara for goodness sake. it is an asian place.
in the end we choose to recruit providers who can hardly form a simple sentence in Ingris /England.
someone from admin (sometimes i wonder if these 'admin' are really from admin or are they trying to masquerade as one in this forum)said that it can be improved ... LOL ... in 3 months?
HK seems to have comparable personal income tax rate and government healthcare expenditure as we do, yet they are able to pay their doctors much more (close to double?) and charge their patients less.
I don't know how they do it, but I think it illustrates the point that doctors' salaries are not the sole or major determinant of charges to patients.
Nevertheless we must remember that the main funding comes from taxes, which ultimately come from tax-payers. It also needs to be said that HKers themselves are concerned about whether or not their system is sustainable given their problem of an aging population, rising expectations, and possible slow-down of economic growth in the medium-term future.
Pretty much like us, really.
"HK seems to have comparable government healthcare expenditure as we do"
No, I was wrong.
http://www.wpro.who.int/countries/2009/hkg/national_health_priorities.htm
HK's government healthcare expenditure is higher than ours.
Speaking from the ground level, I can say that my colleagues and I don't generally look at pay as a factor for staying in public sector vs private, or even staying in SG vs overseas.
What really pushes us away from here, is the crappy working conditions, non-existent work/life balance, and lack of appreciation both from patients and the admin side
Most patients are appreciative and reasonable, and are a joy to take care of. But the few who storm into hospital, demand healthcare services and worst of all, get them subsidised by the government when it's not needed just sicken me. The higher ups also dont' seem to care, since 'customer satisfaction' is all that matters. To h*** with your professional assessment and opinion, we'll just pander to the patient
Frankly speaking, you can go overseas and recruit all you want, but you KNOW there's a problem when locally born, bred and trained doctors are seriously considering leaving for elsewhere because conditions are that bad.
If MOHH wants to continue along this trend, expect to see the proportion of foreign doctors increasing, as the brain drain to other places continue
PS : and for those who keep insisting Doctors should have the 'good of all' in their mind, sorry, but that doesn't pay for my bills, that doesn't comfort me when I'm working 39 hours straight, and that DEFINITELY will get thrown out when you run into an unreasonable, abusive patient.
I've seen what happens to the doctors who, out of the goodness of their hearts, stay in the public system (A particular vascular surgeon in one of the big public hospitals comes to mind). They get overworked, overexploited, underpaid, and under-appreciated by everyone. That's what comes out of being 'good' No wonder everybody is waiting for their bond to expire so they can go to private, or just leave Singapore altogether!
Actually i think, simply put, our nation's healthcare spending is "not enough", though "enough" is a rather relative term. We have chosen to place our money elsewhere for other reasons like economy, stability.
Comparing salaries and patient cost to other countries will definitely look depressing, but the other countries do put a large proportion of their GDP into healthcare.
Certainly.
I think it's not only a matter of how much, but what exactly that money is used for.
We need to ask ourselves whether or not we should continue to subsidise healthcare the way we are doing now (or at all), or whether subsidy should be focused.
Singapore's public expenditure on healthcare is something like 1 percent of its GDP. It's miniscule compared to its Asian neighbours HK, South Korea, Taiwan, Japan, etc spend.
The fundamental problems appears to be insufficient public subsidies.
Fox is absolutely right.
We need more subsidies and preferably subsidies that are portable so patients can choose to see private doctors if they prefer.
A doctor should just stick to doctoring and not comment on health care policy since they are not trained in economics.
Imagine someone asking PAP to focus and restrict subsidy when the fact is we are not even spending sufficient.
What a silly idea!
"A doctor should just stick to doctoring and not comment on health care policy since they are not trained in economics.
Imagine someone asking PAP to focus and restrict subsidy when the fact is we are not even spending sufficient.
What a silly idea!"
to that dumb blond who made such a statement - is our health minister trained in economics?
are those health care administrators like that tin pot who made the remark about obese health care providers trained in economics? :Pisn't singhealth ceo a dr too?
please check your facts before you comment
Hi spectator
I think you are very rude and ignorance.
http://en.wikipedia.org/wiki/Khaw_Boon_Wan
Our great Minister of Health graduated with a Bachelor of Commerce.
Mr Liat is not only a pharmacist by training. He holds an MBA and a BSc (Pharmacy) from the National University of Singapore and MSc (Pharmaceutical Sciences) from the University of Aston, Birmingham, UK. He was awarded The Donald C. Brodie Award for Education in 2000, NTUC May Day Award in 2003, The Health Leader Excellence Award in 2004, Friend of IT-IT Leader Awards in 2006 and the Service to Education Award in 2007.
If he is not well trained in economics, then who is?
Someone with an MBBS?
As for Prof Tan, his many years of clinical experience certainly allows him to comment on operational aspects of healthcare and definitely not on health economics.
Pls check your facts before commenting. With shortages of medical manpower, we should ban doctors from switching to admin where they have neither expertise or experience.
Doctors should just stick to doctoring and not try to act smart and go beyond their narrow area of competence.
As a percentage of GDP, Singapore's has one of the lowest public expenditure on healthcare. I'm not comparing Singapore to Australia or OECD countries. I'm comparing Singapore to the likes of Malaysia and Hong Kong. We can easily double public healthcare spending in Singapore and still not match Malaysia's.
Affordability is an issue in Singapore. Wages form about 40 percent of the GDP and out-of-pocket medical expenditure is about 3 percent. So, the average worker in Singapore spends about 7.5 percent of his disposable income on medical care.
When you complain that doctor salaries are low in Singapore, please also remember that it is low for everyone else (apart from our ministers). Workers in Singapore have less disposable income compared to their counterparts in major Asian cities like Tokyo, Hong Kong, Taipei, etc. Everyone is suffering from low wages and not just the medics.
I just wanted to say, you don't need a degree in economics to learn about GDP and percentage spendings in healthcare, education or defence. Neither do you need a degree before you comment. Or maybe everyone should shut up and not talk about even their own health because they don't have an MBBS.
GDP spending could and maybe should be increased a little more at least. Funding is needed for everything from the much talked about staff salaries of doctors n nurses to operating costs n research grants. With more funding, everyone would definitely be happier...
On a side note, malaysia has started giving cervical cancer vaccines and is spending 150million ringgit?? (if i'm not wrong, feel free to crucify me for wrong figures). Just wondering why aint Singapore doing it ??? It'll just be "peanuts" to them...and it will protect a large proportion of our female population against cervical cancer. you know...spend more...GDP...healthcare....
BUT I HAVE NO DEGREE IN ECONOMICS...only a lousy mbbs...so i should just shut it...i'm just saying...
Beardoc - Well said!
It never fails to amaze me that some people think that a person without a degree in economics cannot understand economics. I guess there are some people who only rely on spoonfeeding in school and never read anything outside the school syllabus.
It's not how many percent of GDP or how much, but how you spend that money - US is the classic example of how more doesn't mean better.
There is also the expectation that the government must subsidise healthcare across the board - why shouldn't people take responsibility for their own health and pay for their own healthcare?
Or do I need a degree in Moral Philosophy to even ask that question?
I used scholar google to search for "public healthcare spending and outcomes" and the first article that popped up was
Crémieux et al, "Health care spending as determinants of health outcomes" Health Economics
Volume 8 Issue 7, Pages 627 - 639.
If you look at table 4, you'll see
Table 4. Correlations between health care spending
and health outcomes
Health indicators Correlation
Male infant mortality - 0.74307
Female infant mortality - 0.66544
Male life expectancy 0.88631
Female life expectancy 0.81834
Seems to me that how much you spend on healthcare does matter. A lot.
Dear Fox,
You may like to note that Singapore is ranked as world no. 2 (as of 2008) for Infant mortality by UNICEF. I'm sure you know how much we spend on healthcare. In comparison, USA is ranked 9th (and you know how much they spend on healthcare). Given this observation, do you still think that greater healthcare spending equates to better health?
Sorry, correction - USA is ranked no. 7 in infant mortality for 2008.
Of course spending matters. A lot of other things also do matter. A number of factors affect infant mortality rate e.g. rural vs. urban, ethnicity, access to gynae care, etc. Access to healthcare in the US is grossly inequitable. If you want to make comparisons, compare to healthcare outcomes in major US or Asian cities.
The claim made was "It's not how many percent of GDP or how much". Obviously, the intended meaning, in plain English, was that how much you spend does not matter AT ALL. Also, it presented a false dilemma i.e. healthcare outcomes are either a consequence of how you spend or how much you spend. Why can't it be how much you spend AND how you spend?
If you cannot understand the flawed reasoning, then try this: It's not about how much you smoke but how good your lung cancer specialist is. Deng Xiaoping smoked into his 90s and is a classic example of how smoking has no effect on longevity.
A simple look into the existing health economic research literature shows that public healthcare spending does matter a lot, if all else holds equal.
@Perspective,
If the amount of public healthcare spending has no consequences, then why don't we slash MOH's budget by 50 percent?
It's not the heat - it's the humidity.
@Fox
I am glad that you explicitly state that "a lot of other things also do matter". And I agree with you. The amount of money spent is NOT the sole factor in determining healthcare outcomes. It is one of the many factors. I hope everyone reading this blog will consider factors other than $$$$ only when thinking about healthcare issues in future. I rest my case.
To summarize
We should raise the pay of healthcare administrators to ensure the best join and not screw our public health policies.
Doctors should stick to doctoring and they should learn to control their greed.
SMA should be given the right to strike doctors that are greedy like angrydoc.
Nurses are important and lowly paid. They should be paid more to make the profession attractive
The rich should be taxed more so that there is money to raise the salaries of healthcare administrators and nurses who are paid peanuts and often abused by doctors who think they are god.
dearesPls check your facts before commenting. With shortages of medical manpower, we should ban doctors from switching to admin where they have neither expertise or experience.
Doctors should just stick to doctoring and not try to act smart and go beyond their narrow area of competence.t anonymous"
a tinpot is now running around trying too hard to be a court clown.
as you can see, there are lots of doctors and nurses who are also armed with MBAs so they are qualified to make co manage with people with pharmacy degrees (oops that another clown) when it comes to health economics
your argument just doesn't hold any water
nurses have been paid peanuts for too long something which i do agree with u.
with healthcare admin people, unfortunately i have no sympathy for them as they are just hiding away in their air conditioned office all day long without having any feel for things on the ground.
what are your thoughts of one of forum contributors suggestion about getting admin people to be on call to 'mop up' unreasonable customers who are 'nangis bapa nagis ibu' when there are many sick patients being attended to in the resus room?
"
"SMA should be given the right to strike doctors that are greedy like angrydoc"
has he breached any clinical guidelines?
greedy? well ... he/she is 'greedy' for more work life balance mate! - sorry angrydoc - we are all 'greedy' for that ;)
by the way, r u very sure that healthcare administrators are lowly paid on an hourly basis?
read somewhere that this senior admin guy in you know where who had brought an overhaul change to HR policies and leave policies not too long ago and that caused a bit of grief amongst health care providers?
heard that he is paid handsome!
ie more than s$200-300k per year?
is that true? ;)
I think spectator is missing the point.
There is a shortage of doctors and nurses right?
So by allowing them to switch to admin, wont this make the shortage worse?
It costs money to station administrators front line and it does not solve any problems. Currently there are nurse managers who function like administrators to take care of complaint cases.
I call angrydoc greedy because of his posts in his blog.
Angrydoc: "I also do not feel ashamed of earning what I deserve. My skills are useful and I am not guilty to charge what they are worth.?
A greedy person justified his high pay by coming out with a lot of nonsenses.
There are docs in the past who put in extra honours without demanding OT pay. This help to reduce healthcare expenditure.
Finally, I never said that healthcare administrators are lowly paid. I said we need to pay top money for competent healthcare administrators as adminstrators are top of the food chain.
As for the change in HR policies and leave policies, I dont have the details.
Can tell me more about it?
"... we need to pay top money for competent..."
"A greedy person justified his high pay by coming out with a lot of nonsenses.
There are docs in the past who put in extra honours without demanding OT pay. This help to reduce healthcare expenditure."
So it's OK for other people to draw a salary worth his work, but not doctors?
Why don't you ask administrators (CEOs, COOs) to "put in extra honours without demanding OT pay" to "help to reduce healthcare expenditure"?
They may be the "top of the food chain", but we are the business end of healthcare.
I say this again:
I do not feel ashamed of earning what I deserve. My skills are useful and I am not guilty to charge what they are worth.
Too long have doctors been made to feel that they must work long hours under poor conditions with low pay. It's time we take some pride in our work and ask for what we are worth.
dear readers,
i think this debate has gotten out of hand. what i think we all must realise is that such debate here is never going to change anything. in fact, i think it simply worsens the public perception of the profession.
yes i agree that doctors are overworked and underpaid, but in singapore, the govt (i.e. the paymasters) takes a very hard line against collective voices for pay rises. we will not achieve anything by venting our anger on the forums here.
in addition, this is simply worsening the public perception of doctors, which makes life much more difficult for all of us. what we need to do should be to make a stand among doctors by moving off to the private sector if we are unhappy.
such confrontational attitudes would only serve to antagonise the admin and the public. in the end, nothing good will come out of it, and patients would becoming increasingly tired of doctors.
so please, for everyone's sake, we need to maintain a public image. whatever goes on behind doesn't matter. with the right image, we can work for what we want.
dearest anon
hahaha .. it is indeed interesting to see the exchanges in this forum between those 'high and mighty' admin and health care givers.
i am sure you know the exact details of the change in leave policies in the last 5 years since a particular person took over the reins of a particular department.
no names mentioned, but i am sure you know who it is ;)
nursing managers have enough on their plate. they always have to deal with abusive FON patients who demand to be attended before critically ill patient and their behaviour is appalling by human standards.
so why isn't it justified to station duty administrators to attend to them. at least you can have a 'feel of the heat on the ground' and having you sitting in your airconditioned offices is not helping the situation either
by the way, u have to change the overall way of how front line staff are being treated by unreasonble patients.
and who are going to be the benefactors if there is going to be a brain of singaporean nurses and drs? u know who.
by the way, i have seen flyers handed out by western nursing agencies outside a particular health care institution! and what can u do about it?
the only way to stem this brain drain is to improve the conditions on the ground. enough is enough.
and impounding the passport of foreign nurses is something which is not practiced by other western healthcare systems
so why is it ok to pay 'competent health care administrators top money - which comes from the general kitty bank and it doesn't need to come from tax payers - the same kitty bank that pays for your 'high and mighty mortal' and not ok to pay top money for nurses? and of course the drs :P
"...by allowing them to switch to admin, wont this make the shortage worse"
So now doctors need your permission to not work as doctors?
Or should all professions where there is a shortage of workers ban their members from switching professions? Ban lawyers from becoming bankers maybe? Physicists from becoming taxi-drivers?
Your arrogance over the power you think you should have over your fellow men - what work they should do, whether or not they should ask for better terms of employment - is just amazing.
changing the working conditions of drs and nurses will not improve the KPI of the health care administrators and thus there is no incentive for them to do so?
the only way out of this are a few options
1. shut up and put up with the crap and be a grumpy ahpek
2. ship out to greener pastures for humane working hours by international standards; for there is a saying - a prophet is not honoured in his own country.
at least your skills and experience will be better appreciated overseas.
my advise for young drs is - if you are smart enough to pass MBBS or FRCP, u will have more than enough intellectual capacity to pass USMLE/Aussie Medical council exams/UK GMC - which is a breeze for NUS grads.
UK grads need not take AMC exams.
i don't think MOH will increase its expenditure in their health care budget anytime soon as it is not in their interest to do so and the electorate is too apathetic about this.
I disagree with you, kovan.
I think "image" is precisely the reason why we have the problem we have today.
I think we need to "re-image" our profession.
I don't thnik doctors are underpaid across the board, but I think we should not feel guilty for be paid what we are paid.
The other issue I am addressing is the expectation of unrestricted healthcare subsidy for all - that is not a strictly professional stand, but something I write about as a citizen and a tax-payer.
I don't think such discussions are useless. It's about awareness, and thinking outside the traditional mould that we have been taught to think in, and which people want us to continue to think in.
Change must begin with an idea.
"The other issue I am addressing is the expectation of unrestricted healthcare subsidy for all - that is not a strictly professional stand, but something I write about as a citizen and a tax-payer."
I'm not even sure why this is such a big issue in Singapore. The amount of public subsidy as a percentage of GDP that Singapore gives out is a record low amongst countries, developing and developed. HK, Malaysia, Taiwan, and South Korea spend much more and get along fine. If you put two and two together, that is the lousy working conditions of medics and the low healthcare spending, then you may see that there is a causal relationship. Your fellow medics seem to be able to join the dots.
If you are sooooo concerned about your tax money, maybe you should ask why Mindef's budget is more than 3 times that of MOH and has been growing at a faster rate in the past decade. I think you can certainly find more savings there.
Public healthcare subsidies in FY2001 = 1.3 billion
Public healthcare subsidies in FY2008 = 1.6 billion
Percentage increase in public healthcare subsidies = 23.1
Mindef budget in FY2001 = 7.8 billion
Mindef budget in FY2008 = 10.8 billion
Percentage increase in defence spending = 38.5
Data are available from
1. http://www.mof.gov.sg/budget_2008/expenditure_overview/mindef.html
2. http://www.mof.gov.sg/budget_2008/expenditure_overview/moh.html
3. http://www.mof.gov.sg/budget_2001/govtexpenditure/security.html
4. http://www.mof.gov.sg/budget_2001/govtexpenditure/social2.html
More appropriately, the issue may be with a misallocation of resources. I've long agreed that Mindef has been allocated far too huge a lion's share of the budget, all to serve the political prejudices of our leaders. Nonetheless, I believe that due consideration has to be given to the breakdown of the subsidies and the structure of the healthcare system to understand if MOH's budget is being correctly allocated to serve healthcare needs and rather than political means and ends.
Dear Kovan
I agree with you that doctors should just shut up and stop venting their greed in public.
This is shameful behaviour that we should all condemn. I suggested previously that greedy docs should just go private instead of staying on in the public sector threatening to quit all the time.
The worst example I heard was one HOD who wanted more funding and guess what when he got more funding, he quit. I think he was just looking for an excuse to quit.
Stop antagonising the admin and the public. It just make you look bad.
Given that public healthcare subsidies are at such low levels, how much more savings do you think can be achieved by stopping Mercedes Benz driving towkays from getting subsidized B2 wards? You'll get only chump change. The 700-pound gorilla in the room is the miniscule healthcare spending, not people driving BMWs to polyclinics.
"Nonetheless, I believe that due consideration has to be given to the breakdown of the subsidies and the structure of the healthcare system to understand if MOH's budget is being correctly allocated to serve healthcare needs and rather than political means and ends."
I'm not sure if subsidies allocation is really such a bugbear in Singapore. Several of the medic posters here are perfectly happy to move to or are in Australia and the UK and maybe HK where means testing is non-existent and public healthcare subsidies are much larger.
"... doctors should just shut up and stop venting their greed in public.
This is shameful behaviour that we should all condemn."
Really?
I personally think it is shameful to ask a group of people to shut up just because they hold and advocate a view that is not the same as yours, and even more so when that view threatens your sense of entitlement.
If I am so self-evidently wrong that no one with an ounce of sense will be persuaded by me, why do you feel so threatened?
angrydoc:in the days before digital media, there is no other sources of alternative view points rather than that of the orang tua.
in the internet age, people are more free to air alternative views rather than gahmen propaganda.
These people who do not agree with us and they do feel that they don't have any more control over what we want to say and they can only grit their teeth.
These same people are also here to expect nurses and drs to be slaves to the system and when nurses/drs holding singaporean pink ics are seeker greener pastures overseas, it is a loss to them and they can import all the FTs they want, who can hardly string a simple sentence in English but it will never be the same as having someone who is pretty familiar with local culture and ground rules.
Dear bersamakita
Why do you look down on FT?
Some of us from Malaysia can speak English, Mandarin, Cantonese and Malay.
More than 50% of specialists are from Malaysia. We work equally as high as drs from Singapore so stop accusing us of not stringing a single sentence in Engligh.
Are u trying to piss off all foreign doctors?
Doctors from India can speak better English than most locals.
If u have nothing constructive to say, say nothing!
Hi are u sure passports of foreign nurses are kept by hospadmin?
It seems illegal. If u feel so strongly about it, can report the relevant hospitals.
http://www.sghrm.com/2009/01/can-i-keep-passport-of-foreign-workers.html
Can I Keep The Passport of The Foreign Workers?
Passport is personal belongings, and employer has no right to keep the passport of the employees.
Many employers keep the foregin workers' passport to make sure the workers will not run away so their $5,000 security bond in risk. However, security bond does not give employers' right to keep the employees' passport.
In the event if the employers need to keep the passport on behalf of the employee, for safety reason, or the employees wish the employer to help them to keep their passport, the employer should advise the employee to sign and agree on the passport keeping arrangement.
For home trip or leisure trip employees needed, the employer can always reject the leave application, but employer has no right to retain their passport.
Dear Anon,
Please do not misunderstand. I believe bersamakita is only indicating the foreign doctors who are unable to communicate effectively with patients and lack the basic skills that all doctors should have, becoming more an encumbrance than an asset to the system. Are you saying that Malaysian doctors are unfamiliar with our shared culture or incompetent? Please do not be overly sensitive and interprete this as an attack upon all foreign doctors.
darling anonymous - we know where u stand on this forum so please don't pretend to be a foreign dr here
"More than 50% of specialists are from Malaysia. We work equally as high as drs from Singapore so stop accusing us of not stringing a single sentence in Engligh.
Are u trying to piss off all foreign doctors?
in all my post, did i point the fingers at drs for not being able to string a simple sentence in Inggris? please read it carefully. i have never pointed my fingers at the malaysians and i have my utmost respect for my malaysian colleagues.
anyway i will leave it up to your own interpretation - for u are smart enough to read between the lines.
i am sure that u are very well aware that the poor foreign nurses/HCAs have their passports kept by their respective HRs involuntarily.
if they want to apply for overseas leave, their 1 month pay is being impounded.
why is this necessary? my dear "anon"
in western public institutions, foreign nurses do not need to have their passports or pay retained for "safe keeping".
so are you telling me that it is untrue of me to say that what i have said is untrue?
all this debate.
Lots of good points raised from all sides.
Well....a man convinced against his will is of his own opinion still.
Also.....for things to change, I have to change.
There's no point in trying to change others in order to change your life. It's all in our hands.
Often times the only reason why we keep on complaining and never change our lives in the way we want to is because we are simply not willing to pay the price to effect the change or pay for the consequences that go with the change.
No point wasting time here guys. Go change your life. Decide what you want to do and do it. Carpe diem!
when conditions are really bad, doctors and nurses will make the call when it is time to call it a day. will we end eventually up like south africa where heaps of health care professions are flocking to NZ/UK/australia? only time will tell.
Hey MOH, raise the healthcare budget to first-world status already, stop acting so third-world with regardings to healthcare spending!
Your top students are already leaving for greener pastures overseas on a yearly basis, not sure how good the Burmese/Indian dr can make up for him/her.
This is quite a silly comment.
The healthcare budget has been raised.
Do you know how much money we spent flying to Australia, New Zealand and UK to recruit foreign medical graduates?
Have you not heard of the employment grant we are giving to foreign graduates?
Hi admin,
I am offended by one of the racist remarks that Burmese doctors and Indian doctors can not offer care similar to what local graduates can.
We are invited to work here and our pay is not much higher compared to local graduates.
We are discriminated by local patients and we deserve to be treated with respect by our colleagues!
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