PS' Speech at the Launch of SMU - SingHealth Graduate Diploma

30 Jun 2009

By Yong Ying-I

Mr Peter Seah, Chairman SingHealth;

Prof Tan Ser Kiat, Group CEO, SingHealth;

Prof Tan Chin Tiong, Deputy President, SMU;

Distinguished Guests;

Ladies and Gentlemen,

Introduction

 Good afternoon. I am delighted to be here at the launch of the SMU-SingHealth Graduate Diploma in Healthcare Management and Leadership.   It’s a great day for healthcare, because it’s the first major local academic certification in this area of management and leadership.  I congratulate SingHealth and SMU for taking the initiative.

Does leadership and management training matter?

2. I recall vividly that at a management offsite not that long ago, Prof Soo Khee Chee got up to comment passionately about leadership challenges.  In the midst of that, he described many people in the room with him as “accidental leaders”.  People had been systematically trained to be good clinicians and surgeons, but they were typically then appointed to leadership and management roles which they were not trained for. 

3. Does it matter?  Can’t leadership and management skills be things that you just pick up on the job?  Yes, they can be, depending on the individual.  Some people are naturally more able than others in this field – Mr Peter Seah, for instance.  But for the rest of us, it helps to have some training and development in these skills.  We may not be brilliant at if after the training but we can improve from where we are today.  I believe that leadership and management skills matter all the more so to our emerging leaders in the public healthcare sector because of the increasingly difficult work challenges you face. 

4. PM noted at the SMA 50th Anniversary dinner last month, that doctors and medical professionals have increasingly difficult jobs to do.  Disease patterns are changing.  Patients are becoming more sophisticated about their treatment options, and challenge their doctors.  Doctors need to communicate, influence and cajole people.  The ability to persuade, the patience to listen and take in other perspectives, and indeed the trust to let the patient manage his condition and let go are also increasingly valuable skills.  But I believe most doctors can take the new challenges of managing their patients in their stride and not feel inadequate.  They are skilled at dealing with individual patients one on one, and they can evolve with the patient.

5. What is more daunting to many is the complexity of leading and managing healthcare at the organization level.  Managing an individual patient is one thing.  Managing and leading one’s own organization full of very smart professionals and demanding patients is much tougher.  At one level, it’s the technical skills of reading financial accounts and managing budgets, and the organizational skills of managing workflow for smooth operations. This is not easy especially in a public sector healthcare operation because patients demand the latest drug and the shortest waiting times, but aren’t able or willing to pay for it, and clinicians have to juggle many flows of monies to make the books balance.  It is much easier to run a private hospital than a public hospital.

6. At a second level of challenge, there is a need to make use of new processes and new ideas, and drive improvements from these.  Take for example telemedicine which is disrupting the way many things are traditionally done.  This requires clinical leaders to be able to continually learn, relearn and embrace change.  Change is certainly happening in the public sector – Khoo Teck Puat hospital is opening next year and a new General Hospital in Jurong will open by 2014.  Both of these will have community hospitals built alongside then, and we will have a much larger role than previously in the step-down space. Minister is in the midst of restructuring the clusters to get to eco-systems that are more suited to meet the needs of Singaporeans in the future, especially the aged.  The last 7 weeks has shown that this concept of embracing change does not always happen at a comfortable pace – there can be sudden shocks like H1N1.  Changes have to be made up on the fly, and decisions made amidst insufficient information.  Leaders then have to communicate these clearly to colleagues and build consensus for the change to happen. Leadership is all the more crucial in a crisis.

7. There is a third layer of complexity and that is organising and coordinating across multiple work units, across organisations, across professionals groups.  This is particularly obvious with the opening of new hospitals like KTPH and the new Duke-NUS medical school. Likewise for aged care, clinicians in the acute hospitals need to work far more closely with people in the charity sector providing step-down care, and with GPs in the community.  Indeed we have seconded staff from the clusters to lead RenCi and Home Nursing Foundation.  To make things happen at the systems level, leaders and managers need to navigate within a very complex ecosystem and work within multidisciplinary teams.   It obviously taps on a range of soft skills which have not much to do with treating an individual patient, and it isn’t skills that are taught in medical school or in a general undergraduate programme. 

The Need for Leadership Development

8. In the face of these challenges, I believe there is general buy-in for a more systematic approach to management training and leadership development in our public sector healthcare family.  Our pipeline of leaders should be equipped with the right skillsets and mindsets to strategically helm our healthcare system, drive sustainable change and implement new initiatives.  A project team comprising the HR and clinical manpower heads of our various clusters have been working on leadership competencies that our healthcare leaders should have.  Their work to-date has identified 4 key areas of leadership and management competencies, namely, (a) intellectual capacity to analyse and solve problems; (b) drive to follow through ideas and achieve desired results; (c) ability to relate, influence and inspire others; and (d) professional and business ethics.  The SMU-SingHealth programme addresses many of these.

9.   It may be useful for me to make a distinction between management skills, which is about managing work (for instance tasks, workflow) and leading people.  I would particularly like to talk about the soft skills of leadership, necessary for leaders to work collaboratively, manage people and motivate and inspire others to excel.  Most of us want to be well led, not just well managed.  We can think fondly back to the bosses who guided and inspired us.  In the healthcare system, it may be the people you equate with being great teachers and mentors like Prof KT Foo, Prof SS Ratnam, Prof Wong Hock Boon, Prof Nambiar, Prof YY Ong and many others.  But since they were working within an  organisational framework, I would consider them to be great leaders.

10. We now need to look in the mirror.  Perhaps we organise work tasks well.  But do we inspire the juniors who work for us?  The flipside of leadership is followership.  You may hold a senior position or a nice title, but if you are not a leader if no one wants to follow up.  Why do followers follow a leader?  Because it gives them hope, and the promise of a better future.  So when we look in the mirror, the questions to ask if whether we develop our juniors to be better than we are?  What do we inspire them to achieve? – earn the most money; do their best to heal the sick without looking first to see if the patient is a VIP or a C-class patient?  Do we encourage in them the right values and ethos to sustain a call to service?  Will they behave as stewards to leave the healthcare system a better place than when they found it?

11. So, are such leaders born?  In my own career experience, I would say that good people can pick up elements of these skills on the job, but at best it is sporadic and arbitrary.  In order to groom a pool outstanding visionary leaders adequate to meet the needs of the organisation now and into the future, we need to develop a structured framework for talent management and development. 

A Virtuous Cycle of Leadership Development

12. In view of this, MOH is looking seriously at strengthening leadership development and talent management in the public healthcare sector, so as to attract, identify and groom the next generation of leaders.  I believe this intervention is key to kickstarting a virtuous cycle of leadership development, with good leaders being able to inspire fresh talent to join their ranks, and mentor them well.

13. Talent management and leadership development is not just about training programmes.  It includes on the job mentoring and coaching, career deployments to roles that help people grow the range of skills – soft skills and hard skills – that they need to be good leaders.  People whom we believe have the potential could be exposed to project team leadership working on a small improvement initiative, and leading a small work unit. They will learn from this, including from their mistakes, and can then progress to managing a larger work unit and big improvement initiatives.  And a division, then an organization, then a larger organization.  This is early days yet but I am ambitious for a serious all-round effort to grow a systematic pipeline of leaders that can take our healthcare system to the next level of excellence.

14. On the training front, I’m not monopolistic.  There is room for entities across the healthcare family to contribute to the platter of offerings.  So I am delighted that SingHealth is driving the development of this Graduate Diploma, which they have opened to participants from across the public sector healthcare family.  In parallel, my Ministry will be offering a senior management training programme to address the key developmental gap in governance and policy foundations.  MOH has worked with the Civil Service College to put together a week-long health policy and leadership programme that starts its inaugural run in one week’s time.  Participants, comprising senior management and future leaders, will explore contemporary healthcare issues, analyse case studies and gain insights into their leadership styles and impact. I encourage SingHealth to consider other learning efforts, which you have a tradition for, with a longstanding role in medical education in Singapore dating back to the early 1900s.

SMU-SingHealth Graduate Diploma

15. In conclusion, may I congratulate once again the 2 parties, SingHealth and SMU, for this timely initiative of a new Graduate Diploma.  Both parties are at the forefront of their respective sectors, and I am confident that your collaboration will play a significant role in developing a new generation of healthcare leaders for Singapore worthy of the trust that Singaporeans place in them to look after their needs. 

16. Thank you.