Volume 41 No.05 MAY 2009 MICA (P) 031/01/2009

PRESIDENT’s FORUM Interview with UNDER SIEGE Dr Andrew Chew Hobbit By Dr Toh Han Chong, Editor Pandemic Pandemonium r Andrew Chew graduated from King Edward VII Medical School in 1955. He was personally speaking Medical Superintendent at Thomson QUARANTINED! Road General Hospital, Tan Tock Seng Hospital, KK Hospital and Singapore travelogue GeneralD Hospital before taking up the position of Deputy Director of Medical Services (Hospitals Amritsar Division) in 1971. Dr Chew was subsequently promoted to Permanent Secretary/Director of Medical & McLeod Services. His next appointment was as Head of Civil Ganj Service from 1984 to 1994, where he served as Permanent Secretary (Public Service Division) in the Ministry of Finance, and concurrently, Permanent Secretary (Special Duties) in the Prime Minister’s Office. Upon retiring, Dr Chew served as Chairman of the and Chairman of the Public Service Commission. For his significant contributions to the Singapore Public Service, Dr Chew was awarded the Public Administration Medal (Gold) in 1975, the Meritorious Service Medal in 1994 and the Distinguished Service Order in 2002. He was also conferred Honorary Fellowship of the Academy of Medicine in 2004 and the Order of Nila Utama (Second Class) in 2008. Currently, Dr Chew is a Member of the Presidential Council of Minority Rights, and also the Pro-Chancellor of NUS.

Photo Credit: Public Service Commission FEATURE

Trustworthiness may be the key answer here. By and large, the political leadership has proven itself honest so that has been already well- Volume 41 No.05 MAY 2009 entrenched. The administrative leadership does exactly the same – we look not for intelligence, but rather, honesty and a willingness to take Editorial board responsibility. EDITOR Dr Toh Han Chong

Deputy Editor Dr Tan Yia Swam Dr Toh Han Chong: What are your best a senior registrar before moving into an memories of medical school that you administrative post in my tenth year, remember to this day? MEMBERS and was asked to run a hospital. I did so Prof Chee Yam Cheng Dr Andrew Chew: I had always wanted for about three years before applying for Dr Martin Chio to study medicine; it was something another position in a clinical setting. A/Prof Daniel Fung I had decided on very early in life, even My interviewer was the late Dr Hsu Liyang Dr Lim Boon Leng during my school days. During the Dr Phay Seng Whatt, who used to be Dr Jeremy Lim Japanese Occupation, I had been to the Chairman of the Public Service Dr Tan Poh Kiang school at Monk’s Hill for a year before Commission (PSC). We had a chat and Dr Tan Wu Meng it closed but I somehow managed to get I decided that I would give up the Dr Teo Eng Swee Cuthbert hold of a few medical texts, which clinical post despite the opportunity. fanned my interest further. Even then, I still had strong ex-officio For me, medicine was something interest in clinical practice but Dr Chong Yeh Woei I had ample opportunities as a Dr Abdul Razakjr Omar I wanted to do – I joined the Overseas Chinese Bank temporarily but declined hospital administrator. Even as an when a more permanent position was administrator, I was quite reluctant EDITORIAL MANAGER offered. The King Edward VII Medical to move beyond hospitals because Ms Krysania Tan School then served Singapore, Malaya I wanted to be situated in a clinical (both the federated and un-federated setting. Somehow, after administering EDITORIAL EXECUTIVE states), Sarawak and British North at the then-Thomson Road General Ms Gracia Ong Borneo. These were the people I met Hospital, Tan Tock Seng Hospital, when I was there; I used to play rugby KK Hospital and Singapore General with PM Mahathir, who was one year Hospital, I ended up in the Ministry of my senior. We were closely knit through Health as Deputy Director of Medical

The views and opinions expressed in all the articles the hostel, medical and sporting groups. Services (Hospitals Division). are those of the authors. These are not the views Prior to this, Dr Yong Nyuk Lin, of the Editorial Board nor the SMA Council unless specifically stated so in writing. The contents of the THC: You have been appointed to the then-Minister of Health asked me Newsletter are not to be printed in whole or in part to join him but I declined. Later, when without prior written approval of the Editor. many senior administrative services, initially in the medical services and Dr Yeoh Seang Aun wanted to retire, Published by the I ended up in the hospital’s division. later at a national level. What are your Singapore Medical Association, I remember receiving a phone call by Level 2, Alumni Medical Centre, 2 College Road, administrative experiences, and do you Singapore 169850. Dr Yong Nyuk Lin, who had become Tel: 6223 1264 ever miss clinical practice? Fax: 6224 7827 Minister of Transport, saying that he was AC: There were a fixed number of not offended when I had refused his job Email: [email protected] positions during my time, and only URL: http://www.sma.org.sg offer but took it up later. I never thought SMA Reg. No.: ROS 198/59 TAP one super-scale post in any particular of the situation that way, but it was very field. I joined Dr Seah Cheng Siang as decent of him.

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When the then-DMS, Eddie Ho, transferred to the Ministry of Social Affairs, I was requested to take his place. I ran MOH for 10 years and the then-Prime Minister made it clear that he would not stop me from clinical practice. Thereafter, he wanted me to move beyond the medical field and gave me three days to consider. I sought the advice of Sim Kee Boon, head of Civil Service, and Minister Howe Yoon Chong, who was previously also head of Civil Service. Both of them concluded that there was no reason not to take up the job, and I agreed. I ended up as head of Civil Service but on hindsight, I may have consulted the wrong persons as both of them may have been the ones who decided on me in the first place! By the time I retired, I had spent ten years as DMS, doubling as Permanent Secretary as well, and ten years in the Ministry of Finance and in the Prime Minister’s Office. When I retired, it was decided that I should continue as Chairman of the Central Provident Fund Board, where I (Photo credit: Public Service Commission) served for four years before becoming Chairman of the PSC. I stayed on as PSC Chairman for another ten years that as a medical graduate of NUS, I THC: Amidst discussions of before I officially retired! had stronger ties and reasons to take up operationalising the medical system, do the offer. I ended up being talked into you think a non-doctor can do a good THC: Are you holding any other becoming Pro-Chancellor! job in running hospitals or healthcare? positions now? AC: I have always opined that it is easier AC: I have lesser activities now, due THC: Doctors seem to be trusted and to change a doctor into an administrator to difficulty in managing without a placed in various prominent positions rather than vice versa. When I was secretarial office.T oday, I hold two by the local government – do physicians seeking advice from Minister Howe Yoon offices on a part-time basis. I am a have certain appealing qualities, or is Chong, he remarked that one only needs Member of the Presidential Council of this merely a coincidence? common sense and good judgment, and Minority Rights, and also the Pro- AC: In the early days, higher education that is very true. Chancellor of NUS. was not easily available to all, perhaps I faced this issue as well, because Initially, I was asked to be the Pro- due to cost or faculty size. Thus, the I was looking for successors for the Chancellor of NTU, but I apologised cream of the crop tended to enter health field and beyond. Looking at to Prof Cham Tao Soon, explaining that medical school and that is where the international examples, all hospitals in I did not see it fit as NTU is mainly an leadership selected its people from. Scotland were run by doctors – never engineering school. A couple of years We also must not forget that by lay administrators. In London, it was later, Prof Lim Pin rang me up and outstanding, non-medically trained the opposite. When I was at St Thomas’, offered me the post of Pro-Chancellor for persons were also picked from Raffles there was an anaesthetist representing NUS. I tried to explain that I could not College. On the medical side, names the medical professionals, the lay accept after having rejected the previous do tend to emerge easily due to the professionals, and myself; a person one, but he was insistent – he proposed smaller cohort. interested in the process. I saw much

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confrontation between the medical and patients in Jakarta would be cultured in some anxious moments, and when lay professionals, and also discovered Singapore before being flown back to they predicted the communist domino that it is not easy to manage doctors, Jakarta for their surgeons to graft. This effect, the Australians were very keen on but doctors dislike being managed by satisfaction was something that I was able recruiting those with MBBS (Singapore) non-doctors! to continue, even when I moved beyond certificates. When the Australian register Different experiences will influence the medical field. opened, it was not surprising to see management but I would say that I often use Lee Seng Teik as an a planeful of doctors flying there to generally, doctors feel more confident example to the Ministry of Foreign register just in case they had to migrate. when being managed by doctors. Non- Affairs – he is a Malaysian and Singapore We are highly sought after in the doctors are of course mindful of this, PR who does his work while carrying Commonwealth countries, and this is but some do a better job than others. It our flag. He is very effective, and will go why we have to ensure that our standards is likely that we will continue to see a to various pharmaceutical companies to never falter. mixture of both, but my own preference It is painful when we lose people. is someone who is well-respected. As long When you think about each graduating as a lay administrator recognises that he class having 5-10% leaving, they may be has to work hard in managing doctors, he doing so out of unhappiness. Today, we will be successful. Being able to introduce are talking about attracting talent instead, so the mindsets from the previous years THC: What has brought you most a multiplying factor is have now changed, partly due to the bad satisfaction from being a leader in the experiences we’ve had. healthcare sector? something that AC: Being able to introduce a I feel most satisfied THC: Talent is one of our resources; how multiplying factor is something that do we manage the tension between the I feel most satisfied about.T eaching is an about. Teaching is an locals and foreigners in a small country? important component in any professional important component AC: It is the politician’s role to be very job – if I can teach, or can identify careful. I remember that even as head of people who are able to teach well; I in any professional job Civil Service, the issue of keeping ethnic would have produced a multiplier effect. – if I can teach, or can balance was difficult to avoid – we were When I became DMS, I enjoyed always discussing how to attract Indian helping the university identify ideal identify people who are and Malay talent. candidates to join the medical school. It was interesting to find out that I hoped that this would help to produce able to teach well; there were Malay populations in more good doctors. I continued this I would have produced Australia and South Africa, but we approach when I was Chairman of the could never attract them back due to PSC because medical or otherwise, one’s a multiplier effect. religious and cultural reasons. We did value to the country as an administrator manage to attract many Indians from or as a teacher-researcher has to be closely the UK into the IT section, via the idea looked at. of Singapore’s cultural similarity and our Being able to work closely with the proximity to India. clinical side so as to bring about skill We had no problems attracting enhancement has been something that request for drugs that are soon-to-expire, Chinese from Hong Kong, but I I have enjoyed. For example, I was very approach SIA for free tickets and provide think they made use of us more pleased to help out in the area of skin aid to nearby countries. He is the sort of than we did them. Our efforts in grafts and tissue cultures. We were very person I enjoy working with. attracting talent started in 1987; as keen on helping Professor Robert Pho we knew they would not come in in bone grafts under hand orthopaedics, THC: What are your thoughts on 1997 when Hong Kong reverted back and to support the development of skin doctors migrating out of Singapore? to the People’s Republic of China – tissue culture technique so as to manage AC: We cannot fight the commercial the world was their oyster. We set burn patients – skin tissue from burn side. Our health ministry went through our sights on blue collar workers,

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extended a “landed PR” and even established a “Kowloon Club” that still exists today. Later on, it was One must not prove efficiency by discovered that many Chinese would rushing through matters. I believe arrive with their daughters, but not their sons. Citizenship was offered that in order to progress, one will to Chinese talents after five years to inevitably make mistakes, but we recognise their contributions. In their sixth year, we realised that many of should keep them at them had migrated to the US. The a minimum. Green Card was over-subscribed in Hong Kong but under-subscribed in Singapore; the talents were very patient. Not all have left – in the Indians are brilliant people; well known Today, there is less time for end, we win some and we lose some. to the rest of the world. They have also interaction. Perhaps we should keep been fortunate in embracing Western- front-line publicity on politicians THC: Were these efforts designed to type education, and are endowed with rather than civil servants to avoid boost our population numbers, in view the ability to do good work particularly another Tan Yong Soon situation. of our low replacement rates? in IT and Mathematics. If the public feels that there is a lack AC: When we embarked on our “Stop China too will be successful, but at a of discretion, then we must have more at Two” campaigns, we were warned decreasing rate. China is revising its law dialogue. However, it is hard to by Professor S S Ratnam that our court; they are inventers, but perhaps the satisfy everybody. population might drop too much. issue is one of trust. China has generally been successful THC: What has resulted in the with its one child policy, but they may THC: Laypersons always view the decreasing interaction? face issues in the next two decades Civil Service as being bureaucratic AC: I think senior civil servants do because the population would have and inflexible, can you convince us not have time to interact with people shrunk by a lot. Also, they do have otherwise? because they are too busy. Person-to- more males than females, which will AC: This can be explained by the lay person interaction is always a good give rise to social problems. public who are dealing with the front opportunity to really see somebody. India, on the other hand, has end personnel, who often have little I would like to see our senior people failed in its family planning policies. discretion. And people who approach having more leisure time; I felt that I However, they will be more successful the counters come from all walks of did not have much of that during my due to their economic manpower. life and are of ranging intelligence. term in the PSC. Every night, I would Discretion tends to be given with have to time myself so as to finish THC: India and China are considered increasing hierarchy. There is a great reading a number of papers. polarised – one is considered to be need for people in the upper ranks of Looking at the senior administrative endowed with the rule of law and the the Civil Service to interact with those staff, it would be wise for them to English language while the other relies from the private sector. plan leisure time for themselves; else on organised central command. Which When was Prime they will get caught up in their work. do you think will fare better in the Minister, he advised his Ministers to next decade? take up golf, and this saw many of THC: There seems to be a push AC: I would think the rule of law and them attempting the game. I took his towards progressive and innovative grasp of English does shorten the road cue and also appointed senior civil thinking in education, finance and to development. However, India is not servants with club memberships at the trade industry now. without its problems – being left with Sentosa, Keppel and Tanah Merah. AC: Progress comes in spurts, the British policies of division and This was so they could meet up and for example the push to make IT rule meant that dissent would curb interact with people from the widespread by Phillip Yeo. We expect its national growth. Then again, the private sector. things to be accomplished faster today

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than before, and the public may feel is corrupt, sooner or later, the other read papers written by authors he left out at times. However, having too will follow. knew and trusted as he did not want many consultations will hinder the It is noteworthy that we have many to waste his time. speed of progress. This may attribute honest people as well as the Corrupt These are anecdotes that one to reduced contact time with the Practices Investigation Bureau (CPIB) hears about others, and they provide people, and give rise to a danger of directly responsible to the Prime suggestions that could be beneficial to mistakes being made – one must not Minister. The appointment of people oneself. Then again, there are many prove efficiency by rushing through to vantage positions is important and people in the world that I admire, but matters. I believe that in order to depends on the consensus of a few I could not do the same things they progress, one will inevitably make minds. Therefore, in the appointment did. In this way, I would rather lead mistakes, but we should keep them at of senior positions; there are at least a than be led. a minimum. dozen members in the PSC. I would say that for the next two generations, THC: What sort of Singapore THC: Given the latest AWARE we can be confident that good people would you envision for your saga, do you think we will see more are in place. grandchildren? AC: Singaporeans willing to stand for We are thinking of our own their causes? THC: How does the Civil Service experiences, and I believe we should AC: I think this is natural development deal with the issue of outliers who not shape things for others. When that comes with more people being may speak against the system? friends recount that their children have migrated overseas, I explain better educated. Looking at the sex AC: There is nothing to say that one that this is because they feel that ratio in tertiary education, there cannot disagree with the system but life away is better. Who are we to are more females than males. These at the same time, one cannot sabotage say that life here is better; they womenfolk seem to mature faster all these policies. One should be should discover this for themselves. in early life, and are making strong politicised to be aware of the goings- I would still advise that the contributions that cannot be ignored. on but one cannot be political. If one Singapore citizenship should not In fact, if you are a politician, you is political, then that person should be given up too readily. would look at AWARE very closely not be in that job. This is the reason Life away may not be better, as and question if you have missed out why no civil servant can be an active there are many factors involved; the the female vote. political party member – if anyone most important one being family ties wants to stand for elections, then he or and the family unit. For example, THC: Will a strong and vibrant Civil she will have to leave the Civil Service. when Professor John Wong was Service contribute to the success A civil servant can have differing offered Professorship in Cornell, he of Singapore, in spite of whatever views but he or she will also have to turned it down in order to be close to leadership that is in place? accept the dominant view. his father. AC: Trustworthiness may be the key I appreciate the phrase “the grass answer here. By and large, the political THC: Have there been any major is greener on the other side” in the leadership has proven itself honest so influences that shaped your life or literal sense. I was playing golf in that has been already well-entrenched. belief system? Joondalup, Perth and my ball went The administrative leadership does AC: It is the most striking events that into a beautiful green patch. When exactly the same – we look not for mould a person. I used to admire I crossed over to look for my ball, intelligence, but rather, honesty and how Chief Justice Yong Pung How I realised that it only looked green a willingness to take responsibility. went off the beaten path in making from my side! Instead of being lush I think that as long as this is in place, his decisions. As Chairman of the and green, it was sparse and filthy. it will be hard to break the practice. Institute of Policy Studies and Vice- The grass may appear to be greener on We are known to have a good Chairman of OCBC Bank, he would the other side but once you are there, and reliable Civil Service. It is no always question if he had fulfilled it may not necessarily be true. use having strong political leadership his worth. This is a man who is very without strong administrative support. conscious of his responsibilities. THC: Thank you for your insightful Both have to go hand in hand – if one Dr was said to only answers.

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