That was indeed torturous.

But yes, from the sound of things, i have a few theories.

1. Likely, hospital administrators were tasked to handle it, but without clear guidelines from the Ministry.

2. Hospital administrators then, began to “tai chi”, each one asking another to do it. No single person standing up and taking charge. This is possible, as in typical singapore fashion, they dont want to make decision, because anything that goes wrong, they will be held liable. Think about Mas Selamat situation and who eventually were blamed.

3. The lower echelons of the medical staff – i.e. – nurses, of course, very likely, operating without any clear direction. I can understand the male nurse being burly. He was probably thrown in the deep end, not knowing what to do, yet having to take responsibility, and also with the possibility of getting sick himself. Those folks are under tremendous stress, for sure.

Somehow, it just so reminds me of my Army days. We can have all the planning in the world, parades and such, but when its time to go for an exercise, everything breaks down.

i dont want to sound mean…he should get himself infected..as ” a commoner”…and go thru the entire routine to understnad whether his strategy is really a “walk in the park”! All this idiots talked as if they are “gods” !

hahaha bloody hilarious… nowadays most public institutions in SG function like the SAF – i.e. sounds good on the outside, total mess and utter crap on the inside.

Vcki Yang, I really feel sad about your experience.

Based on my years in the army I see the operations of MOH staff as you described and the army operations as being similiar.

We say we are a first world nation but when we see the situation as you, Vicki described then I have my doubts.

Can we compare our ability to operate smoothly with the Nazis during the Second World War and that was more than 60 years ago?

They were miles and streets ahead.

We are still way behind.

See how efficiently they got the Jews on to the trains then to Buchenwald, Auschwitz, Sobibor, Dachau and a few other death camps with round the clock creamatoriums.

Vicki Yang’s experience is like the experiences of reservists waiting for their kit bag. They wait the whole day getting their kit bag and another whole day returning them. Two whole days gone. Waste of time and money.

And yet you cannot mention the army because such time wasting operations are top secret – have to do with defence of the country, you know.

We are still backward in some ways. The EElites say they brought us to the first world and so should sky high pay and more then multihued Obama.

Yet again, another case of our dear leader’s “great strategy” and the paper just have to praise them for it….

when will they learn, that a balloon that is inflated too much will burst? guess it brings back the saying that a leopard can never (ever?) change its spots

…but there is another (better) side of the story as told by this blogger..

http://geraldgiam.sg/2009/06/surviving-suspected-h1n1/

From the looks of it, the silly ministers are up to it again. Lots of hot air and farting through the mouth!!

Shamelessly taking credit due to other people and blaming others if thing go wrong.

The whole pap system is a myth. Talk may not nocessarily translated into action. We have seen it many times. I am certain people going to CDC for help do face the same level of arrogant and ignorant staff and worst of all is to pay these people 8 months bonuses for such lousy performance.

If they know what they, including all other civil services, they would publish procedures and important notices in their websites. They simply do not know and do not care! These days, the top or people in charge do not even need to shift their bottoms, the easiest way to check is to look at the websites. Are there info for the public or procedures established by the hospitals? If the civil service depts haven’t got a clue, they can cross reference other 1st world nations and learn from them.

That is the whole problem with young Singaporean like Vicki this days. To them public service is like they walked into a 5 stars hotel.

Hey Vicki, why don’t you take over the job of those who attend to you? Putting a mask and wear that non-woven protector and also the latex grove for long hours?

A society of complaint queen & king, Vicki is definitely one of them.

Vicki, may I suggest that you send a copy of your post to the Ministry of Health marked: “For the attention of the Health Minister aka Khaw Boon Wan”

Should you receive a reply, pl post it on TOC for us to read.

When oversea friends stay in Singapore for some time and ask me how come what they read from ShittyTimes are different from reality and the ground they discover, I tell them that Singapore is just a one big Truman Show, and ask them to learn the word WAYANG. It is really nothing new as Singapore is just big WAYANG show for the world.

Kaw annouce last few days that we are changing from containment to mitigation strategy. However, according to today 26 jun Shitty Times headline. MOH say we will only go into mitigation if the H1N1 positive case hit 15%. now it is only 4%!

So can I ask, who is telling the truth? Currently, only 2 countries has gone into cure strategy. NZ and Japan.

Another thing that I doubt that they can go into treatment stretagy is that, recently my company doctor told me that Singapore only has 3 million tamiflu tablets. Unless they break one tablet into two. Where got enough, to move to mitigation?!

Pay these bunch of minister to massage figures and play with words. The thought of it, make me sick.

The Cow Strategy … it is about eating grass outside TTSH, dude.

Ha, Ha, for the ladies that didn’t go thru Army, welcome to how our systems does things in reality, behind the glitter screen, dinosaurs lumbering about…

Seriously, the focus is on the H1N1 just to divert the bad news from the economic sector. 5-10 out of 30 minutes each night news on H1N1, yet not a beep on creating new jobs, etc. Oh, half of tonite’s was on Michael Jackson. Well done, MediaCorp.

Let’s help the “authorities” think thru their ivory towers & fat pay. Maybe TTSH should use an “idiot card” — list of actions to be carried out, hung around each patient neck.

1) check patient has 1 head, 2 eyes, 2 arms, 1 nose, etc. — tick, sign, time in/out.
2) Take body temperature — tick, sign, time in/out.
3) Take blood sample — tick, sign, time in/out.
4) Check flu-like symptoms — tick, sign, time in/out,
5) etc…

Each station should be prominently labeled so that patients know progress and which station next. Simple right? Even a 5-year-old can have strategy.

Most of the public institutions are like that because the management says one thing to the media for good publicity and leave the staff manning the operations to second-guess from the media publicity. This is a classic example of the brain does not synchronise with their “kaki tangan” or legs and hands, albeit the staff are trying their best to cope and do according to what they think is right just like in this instance. Keep your finger crossed and do not swallow wholesale of what the media says. Be realistic is the key word.

Nurse: We have to know whether you’re pregnant.

Vicki’s Friend: I can’t be pregnant. I’m a virgin.

LOL. How much exposure to the ground do one really need to know that?

On a serious note, I am quite concerned with the following:

1) It costs S$85 for the outpatient verification of H1N1 – where’s the incentive for poorer and jobless Singaporeans to test for H1N1 given that the H1N1 Outbreak has reached community phase. Tamiflu cost S$60 per treatment. Can Medisave be used to pay for these costs? What schemes are avaiable to waiver H1N1 test charges?

2) The tamiflu stockpile in Singapore is available for 3M people. There isn’t enough for every Singaporean and PR. Even worse is that a good fraction of these Tamiflu stockpiles actually expired in Dec 2007. What Health Science Authority, the US Food & Drug Administration and other medical regulatory agencies did was to arbitarily extend the expiry date to Dec 2010. Is this move even legitimate? Will new Tamiflu production actually replace these “extended” Tamiflu?

3) MOH has been very forthcoming in making useful knowledge for contact tracing public. While MOH has published figures on where H1N1 patients most probably contracted H1N1, MOH has not released any news if any H1N1 patients were discharged. We have no idea whether Tamiflu is actually effective against H1N1.

u wanted to b treated like royalties? Can! If u r from any of e UAE states..increasingly u see many at TTSH..I know because my friend used to make such arrangement!

#10 gorang pisang

Vicki was just narrating her experience and it could all have been true, happened as she described. What then?

You appear to have jumped to the conclusion that Vicki was wrong for writing as she did. That’s something we call prejudice.

#10 gorang pisang

Vicki was just narrating her experience and it could all have been true, happened as she described. What then?

You appear to have jumped to the conclusion that Vicki was wrong for writing as she did. That’s something we call “prejudice.”

This is not the first time, I take the world class public transport , aka MRT and there are many times the train breaks down and you see people going in all directions and the MRT staff are running around trying to figure out what to do, I have come to think that this is their standard drill ( Running around like a headless chicken)

The only way to test the staff’s readiness is when you have to of the following

1) An actual event

2) A triggered event and a independent observer that will publish their findings with no cosmetics for the public, this will give the people in their ivory towers a TRUE wake up call in their lack of understanding on what is happening on the ground.

Butter factory that make butter?! What in the blue hell?! Its a club….!

gorang pisang: True, nobody likes a whinger. But faulting everyone who raises valid points about a system that can and SHOULD be improved – reveals a new level of insularity. By your standards, are we meant to always remain silent in the face of telling evidence?

Vicki’s points are not those of a demanding adolescent, but someone who has made careful observations and identified a series of worrying possibilities. I don’t think she wanted to be treated like “royalty” as some thoughtless comments suggest; she’s merely a person who wants to believe that her country has a virus effectively under control. Her comments are hardly directed at nurses, but rather, the administration as a whole.

“The holding area looked like a detention class. Classroom tables and uncomfortable white plastic chairs (usually used in funerals and functions in community centre halls) were placed more than two arms’ length apart from each other. A small television with very bad reception sat on one end”.

Uncle Khaw, so you know lah! better provide them with 5 Stars hotel facilities. These people feel that they are princess.

The forgot that not too long ago their grandparents came here pannyless, shoeless and jobless.

Vicki,

very interesting to hear about your ’swine flu’ experience at TTSH. I guess once you mention the H1N1 swine flu virus, the medical staff generally would like to ‘run away from patients who may have it’.

The Minister Khaw should get his act together, making sure that the medical staff at the various hospitals are updated, and told what to do, when dealing with patients who may have the H1N1 virus.

Such behavior from the staff at TTSH is not acceptable.

The H1N1 virus is still around here in America.

At least one million people in the United States have had swine flu, or around 50 times more than the number of cases reported to health authorities, an official at the Centers for Disease Control and Prevention (CDC).

The Singapore Health Ministry statement confirmed two more cases Wednesday. That brings Singapore’s total to 49. That’s the swine flu update that I am aware of.

My advise to my friends, is to avoid crowded places, wash hands, and if possible, wear masks. Bearing in mind, that the H1N1 virus is air-bourne, and transmitted from a sick person to another person.

I STOPPED going to see movies as well, and do my grocery shopping late at night, when there are very few people. And my packet of disposal masks are always in my glove compartment. It is a continuing practice…but what other choice do I have?

I am a staff nurse, I trained at TTSH before, and my father died there! It’s a horrible, horrible, horrible hospital! Serious under staffs, with many foreign doctors and nurses!

My father stayed for 2 days for stomach distention, and they did NOTHING! Till the time he collapsed, they didn’t even take the basic FBC and UE. No X-ray, no ECG! As a fellow medical staff, I expect them to know their job. So I did not go after them, and that was the result they given me! My Big Mistake!

So my advise to your guys! Unless really, really, really necessary, DON”T SEND YOUR LOVE ONE to TTSH! Not even for paying class! They will die because of neglect! A LETTER OF REGRAT (that’s not apology!) will not bring the life of your love one!

What vicki wrote is a good example that our Ministers do not deserve fat pay and our medical fee should not have increased with such lousy services. Let’s have more of such incidents disclosed in the coming election and put the pap to shame.

The whole H1N1 containment execise is half hearted. Today’s mainstream ST article on how well prepared as compared to oher countries is such a propaganda and self congratutory that is looks like a joke.

well, ministers are like the marketing dept, they are there to assure the customer and make empty promises. half the time the operations dept have no idea what marketing has promised and end up taking the flak.

so what would you say if you’re khaw? our ministry is screwing up all over the shop because we have no idea how to organise the management of a pandemic that has spread like wildfire? of course he has to keep the peace to avoid panic be

behaviour. that’s his job purview.

it is up to us the humble citizen to take personal responsibility and avoid hanging out at public spots during the crisis. quite easily done.

Looks like they sure did not have any drills for such incidents occuring again after SARS.

And from reading the passage, the paramedics are shit scared to work as well.
With the high population density in Singapore….this preparation looks like a joke….Khaw work harder….or leave….No dramas…

I hope you and your virgin friend is fine, Vicki…

Refer to: We have no idea whether Tamiflu is actually effective against H1N1.

According to WHO, it is effective because they have tried it on several sever cases of H1N1 infection. But what you don’t know is that it takes more than one tablet to administrate treatment. And in the case of country wide spread, the tamiflu will only be given to important people such as police, medical people, minister and people that can significant contribution to the country. This apply thru out the world.

On the bright side according to WHO, most H1N1 people can self heal without the tamiflu. However, history had told us that virus don’t stay in it original form for
period. When it evolve, then we will not know what will happen.

//“And what were you and your friends outside doing at the Butter Factory? Are you working there?”

“No, I don’t work there.”

“What brand of butter does this factory produce?”

I stared at him, utterly perplexed at the question and unable to react instantly, only managing to croak out a “What?” He asked again.

“It…. it doesn’t produce butter… It’s a club,” I stammered.

“Oh, it’s a club!” he exclaimed, as he scribbled away on some sheet of paper, enlightened.///////

Being fully aware that tha H1N! risk is higher in crowded places, and choosing to go to “Butter Factory ” is mistake number one.
The presumption that everyone knows the “Butter Factory ” is a club is mistake number two. A lot of people may not care too much about these ‘club’ places.
Being utterly perplexed at the question is thus mistake number three.

#24 goreng pisang….

You sure sound gorenged..or rather with a fried mind…my friend…

I think you have not travelled enough to countries which charge our prices…. to see the services rendered….try Thailand, it’s nearer for you…check out the services…

Yeah..proper chairs, arrangements and procedures give confidence especially to those in such anxious circumstances….

You sound like as if you come from the old world of anything will do and can do….

NO IT DOESN’T…..proper shift management for staffs working in such conditions must be done, rostered well by HR…all these can be done….and is being done in foriegn country’s…even in places like India…

So do not come out and say S’poreans complaint. They complaint or give criticism because there is SO MUCH OF ROOM TO IMPROVE ON……

You too…need to see things and improve on your foresight….because most people like you…only complaint when it happens to you or your family…..and this talk of S’poreans complain…. king & queen just perpectuates . ….

wake up my friend…and smell the roses… Singapore needs constructive destruction….or people like you will make us only go around in circles.

36) prettyplace

///Singapore needs constructive destruction///

how does this works?

36) prettyplace

////proper shift management for staffs working in such conditions must be done, rostered well by HR…all these can be done////

there is no proper shift management for staffs in TTSH?
I am suprised, how do a staff know when to come to report for work?

#Kopitiam Apek….

I think what she meant was….. the doctor…is tending to a patient from a known cluster area….thus the doctor should have known what the place was….
I am sure it was sent via email to the doc…but he must have been just too busy to read…..or he must have read it & have been just trying to joke….and have a little bit of private fun..hehe

I have a gut feel that for every 1 case detacted, there are 5 floating out there. We probably have close to 2,000 infected cases rigth now. Just look at the alarming increase in detacted cases each day.

Take very very special care not to infect the high risk groups.

#10,24,26 goreng pisang….

complaint kings and queens are a special breed,
product of the process of evolution process
born to a life of comfort
no covered linkway cannot walk in the sun nor rain lest they will vapourise
no idea how to improve but complain
it ’s free

///Hey Vicki, why don’t you take over the job of those who attend to you?///

don’t think it will work, she will quit in one day, then complain FT take away their job

///They forgot that not too long ago their grandparents came here pennyless, shoeless and jobless//

they have indicated that their grandparents are the state’s responsibilty, gahmen must pay for to feed them , not these kings and queens

Apek,…

wrong word creative destruction….typing too fast lah..should go less on the kopi..

shift management as in…making sure they get proper rest…especially during such conditions…they sure come to work….i know and even your child would know, if you have one…

from the way things are explained by Vicki….there seems to be a communication lapse between staffs…all this comes under proper HR as well…..you see it or …do i need to spell it out…

Many moons back there were days I felt everyone are out to give me a bad day. Black faces greeted me everywhere for the day. Kopi girl rude to me, some driversI overtook looks like going to eat me for lunch, bank clerks rude to me, etc,etc….

But then I realised there is only one common thing in all these encounters, it is me. I look at my self in the mirror, and there to my horrors, I saw a sulky face.

Then I became a changed man, (but then sometimes changed back), I smiled, like SIA girls to everybody I met, taking care not to overdo it, lest the civil servants at Woodbridge IMH start paying special interest in me. And, eureka, I did get a better day.

So maybe that is what we may have to do to make ourself have a better service experience, is to be a better customer ourslves first, that is the part that we have control, and if sway sway still get kanasai service, then maybe it our kharma liao.
: 0

just 1 cent worth of my thoughts.

This girl is ill for goodness sake! Try smiling when you have a fever and the worry of being contaminated.

I thought Spore is filthy rich, and the civil service is gold standard, as the Govt always boasted, so why is it not right for people to expect 5-star hospital service hah? And we pay so much you know!

To those who say avoid this, avoid that, c’mon, you might as well stop living altogether, everywhere is crowded when you step out of your front door in Spore unless you live in the Istana. Its great that the girls went to have a good night out. The economy will collapse if everyone behave kiasi.

44) KhawSense

/// This girl is ill for goodness sake! Try smiling when you have a fever and the worry of being contaminated.///

The sequence was in the wrong order. the worrying should have been done before going to Butter Factory not after

///I thought Spore is filthy rich, and the civil service is gold standard, as the Govt always boasted, so why is it not right for people to expect 5-star hospital service hah? And we pay so much you know! ////

It chicken and egg isn’t it?
want 5 stars standard, complain high price, please select one

////. Its great that the girls went to have a good night out. The economy will collapse if everyone behave kiasi////

If economy depend really on the girls going to the club, we are indeed in deepsh*t.

42) prettyplace

creative destruction.. mmmm

is it not the same as “Throwing the Baby out with the Bath Water?”

Apek

You sound so shallow I don’t know where to begin. At least I have KhawSense, you have no sense.

47) KhawSense

///You sound so shallow I don’t know where to begin///

try begining by clarifying how you define shallow?

@26) gorang pisang on June 27th, 2009 10.55 am

“….The forgot that not too long ago their grandparents came here pannyless, shoeless and jobless….”

Pls get out of the time capsule. 50 years of self-rule, several generations have gone thru NS, the PEOPLE’s (not the gahmen’s) sweat & tear build Spore to what it is today. And we EXPECT it is OK that their grandchildren remain pennyless, shoeless and jobless NOW?? May we need to wait another 50 years …. Oh, too bad, then there wouldn’t be any true-blue Sporeans left here…. All FT/FWs.

BTW, are our MP’s high pays consider 5-star hotel standard? I thought US President Obama’s already 5-star. Also, their grandparents ” ….not too long …. came here ….”, meaning I EXPECT some MPs to be shoeless, shirtless, etc….

16) theforgottongeneration

///Let’s help the “authorities” think thru their ivory towers & fat pay. Maybe TTSH should use an “idiot card” — list of actions to be carried out, hung around each patient neck.

1) check patient has 1 head, 2 eyes, 2 arms, 1 nose, etc. — tick, sign, time in/out.
2) Take body temperature — tick, sign, time in/out.
3) Take blood sample — tick, sign, time in/out.
4) Check flu-like symptoms — tick, sign, time in/out,
5) etc…

Each station should be prominently labeled so that patients know progress and which station next. Simple right? Even a 5-year-old can have strategy.////

Wah, such a brilliant idea.

If we become a nation of complain kings and queens, who is responsible for it. Society, education system, political system, etc? Hello, we did not pop into Sg by magic! This must be the fruits of wonderful Singapore that the MSM talk so much about! Please don’t talk down your country leh.

50) KopitiamApek , should get the TTSH admin’s salary. The citizens are not paid to think for them.

Mr Khaw our health minister is the best we have got.

Our nursing staffs and doctors are also outstanding .

It is easy to comment and complain, but try working as a nurse or doctor in our hospitals and you will know how much they have sacrificed.

I would like Mr Khaw to build more dental clinics in Singapore. Our polyclinics also must be better equipped with more space. Our polyclinics are too crowded.

Please Mr Khaw look into it. I suppport your idea of smaller hospitals. I also support your handling of the H1N1 crisis.

Thank you Penang for giving us Mr Khaw.

Do you think Khaw Boon Wan reads this article ? given its popularity ?

Silence is golden……..

51) Sylvester

are we thinking for them?
or are we thinking that we are thinkingf or them?

52) PekChek

thank you for your refreshing point of view,
a rarity in TOC, which is Compliants Central

no one can be faulted for thinking that TOC stand for
Tantrum Outburst Complainers

but over time we hope it will morph into a
Totality Of Calmness

whereby logic and rational thoughts previal.

Dear Mr. Khaw,

I hope you and/or your officers had a chance to read this article. If this is the real situation on the ground it would be really embarrassing. Hopefully something can be done as soon as possible. If there are unfair accusation, it should be corrected. Otherwise you will lose support from the ground. People who supported you would feel betrayed. I believe you take such feedback seriously. Unlike some others who often suggest that these people just like to complaint.

Sincerely,
Your Supporter

Hi RED-man #34,

WHO said Tamiflu is effective because they have tried it on several H1N1 cases. What WHO didn tell us was the success rate. For example, 2000 successful cases sound a lot on its own, but when reported as 2000 out of 500000, is no big figure.

Donaldson Tan highlighted in ¨TOC: Swine Flu Could Hit One in Three¨ (13 May 2009) that:

a) it is not uncommon if one’s company healthcare plan or healthcare insurance do not cover Swine Flu
b) it is unknown if Medisave can be used to cover Swine Flu treatment.
c) H1N1 Standard Treatment is One Week’s Dosage of Tamiflu Tablets.

In retrospect of recent development, I think all the possible charges are:
1) GP Fees
2) 933 Ambulance
3) H1N1 Test Charge (it seems this test covers other stuff such as STD and HIV)
4) Overnight Stay at TTSH
5) H1N1 Treatment

Whoever benefits pay. In this case of H1N1 Pandemic, both the public and the potential H1N1 patient benefit for verifying his / her status. It is only fair that there should be H1N1 subsidy on top of standard subsidy already entitled due as a Singaporean.

Given that H1N1 is not deadly, a prohibitive charge of S$214 (see Who is Responsible for Cost?) on top of a 1/3 chance of contracting H1N1 upon exposure, there is really no incentive to visit the doctor or go to TTSH.

H1N1 faq

http://www.ttsh.com.sg/swineflu/swine-flu.htm#screening

2) blackfeline

///i dont want to sound mean…he should get himself infected..as ” a commoner///

you don’t want to sound mean? really?

4) Rurehe

///Can we compare our ability to operate smoothly with the Nazis during the Second World War and that was more than 60 years ago?
They were miles and streets ahead.
We are still way behind.
See how efficiently they got the Jews on to the trains then to Buchenwald, Auschwitz, Sobibor, Dachau and a few other death camps with round the clock creamatoriums. ////

efficiency in mass murder?
quite atrocious comaprison.

57) smallvice585

I think if one look at it at a broader perspective, is it a sum worth paying (or if you prefer, dying for?
$214

When some are willing pay a lot more for the latest fancy handphone, to replace the equally fancy that they just got tired of.
And interestingly, the long queues also at handphone shops, no complaints heard here about that leh.

44) KhawSense

/// Its great that the girls went to have a good night out. The economy will collapse if everyone behave kiasi.////

Oh btw, I learned that Ladies night is FOC for the ladies.

how is that talent able to prove that H1N1 is spreading SLOWER?

where slower is a comparative term.

compare with itself? comparing with other countries is unfair as countries are very different. so, the only fair comparison is with itself but then this is impossibility.

So, can someone prove that it is transmittion SLOWER?

63) Upsize the Downsize?

///how is that talent able to prove that H1N1 is spreading SLOWER?///

Spreading slower? Someone said that?

57) smallvice585
///Donaldson Tan highlighted in ¨TOC: Swine Flu Could Hit One in Three¨ (13 May ////

Another view here.

///Let the Games continue!
Thursday, 25 June 2009, 9:45 am | 606 views
Ravi Philemon / Head, Current Affairs Desk

H1N1 not that dangerous////

let the economy collapse loh, life will still go on & on & on….

Hi Kopitiam Apek #61,

NO, you are not going to die from H1N1. It is a pandemic because it spreads fast. The WHO Pandemic Scale does not prescribe a status for the deadliness of the H1N1 flu.

67) smallvice585

phew!!!
we will live !

Heng ah! nothing like this……

Stephen King’s novel ” The Stand” takes place over nineteen days, with the escape and spread of a human-made biological weapon, a superflu virus known formally as “Project Blue” The epidemic leads to the death of most of the human population in North America and eventually , the world.

@54) KopitiamApek on June 27th, 2009 9.14 pm

” …51) Sylvester

are we thinking for them?
or are we thinking that we are thinkingf or them?…”

Actually, we are thinking that we think that they should think that they can think for themselves, without thinking that others should think for them to think.

69) theforgottongeneration

that’s what you think. and it is noted.

we are
what we think we are
what others think we are
and what we really are

66) mice is nice

///let the economy collapse loh, life will still go on & on & on….////

don’t like dat lah,
wait kopitiam close shop, my kopi-O how?

From what I read, it just seems like the Khaw Strategy sounds great on paper, but there has been a failure to address the actual logistics and practicalities in terms of implementation. The medical staff are clearly doing what they can, running about trying to take care of everything and sort everything out, but there is no real orchestration or coordination in what they do. They aren’t working as a team, because the system seems to lack any structure in place that would ensure efficient communication and organisation, not just between the staff and patients, but amongst the staff themselves.

I don’t suppose the doctors and nurses, working the hours they do and having to deal with so many people in a day, would have the time to constantly keep up with reading the news articles on updates about new clusters, but perhaps there should be a way to update them in concise and succint ways (oh, if they could get Tweets on their phones or something!)? And if they could have little charts or boards up or something for all the staff to check and keep track of which patient where has had what test?

The inefficiency just stems from a total breakdown in communication, and everyone running around carrying out their own agenda without figuring out if it forwards the agenda of the team on the whole, which just confuses and slows everything down. This might be how it is in the military and many other organisations, but that doesn’t mean we can just sit back and go, “oh this is the Singaporean way”, we need to find some way to make it better.

More teamwork! More coordination! More communication! Less “keeping my head down so I don’t get in trouble”!

Kirsten,

With new tech such as internet, there is no excuse for lack of info. What is the website for? The best place to post procedures etc is the orgn’s website or intranet.

Yes, definitely, the Intranet would be a great way for the staff to all get updated about procedures and progress! It is such a simple solution, yet from Vicki’s account it hasn’t seemed to have been used very well.

70) KopitiamApek on June 27th, 2009 11.46 pm

you sound like Rues , a forummer, from CNA forums. I USED to frequent that place. Not anymore. Not even 1 post i have made then since long ago.
anyway, i drink deh si siu dai only.

on a separate issue, I like to tell singaporeans this thing I observed in my neighborhood :

1. Earlier part of the year or late last year, in a small part of ALJUNIED GRC, there was mosquito-DENGUE problem to the extent that there were about 3 victims at least that went into HOSPITAL .There was a banner showing residents. Note: Dengue can be deadly. This part I am talking about is NOT the entire GRC but only the part of Aljunied I live in, a few blocks of flat only. I do not know how other part of Aljunied is affected.

2. So, by May 2009 , the figure / dengue statistic could possible to be higher than 3 by May 2009 if not remain at 3.

3. INTERESTING! ! ! : recently, ‘they’ placed a banner again but interestingly it read something like AS of JUNE 2009, there has been 9 cases of DENGUE infection.

Did someone not caught my drift?

ERRATA : the 3rd point should read:

it read something like “There are 9 Dengue cases in your neighborhood since 03 – 06 – 09.

view the foto here : http://www.flickr.com/photos/singpraise/3666924142/

72) Kirsten

It is amazing that you did a critique of the entire administration process a major hospital based on the reading alone.
So the thousands (or hundreds? ) of staff worrking there in TTSH daily devoted to help a fellow human are all a buch of nincompoops?

don’t know if cow strategy mentioned about plans when death occurs. Well, we would know the value of ordinary folks life :(…

75) Wong Kan Kan of KK club of honesty elite

//////you sound like Rues a forummer, from CNA forum///

Who is he/she and how do I sound like him. I don’t recall making any sound?

Allow me to share this perspective of the TOC community

Based on the TOC’s most popular post with 19,423 post
Assuming none of the 19,423 are repeat views from same people (which is unlikely)
If we can assume this number represents the TOC’s virtual population.
This number will works out to be 0.5% of the population of Singapore of 4 million people.

The reamining 99.5% are not in TOC perhaps for the followingnon exhaustive list of reason.

1. Those who are illiterate
2. Those who do not read/write English
3. Those who are literate in English but are IT illiterate
4. Those who are literate in English and IT literate but unaware of such on-line community sites as TOC
5. Those who are literate in English and IT literate, aware of the site, but do not wish to be part of the on-line community
6.Those who are literate in English and IT literate aware of the site, but do not wish to be part of the on-line community as the do not support the general views of TOC community

Another typical bitch because I have to article. Vicky was there for 9 hours because the whole test results will take several hours to conclude. The hospital can’t put her to CDC until she is confirmed to be a patient, nor can they put here into TTSH as it would be unsafe for fellow patients.

There is no doubt that there is miscomm between top and bottom, but this is common in every organisation, hospitals, SAF / Govt non-withstanding. This isn’t a daily routine for most people, nurses inclusive, and people need to adjust.

Back to the various tests that she is subjected to, I wouldn’t have given her the chance to say no. She claims that she isn’t pregnant, what if she is. Her friend is a virgin, but what if she lied. What’s the big blurdy deal of going through a pregnancy test just to be sure? And btw, one can still be technically a virgin and yet be pregnant. Just don’t have penetrative sex. Dry humping can make you pregnant anyway and one can still remain a virgin.

81) inix

wise words you wrote

they did not complain when they were in the overcrowded Butter Factory
it was FOC for ladies on that Ladies’ Night, vigin or not
but looks like they paid more eventually albeit in other ways

how come they are not ranting nor complaining againts Butter Fcatory for giving them this additional free item called H1N1

hi KopitiamApek, on June 27th, 2009 11.52 pm

////don’t like dat lah,
wait kopitiam close shop, my kopi-O how?////

hmmm, be flexible loh, you have a few options,
1) live on instant 3-in-1 coffee
2) buy a coffee machine
3) stock up on grounded coffe powder
4) order cartons of canned coffee

dun drink too much, you must have had an overdose yesterday!! :P

KopitiamApek(#82),

if any night entertainment organization gives free entries to ah sohs(over fifty yr old), I will also want to patronize. Why blame anyone/organization for giving free service, including butter ?

However, I am arm in arm with You with regards Medical Staff not knowing that the Butter Factory is the Name of a Nite Entertainment Spot. I thought it is a ‘niuyou’, literal butter factory too. Only now I know one get buttered in a different way in this factory, lol.

Btw, Sir, You can help to increase the readership in TOC, tell your drinking khakis(fraternity), the kopi soh, kopi muays and others about this site. The more(readers/posters) the merrier, and may be we can have more companies.

Almost forgot, my bad.

Why on Earth named an Operational Procedure after a human ? For posterity ?

Just call it H1N1 Procedures lah, simple, direct and accordant with the Outbreak.

Hi Inix #81,

Please watch your language. Please don’t call someone a bitch just because you disagree with her view. You said that miscommunication is common in all organisations (public or not). Well, common doesn’t mean it is okay or acceptable. Common means this is a very widespread problem.

Vicki went through the ordeal so that you and the public would be safe from H1N1. Instead of expressing gratitude for her social conscience, you stand here as if it is her problem and it is not yours, and if she did something against the public, she should be lynched for it. H1N1 is everyone’s problem – we all have a role in maintaining public health and discouraging people to go up for H1N1 checks at TTSH is definitely not one of them.

#86

Good observation there, smallvice585. I concur with your comments.

@ smallvice585

If you read carefully, I didn’t call her a bitch. I used the word bitch as in the context of bitching, complaining. She went through the ordeal. Great. I went through the ordeal too when I came back from Thailand on a business trip. No big deal.

Next, I never said miscomm is an acceptable problem. I said miscomm is a widespread problem. One which will continue to perpetuate, simply because we’re humans. If we were more tolerate of miscomm and just get the problems fixed instead of complaining, the world would be a better place.

Next, I think she did the right thing by going for the testing. But doing the right thing does not mean she is given the right to place doubt on the integrity and effectiveness on the people who are keeping us safe. The nurse was being nice by saying I think we better take it. I would just just told her and her friend off.

81) inix

You can say that about miscommunication, but that is still something that should be avoided….

#46 Koip tiam Apek…..

If implemented right we still get to keep the baby and the water…just have to chuck the container, which contains everyone….

By the looks of it..you rather keep the container and chuck the water for new water and the baby for foriegn babies…..

#81 inix ” And btw, one can still be technically a virgin and yet be pregnant. Just don’t have penetrative sex.”

I like your type of thinking. Many may not be able to think technically.

eg. technically speaking maybe = maybe not.

cheers.

80) KopitiamApek on June 28th, 2009 12.37 pm

In short, many singaporeans are PATHETICALLY APATHETIC , social-politico-wise, dio boh? In terms of Makan chilli crab, they definitely not APATHETIC.
When it comes to buy-sell HDB , they sure not apathetic. When comes to queuing up for goodies, they not apathetic. When it is about travelling and jiahong, they surely not apathetic.

while TOC has been given numerous national-level exposure by MSM, even in 2008 ALONE, it still appears to be very the case that many have not heard of TOC and or know in detail what it is about and for what. When many are social-politically apathetic, it is definitely likely that they would not know TOC or websites like these (eg. Wayangparty.com <– please do not delete this comment for mentioning it).

Even more likely is when people KNOW or HEARD of it, people consciously choose not to go in there for reasons related to mentality.

So, it is a shame that many do not voice up even though understanding that there can be benefits for themselves and the community doing so. I mean, when many more make comments here, articles by LDS-types would be shot down even faster with even more rebuttals and reasonings. Community moderation would work even more efficiently. We can even conduct polls that get hundreds of thousands of unique individuals taking part making the poll results CREDIBLE and create effects like a PETITION which got 90% population to sign it. This will be as strong a signal as having MPs in the house , but only in my honest opinion. I can certainly be wrong, of course.

84) ah soh

////not knowing that the Butter Factory is the Name of a Nite Entertainment Spot. ///

life is a never ending journey of learning
I have learned so much at TOC

@SZ

Definitely need to be improved / avoided upon as much as possible. But again, working 12 hour shifts, getting screamed at, being the lowest lifeform in a hospital, hey, how not to cock up?

Add to a ST Forum trigger happy public, oh well. All I know is this, I will also cock up in such an environment.

91) Lee Fatt Yew

Thanks for your good post

///Even more likely is when people KNOW or HEARD of it, people consciously choose not to go in there for reasons related to mentality.///

Depend on what you meant by mentality. It is still a free choice. When the discussion reaches a certain level of intellectual challenge, more will participate, it it stays as “complaints central”, some will be put off.

///We can even conduct polls that get hundreds of thousands of unique individuals taking part ///

TOC has a long way to go to get anywhere close to that number, currently a few zeros missing.

But with perserverence , it will get there. Rome was not built in a day. (nor in a night)

89) prettyplace
///By the looks of it..you rather keep the container and chuck the water for new water and the baby for foriegn babies…..///

Aiyah, how come you say like dat? I so bad wan meh?

On deeper analysis, there are 3 parts to the issue.
The Container
The Water
The Baby

The container should be rehabiltated and re-used
The water reclaimed as NeWater, and re-used
The Baby – foreign, local, black, white, yellow , green, also boleh, to be unconditionally loved.

kopitiamapek,

Vicki wasn’t asking for 5 star treatment, and i believe she was criticizing the system fairly and constructively. The area was dealing with people down who were unwell, so giving them plastic chairs and tables to rest on is not acceptable. Please put yourself in their shoes before blabbing off here.

She wasn’t saying that all staff at TTSH have to be updated about the clubbing scene, but more like they should already know that butter factory is a club since it is the 3rd local cluster. Vicki should not be the one providing them with the info, as they should have known earlier.

I feel that your criticisms are extremely biased. Vicki’s article is balanced and empathetic to the staff’s plight. The system truely needs improvement to contain the pandemic efficiently and your comments isn’t helping much.

Hi rollingballs,

Good points there. I think many Singaporeans are suffering from the helpless complex. Helplessness is what governments use to generate apathy which slightly favour their cause.

By really thinking about oneself as inferior and helpless, the PAP government is already one step ahead in doing in the population to sustain their hegemony. By expecting and depending the PAP government for solution, one is already giving PAP government power over oneself. I hope kopitiamapek can understand this.

The holding area looked like a…..
Few things TTSH need to improve the holding area:
(1) Leather sofa or massage chair.
(2) Starhub HD Channel.
(3) Games console. Better to have PS3 for kids.

Butter Factory should be happy because the exposrure they get from the media. Now I know Butter Factory dun produce butter and the doctor. Why Vicky expect every people know this is a club ??

hi yaya #99,

That’s because Butterfactory was already identified as a H1N1 cluster prior to her coming to TTSH. If TTSH staff are not familiar with that information, who should? There appears to be no situation intelligence by medical staff on the ground.

Hmm… guess they wanted to earn some extra cash from the pregnancy test…

[...] Swine Flu – Singapore Social Activist: Let the games continue! – TOC: The Khaw Strategy – myth or fact? – The Gigamole Diaries: Anthropomorphising the virus – Prof Tambyah’s [...]

To me, blogs/forums are places for diff. voices. However,it seems some are sounding like from HM/TTSH defending their much vaulted H1N1 prevention procedures. Should take criticism constructively. Not happy, can go to other blogs, what. Call things like b**** for what? (ok, sometimes I use strong words too!)

I do sense however that Vicki may have sensationalize her story a bit, but she will eventually learn to get over the many cock-ups in our systems (like being immuned or zombied). The main point is that this could be another TT Durai & Co. NKF stuff. Better safe than sorry with viruses! To dispute her, someone should go undercover and report on the “real” situation — smiling faces, 3-star hotel but clean & efficient, everyone have shoes, knows about penetrative sex, etc… Again, we should be talking about systems, not people.

To be positive let take a brief & unscientific comparsion on bloggers’ pattern. In Reach, the govt blog, I see an official article “Singapore’s Population Trends” posted 22/6/2009, 6:14 PM. This seems to have same discussion scope like TOC’s article “A Nation of Foreigners in 11 Years”, posted 22 June, 12:49 am; don’t know or care who is following who. To date, Reach = 27 postings / 442 views; TOC = 193 postings / 4327 views. Both sites have a high percentage of whinning, no official solutions, less than 0.5% population readership, some posted more than once, blah, blah,… With due respect to all parties, clearly analyzing what’s happening on the net is not as simple as listening to Kopitiam talk, slipping kopi-O. But, if have to put money, who do you think I will go for?

To be sure, I am definitely not pro-TOC, anti-this or that; anyone commenting in a public space is definitely not a little kid, feeding only on MSM/official info. I will jump ship if the discussions are pure BS. Much like Sporeans are jumping to other countries…

I think a little bit of fairness is necessary here. We musn’t forget that the writer’s experience came at a time when there was a sudden jump in the number of H1N1 cases. I did sounded out before (somewhere here in TOC) supporting MOH’s position in maintaining the Yellow Alert level as opposed to the worldwide higher alert level code. This was so that the people manning the triage areas are not overly exhausted before the real influx of cases – which we are now seeing.

One key point missed out by some is the fact that TTSH has been using temporary staff to man its triage screening counters, and these are very young adults who are exposing themselves to such dangers because jobs are so hard to come by these days. Nurses are not administrators, yet they are doubling up as one, for the simple reason that no one wants to be around the vicinity of TTSH, let alone work here.

We should compliment these nurses instead of slamming them. Should the outbreak gets worse, and admin staff start to leave their jobs under pressure from their families (like the SARS outbreak), then we are going to be left with nurses and doctors to handle all aspects of healthcare. These are the heroes, who see healthcare as a calling, and will not shy away from danger. These are the people we will be depending on. Let us be a little grateful instead of being typical – typical Singaporeans as some have mentioned.

Why take it out on the staff of TTSH instead of those at the nightspot? The staff there should have screened patrons more carefully so that party-goers are protected to the fullest. It sounds real stupid to me for the writer to blame the caregiver instead of the germ-trafficker.

It is so sad ! !

The jobless are desperate to take up employment even when they have to expose themselves to virulent diseases. Their job requirements include good co-ordinations which they lack experiences and their lack of experiences burden the Healthcare(Medical staff) staff causing stress and confusion. Then come the typical demanding Singaporeans who want services that tally with the fees they have to pay. Wow ! Not easy.

The above was the situation when there was only under 400 H1n1 sufferes, I dare not imagine when the figure goes beyond 4000, how and what would it be ? And what if and when mortality rate goes up due to mutation or whatever.

It is baffling why pregnancy got involved with the H1n1 screening, there was absolutely no information regarding the effect(s) of H1N1 on pregnancy and vice-versa. Why the insistence on pregnancy test ?

There were also many who questioned the $214 charged for been socially responsible, would it not be socially responsible for the Health Ministry to publicise what the cost stands for since large scale infection was envisaged ?
I would think that the Health Ministry should publicise the procedures members of the public have to undergo for H1N1 Screenings, so that suspected and infected members will know better when they arrived for screenings and treatments.

It is only fair to say that we have to compromise whenever a sudden outbreak or natural calamity occur due to lack of practical and procedural experiences. Having said this, I would urge the Respective Authority to always inform and educate the people on how to react and respond to measures when unfortunate events happen, by using the Media; television, radio, telephone(sms), Internet and publications etc.

patriot

It has been reported again and again in local newspapers and stated by Health officials, both international and local, that the H1N1 infections are “MILD”. Is this really so?

Read here:

http://wywhoo.wordpress.com/2009/06/29/h1n1-local-cases-reached-599/

@104) gemami on June 29th, 2009 12.27 pm
@105) patriot on June 29th, 2009 1.40 pm

I agree that we have to spare some thoughts for the TTSH staff. I mean, so easy for the Ministers/WHO to press buttons, announce this and that over the news with a smirk look, and expect their staff to dance to different tunes.

If a battle plan require 1000 soldiers & there is only 500, does a general sent half trained/equipped troops into battle just to made up the numbers? Whatever happens on the battlefield then, the general just sit in his comfy office tweaking his thumbs! Are TTSH staff paid extra for the increased workload? Are they properly trained, both technically and in PR matters ranging anywhere from 1-star to 5-star skills? Another poor point about our management system — they seldom compliment the staff on their efforts, thus little motivation. Rather they just say this and that, and balked in the glory if things turned out right.

I always said, you can have the best troops (Gurkhas) guarding MSK in a top-security facility, but yet that “bai-ka” can walk out! Where is the root problem? “An army of asses led by a tiger is superior to an army of tigers led by an ass.” Meritocratic society indeed!

I do not know what strategies is MOH planning or already planned. I will just stay away from more crowded places & the MRT.

looks like H1N1 has a simpler & better strategy- show no mercy, exploit all loopholes, and just go forth & spread!!

what doesn’t kill us (H1N1) makes us stronger!!

:P

107) the forgottongen

Your reply is good. Want we need is a good management. Wherether the full time or part time staff, is work the same. TTSH should learn from this and learn to act fast enough to cope with new cases.

94) inix

Another reason could be the hype that comes before all this…the bigger you blow the balloon, the easier it is to burst and create a loud noise

“Butterfactory was already identified as a H1N1 cluster” – smallvice585 @100

Is this very important info published in the health ministry website? including all other identified places. It seems SG is good at following what others have in hardware or infrastructure but when it comes to using it (where it needs raw brains, cannot be copied from anywhere), it all falls flat.

hi Angelina,

it goes to show there are things 1 can copy, there are things that cannot be copied.

“the prove is in the pudding!”, recipe follow 100% does not prove the results will be the same.

To Apek

If someone is ’shallow’ it means he or she only see things on the surface and take it for what it is, he or she does not think further about it, not to mention analyse. Easiest eg for me to show you is from your post “Oh btw, I learned that Ladies night is FOC for the ladies” inferring that it has no bearing on business?

Do you really think that Butter Factory is a charitable orgn for ladies to have fun? The Ladies night is for attracting the male PAYING crowd on the quiet weekday. Without any customer, the owner still need to pay rental, staff and other fixed expenses. So this clever idea is to boost buiness.

Do you also not know that business = economy? If everyone is like you, scared to die, stop going to clubs, cinemas, eateries, supermarkets, in fact everwhere including travelling on public tranpsort, won’t the economy stop?

Hi “mice is nice” #113

Not just Govt depts, but a lot of SG private companies do not know how to make use of the 21st century’s best business tool, the Internet. When they have websites, they usually do not update their info, do not care about what info is there, and do not care about presentation. For Govt depts, it is nothing but meeting requirement to have a website, its a waste of internet space!

114) KhawSense

Firstly, I shall assume that “To Apek” refers to KopitiamApek and thus your post is directed at me

For clarity of whom I am replying to, I rather address you in full as KhawSense , not Khaw or Sense or KS or any other abbreviated form.

Thank you for sharing your defination of “shallow” and your kind effort in explaining by using the easiest example for me to comprehend using my own post “Oh btw, I learned that Ladies night is FOC for the ladies” .

You went on to say that my post “Oh btw, I learned that Ladies night is FOC for the ladies” was inferring that it has no bearing on business, and took the trobule to elaborate your point with an entire paragraph. I even can agree what you wrote in that paragraph about the clever biz idea.

I only have one further question.
From a sinle sentence I posted “Oh btw, I learned that Ladies night is FOC for the ladies” .
how did you, in your non shallow ways which I suppose you will see things beyond the surface and take never it for what it is, think a whole deal further about it, and analyse and finally arrive at the conclusion that I was inferring that it has no bearing on business? and thus I am shallow by your defination.

Please share your deep analysis with shallow old me.

And you stated that that was the easiest example, may I infer that there are other non easy examples?

104) gemami

agree with what you posted. a balanced view,

///Why take it out on the staff of TTSH instead of those at the nightspot? The staff there should have screened patrons more carefully so that party-goers are protected to the fullest. It sounds real stupid to me for the writer to blame the caregiver instead of the germ-trafficker.///

the germ trafficker gave the writer a night of fun (at least while it lasted) and it’s FOC on Ladies’ Night; but the care giver gave her a bill. : )

98) smallvice585

///Good points there. I think many Singaporeans are suffering from the helpless complex. Helplessness is what governments use to generate apathy which slightly favour their cause.

By really thinking about oneself as inferior and helpless, the PAP government is already one step ahead in doing in the population to sustain their hegemony. By expecting and depending the PAP government for solution, one is already giving PAP government power over oneself. I hope kopitiamapek can understand this.///

Since I have been mentioned in the very last part of your post, I will post my humble and what some have even branded as “shallow” response.

By really thinking about oneself as inferior and helpless, one will be inferior and helpless PERIOD.

regardless, if it is a PAP gahmen, or whatever gahmen.

Helplessness is also being in a perpectual a victim frame of mind whereby one thinks that everyone out there (the gahmen included of course, and for this subject, the TTSH, but not ButterFactory) is so dung unfair to him./ her and thus justify his miserable stae of life he/she is now.

What one can control in one’sr life (and which is a large proportion) one should take control, after you do that, helplessnwess will desert you, and you will not have the need to blame others for our life’s screw-ups caused by our own victim state of mind.

109) mice is nice !!

///what doesn’t kill us (H1N1) makes us stronger!!///

actually you got a point there.
we get our immunity through exposure.

97) rollingballs

I note your feelings that my criticisms are extremely biased, but agreeing to disagree, your post is also, if I may borrow your words, “extremely biased”.
It is all a matter of how one choose to look at it.

btw, plastic chairs are very where in private GP clinics too.
Would it hurt to tell those TTSH staff upfront what ButterFactory is rather than to kick up a fuss over that? she should conserve her energy while her frail body is trying to recover, not wasting it with anger and resentment.

Hi theforgottongeneration on June 29th, 2009 2.41 pm,

It is true that no one should go into battle unprepared, and that it is all too easy for one or two ministers to press some magic buttons and hope that the battle is immediately won.
This is why I am hoping that such articles take into consideration the sentiments of the ground staff, who are really working their butts off trying to make the magic button work, like the big shot ministers hope it would.

From day one since the news of the outbreak leaked out, we have been implementing one form of measure to another almost on a weekly basis. This past week, the directives coming out from the hospital authorities, based on MOH guidelines, are evolving almost on a daily basis. Many temporary staff have also left their jobs, and with the scenario not about to improve but getting worse, we are beginning to see some staff resigning already.

With all these happening around the healthcare environment, even managers and executives are having to chip in to fill all these gaps left behind by the sudden string of resignations. Yet, on the battle front, we are doing all we can to make it as comfortable as possible for anyone stricken with the H1N1 virus.

One thing the public must not believe is the proclamation that we are well-prepared because of our experience during the SARS crisis. Far from it. This is a new challenge and a totally different one. Where SARS was concerned, there was no margin for error because it was so deadly, so we were more stringent and left no stones unturned. Perhaps, with the H1N1 virus, the level of emphasis is lesser because it is not so deadly. However, one must not question the integrity of the doctors and nurses who battle on at the frontlines.

Hi Patriiot,

It is not an easy job as you have rightly described it. I must add that the biggest concern that weigh heaviest on the shoulders of the front line staff is the fear of contracting the virus while in the line of duty. There is always the concern that the virus might mutate and the new strain becoming more fatal than the current one. Who then would want to be the first to acquire this new strain? If it is a deadly mutated strain, death is a certainty.

This is why I hope the public could be a little kinder to these brave citizens who are there battling it out day after day. Give them encouragement and save your rebukes for whatever deficiency or lack of efficiency. They do not deserve them.

You asked for information regarding the effect H1N1 has on pregnancy. The H1N1 strain of the Swine Flu, is a new strain – and because it is a new strain, no one knows exactly what impact it has on different medical conditions. The only information it can depend is on those that have been recorded where past (closest) similar strains have occurred. And pregnant women is one group that is more susceptible to infection. That’s why the added precautions.

I believe the writer’s account arose from the strict guidelines provided to the frontline staff to ensure that certain ‘compulsory’ questions must be asked. Exercising one’s initiative is not an option in this current situation. And this must be the reason why the nurse had to asked the questions she had asked. Why take offence when she is doing what she must do? She does not have a choice.

As for the $214, I find it quite shocking when it was first revealed. I still find it shocking! No one should be paying one cent for this fight which even the world’s best government could not contain.

Vicki,

When it comes to new diseases, when it comes to outbreaks, your basic human right and choice is secondary to what the hospital is deem necessary to make sure that you are not a carrier.

It is probably standard protocol for them to test for pregnancy, even if you claim to not have had sex before, or for the last 6 months in such situations. Who is the nurse to believe? Your word? What if it turns out that a girl who says, I am a virgin; turns out to be pregnant 1 month later? What if H1N1 caused this pregnant girl to miscarry and puts her life in danger? Will you then drag the nurse out and stone her? ‘She was suppose to do the test no matter what’ you all may cry.

We do not understand the virus fully, and so a blanket series of tests are needed.

However, I believe that your other complains are valid. I do have medical background, I know the importance of training and well documented protocols.

Jin Xian:

If you had read the article properly, you woulf have known that the nurse said that the pregnancy test was needed before taking an x-ray. Foetus exposed to x-ray have higher chances of developing complications, especially if the x-ray is exposed through the abdomen.

Even then: diagnostic x-ray seems to be pretty safe for unborn babies, especially since I would think that this is only a chest x-ray (for lung check).
http://www.babycentre.co.uk/pregnancy/isitsafeto/xrayduringpregexpert/

Nothing to do with N1H1.

Dang.. H1N1 it is. Swine’s easier to get right.

Amused:

Isn’t the X ray part of the battery of tests needed for H1N1? yes, the X ray will cause complications to the foetus too – I assumed everyone would know that. Its H1N1 that most people don’t understand and probably will brush off.

hi KopitiamApek,

post #119

////actually you got a point there.
we get our immunity through exposure.////

i was refering to H1N1 getting stronger…. -.-”

KopitiamApek

Let me refresh your memory.

My post: ////. Its great that the girls went to have a good night out. The economy will collapse if everyone behave kiasi////

Your rebuttal: //If economy depend really on the girls going to the club, we are indeed in deepsh*t.//

- Aren’t you indeed saying that the customers at the Butter Factory has nothing to with business which has nothing to do with the economy?

Another of your rebuttal still to the same issue: //Oh btw, I learned that Ladies night is FOC for the ladies.”//

Aren’t you saying they are not paying customers so have nothing to do with business? BTW, besides drawing the male crowd, the girls have to pay for drinks, I suppose only entrance is waived.

With regards your earier post @45:

my post: /// This girl is ill for goodness sake! Try smiling when you have a fever and the worry of being contaminated.///

your post: //The sequence was in the wrong order. the worrying should have been done before going to Butter Factory not after.//

- Butter Factory might as well close down and the whole MRT system might as well shut because of the infected passenger who travelled by train. Otherwise if you are infected, it means you are asking for it.

my post: ///I thought Spore is filthy rich, and the civil service is gold standard, as the Govt always boasted, so why is it not right for people to expect 5-star hospital service hah? And we pay so much you know! ////

your post: //It chicken and egg isn’t it? want 5 stars standard, complain high price, please select one

- Didn’t you read my last line, “And we pay so much you know!” Pay high price get no star service.

@121) gemami on June 30th, 2009 8.02 am

Yes, it is difficult to be at the frontline, isn’t it? I guess that is why there are many questioning, e.g. about their NS liability. So easy to take in FT/FWs like nothing, then sit back & leave it to the Sporeans to “integrate”/defend these people. Press buttons only what.

Recall, initially I said even a five-year-old can have strategy;-
* Pressing button — “Khaw” strategy
* Implement plans — “TTSH” strategy
* Test effectiveness — “Vicki” strategy
* Brainstorming — “many” strategy (& some are real nasty in their strategies here!)
* Footing the cost — “sotong (aka socially responsible) person” strategy
* If things go wrong — “TTSH” or “Vicki” or “socially irresponsible person” strategy
* If things turn out wonderful — “Khaw” strategy

Simple, right?

Dear Gemami;

appreciates your address very much, knowing that You are a staff in TTSH, me thought You would appear here and You did. Thank You for the informations and hope that You did not miss my call for compromise for sudden large scale and unknown outbreaks. Two of my children are staff in TTSH as well and my spouse has worked in healthcare for 35 years and with my mother warded infrequently at CGH resulting in me visiting so frequently, I am a little aquainted with hospital routine and protocol.

As I have posted above, I would still call upon the Health Ministry to disseminate timely informations and guidelines to members of the public on how they should prepare themselves when infected and affected by contagious diseases. Hope that such informations and guidelines WILL BE FREQUENTLY AND WIDELY PUBLICIZED OVER THE PUBLIC MEDIA. This measure will greatly help in calming the patients and their families which will in turn reduce the burdens of the Medical Staff having to deal with anxious inquiries and queries which could lead to unneccessary misunderstandings.

Once again, I call upon patients and family members to understand that Medical Staff are highly stress and expose to dangers themselves in such challenging times. AS SUCH, LET US GAVE THEM THE GREATEST CO-OPERATIONS AND UNDERSTANDINGS.

CHEERS ALL

patriot

128) KhawSense

Thank you for spelling KopitiamApek in full.

Your post #128 is a rehash of your post #114 with no new substance added. as such provided no answer to the question I posed to you.

Instead it raises an addtionnal question from me on what you wrote in the last line of post #128. …///Didn’t you read my last line, “And we pay so much you know!” Pay high price get no star service.////

There is no mention about any monetary value in this article. So where is the high price you are refering to,may I know?

Hi All;

I like to make a spelling correction to the Word ‘aquaintance’ in my earlier post; it should be acquaintance, my wrong.

Just came from Blogger utopia 8787’s Site; got this information in his Latest Thread (linked to Singapore Daily 30 June 2009) that a foreign based Singaporean, Zaiton Rosie, was given a free(no charge of fee) for a H1N1 Screen. We also learnt that another Singaporean Dapnne was charged #214 for the H1N1 Screening, here.

If Foreign Based Singaporean, Zaiton Rosie, was indeed given free screening for H1N1, then the Singapore Authority owes all Singaporeans an explanation for the discrimination against Singaporeans for charging them fees for H1N1 Screening.

Hope TOC could do all Singaporeans a favour by probing into this information further.

And any parliamentarian and or senior civil servant reading this comment, please be responsible to provide an explanation.

patriot

Like to make one more request that number of cases and locations where cases happened be updated regularly over the Media.

Me watch and listen to radio most time of the day and found that other news other than the H1N1 developments, always hoarded the headlines.

The H1N1 , though of low mortality rate, could mutate without warning and as we seem to be one of the worst hit, it is only commonsense to know that more are infected each day. It is therefore imperative that any preventive measure, including updatings of the last case, be made known as soon as possible, regularly.

Hope the Authority will act seriously.

patriot

132)Patriot
I just came to know there is such a thing call Foreign Based Singaporean,screening also free ?got such priviledge meh?How to apply?

Khaw is a player, he does what his master tells him to do. By taking subsidies away with means testing (good marketing), he is only a profit driven guy. Do you think he really cares if we cant afford? He already said we can consider JB.

Hi theforgottongeneration on June 30th, 2009 6.43 pm,

I like your reasoning. It flows very well and I cannot bring myself to find any fault with your line of argument. Hats off to you.

Hi Patriot,

First of all, I wish your mother well. Hospital visit is truly an unwelcomed chore.
I agree fully that MOH could do better. Me too am finding it hard to get real time updates. People like me are the first to get the most updated news, yet, we are just as ignorant as anyone else. We do get to hear trickles of this and that but most times no one can say for sure if what we hear are true or not.

It is quite chaotic these past two weeks and that’s why you don’t see me posting as regularly as I do. But believe me that we at the front line are doing all we can to assist patients and make their visit as pleasant as we possibly can.

@patriot

I’m not sure who is right or who is wrong, but AFAIK, hospitals does not, and is unable to make a distinction of foreign based / locally based Singaporeans. And I would be uncomfortable as such should they make this distinction.

How are they going to check? Can you please bring your passport?

Hi Inix:

As I have mentioned in the earlier post, I happened to read utopia8787 Latest Posting captioned: ‘Evidence of locals becoming second class citizens’ which is aggregated at The Singapore Daily Website on 30th June 2009. It is in there that I got the information.

May I suggest that readers pay a visit to utopia8787 Site or access it via The Singapore Daily.

patriot

Jin Xian:

From the article:
“All H1N1 suspects are supposed to have their blood samples, two swabs of mucus and fluids taken from them to be tested, as well as X-rays.”

Based on the article alone, I would not be able to tell for sure if a pregnancy test is part of the battery a suspected infected person has to go through as it is not mentioned.

As a layperson, I find the X-ray requirement to be strange though. We can detect flu viruses from X-rays now? And what’s the blood sample test for? I thought the virus is tested from the mucus swabs?

Here is another account (about 1 month old) that I found. It is pretty similar to Vicki’s:
http://www.zdnetasia.com/blogs/bcp/0,3800011228,63011292,00.htm

Patriot

I am really amazed that in ‘high tech’ MOST WIRED Spore, crucial info from the civil service to the population cannot be communicated.

Same for hawker gradings & criteria not found in NEA website. Do hawkers even know what is required of them to get A grading? Me thinks it is hygiene but hawkers think its cleanliness?

Same for immigration policies. Are we allowed dual citizenship or not?

Same for postal customs policies. What is allowed and not allowed?

Same for “help for the needy”. Any clear guidance on how to get help?

Many, many other things.

News is useless without someone making sense out of it.

Otherwise, more news is just more confusion.

There is definitely room for improvement for MOH’s public relation strategy.

Hi Angelina:

just my impression, can’t say if I got it right, the Local System is full of bureaucracy, full of form, but little substance. Everything is so rigid, everyone wait for another to make decision, so in case something goes wrong, the decision maker will be answerable, this is one. Another will be the show of power by superior over subordinate, question like ‘who are you to make decision ?’ when the superior is out to make working life difficult for worker etc.

Free play of commonsense and initiative are normally disallowed, work flow, inter departmental and multi organizational(Different Ministry) co-ordinations are usually poor. Advanced equipments and Modern Information Technological are not able to overcome bureaucracy plus rigid officialism and poor co-ordination/co-operation in Officialdom. This is a fact and glaringly so in local context. Most Singaporeans are likely to have experienced officialism when dealing with Singapore Authorities.

Let us just hope and pray things will change for the better soon.

patriot

@140) Angelina on July 1st, 2009 7.43 pm

Concur with #142) patriot on July 1st, 2009 9.25 pm

Just announced SAF is now much more networked together using hi-tech stuff. Does this means end of all its trademark/copyright cock-ups, Murphy’s Law, S.A.F (Systems All ******)?

Yippe! hope it also mean reservists don’t have to manually re-doublecheck if their service records are correct EVERY year. (But records supposedly computerised years ago, leh, otherwise how they print out sheets for us to check?). Light at end of tunnel… recommend 6 months bonus this year!

Agree with smallvice585 on July 1st, 2009 8.14 pm. We need people who can make sense of the news that are being dished out.

Hi Angelina on July 1st, 2009 7.43 pm,

An interesting point, that we so wired up so much so that we are geting confused by all the wirings. Technology is supposed to make things and make life easier for all. And with the civil service getting on board the online platforms it was meant to be an avenue for all to be better connected and therefore, better informed.

I have carried out some investigations of my own regards the claims by Vicki above and by those who have posted links (Amused on July 1st, 2009 2.11 pm ) to similar cases being reported. I have also checked with my colleagues who have returned from some of the affected countries and who had to go through the H1N1 Swab test.

There is some truth to some of the claims and most certainly, there is a lot of room for improvement to help those who come for the swab test to be better managed. (We have to keep in mind though that most of the assisting staff are temporary or contracted ones).

Some changes have already being implemented, for example, patients can return home while waiting for the test results, and results are produced at a faster rate of between four to five hours. This is in keeping with MOH guidelines issued earlier this week because of the sudden surge in cases.

The key point to note here is, like I have mentioned, the situation is always evolving. What we are doing today may be different to what we will do tomorrow. It all depends on the situation. Should the virus be found to have mutated today, you can bet that another round of confusion will be the order of the day.

We at the front lines will then have to brace ourselves to work around these changes.

@patriot

Just read the article. Indeed the guy didn’t pay, but it did not mean that the hospital gave preference to a Singaporean who lived overseas.utopia8787 simply inferred that the hospital is doing that without any proof.

Sure, the guy went home without paying, but coming from one who just returned from TTSH 2 weeks ago, I did the same thing. I didn’t pay a single thing when my wife was discharged, nor when my wife exited the hospital A&E’s outpatient just 1 week ago.

I just got my bill 2 days ago.

I really don’t know if they have any proper IT automated system in place to handle these situation. Most likely a semi-auto/manual system which is prone to operational hiccups.

I feel that they can be better prepared after the SARS incident many years back.

Hi Inix Post #145:

noted your Comment.

There was probably some misunderstandings in the billing procedures, I am not too sure.

I am confused and had expressed so in a later posting I made at said utopia 8787’s Article. Maybe need to wait for more feedbacks.

Dear Gemami:

I like to thank You sincerely for your wish for my mother’s recovery, she is doing fine now. Also thank You for the informations with regard contingency measures and operational difficulties and hiccups in implementations. Quite as expected though, as some negative human factors are always at play, unavoidable shall I say.
Fortunately, H1N1 has not been/being deadly and let us hope that it will end soon.

Cheers !

patriot

doctorwho #146

No need any proper IT system lah. Just post clear procedures and info of where cases occur in the website, with daily updates. This is the very least expected of a “most wired” nation led by an “A-team”. Moreover Spore is sooooo tiny. How do you think the US or UK can disseminate info to the whole country?

Is the website just another thing for show only? Others have we must oso have.

Khaw should order the info be posted in the website with daily updates, and issue a press release that the info is available in the website, advising the public to check it daily.

The way I see it, these ministers and all are just not sincere in what they want to do. Its not about ignorance or lack of inteligence.

website is for show, there are ah peks & ah mahs who dun even have PC at home.

to err is human, but some are just complacent lah.

Good point, but most of these ah peks & ah mahs have children or grandchildren who can inform them right? I thought every school has computers and every child in SG goes high-tech?

The ah peks & ah mahs who do not have internet access most likely do not go clubbing right? SG is small, word of mouth will reach them & ignorant adults if MORE people are better informed.

hi Angelina,

you think all those ah peks & ah mahs bond so well with their children & grandchildren meh.

eh, who’s job is it to disseminate the info? those with the info must be proactive lah, S’pore infrastructure so advanced can do with a more efficient way of spreading news. dun taichi that responsibility & say “its now up to individual aka social reponsibility”…

if so, then its like “kampong strategy” liao, not world class anymore…

the info must be able to travel faster than H1N1 (person-person) right? if H1N1 spread faster than our healthcare providers can inform the public, then really they should change vocation liao… & better go E2i sign up for retraining!!

^.^

OK, so are you saying the internet is useless in SG context because ah peks & ah sohs have no access? If the cyber superhighway for disseminating info is not good enough, its finished! China & India have sprinted pass us and we are still crawling. Don’t even compare to US or Europe.

84) ah soh

Apologies for responding almost seventy posts later.

///if any night entertainment organization gives free entries to ah sohs(over fifty yr old), I will also want to patronize. ////

there are

///Btw, Sir, You can help to increase the readership in TOC, tell your drinking khakis(fraternity), the kopi soh, kopi muays and others about this site. The more(readers/posters) the merrier, and may be we can have more companies.///

Yes. and with wireless@SG at all the koptiams, all of them will be feverishly typing to post at TOC with their laptops while their kopi-O to go cold.

@doctorwho

Hospitals spend millions in IT but still won’t have a fully automated system. It is just not possible. Even with the best systems, a human factor must be involved, and its just much more difficult for a hospital to buy equipment, as compared to a normal business due to various highly varied concerns.

Each system in itself might be an improvement, but might also result in additional workload. A recent case in point would be the electronic prescription system. It reduces errors, but no doubt causes more pain for doctors who now have to login and do data entry when it wasn’t necessary in the past. So which is more efficient? Different measurement results in different value.

Even if we measure it in payment terms, it will post another challenge. What about families who want to just get out of the hospital ASAP? Do you make them pay first before they can leave? Procedures and technology can only resolve some issues, but unfortunately, not all issues.

@Angelina

Easier then it sounds. Procedures need to be learnt, need to be trained, need to be practised. No procedure, no matter how perfect, will work 100%, when people are getting used to them.

In the context of H1N1 and TTSH, people arn’t able to get used to it at all. Not when its changing at a daily basis due to the changing nature of the flu pandemic. Give the guys at TTSH a break. These poor souls are working their ass off.

@Angelia #153

Do you read every website everyday? Do visit http://www.flu.gov.sg everyday? Or every second for that matter?

Do you know how many person died in Iran over the past 2 weeks?? Do you know how many people are dying this very minute in USA? Do you know how many people are queueing up at TTSH at this very moment?

I don’t believe you can answer yes to every question. And unless you do, don’t have the expectation that news can be spread to every tom dick and harry. There will be people who misses out, one way or another.

hi Angelina,

////If the cyber superhighway for disseminating info is not good enough, its finished!////

the internet may be commonplace now, but that does not mean its a catch-all media where everyone (i really mena everyone) is plugged in & logged on daily.

looks like Inix has beaten me to the post.

////There will be people who misses out, one way or another.////

this is a good case study on how critical info is disseminated. luckly H1N1 fatality rate is low, this goes to show there are serious flaws in the system. this is not the case of social responsibility gone out of the window loh…

Wow! How did we end up discussing ‘Information Dissemination’ in a topic about ‘Khaw’s Healthcare strategy’?

Based on the arguments between Angelina and the others, one can deduce that there are two different lines of arguments here, and both are valid enough to take a closer look at.

Angelina questions our super-high internet connectivity and why it is not able to do the job it is supposed to do, while others like mice is nice and inix ponders over whether the people handling the job are qualified enough.

It is true that with better internet connectivity, one would expect better information management and dissemination. However, this is dependent upon the people who are responsible for data collection.

From my own experience and from what I see around me in my workplace, I would agree more with inix and mice-is-nice. We can have the best systems, we can have the best link-ups and connectivity, but the data that the system works on, relies very much on who sits behind it providing all the required data. And these data have to come from those who work directly with infected patients – the doctors and nurses. And the doctors and nurses are so busy fighting the battle at the frontline, how are they to sit down and provide the data – which may change from one minute to another?

In the case of H1N1, even expert opinions on its infectious intensity and whether it will mutate to a more lethal strain are divided. How then can anyone provide data that are not yet conclusive? It is like trying to catch water with your bare hands. You can’t. So instead of wasting time, resources and energy trying to draw up something in black and white over a virus that no one can clearly say for sure how mild or lethal it may be, or how it is going to evolve, isn’t it better to channel all these effort toward the battle at the frontlines?

There is the added danger of providing the public with information that change from one minute to another because the information may become irrelevant after they are published – causing more confusion then help.

If you ask me, I would rather sit on plastic white chairs, for hours if needed, to make sure that I do not have the virus (especially when I know I have been exposed to it). I can then sleep peacefully each night, knowing that my family and friends are safe from any transmission from me.

159) gemami

The Fog of War may describe the current H1N1 situation TTSH and related healthcare orgs are in.

in the early kampong days
it was a picnic for the whole family when there was a typhoid/tb epidemic
there was no chairs no tents
just stand in line to be jabbed
than agin
durin the kampond days
there was no $85 min charges as well
not even $0.85cents…….

but
all in all
typhoid/tb epidemic was CONTAINED
that is the sole purpose!
~period~

161) whenmatasworeshorts

also standing in line with pails in hand
to collect a day’s supply of water
during the super dry seasons when we were deprived of rain for weeks
reservoir level worryingly low

161) whenmatasworeshorts

also those days, most have no money to splurt at ButterFactory lah
and even less opportunity to be educated (paid by the state) sufficiently to be literate enough to be posting on the internet to complain about lousy TTSH service after a good time at ButterFactory.

hi Gemami,

true, the pace of the spread makes little sense to put too much effort on being constantly up-to-date. besides, i think (i dun really have indepth knowledge) healthcare staff quite understaffed, therefore the lapse is understandable.

………………………………………………………………………………………………………………………….

hi KopitiamApek,

eh, maybe the fog of war is just miscommunication? well, the same with real wars in the present day.

eh, times have changed, so have expectations. if we are still satisfied with things being done a few decades ago, then is sad that no progress has been made. people who go ButterFactory do go there to have a good time, i can’t say the same about people going to TTSH for a good time. lol….

apples & oranges?

164) mice is nice

Agree. times have changed, so have expectations.
but higher expectation must comes with higher cost
not being satisfied with things being done a few decades ago, and demanding progress, one must correspondingly expect to pay more for the better services.

As much as we want our own pay to rise, so do the people employed to carry out the service and that will translate into higher cost which the end user must be prepared to pay. It is either that, or it get paid indirectly by taxpayers, regardless if the are users of that service.

Decades ago, we are content with crummy boneshaker buses, much like what we see on TV in some 3rd world countries with passengers precariously hanging at the doors, and they come like once a week (joking) and the bus fare was max 50 cents. Now we have fully aircon buses, if they arrive 10 minutes late, the driver gets a warning if there is a complain, all these cannot come without a higher cost.

Similarly the hospitals of time gone by are places you will not want to stay if you don’t have to. The C class wards can have 60 beds in a huge hall, no screens , no phone, no call button, no TV, no nothing. A sick person can yell all day for the nurse to come to his aid, and the poor guys in the surrounding beds have to endure his yell, all that for a grand sum of $4 per day. A plastic chair was a luxury. The visitors have no chairs.

The better things we have now are possible because the past generations worked to make what we have today. To sustain it and make it even better will be what the present generation should works towards. We all have the right to higher expecation. But when some start thinking that it is a birth right just because they are born at a better time , then that it is really when the progress stops.

hi KopitiamApek,

our quality of healthcare correspond to the price? 1 wonder where the bulk of the money went to. just because frontline staff put in more effort to deliver quality service does not mean their pay go up in tendom. frontline staffs’ salary has been hovering where it was years back, with little or no increase. so your point where 1 is to pay more for better service is flawed.

either way, in S’pore many things are way overpriced, the link between cost vs quality in S’pore’s context is a weak 1.

not everything is open to market forces, our public transport is certainly 1 of them. anyway let’s not venture about public transport issues here.

I find it annoyingly hypocritical when people are at one point bitching about their supposedly low pay while asking for more, and at the other point, bitching about how the rest of the Singapore has somehow became more expensive to be in tandem.

166) mice is nice

///quality of healthcare correspond to the price?///

my point is that when service level and infrastructure improves, there must be a correspodning increase in price
whether the current charges correspond to the cost of providing the current service level, I am not position to comment on this , as I do not have privy to the info

/// 1 wonder where the bulk of the money went to. ////
I am not position to comment on this too, as I do not have privy to the info

166) mice is nice

///not everything is open to market forces, our public transport is certainly 1 of them. anyway let’s not venture about public transport issues here.///

venture little bit lah
the train operators are running it to be commercially viable
whether they are making tons of profit I am not too sure
but this is certain, the cost of buiding the MRT infrastructure, in billions to date, is not borned by the operators. The gahmen built it and handed it over to the operators at no cost
otherwise we should be paying a lot more to use the trains

166) mice is nice

///staffs’ salary has been hovering where it was years back, with little or no increase. so your point where 1 is to pay more for better service is flawed.///

there must be some increase lah
and secondly, even if these poor healthcare sector staffs really have been so sway to have no pay rise for years, and have not quit in protest yet, the improved service level could also come from having more staff, thus also translating to higher cost.

Hi KopitiamApek,

points in post #168, on July 4th, 2009 9.02 pm

////my point is that when service level and infrastructure improves, there must be a correspodning increase in price////
point taken, but its an assumption.

////whether the current charges correspond to the cost of providing the current service level, I am not position to comment on this , as I do not have privy to the info////
then why you assume the above huh?

////I am not position to comment on this too, as I do not have privy to the info////
no problem, not everytime we will have all info on our fingertips.

post #169, on July 4th, 2009 9.08 pm

strange, now you change tact. comparing bus services decades ago & the current. things have changed, like the way its run in the past vs now. here’s your earlier words.
////Decades ago, we are content with crummy boneshaker buses, much like what we see on TV in some 3rd world countries with passengers precariously hanging at the doors, and they come like once a week (joking) and the bus fare was max 50 cents. Now we have fully aircon buses, if they arrive 10 minutes late, the driver gets a warning if there is a complain, all these cannot come without a higher cost.////

besides, the way bus services is run & how hospitals are run is very different. many take bus everyday, but not all go hospital everyday.

hi KopitiamApek,

post #170 on July 4th, 2009 9.15 pm

////there must be some increase lah////
you guessing only is it?

////and secondly, even if these poor healthcare sector staffs really have been so sway to have no pay rise for years, and have not quit in protest yet, the improved service level could also come from having more staff, thus also translating to higher cost.////
eh, you again guessing that there is an improvement in service?
there may be more staff now, but there also may be more patients, heavier workloads, & the increasing complexity of health threats in the form of new & novel bugs. as for higher costs, let’s not forget those space-age medical equipement can easily cost more than $***k.

171) mice is nice

to clarify where I am coming from…
when service improves, there must be a corresponding cost increase. I think it would be fair to say that, correct? that is not an assumption,

but wether the quantum of increase in cost matches the increase in service qualiity is what I cannot ascertain.

on the bus example, no change of tack mah? same line of thought as healthcare example.

I do not quite get your point on this leh “besides, the way bus services is run & how hospitals are run is very different. many take bus everyday, but not all go hospital everyday.”

167) inix

One needs to appreciate the interdependance of labour cost and cost of services and goods. If we want a higher pay, the services and goods in the sector we are in will have to cost more. In order to keep cost down, local labour gets replaced by imported labour. So thus the issue of foreign workers, local pay, and cost of everything are all in a interdependant web.

But of course, the magic solution here in TOC is Temasek’s lost biilions and million dollar minister pay.

2 wrong don’t make one right.

hi KopitiamApek,

ah, you have a point but the reality is not like what you have said- to justify the increase in price.

healthcare & public transport have very different target “customers”, so i dunno why you bring up such a comparision. the only similiarity is that both cater to society’s need, but in very different ways.

dunno how to expain in depth, but if you still dun understand then i think other posters could chip in to explain to you.

please do. I am here to learn

@mice is nice

Putting Public Transport aside, I think Healthcare is a very industry to regulate. The fundamental problem IS money. Money talks and unfortunately, the healthcare / pharma industry is dominated by money and the Govt don’t have it easy trying to manage this.

1: Healthcare is expensive – Why is it expensive? Well, the following reasons apply

Labour – Nurses today are paid significantly higher as compared to yesteryears. Not to mention doctors / specialists

Medicine – Medicine is also getting to be increasingly expensive. The rich country get charged more syndrome unfortunately also applies to us. It gets extra annoying when we see that Thailand and Malaysia drugs are often 50 – 60% cheaper then SG.

Equipment – Again, better healthcare = better healthcare equipment. All the MRI, CT scan machines all need money.

Productivity Enhancements – Hospitals are consistently upgrading their hardware trying to improve on their service. SMS updates (so that you don’t wait there like a fool), computer prescription, drug delivery all are aimed at providing better service. But they come at a cost, and it isn’t small.

Lack of Doctors – People keep bitching about the fact that we can easily sidestep the issue by increasing the number of places for Doctors in NUS / whatever. The issue isn’t this simple. If its about money, we can pump, but Medicine can kill if applied wrongly, and I am not comfortable if it aint the best who become Doctor.

Most certainly of all, I don’t want any tom dick / harry to become a doctor.

The next issues that faces KBW is the private vs public hospital issue. There are challenges to both ends fundamentally. If Singapore do what Malaysia do, go free medical on Public Hospital, would it create a Public is crap, Private is better situation?

This is exactly what is happening in Malaysia where the Govt Hospitals are unable to compete with the Private Hospitals due to the huge brain drain by the private hospital.

Next, how about the problem of having to look at all frivolous cases. Already the A&E is overloaded, by going free healthcare, won’t we result in a much heavier load for the hospitals? These are very practical problems which countries like AU are facing today and still have no answer for.

I personally think that what can be done, is the following;

1: Expanding the Private Medishield Scheme. Make it compulsory and all kids must (and the law must mandate that all babies can be) insured from birth and not 30 days after

2: Cover all in-patient & out-patient treatment via this insurance, and double healthcare budget to fund this portion. Its currently around 3% of GDP, and we can have it up to 5% of GDP.

3: Cover all pre-existing issues for Singaporeans, and up all Medishield related Medical Insurance Premiums 50 – 100% to around $300PA under 40 years old, and $500PA under 50 years old.

4: Setup a Government Fund for Singaporeans (PRs not involved) where Singaporeans will be able to apply for Private Medishield Insurance paid for by the Government for the needy.

5: This can be afforded by a corresponding increase of GST to 10% as a corresponding increase in income tax wouldn’t get the same results. With this proposal, I suspect that we will be able to get a better healthcare system as no one will be denied healthcare / made bankrupt due to healthcare, but the trade off is to pay slightly higher taxes.

176) inix on

Very well written and accurate observation of the health care situation.

///1: Expanding the Private Medishield Scheme. Make it compulsory and all kids must (and the law must mandate that all babies can be) insured from birth and not 30 days after///

I stand corrected, but I do believe this is on the cards.

A&E overloaded is a problem for decades that seems to never go away,
if I may use this anology, it is just like building more roads, and this encourages more to use it and then, hello traffic jam!

Brain drain is also a long standing hard to solve issue.

Opening up the medical sector to foreign doctors will be worth exploring. The medical sector should not be so special that it is shielded from internatonal competition, and that will drive up the quality of doctors in SG, and keep the fees in check.

hi Inix,

i agree with what KopitiamApek,

you have put together a comprehensive list of reasons why healthcare costs are not cheap.

put to rest the case of why paying more does not mean service standards have gone up in tendom.

:)

178) mice is nice

///service standards have gone up in tendom.////
that part we can agree that is hard to measure

178) mice is nice
agree.
put to rest the case.

167) inix on July 4th, 2009 2.40 pm

“I find it annoyingly hypocritical when people are at one point bitching about their supposedly low pay while asking for more, and at the other point, bitching about how the rest of the Singapore has somehow became more expensive to be in tandem.”

Inix,

Are you saying medical fees will never be increased for higher profit gain? Is there an independent body making sure hospitals or medical service providers do not make profits or only make a limited profit? This applies to everything else like transport and HDB.

Please inform forumers if you know of any independent bodies keeping profit figures in check. Unless you can name the orgns doing this, you cannot make the above statement blaming people’s ‘hypocricy’. Pls bear this in mind whenever people whine that costs have all gone up and wish pay has gone up too.

inix

If you are really that ignorant, here is how businesses work:

Anything on top of costs = Profit

Costs include workers pay (the other big component is rental which of course the state owned businesses like HDB does not need to worry about)

Therefore in business oeprations, the lower the workers pay and the higher the price you can sell for your service or goods, the higher the profit. Pls get this in your head that it is not necessary the case that things are more expensive because of higher pay.

@Rafflesian

If you had came up with a better reply, I would probably have follow up with an extended reply like how I would commonly do in my previous replies to other posts. But with you, I will only say this.

If businesses is all about costs, then unfortunately, or fortunately I should say, you have no idea how business function. This might be something new to you, but nevertheless, learn this new phase. Value Creation is what business is all about.

Go back to school and learn some basic stuff before you call me ignorant. Until that, I’ll not be wasting time with your posts :)

mice is nice & inix:

“the internet may be commonplace now, but that does not mean its a catch-all media where everyone (i really mena everyone) is plugged in & logged on daily.”

- When the radio was first invented, we can also say, the radio may be commonplace now, but that does not mean……. It applies to newspapers, if people can’t be bothered to open it and read, it is no use.

You carry on thinking this way and you will get left behind. If I make a press release (assuming I have the power to do so, like Khaw), that places with major outbreaks are posted in the website, will YOU really not be bothered to plug in? If you can’t be bothered to plug in, then who is to blame?

inix:
As for procedures implementation, of course it is not as easy as we think but Khaw made a statement that Spore is READY which is what all the fuss is about in this article!

inix @184

You said “Value Creation is what business is all about.”

Really? Business is NOT about PROFIT?????????? LAUGH TOO MUCH NOW!

inix,

Pls, you must tell forumers which business school did you go to. Allow me the pleasure to repeat your statement:

“Value Creation is what business is ALL about.”

Still can’t stop laughing.

what can u ask for. We can have Malaysian, Indonesian, Indian as MP and Minister.
Have you ever come across Indonesia, Malaysia, India have Singaporean
as Minister?
Phew. We Singaporean are the minority.

Now, the Khaw even encourage Singaporean to live in Johor for retirement
yet he can have his pension in Singapore.
Phew. Phew. Phew. Phew. Phew. Phew. Phew. Phew. Phew.Phew. Phew. Phew.

@Rafflesian

Your stupidity is amazing! Let me make this simple for you. No value = No Sales = No profit. Cost is not everything. Value is. I’m amazed that you didn’t know that. Oh well :D

@Angelina

Its because I work in a cutting edge industry that I know these things happen. As for Singapore being ready, we all know its for preping the nation more then anything

hi Angelina,

eh, let’s not get too personal when you reply with words like,
////If you can’t be bothered to plug in, then who is to blame?////
if you are looking for someone to blame, look for those with bigger responsibilities, not the person on the street who have not been travelling- to “import” the bug.

anyway, from situation developing on a day-to-day basis, once the bug crossed into S’pore’s porous border, a relatively fast & stealthy spread is certain. with all the info available, yet companies & other organisations are slow to react & draw up contingency plans.

to think that it took quite a few days before we had the 1st local confirmed infection, who should we blame for giving a window of opportunity for the bug to spread? we were never ready the the true sense, many businesses had no contingency plans. what more of mixed signals telling us not to over-react?

as for,
////will YOU really not be bothered to plug in? If you can’t be bothered to plug in, then who is to blame?////
my reply is, this:
1) S’pore is humming away 24/7, in a densely populated & tiny country, the bug has the upper hand in speed & stealth in spreading.
2) there is a time lag;
2a) positively identifying the place/s of infection
2b) notifying the relevent authorities
2c) authorities disseminating the info to public
2d) contact tracing takes time, window of opportunity for spreading further
3) when a community level spread is possible contact tracing is like catching the wind with a net…
4) there is simply no foolproof way (that i know) to identify in real time the rate of the spread. is staying updated an effective way to keep the chances of infection down?

just because internet is a widely used medium for news, it’s not a catch-all. don’t you get it?

*faintz*

Hi mice is nice,

Don’t put words in my mouth, I did not say its a “catch-all” but if there is another popular mass medium (not necc for news), which most big nations in the world is using, why not use it? Thats all I am saying. Why have the MOST WIRED nation which according to you is of no significance?

Before you deviate any further, may I clarify that the issue on hand was that people (incl the doc) did not have a clue where the outbreak started in Spore, and the medical service providers (hospitals) did not seem to know what each other is supposed to do (procedure).

What I suspect is not about the effectiveness or not of the internet but more of not wanting anything printed in black & white. They are not sure of the info and not sure what they are doing, period.

Luckily this swine flu does not appear to be fatal, if it is deadly and there is press release that info is updated daily on the internet, (again I re-iterate, info of where major outbreaks are and what to do if you suspect you are infected) I can guarantee the website will be so congested, it crashes! I can guarantee you will not be the last reluctant visitor to the site.

hi Angelina,

////Don’t put words in my mouth, I did not say its a “catch-all”////
sorry if i did. but i was given the impression form you that being highly wired & plugged in S’poreans on the whole should be well informed.

dun ask me questions like
////Why have the MOST WIRED nation which according to you is of no significance?////
////the issue on hand was that people (incl the doc) did not have a clue where the outbreak started in Spore, and the medical service providers (hospitals) did not seem to know what each other is supposed to do (procedure).////
i am not the official channel or work in the healthcare or related industry to give an answer.

////What I suspect is not about the effectiveness or not of the internet but more of not wanting anything printed in black & white. They are not sure of the info and not sure what they are doing, period.////
this i totally agree!! no evidence, no accountability!! can just say “dunno, dunno, not aware…” & *siam*…. :/

189) inix on July 6th, 2009 11.49 pm

“Your stupidity is amazing! Let me make this simple for you. No value = No Sales = No profit. Cost is not everything. Value is. I’m amazed that you didn’t know that. Oh well”

You really sound like one of those high & mighty “top talented scholars” that the PAP recruited in recent years. Almost everything gets messed up because of SQUARE heads like you.

Are you saying all the restaurants which do not make profit have zero value? The private hospitals which do not make profit also have zero value. The electronic shop that do not make profit have zero value?

Are you saying businesses which make bigger profits have better value than those which make losses even if they are trading the same items with exactly the same quality service. Do price, promotion & location not feature in your idea of business? ONLY value of the product????

Is it completely impossible to you that your cutting edge prodcut or technology or service might end up a loss maker? If your cutting edge product, though highly valuable will cost too much to build or make in order to make a profit, will there be buyers prepared to pay for it? If it is not possible to mass produce, will the business make a profit?

I can see how or why SG is so way behind in many things with ‘clever’ people like you thinking so simply.

inix

If you can create a human robot to do household chores (which to me is of value) are you saying there WILL be sales, and guranteed PROFIT? What if you cannot mass produce it to cover your fixed costs (rental & wages)? What if it costs you hundreds of thousands to promote the new innovation?

Wish it is so simple like you think what business is ALL about. Bank investors won’t need to hire specialists in their jobs, just somebody to evaluate the value of the products or services!

For those reading this discussion, my point is that things are gettng more expensive can be due to costs other than wages, mainly rental, transport, utilities and most crucially, growing the profit. So if people wish for higher wages, they should NOT be blamed for complaining about the higher costs of things. This is simple common sense but “inix” argued that business is ALL about value creation!

And “inix” says my stupidity is amazing in #194! Unless “inix” has any intelligence at all, I won’t take his understanding of stupidity for granted.

hi Rafflesian,

post #196 on July 7th, 2009 7.20 pm

////my point is that things are gettng more expensive can be due to costs other than wages, mainly rental, transport, utilities and most crucially, growing the profit.////

spelt out logically, in local context.

its a pity Inix had to start the ball rolling with post #167on July 4th, 2009 2.40 pm.
did an about turn to redeem the situation in post #177 on July 5th, 2009 11.55 am.

let’s not getting at each others’ neck too often, refrain from flame baiting strangers online & try keep cool in this tiny RED DOTE called S’pore.

1 post entails a 4 post reply, and since you still don’t get the drift, I won’t be bothered to reply anyway.

@mice is nice

I still hold to my statement. I have absolute disdain for people who bitch about increase of prices when they want their own pay to be increased. To me, its like complaining about the Coffee Price increasing by 10c, and saying that the cofeeshops are making huge amount of money, while quietly smirking that pay rise that you got.

Fundamentally, COL is undoubtedly linked to standard of living (although they are not the same), and that as people gets more, they want more.

Next, I wasn’t doing an about-turn. I was just explaining my take on why healthcare is difficult to regulate, and expensive at the same time. I don’t like to bitch on things that are expensive. Its simply pointless.

inix

Does one has to agree with you to get the drift? Can’t one challenge your warped theory from one’s wealth of experience?

Why are you so fond of the word ‘BITCH’?? There is no need for this sort of language to impress your views on others.

hi Inix,

////I still hold to my statement. I have absolute disdain for people who bitch about increase of prices when they want their own pay to be increased. To me, its like complaining about the Coffee Price increasing by 10c, and saying that the cofeeshops are making huge amount of money, while quietly smirking that pay rise that you got.////

firstly, you do not know me, so how can you claim others’ pay did indeed rise? secondly, i will not be drawn into a flame war with you.

////Next, I wasn’t doing an about-turn. I was just explaining my take on why healthcare is difficult to regulate, and expensive at the same time. I don’t like to bitch on things that are expensive. Its simply pointless.////

alright, maybe i mistaken.

& yeah, i think i don’t get the drift.

………………………………………………………………………………………………………………………….

hi Rafflesian,

let’s ignore posters who lack etiquette. its unfortunate, but let’s not get too personal with people online, its not worth the effort & time.

thanks for speaking up for me. ;)