General Practitioners (GPs) are integral teammates for Healthier SG, and the Government is engaging them in this spirit.
Case in point, Minister for Health Ong Ye Kung’s no-nonsense rebuttal to Non-constituency Member of Parliament Hazel Poa in Parliament this Wednesday (Oct 5).
“I just want to make sure that I understood the Minister correctly. When he said that there will be no KPI for family doctors and no clawback,” said Ms Poa about Healthier SG’s KPIs for assessing family doctors.
“That would mean that essentially, if I recall correctly, the amount of money that we’ll be paying in service fee is $400 million a year.”
“Does that mean that we will be paying this $400 million a year with no accountability?” she added.
Teammates going forward
Not so, responded Minister Ong.
“Miss Hazel asked a question but she’s actually making a statement,” he said.
“She just made a statement to say: This is not a good spend of money. And if you want it to be spent well, give KPIs and targets to the GPs. And they do not meet, claw back the fees.”
“This is not what we should do,” Minister Ong continued, noting that, yes, the GPs will have KPIs with targets — which the Government will work with the GPs to achieve together.
“But I do not think we want to treat them like vendors and contractors. Where if you miss out on certain KPI, we claw back the fee,” he said. “They care about the health of the population as much as we do, maybe more than members in the chamber.”
“Treat them as part of the team together in the right spirit.”
Healthier SG’s KPIs and targets
So, on an overall scale, how exactly will we measure Healthier SG’s impact? And what of that $400 million?
The shorter answer first.
“$400 million is first to subsidise residents. For health screenings, Healthpoints and all that,” clarified Minister Ong. “The other half is a service fee to GPs to help us take care of the population.”
And as for measuring impact, here are Healthier SG’s KPIs, as the Government set out in the White Paper:
These short-, medium- and long-term KPIs indicate a large-scale project just beginning.
“MOH (Ministry of Health) is having extensive discussions with clinicians and other stakeholders to set out the technical definitions and our approach to data sharing and measuring these outcomes,” said Minister Ong, adding that there’ll be twists, turns and uncertainties as Healthier SG progresses.
“From there we will establish the baselines of various indicators. And then determine what targets we want to achieve and by when.”
“While it is important to measure outcomes and targets, those of us who have run organisations before will know that this is not straightforward,” added the Minister.
Because — especially for a long-term project this big and game-changing — leaders know that it is dangerous to just chase KPIs and targets.
“A leader that is driving the change will have a different starting point,” Minister Ong explained.
“The starting point is to bring everyone on board. Make sure everyone understands and buys into the mission and objective. And we jointly set KPIs and targets and then do our best to achieve them in the right spirit.”
Making sure Healthier SG works
Simply managing, as opposed to leading, results in problems.
“And in our zeal to over-manage, we penalise people for not meeting targets in the middle of a big change — that’s when people become cynical, and they lose heart,” said Minister Ong. “Then you get perverse outcomes.”
“Imagine: if we really say ‘Doctors, you don’t meet your KPI, we claw back your service fee.’.”
“Then it’s very simple for the doctors. Number one: I don’t join Healthier SG. Or two: I join, but cherry-pick the healthy residents,” the Minister outlined as to how unilateral target-setting could backfire here.
“The way we look at KPIs, you’re able to differentiate the leaders from the managers.”
So: iterative, team-developed KPI targets for Heather SG based on feedback and data. That’s the way forward.
“It is important for GPs and MOH to work together. And for GPs to feel that they are an integral part of this change,” said Minister Ong.