The boy who knew too much: a child prodigy

This is the true story of scientific child prodigy, and former baby genius, Ainan Celeste Cawley, written by his father. It is the true story, too, of his gifted brothers and of all the Cawley family. I write also of child prodigy and genius in general: what it is, and how it is so often neglected in the modern world. As a society, we so often fail those we should most hope to see succeed: our gifted children and the gifted adults they become. Site Copyright: Valentine Cawley, 2006 +

Tuesday, May 26, 2009

Service standards in Singapore's hospitals.

Nursing is all about service: service to one's patients. So, too, is the art of medicine (I use "art" deliberately, because medicine is often surprisingly unscientific): it is about doing what can be done for the patient. The focus should ever be the patient and not what the doctor/nurse wants to do for themselves in that particular moment.

Singapore prides itself on its hospitals. I suppose it does so because it is comparing them to those of its relatively impoverished neighbours. I think this a funny comparison to make, since it tells us nothing about how good, in absolute terms, Singapore's hospitals are.

In the past few days, I have been visiting a Singaporean hospital to attend to someone close to me, who is not well. In doing so, I couldn't help but notice certain tendencies in the way the staff...both doctors and nurses...attended to their patients.

I watched, with some amazement, as the nurses were asked repeatedly for a cup, to pour water into, over the space of several hours. The conversations went a bit like this:

"Could we have a cup please?"

"I'll be back."

Three quarters of an hour passed by...and she didn't come back.

So, we asked two others who were probably nurses, since they were dressed in blue.

"Could we have a cup please?"

"We are doing our rounds.", was the unclear answer.

It wasn't clear what that meant, so we sat and waited for the better part of an hour until it became clear what "we are doing our rounds" meant: it meant "We are not going to get it for you, because we just can't be bothered."

They didn't come back.

This kind of conversation and response went on for some time, more, until, finally, I approached a senior nurse and asked for a cup and explained that no-one had got one, despite being repeatedly asked. She looked away, perhaps ashamed and walked off to a room marked "Pantry" to get one. What I was rather stunned to note was that this Pantry was less than 20 metres from the bed where we had been sat. Thus, in all those hours, not one staff member had been bothered to walk 20 metres to get a cup. Had I known it was there, I would have got it myself.

I learnt my lesson, however. When it came time to find some hot water, I didn't ask any of the staff there for assistance: I went to the pantry myself.

This kind of poor service response carried across to ALL requests to the staff, whatever its nature. "Could we have the results of such and such tests?" Ages would pass - and no results would come, unless reminded. "When is the Doctor coming down?" "Soon", would be the answer. An hour or two would pass and still the Doctor would not have come down. "Is there a room in the hospital to do exercise?" "I will get back to you." A day later, she has not.

Another notable tactic of the staff at this hospital is to pass responsibility: "Oh, I will ask such and such..."; "Such and such does that...". It never occurs to any of them that they, themselves, could complete the task requested immediately, without delay, by simply doing it. Instead, however, they prefer to delegate it to someone else - someone who is not around and by the time they are around, they will have forgotten the request.

After a while, one got the distinct impression that the hospital had a special policy of hiring morons only, for its staff positions. It seemed that simply NO-ONE wanted to do something upon being asked - but would always find a reason to delay doing it, that moment, until, of course, they had forgotten the request - deliberately or otherwise.

Singapore's hospitals are great buildings, but they don't have great staff, is my inevitable conclusion. As always, Singapore is strong on hardware and poor on software - or strong on infrastructure and poor on people. At least, that is the way it seems, if one watches how Singapore works.

The poor service I have observed in a Singaporean hospital is completely unnecessary. It just comes from people being LAZY. They are just too lazy to immediately attend to all matters requested - too lazy to do jobs themselves without delegation. It is time for an inviolable rule to be introduced, into all Singaporean hospitals, to improve service standards: any and all staff members should immediately attend to patient requests, without delegation and without delay, if it is within their power to fulfil that particular request. Were this simple rule implemented being sick in Singapore would become a whole lot better an experience.

The odd thing about all this is that Singaporean hospitals are not even free, as many hospitals in many developed countries are. Yet, the free hospitals I have experience of, offered much better service, than Singaporean hospitals do.

Why is an expensive Singaporean hospital offering poorer service than FREE foreign hospitals?

Perhaps the Minister for Health would like to explain this conundrum. Or perhaps readers have their own views on the situation.

(If you would like to learn more of Ainan Celeste Cawley, a scientific child prodigy, aged eight years and seven months, or his gifted brothers, Fintan, five years exactly, and Tiarnan, twenty-eight months, please go to: I also write of gifted education, IQ, intelligence, the Irish, the Malays, Singapore, College, University, Chemistry, Science, genetics, left-handedness, precocity, child prodigy, child genius, baby genius, adult genius, savant, wunderkind, wonderkind, genio, гений ребенок prodigy, genie, μεγαλοφυία θαύμα παιδιών, bambino, kind.

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posted by Valentine Cawley @ 9:52 AM 


Blogger Indiana said...

Having has some experience in Hopsitals here, inc. a stint to have a compound fracture of the elbow put back together and recently visiting a friend regularly while he underwent cancer treatment I would love to know which hospital you are talking about?

11:14 AM  
Anonymous Anonymous said...

As far as i know, on those times that i've been to local hospital to visit someone, the staff there, who are mostly Filipino are very friendly, helpful and dedicated. Some of them even sleep in the hospital instead of going home so that they can tend to the patients.

In fact, my dad has ever left them with instructions on certain matters when visiting a relative, and they do carry it out without fail.

Perhaps you are just suay (unlucky)...

* on a side note, perhaps you should look at the whole picture and realise the cost involved in sustaining a totally free medical care system- Sadly to say, politicians in certain countries are unable to remove it (although they would want to, in order to cut their budget deficit or spend more on other areas) simply because the population has grown too accustomed to it, and treat it as a right rather than a privilege.

I believe that a subsidy, like the current system for citizens, provides a balance between cost and welfare- i.e. between being responsible for one's own health, and getting treatment

Of course it is a natural human tendency to want a free lunch. Unfortunately, it is not possible...singapore tax rate is about 20% tops, while for UK it is 40% tops.
Perhaps you would like to pay a higher income tax? Or maybe you want like to print your own money to fund a free medical care?
Frankly speaking, i would prefer to keep my income to myself than see it spent on others...
Not to mention give it to the govt and see it shrink before going to health care and MP claimed expenses...

11:57 AM  
Blogger beAr said...

i wonder which hospital could you have been referring to? i was recently hospitalised at SGH for a minor study and received rather good care...

12:42 PM  
Anonymous Anonymous said...

Expensive is relative.
Service is excellent if you can afford it (1st class wards in private hospitals are comparable to 5 star hotels). Or command it if you are some bigwig ... eg like a minister(public hospital is fine).

do remember u are in Singapore so refrain from the "noble cause" rant 'cos we are a meritocracy (cash and major credit cards accepted).

May I know which hospital you are referring to?

4:53 PM  
Blogger Valentine Cawley said...

Hi Indiana,

Given that the patient in question is still a patient, I think it would be unwise to specify the hospital lest I stir up trouble for her. I will leave that to a later date.


5:17 PM  
Blogger Valentine Cawley said...

Re. Unlucky.

It could just as easily be that you were LUCKY. I think it unlikely that the experience we had was uncommon, in that it concerns a random patient at a random time.

Furthermore, it wasn't just one patient treated so. Rather laughably, I even found myself hanging a drip for the patient next door, because there was no nurse around to do so. How about THAT for service?

I wonder how long it would take for them to notice that a patient had died?

Regarding cost: you are right...only countries with higher taxes can afford free healthcare. So, there is a downside to it. However, having lived in societies with free healthcare, I do find them more humane and civilized - and even the poorest has access to good healthcare - including TRANSPLANTS and other extraordinarily expensive procedures. It has its moral merits.

Thanks for your comment.

5:20 PM  
Blogger Valentine Cawley said...

Re. Cash and credit cards accepted...yes, this describes Singapore. However, it does not describe a describes a PLUTOCRACY...rule by the rich.

You are right: "noble causes" don't get far in pragmatic, soul-less Singapore. Unless, it makes a lot of cash, of course...

5:22 PM  
Blogger Valentine Cawley said...

None of the commenters here have said what CLASS of ward they were in. Perhaps "care" here is ward class related. That is, related to how much you pay. That would explain the differential in experiences.

Thanks, all, for your comments.

5:23 PM  
Anonymous Anonymous said...

I, too, have noted sloppy service. The staff seemed a little disorganized...perhaps that explains what was happening. Maybe they weren't able to "multi-task"?

5:24 PM  
Blogger Valentine Cawley said...

I agree: they did not seem to be able to cope with the demands upon them - even though there were a LOT of them. I think they need to learn how to focus on each task until it is done, then begin another. I rather got the feel that many tasks slipped away from them, unless they were repeatedly reminded. It often took many requests to accomplish any given goal or task.

Thanks for your comment.

5:27 PM  
Anonymous Anonymous said...

Yes. Singaporeans are generally lazy and lazier than their Malay neighbours. I think this is because most of Singapore suffers from some ill health. Likely, mental or emotional.

7:56 PM  
Blogger Valentine Cawley said...

Re. Lazy locals.

What is your perspective? Are you local or foreign, resident or overseas? It would be interesting to know.

I think, perhaps, some of it is to do with pride/self-image. There is a local tendency to think too highly of oneself to even begin to serve another...even when service is the essential purpose of the job. Hence, one finds poor service in roles in which people meet people, in Singapore.

Thanks for your comment.

8:46 PM  
Anonymous Anonymous said...

hospital horror stories? i like...

let me chime in.

have a good day.

9:27 AM  
Blogger Valentine Cawley said...

Yes. Re. seems that they are rather too overworked. That is an argument for more investment in hospitals.

Thanks for your comment.

9:56 AM  
Anonymous Anonymous said...

hi valentine,

rather too overworked? rather, you are too kind.

the staff must have been blind not to notice the patient unless he was dressed in such a manner that he melted into the furniture.

can you imagine waiting for 34-hours? i'd like to hear from health professionals how many shifts that works out to be: you come into work the next day and the poor man is still there.

kind regards.

11:38 AM  
Blogger beAr said...

i stayed in a B2 ward (actually, strictly speaking, i paid B2 prices but stayed in a better ward, due to the nature of my study).

4:20 PM  
Anonymous Wang said...


Considering having visited many Govt restructured hospitals inclusive of C class wards for geriatic family and also friends and children and overall to be at least good if not better than those in the West.
Considering my relatives who have experienced lacksaidical or bad service as well as OK service in the NHS system in UK London and others in Oz or in Kiwi/USA

I would find that your generalisation to be based on your particular circumstance strange considering speaking Malay to Malay, Tamil to Tamil, Chinese to Chinese and English to all others of racial descent that overall service is quite okay.

Would suggest that you raise a complaint and the exact details to the administrator as they would take action against staff


11:46 AM  
Blogger Valentine Cawley said...

Dear Wang,

I think I have not made myself clear enough. The problem observed at the hospital, in Singapore, applied to the operation of the whole ward...not just to the service received by the patient in question. Recall that I ended up, rather bizarrely, attaching the drip of the patient next door, to the stand, because no nurse could be found.

I have experience of hospitals in the UK and USA...and found them more organized and efficient than what I witnessed at this Singaporean hospital.

Another problem was the lack of English of some staff. One staff member completely misunderstood something I said to her and ended up believing that the patient had a drug allergy, when they didn't. This kind of thing can actually be dangerous. (She was Philippine...but had less good English than normally expected from this nationality.)

Thank you for your comment.

12:19 PM  

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