​By Dr Daphne Khoo
Group Director (Healthcare Performance Group), Ministry of Health
(Former Director, Clinical Governance & Quality Management, SingHealth and Head, Endocrinology, SGH)

When I was a young Endocrinologist in SGH, my Division Chairman would ask me during performance appraisal each year:  “Are you planning to stay long term or are you going to the private sector?”  Every year, my answer was, “Private sector.”

When I found myself much older and still working in SGH,  I became confident that I would never leave the public sector.   My subsequent actions simply illustrate that life is often unpredictable. After 28 years in public healthcare, my decision to leave SingHealth in 2011 was a painful and difficult one. T  he Department of Endocrinology at SGH was like a second family. 

My bosses were tremendously supportive and the work was a source of great satisfaction.   While some would assume it was the money that clinched the deal, the reality was that the new job offered learning opportunities that were simply not available within Singapore.

In my new role as global Chief Medical Officer of a large Asian healthcare company, I had oversight of the medical function in more than 20 hospitals in India, five in Vietnam, Hong Kong’s largest chain of GP clinics, some 200 dental clinics in Australia, a hospital in Mauritius and a lab in Dubai.

"While my stint in the private sector was one of the happiest periods of my life, I always wanted to return to the public sector at some point."

The need to adapt to, as well as plan for different countries, cultures, levels of medical competency and technical sophistication was an incredible experience and I learned a lot.   While we think we struggle in Singapore with integration issues, integrating healthcare systems of varying levels of maturity in different countries is a challenge of a totally different order.   The financial discipline and accountability culture of the private sector were life-changing for me.

I learned to better appreciate the strengths of our system.   At the same time, I felt Singapore could learn a lot from emerging economies in the area of ‘frugal innovation’.   When patients’ resources are limited and needs are great, innovations emerge out of necessity.

In each country and subsidiary, my mental models of what was achievable or optimal were constantly challenged.   The size and scale of India was staggering.   Our main cardiac hospital in Delhi did 5,000 cardiac surgeries a year, three times more than all the cases in Singapore combined.   While Singapore launches a new hospital perhaps once every five years, the company launched an average of three hospitals per year in India.   The energy in India was palpable.

A major attraction of the new job had been the perceived opportunity to build clinical knowledge and skills in Vietnam.   However, communication proved a major challenge with items like “Dying Alive Programme” and “Mountainous Living Allowance” being tabled for discussion.   An extremely respected but linguistically challenged senior physician referred to me as “The most graceful and adorable woman I have never met”. Nonetheless, I had great respect for our Vietnamese colleagues.   Their empathy for patients was clearly evident.   They objected to fee hikes even though they stood to personally benefit. Many doctors came to work on motorbikes, including our deputy CEO.

Why MOH? Firstly, as a doctor, and influenced by SGH’s culture, the pursuit of knowledge has always been integral to me. I had spent time in the clinical, research, educational, administrative, private and international arenas. Policy was perhaps the one gap in my training.

While my stint in the private sector was one of the happiest periods of my life, I always wanted to return to the public sector at some point. When the time came to leave, I eventually chose to join the Ministry of Health (MOH).

Why MOH?   Firstly, as a doctor, and influenced by SGH’s culture, the pursuit of knowledge has always been integral to me.   I had spent time in the clinical, research, educational, administrative, private and international arenas. Policy was perhaps the one gap in my training.

Secondly, while in the private sector, I had come to appreciate the importance of data-driven decision making.   In Singapore, possibly only MOH has access to sufficient data to draw conclusions with regard to the national healthcare landscape.   Finally, others felt that my prior exposure to both the private and public sectors would be useful for the organisation.

Any ‘detour’ in a career usually comes with opportunity costs.   Nonetheless, the experience taught me things I could not otherwise have learned, equipped me to take on roles I could not otherwise have done, and changed me in fundamental ways.


 Illustration by SingHealth Academy