How could Singapore cope with the next great epidemic?
By Tinesh Indrarajah
Exclusive Interview: Peter Ho, former head of the civil service.
Image: Andy Mitchell, licensed under CC BY-SA 2.0
Ho is alluding to how SARS emerged from the left field to surprise Singapore in 2003. Unexpected emergencies like disease outbreaks, tsunamis and recessions have affected Asia over the last decade, and will continue to so in the future.
GovInsider spoke to Peter Ho about what strategies can help governments prepare to face complex challenges.
Wicked Problems
All governments operate in “complex, fast-changing and uncertain environments” says Ho. The biggest and most challenging problems they face, like SARS, are similarly complex.
These problems are complex because they usually don’t have a clear cause, he notes. This issue is made worse when different parties have varying opinions on what the real cause of the problem is.
Aside from determining the causes of a problem, governments also face difficulty in negotiating the “many potential stakeholders in the problem”, says Ho. Major government challenges involve different segments of society, and each of them are affected in different ways by the same problem.
Ho also points out that “there are many possible solutions” to complex challenges depending on one’s perspective. During SARS, governments were forced to balance differing opinions from health officials, academics and medical professionals when crafting solutions. It is these highly-complex challenges that are termed “wicked problems”.
Whole of Government
Ho states that independent action by government ministries is not effective in dealing with wicked problems. He adds that any single agency will have “neither the competence to cover all aspects of the problem nor do they have understanding of all dimensions of the problem.”
Therefore, a “whole of government” approach serves as a better solution for wicked problems. This approach includes the opinions of different government ministries. It also values insights from external agencies. In this way, a more comprehensive solution is crafted that takes into account differing perspectives.
This model of information sharing does not come naturally to people within organizations, Ho acknowledges. It is human nature for people to “prefer to operate within their silos”, he says.
Instead, a more collaborative approach is needed to create better solutions. Using Singapore as an example, Ho notes that, “we may not have achieved nirvana, but I think we have moved further down the road in terms of a whole of government approach because we understand the importance of tackling these complex and wicked problems in a holistic way.”
Strong Leadership
“Whole of government is really an act of strong leadership,” asserts Ho. Government leaders need to first recognize that a unified approach is indeed useful to tackle wicked problems. It is this initial recognition, and belief, that will determine its effectiveness, he says.
Time is the greatest investment required from senior figures, Ho notes. Government leaders need to be prepared to commit their time and resources to encourage their people to operate using this approach when encountering wicked problems.
However, the “whole of government approach is easy to understand in theory but very difficult to achieve in practice”, he says. One important reason for its possible failure is when leaders do not enforce it consistently.
Another is when leaders are not communicating their vision clearly to staff, he says. If both management and staff are not on the same page, information between organizations will not be shared properly.
If government leaders are effective in enforcing and communicating their vision clearly, a third reason for failure is under-performing staff. In such cases, leaders need to act against poor performance.
Alert Workforce
Proper management of wicked problems also requires an alert workforce. With reference to the recent discovery of a multi-drug resistant tuberculosis cluster in Singapore, Ho says, “The only way to reduce the chance that this is going to happen is to have very alert health officials.”
Dr. Cynthia Chee is one of those “alert” health officials. Alongside her team at the Tuberculosis Control Unit at Tan Tock Seng Hospital, Dr. Chee connected six different patients with the tuberculosis strain to a particular HDB block in Ang Mo Kio.
Her connection is especially impressive because the six patients were admitted over a span of four to five years. She was alert enough to recognise the similarities in diagnosis and quickly notified the Ministry of Health, which resulted in free TB screening for residents of that block.
A whole of government approach helps develop this alert attitude among the workforce, he says. Emphasis on information sharing from the top prepares the workforce to respond to emergencies better. In today’s closely-connected world, developing this kind of alertness is critical in making people sensitive to future emergencies, he stresses.
SARS was indeed a wake-up call for governments in the region. They must be alert and take a whole of government approach to avoid nasty surprises in the future.