February 23, 2022, 04:13 PM
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Open letters posted anonymously on social media are calling attention to the plight of nurses in Singapore.
Letters written by a collective of healthcare workers
An Instagram account run by a few individuals, one of whom is a healthcare worker who is his 30s and has been in the service for more than six years, put up two letters about one month apart to shed light on the healthcare sector here.
The earlier letter appeared on Jan. 23 and was addressed to Kenneth Mak, the director of medical services at the Ministry of Health:
The latest one came out on Feb. 21 and was addressed to Gan Kim Yong, the Trade and Industry Minister.
Letters written by healthcare professionals on frontlines
The earlier letter and latest one were signed off by "The Honest Healthcare Worker" to represent the collective.
Content on the Instagram account, @thehonesthealthcareworker, which posted the letters, can be traced back to February 2021.
In response to Mothership.sg's queries, the Instagram account confirmed that it was initially run by a group of five people in the healthcare sector, but due to a lack of time, only two of them have kept up with posting on the account.
Those involved represent doctors, nurses and allied health professionals, with a view to give more details of the disquiet in the healthcare sector that are under addressed.
One representative manning the account, said: "I’m not anti-establishment. I really am not. I’m very grateful for the opportunities that I’ve been given. I fully respect the institutions that they are there because they need to be there."
"My problem is not with the institution or with policies, but with the under addressed concerns. I respect the public officers immensely. I really do. I really do."
The person manning the Instagram account cannot be identified as they are not authorised to speak to the media.
In recent days, there has been calls for the public not to flood clinics just to get medical leave.
Latest letter
The latest open letter was posted in response to a recent statement made by Gan, who is one of the co-chairs of the Covid-19 Multi-Ministry Taskforce (MTF).
At the Feb. 16 MTF press conference, Gan gave an update that said Singapore's healthcare system "remains stable" and "has been able to cope with infections".
"On a slow road to collapse"
The latest anonymous letter, which appeared five days after Gan's statement was made, is claiming otherwise.
And it is this contrary take on the healthcare system that is winning the anonymous letter and its writers sympathy and attention from the public, with the situation in Singapore described, in dramatic terms, as "on a slow road to collapse".
The letter also went as far as to describe Gan's statement as "out of touch with the reality on the ground".
Healthcare workers quitting
This latest anonymous letter highlighted that nurses in Singapore are burnt out, and their numbers have "declined sharply" as many have left.
Although not mentioned in the letters, government data released in November 2021 showed then that around 1,500 healthcare workers resigned in the first half of 2021, compared with 2,000 annually pre-pandemic.
One statistic put forth to back this assertion claimed the nurse-to-patient ratio has doubled from 1:6 to 1:12.
The inclusion of this detail added a degree of credibility to the letter, as it showed that whoever penned it might indeed be privy to the inner workings of hospitals here.
The person behind the Instagram account told Mothership.sg that one nurse can be allocated as many as 16 patients to take care of these days.
Nurses are also asked to return to work on off-days to cope with the manpower crunch as more staff are getting infected with Covid-19.
"Some of them have not taken leave in a year," the post said, "and now, their off days and rest days are further restricted by management".
Previous letter highlighted same issue
The previous letter, addressed to Mak, which appeared a month ago on Jan. 23, had already beseeched him not to impose leave restrictions on healthcare workers again.
The situation on the ground, the letter asserted, was that healthcare workers do not have time to catch a breather because they have to deal with both present and backlog cases at any given time.
The letter argued that even though the Omicron wave is not as severe as the Delta wave given the medical data, the healthcare workers have not managed to catch a break as "elective surgeries that were deferred have returned again".
This detail has also provided credibility to the earlier anonymous letter as it highlighted a certain knowledge of the developments in hospitals.
The Jan. 23 letter had at that time already urged the authorities to look into a "deeper solution" instead.
Fear that patients in public healthcare will be affected
As a result of insufficient regular time off, the latest letter on Feb. 21 pointed out that working conditions for the healthcare workers have "worsened significantly", and yet there "has been no change in remuneration or increase in practical support".
The letter also claimed that doctors have quit residencies, allied health professionals -- a formal designation for healthcare workers registered in Singapore under MOH -- are leaving at an alarming rate, and "many more" of their "esteemed colleagues are preparing to leave".
This has carved experienced hands out of hospitals -- which is the least ideal outcome when public health arguably relies heavily on experienced professionals.
The latest anonymous letter then claimed that as a result, the junior healthcare workers who lack experience are the ones left behind and tasked to work on complex cases.
And the reason the junior staff are left is because they might be bonded by contracts.
"I fear for patients in public healthcare today," the letter added.
The person manning the Instagram account said they are staying on at the moment and not quitting because of a duty to peers as well as to patients: "I still believe that it's a calling, that regardless of how people treat me, regardless of what I get paid. I still believe that it is a calling."
"There are a handful of us who still believe in this and we're getting fewer," they added.
Seeking support from authorities
At the end of the latest letter, the healthcare worker appealed for "frank honesty and support" from the MTF:
Our working conditions have worsened significantly and yet there has been no change to our remuneration or increase in practical support. And yet we are expected to tolerate endless leave restrictions while the rest of Singapore flies around the world for their vacations? I think not. All we are asking for is frank honesty and support. It is the least we deserve for the literal blood, sweat and tears that we have given in the service of our nation.
In addition to this statement, the person manning the Instagram account said:
I'm just really disappointed because it's not about recruiting more people. It's not about mobilising the SAF or the healthcare volunteer corps. It's about really caring for your staff. It's about really taking the time to understand what their needs are and making the necessary changes. Covid didn't create the problems. It just surfaced the problems that were already there for the longest time.
Health Minister writes letter to healthcare staff
Health Minister Ong Ye Kung penned a letter to healthcare workers in public hospitals and polyclinics on Monday, Feb. 21, in a bid to boost morale and lift spirits of those battered at the frontlines.
His missive comes in the wake of a surge in Omicron cases in Singapore that threaten to overwhelm the public healthcare system and further tax nurses and doctors who have worked relentlessly at the frontlines for more than two years.
His note, which addressed healthcare workers as "colleagues", sought to reassure them that the government is instituting measures to lighten their burden.
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