Forum: Enhancing fairness, transparency and accountability in healthcare

I refer to the article (Neurosurgeon sacked for data breach loses suit against SingHealth, Jan 22). This case underscores the critical importance of safeguarding patient data while also raising important points on fairness, transparency and accountability in Singapore’s healthcare system.

First and foremost, protecting patient data is paramount, and accessing data without proper authorisation breaches both privacy laws and professional ethics, irrespective of intent. The disciplinary actions taken in this case reflect SingHealth’s commitment to upholding high standards of accountability.

At the same time, building on existing avenues or introducing additional safe channels where healthcare professionals can raise legitimate concerns, particularly those related to patient safety, could further enhance accountability and trust.

Second, in highly specialised areas such as neurosurgery, where outcomes are inherently complex, it is desirable to involve independent internal or external experts to review patient outcomes. Subject-matter expertise is crucial to ensure fair evaluations and credible conclusions in such intricate cases, which the inquiry would have considered.

Third, the implementation and use of risk-adjusted benchmarking for clinical outcomes offer significant benefits to healthcare systems by factoring in patient complexity and external influences beyond a professional’s control. Risk-adjusted benchmarking promotes accountability but also fosters a culture of continuous improvement by providing a clearer and more equitable understanding of clinical outcomes.

Finally, in healthcare environments characterised by high levels of complexity and interdependent teamwork, effective collaboration is essential to achieve optimal patient outcomes.

It is therefore crucial for healthcare systems to prioritise the development of clear and fair processes that promote mutual trust, respect, and accountability among team members and organisations. By fostering a collaborative culture, institutions can ensure that both individual professionals and teams work cohesively, which is fundamental to effective patient care and maintaining institutional integrity.

Singapore’s healthcare system is rightly regarded as world-class, and by continuing to refine processes for transparency, fairness and accountability, we can ensure it remains a global leader in patient care and professional integrity.

Dr Shridhar Iyer
Senior Consultant, Mount Elizabeth Medical Centre