Professor Tan Eng Chye, President, National University of Singapore
Professor John Eu-Li Wong, Chief Executive, National University Health System
Professor Patrick Finbarr Allen, Dean, NUS Faculty of Dentistry.
Distinguished Guests, Ladies and Gentlemen
1. Although I hate going to the dentist, tonight I am really happy to join so many dentists here on this special occasion – the 90th anniversary of the NUS Faculty of Dentistry. And for once I get to talk and the dentists listen!
The Past and the Future
2. Let me first recount the growth of the faculty over nine decades. It has a humble beginning. In 1929, it had five small rooms and seven students as a Department of Dentistry within the King Edward VII College of Medicine. Singapore’s first public dental clinic was set up just beside the school.
3. In 90 years, the school grew to a 21st century faculty of international academic excellence. Many have contributed to this transformation –Deans who led the faculty, NUS leadership which supported it, staff and faculty members who did the heavy lifting, and students who studied hard, graduated and upheld the reputation of the school.
4. I am glad that Professor Loh Hong Sai who served as Dean from 1986 to 1995 is seated amongst us. He directed the Faculty’s relocation and operationalisation from the Singapore General Hospital to the National University Hospital in 1986, during which an outpatient clinic at NUH also started. Thank you for that.
5. Professor Chew Chong Lin, who succeeded Professor Loh in 1995 until 2000, is also here with us tonight. He led a Curriculum Review during his term as Dean, which resulted in several changes such as the introduction of competency-based curriculum and problem-based learning. Some of our faculties are just starting to do this so Professor Chew was way ahead of his time. Under his leadership, the school adopted technology in training through the use of pre-clinical simulations, which I believe is a game changer in medical education.
6. I have no doubt NUS Dentistry will continue to grow. Let me share a few recent developments. Earlier this year, the Faculty completed its move to the new National University Centre for Oral Health, Singapore building. This co-location of Singapore’s only dental school, research facilities, and dental services clinics will bring about synergies in teaching, research, training of dental and oral health therapy students, and will ultimately lead to better patient care.
7. The Faculty has also set up a Population Oral Health Services Research Unit to conduct population-level studies, including the ongoing national adult oral health survey. Its findings will better inform the formulation of public policies, rules and programmes concerning oral health care.
8. The Faculty is increasing its undergraduate intake from the current 60 to 80 in 2021 to meet the future demand for dentists. The undergraduate curriculum will continue to incorporate innovative education practices, that will complement conventional teaching methods, to make training more personalised and realistic, yet scalable and efficient.
Making Higher Education Affordable
9. Tonight, let me also touch on two societal issues that concern the Faculty. First, is the recent move to make higher education more affordable.
10. Medicine and Dentistry training is expensive. Compared to general degrees, it is about 4-5 times more expensive. NUS Dentistry fees are about $29,000 per year. This is around 25% of the cost, and Government funds the other 75%. At the recent National Day Rally, PM Lee announced the enhancement of Government bursaries for undergraduate and diploma students from lower- and middle-income families.
11. The objective is to ensure that every student is given the opportunity to fulfil his or her fullest potential, regardless of financial background. In particular, for Dentistry and Medicine, the quantum of increase is especially significant, in order to make course fees affordable, especially for the lowest income.
12. This has raised some eyebrows. At post-Rally dialogues, I was asked why there has been such a big increase for Medicine and Dentistry students, who are already seen as privileged and elite? I explained that this is means tested assistance, and the biggest support goes to lower-income students. If they have potential, their financial situation cannot be an obstacle for them to realise their dreams of becoming doctors or dentists. This must be what Singapore stands for. Further, all medical and dentistry students are also bonded to the public healthcare system.
13. Having received significant support from the system, the graduates will feel a sense of responsibility to contribute back to the faculty, school and society. Many alumni members pay it forward with their time and energy, including teaching at the faculty.
14. The dentistry community has also supported national public initiatives such as the School Dental Programme – and here MOE is very grateful. Today, 97% of primary school and 94% of secondary school students participated in the dental programme. We are also working together to carry out dental screening for our 3 to 4-year-old children in about 800 preschools this year.
15. The community has also been contributing financially to their alma mater. For example, the Singapore Dental Association (SDA) established an endowment fund donation worth $500,000. This year, the SDA donated another $90,000 in support of education in geriatric oral health care, and to commemorate the Faculty’s 90th anniversary.
16. The Class of 1981 raised $180,000 and established a bursary fund for dental students for its 30th anniversary. To date, 18 students have benefitted from this fund.
17. Notwithstanding greater Government support in bursaries, I urge all alumni, staff and key stakeholders to continue your strong support to nurture our future dentists. The Government will continue to match your donations up to 1.5 times, to maximise opportunities for the young.
18. Government funding of education plus means-tested bursaries provide a strong base. Your support enables the Faculty to exercise judgement and flexibility, and give additional help to those who deserve and need it. For the neediest cases, all the fees will be waived, and the student may even get some monthly allowance to get by with our full support.
Upholding Public Trust
19. The second issue I would like to talk about is public trust. Last month, I spoke at the Yong Loo Lin School of Medicine Graduation Dinner and shared on this topic. My dentist friends advised me to speak about it tonight as well.
20. Media was not present at that Yong Loo Lin graduation dinner, but as a matter of routine I sent them my speech. I was not expecting any coverage. As it turned out, they actually were quite interested and gave me quite good coverage.
21. They asked me why I chose to speak about public trust out of the blue. What was the context? Is the Government thinking of enacting a law to ensure public trust? The answer to the last question is of course no, because you can’t legislate public trust. The honest reason is that after seeing all the discipline and legal cases against doctors, I could identify with what the profession is going through in grappling with their challenges. And I believe the cause of the challenges is a general erosion of public trust. I wanted to acknowledge it and explain the serious consequences - what the medical profession is facing can become a much more widespread social phenomenon.
22. Why is it an issue of public trust and what are the consequences? Let me explain. When patients come to you without adequate trust, and even suspect that you may do something wrong to them, you are off to a wrong start. The doctor will take a defensive posture, manage his own risk exposure, and put more weight on what might make the patient happier than what is in their best interest. You start to lose the soul of the profession. Dentists are facing the same pressures. Your only saving grace may be that patients who come to you may be in great pain and more likely to accept your treatment unquestionably.
23. It is a challenge that resonates with most public servants, including Ministers. Doing what makes people happier, instead of what is in their best long-term interest. Doesn’t that sound familiar even in politics? But whether in medicine, public service or any other profession, when there is a lack of trust as a starting point, the outcomes are always sub-optimal, even distorted and wasteful, and can undo decades of institution building. We see it happening in some Western countries already.
24. What causes it? I believe it is a deep global trend, brought about by technology. To have so much knowledge accessible to so many people is an undoubted boon. But it also changed the way we receive and distribute information, real, distorted or outright fake, and fundamentally altered our relationships with authorities, institutions and professions.
25. The public we interact with today is different from the past. Everyone has an encyclopaedia in our palms. We can verify and counter-check all the information and advice we receive, almost as a habit. In a face-to-face meeting today in a meeting room, everyone is not just talking to each other, they are also interacting with parties outside the room, and sometimes there are sub-discussions happening via Whatsapp. It’s much harder to engender trust in that kind of environment.
26. Coupled with this is the fact that bad news and falsehoods travel much faster and are more far-reaching than before. If we look at the news received through our chat groups, how many of them are bad news, how many are good news and how many are feel-good cat videos? When the spread of bad news is on steroids, it will erode public trust. It is the inevitable process of atrophy. A constant drip will erode even the hardest rock over time.
27. Unfortunately, there is not much we can do about it. Telling people to trust others more, simply does not work, and I think it can even backfire. I give you an illustration. While I was told that many at the Yong Loo Lin School of Medicine Graduation Dinner agreed with my analysis, a social media narrative quickly developed, which was: Minister said public trust is eroding, so we are right not to trust authorities! I guess I better not send the media tonight’s speech.
28. There will also be a tendency to respond by raising the penalty for professional misconduct. While that may stave off public criticisms temporarily, it is worse for the long-term because in all justice systems the penalty must be proportionate to the misdeed, provided there is a misdeed. While in India recently, I was told by business leaders that the cases for companies failing to meet labour standards are piling up at the Courts. One solution implemented years ago was to raise the penalty for such violations and take to task the owners or CEOs of the companies, which placated the unions for a while but did not solve any problem and in fact distort ground practices further. It simply does not work when you just raise penalties for violations.
29. My conclusion is that as authorities and professionals, we must understand we are in the same boat, and changing this profound shift in public attitude is beyond our influence. But history has shown that human societies can be highly adaptive. Given time, equilibrium can be restored, as people adjust the way they select, consume, use and distribute information.
30. This is an evolutionary and adaptive process that will take time, just as it took time for humans to become immune to certain viruses. But that happened after several violent epidemics, and we can take steps to avoid such catastrophic adjustment processes.
31. As authorities and professionals, we need to do our best to earn public trust, by practising our trade well, constantly enhancing our knowledge, demonstrating our professionalism, establishing and upholding moral code of conduct, and always doing good for society. To do so, professional communities must rise up to the challenge. Then maybe the erosion that is caused can be patched up by a filling, and we need not resort to root canal or extraction.
Conclusion
32. For 90 years, the Faculty of Dentistry has nurtured dentists who have served generations of Singaporeans. Contributions from the staff and graduates have been meaningful and substantial to Singapore. Despite the common challenges we face, I trust that this distinguished institution will continue scaling greater heights to lead the way in academic dentistry. Have a good evening!