picture in my mind

Still on a John Oliver binge 

(although thankfully not pumped on coffee; 

such previous 2am-posts should not be repeated).

I re-watched this:

And it brings me to the topic of just public anything: if you're a professional in a public system, chances are you are at the very least frustrated with the way things work. The above is an extreme example thankfully not from my country (although who knows how things really are in my country; we don't have a John Oliver equivalent and even if we did, he'd be jailed on Day 1 of his show), but listening to it brings up all my latent rage at the way some things are done in the systems and institutions that I function or have functioned in.

To be fair and not completely ungrateful, our local system and the government tries; it does. But when dollars and cents are the bottomline in our inescapable capitalist world, something always has to give. And often, it is quality -- because we all know KPI are the golden nuggets we aim for instead. This, more than anything, I realise, is what drove me out of the hospital into the community -- I may get into trouble for this but goodness, it has to be said: if I had a child who needed language therapy, no way would I rely on therapists in our public hospitals. Not because they are terrible therapists to begin with -- hey, I'm one myself, and one parent actually told me she felt therapists in the hospitals always seem better to her, true or not ahah -- but because they have to work in a system that is difficult, if not impossible. Absolutely crazy waitlists and enormous caseloads which meant that we saw children with such poor frequency, we may as well not see them at all. I had little confidence that I was making a difference to my children other than being a general placebo effect. I shall concede that parent education was a bit better -- because what little time I had with parents, I tried to make them understand the gravity of the disorder that their child had and how to interact with them better, and that sometimes needs less than a few therapy sessions fortunately.

I have to put a disclaimer here though, that I am speaking mainly with regard to language therapy, although I'd say most other communication disorders including speech, voice, and stuttering are not invulnerable to the same problem. When the system that you function in chokes the very thing you do, there are only rightfully two options: either you change the system or you get out. The hospital was an impregnable fortress whose systems are so entrenched and far too entwined at high ministerial and managerial levels to make any major change; it felt like a hopeless case. I mean, when we had a dialogue with our team director once, he expressed his understanding of our woes i.e. 8-session workdays with concurrent ongoing multiple projects that burnt us out, but insisted that his hands were similarly tied unless we could prove that having 4-session days for instance could tangibly raise outcome measures e.g. percentage consonants correct. Ludicrous in every sense; in what world and with what time would we have the luxury to do such studies. We were already maxed out as we were.

So now I'm out of the hospital, happy to do what feels like better-quality speech and language therapy within the schools -- until... I realise this is still Singapore, and crappy systems with stupid KPI goals still exist. But! The system is so new, so young, and so uncertain, I feel like it has the potential to change and evolve into something better -- before it becomes set in stone like archaic, old, immovable systems. A healthy philosophy needs to underpin the system if it needs to be sustainable in the long run -- doesn't Google have the winning formula? I've been to Google! They treat their people like royalty, and they're the most prominent cyber company in the entire world! You would think other companies and other systems might get a clue by now. If you have quality brains working for you, you feed it quality input, then you're more likely to get quality output; you don't treat it like crap, simply apologize, and tell them to deal with reality. It's not rocket science.

I will try to push for change, I will. Ganbatte, S! Because while the hospital appears impossible (and I have to say I salute those people who stay to make things better!), where I am right now may be more amenable to change.