Singapore solution for the NHS, Buying Happiness?

 The obstetrics and gynaecology clinic inside the vast Singapore General Hospital is unlike any ward in the UK.

There are no counters or rows of staff waiting to take patients' details. Instead their appointments have been registered via a mobile phone app and they sign in using touchscreen kiosks.

They use fixed machines to measure blood pressure, weight and height and they receive a printed plan of their day at the hospital, including timings for scans, tests and appointments to see doctors.

Across the hospital, which treats a million patients every year, there are robots delivering medications, picking drugs for prescriptions and washing equipment. Computer records are linked up and information shared easily between GPs, clinics and hospital staff.

Singapore: View across the Harbour to Fort Canning and the Cathedral
John Edmund Taylor (active 1860-1885)
Photo Credit: Wellcome Collection  Public Domain 

Labour's shadow health secretary, Wes Streeting, is a fan.

"This is a system that is designed around patients...The NHS [National Health Service] is perfectly capable of arranging appointments in a way that maximizes the convenience of patients - it just often chooses not to, or the system isn't wired to think about that."...

At the end of his Singapore tour, Streeting was struck by how often officials he met praised the NHS for its streamlined single organisation structure.

"We're not realising any of those advantages... Consultants and nurses often feel the dead weight of management bureaucracy holds them back. We do need to adopt a culture of innovation."

His "tough love" plans are being drawn up to deliver just that: "The NHS," says Streeting, "is a a service, not a shrine."

(Shaun Lintern, The Sunday Times, 2023)

Thank goodness some politicians are willing to learn from the good practice being shown in other countries. Many thanks Singapore.

Trying to buy happiness

This is the beginning of my journey into the secret world of psychiatric care for the ultra-high net worth elite...

Paracelsus Recovery is in an unassuming former residential building overlooking Lake Zurich. Inside are treatment rooms and luxury apartments for up to three clients, though schedules are strictly vetted to make sure no two clients ever meet. This is because they are some of the wealthiest, most powerful and most recognised people in the world. Aristocrats and executives, celebrities and royalty, heads of state and Arab sheiks seek out this facility when they've hit rock bottom, paying about £100,000 a week to be treated here...

Ian Gerber, Paracelsus's chief executive and founder... understands that to help his millionaires get better, he needs to cater to their nonsensical whims as well as providing cutting-edge medical care... Before they check in, they are offered a brochure of floristry and art to choose from, though some still bring in their own interior designers to re-wallpaper their rooms. Several Middle Eastern clients have set up Bedouin tents on the roof terrace of the penthouse...

Happy Days
Richard J. Croft (b. 1935)
Photo Credit: Down County Museum [CC BY-NC-ND]

The city is rife with people whose breakdowns are bubbling beneath the surface. Referrals for CEOs have skyrocketed, according to Gerber, who believes he is seeing a crisis in the boardroom. In 2020 referrals for CEOs increased by 500 per cent over the previous seven years, and last year his team saw referral rates for CEOs double again on the previous two years...

Burn outs from CEOs are often down to substance issues, coping with stress that way... The CEOs is the job that attracts the most psychopaths and narcissists, and Gerber says they're chronically drawn to dopamine-related substances, most commonly cocaine...

So there are  instances of people in London offices secretly injecting drugs at work? 

"Yes. Big-shot people," Gerber replies gravely.

In which industries?

"Commodities. Financials. Psychopathic CEOs will come to us when appearances, their facades start to crumble. That's often the reason or the moment they will seek treatment, and not before."...

One client  commuted weekly between the clinic and a London television studio... Gerber has treated professional athletes... entertainers who've checked in mid-tour and at least one Hollywood A-lister... He has also worked with politicians -  including Westminster's - and heads of state from other countries. For one foreign political leader we had cabinet meetings - and press appearances kept down to a minimum. And there were cover stories that the person wasn't well - you know, cold flu - because if you're head of state you don't really have an excuse for not appearing. There is no way you would get re-elected with that stigma...

"Money can't buy happiness - it's quite the opposite," Gerber argues. "It doesn't matter how much money you have or what your last name is."...

(Sian Boyle, Sunday Times, 2023)