Q&A with Khoo Teck Puat Hospital, Dementia Singapore and Singapore Cancer Society
Leaders from across Singapore’s healthcare ecosystem came together for a generative conversation at the CEO Roundtable on Systems Leadership in Healthcare on 15 October 2025, co-organised by SIM Academy’s Centre for Systems Leadership (CSL) and NHG College.
Over the two-hour session, participants exchanged candid insights on capacity and capability building, new operating models, and the shift from organisation-centric perspectives to ecosystem-wide systemic challenges.
Moderated by Dr Ng Yeuk Fan, Director, Corporate Development at Khoo Teck Puat Hospital, the discussion was enriched by Professor Michael C. Jackson, Emeritus Professor at the University of Hull, who shared his pioneering work in Critical Systems Thinking and real-world experience in the UK.
Following the event, we spoke with several participants to capture their key insights and aspirations for the future of Singapore’s healthcare and social sectors.
A/PROF NG YEUK FAN, DIRECTOR OF CORPORATE DEVELOPMENT AT KHOO TECK PUAT HOSPITAL
Q: You mentioned that most systems are assumed in healthcare. Can you elaborate on this, and how can we better approach healthcare challenges systemically?
A: When I remarked that “most systems are assumed,” I meant that in the real world — especially in health and social care — systems are perspectives we take to make sense of complexity. Yet, because these perspectives differ depending on our roles, lived experiences, and the phase of change we are in, we often hold unspoken or misaligned assumptions about what the “system” is. Some see it as clinical workflows, others as organisational structures, population health arrangements, or even governance and data systems. Without explicit dialogue to surface and align these perspectives, our collective efforts at improvement risk working at cross-purposes. We must therefore invest more in conversations that make systems visible, so that we can redesign them together toward shared outcomes.
Q: What are your main insights from the CEO Roundtable, and how do you see the healthcare ecosystem collaborating more effectively?
A: From the CEO Roundtable, several insights stood out. First, misalignment often hides in information flow, not intent — system stewards must learn to manage the “seeing before the solving”. Second, building systems capability is a long-term effort. Many organisations try to “simplify” systems thinking by assuming that if work processes are designed well enough, people will act systemically without needing to learn systems thinking itself. But CEOs agreed that this is a shortcut — while it may produce short-term coherence, it leaves staff and emerging leaders unprepared for complex situations. There is ultimately no substitute for developing the ability to think systemically, both individually and collectively as leadership teams.
Q: What are your aspirations for how the healthcare ecosystem can collaborate more effectively to improve patient outcomes?
A: My aspiration is that more people in our health and social care ecosystem come to see that systemic work is possible. Once we understand that a deeper level of sophistication in seeing and shaping systems can be learned, we lay the foundation for far more effective and adaptive forms of leadership. But this requires first the awareness and belief that such sophistication is possible — that we can, together, become more capable stewards of our complex systems for better outcomes.
MR PAUL HENG, BOARD MEMBER, DEMENTIA SINGAPORE
Q: Dementia care spans across families, healthcare institutions, and communities. What are the systemic gaps you see in ensuring continuity of care across these touchpoints?
A: The need for professional dementia care continues to rise here in Singapore. The number of persons with dementia is steadily increasing, and this trend is expected to continue in the foreseeable future. Historically, dementia has been associated with old age. However, this is no longer the case, as persons with what we term Young Onset Dementia (YOD)—those diagnosed before the age of 65—are becoming more prevalent.
Although DSG is a 35-year-old organisation (we were previously known as the Alzheimer’s Disease Association), our learning journey continues. The two most recent gaps we’ve identified are the need for specialised care for YODs and palliative care.
We don’t know what we don’t know. Therefore, our learning journey persists. There is no established playbook for us. I am confident that as we forge ahead, we will uncover even more gaps along the way.
Q: What does a “systems-thinking culture” look like in an organisation like Dementia Singapore?
A: DSG is not unlike any other organisation. One of the key difference is perhaps, the existence of a board of directors whose main role is to work with the senior management team to set the vision and mission for DSG on a 3-year basis. Given the speed and regularity of changes, it would be wise of us to shorten the 3 to, perhaps 2 year visions.
For 35 years, we have operated in a manner that we have been accustomed to. Again, this is not unlike many other organisations. However, the necessary changes, perhaps primarily in how we think and lead DSG, must start from the top. For every decision, change, or initiative we plan to undertake, we must adopt a holistic (versus siloed) perspective, considering all the various stakeholders within our ecosystem.
This transformation will not happen overnight, of course. The key driver is the first step, and that must come from the board. The senior management team has completed two rounds of two-day systems leadership training, but little has changed since then. In my opinion, we need to get the board similarly trained and have one or two champions to push the envelope from there.
Q: From the discussions at the Healthcare CEO Roundtable, what are the main key takeaways and insights you would like to share with the healthcare and social service ecosystem? Additionally, what are your aspirations for how the healthcare ecosystem can collaborate more effectively to improve patient outcomes?
A: We need to retire the saying: “If it ain’t broken, why fix it” with “We need to make a systemic shift if we want to continue being an effective organisation.” What has worked for the past 35 years may continue to work for the years to come, but should we be satisfied with that? Or do we aspire to be better? Like any other social service agencies, my hope for DSG is that our continued evolution will eventually make our current role redundant.
MR DENNIS CHIA, GROUP DIRECTOR, SINGAPORE CANCER SOCIETY
Q: What do you see as the biggest challenges currently facing the social service sector? Could you share your approach to addressing these challenges as a leader?
A: One of the most pressing challenges is capacity building. In the charity and social service sectors, there is a strong emphasis on addressing immediate needs, particularly in patient care. However, this often comes at the expense of long-term investment in developing people and systems. We need to dedicate time to develop our people for the future, training them to think systemically and approach problems from a broader perspective. I believe it’s essential to balance urgent service delivery with strategic workforce development. This includes fostering a culture of continuous learning, investing in leadership development, and aligning team capabilities with long-term organisational goals.
Q: What mindset shifts do you believe are most essential for social service organisations to think and act more systemically?
A: To think and act more systemically, social service organisations must shift from siloed, function-specific KPIs to a shared accountability model, if they have not already done so. The “silo mentality” can hinder a holistic understanding of the service user’s journey. Encouraging cross-functional collaboration and aligning incentives around system-wide outcomes—rather than isolated departmental metrics—are critical steps toward systemic thinking. System enablers would need to be in place to support shared accountability and care, including ability and willingness to share data.
Q: For emerging social service leaders navigating today’s BANI environment—bold, adaptive, non-linear, and inclusive—what would be your top advice for leading effectively and staying flexible in such a complex landscape?
A: We need to train leaders to think systematically and create structures that support holistic problem-solving. This is especially important to guide emerging leaders through complexity. I encourage us to think about these beyond “departments” and “organisations” because our service users navigate the entire ecosystem.
Q: From the discussions at the Healthcare CEO Roundtable, what are the main key takeaways and insights you would like to share with the healthcare and social service ecosystem? Additionally, what are your aspirations for how the healthcare ecosystem can collaborate more effectively to improve patient outcomes?
A: There is a need to strengthen system resilience in Singapore’s healthcare landscape. Frameworks like E.P.I.C. (shared by Prof. Michael C. Jackson) are useful for guiding systemic reflection, especially in a complex industry such as healthcare.
It is important for us to collaborate across the entire healthcare ecosystem, in support of national initiatives like HealthierSG, so that we can collectively serve our population in the best possible way.
Leadership Must Evolve from Managing Institutions to Stewarding Ecosystems
Thomas Lim, dean of the SIM Academy’s Centre for Systems Leadership, remarked that the CEO Roundtable reaffirmed Singapore’s healthcare and social service sectors are at a critical juncture, where leadership must shift from managing individual institutions to stewarding entire ecosystems.
“The conversations revealed that systemic thinking is not merely an abstract philosophy, but a practical discipline of seeing connections, aligning collective intent, and cultivating shared stewardship across boundaries,” he said. “As participants reflected, the ability to ‘see before solving’ is foundational for progress. It enables leaders to surface assumptions, coordinate meaningfully, and design solutions that endure beyond individual programs or funding cycles.”
At the Centre for Systems Leadership, we see this as an inflection point. Developing systemic capability in healthcare and social services means cultivating leaders who can balance complexity with compassion, structure with learning, and urgency with reflection. The Roundtable emphasised that this journey must be collective, linking boards, management teams, and frontline practitioners in a unified learning ecosystem. Moving forward, the focus is not about adding new frameworks, but about deepening shared understanding so that systemic thinking becomes a common language, guiding Singapore’s care systems towards becoming more connected, adaptive, and humane.