Interviewed by Charlie Penny and Jonathon Gray
Eugene Fidelis Soh is Deputy Group CEO of Singapore’s NHG Health and Executive Director of the Centre for Healthcare Innovation. He leads efforts to improve population health for 1.5 million residents, integrating health and social care, strengthening primary and community services, and driving innovation. In this interview, he reflects on the experiences that shaped him and why collective leadership is essential for the future.
What motivated you to go into healthcare?
I started in medicine and grew into healthcare. As a doctor, you can get frustrated with the inability to deliver the care you want for your patients. That came very personally for me when my mother was diagnosed with end-stage breast cancer. Coming from a family of doctors, it felt almost criminal not to have picked it up earlier.
While we could blame the doctors and nurses, the truth was that the health system did not provide the environment for them to deliver the care they wanted. That shifted my perspective towards healthcare and public health, and to redesigning health systems going forward.
Could you help us by defining what you mean when you talk about healthcare?
As a young doctor, you learn to diagnose, treat and rehabilitate. Healthcare is the system that enables clinicians to do that well. It boils down to access, quality and affordability, the “iron triangle”.
But if we want to keep people healthy and reduce consumption of healthcare, we need a preventive approach and a fundamental shift from healthcare to health. That transformation has unfolded over two decades of my career, as I’ve seen systems, like Canterbury in New Zealand, move from good clinical care to population health as the guiding mental model. There is much still to do.
Are there any major experiences or challenges that have informed your style as a leader?
The biggest challenges and the biggest opportunities are about people. It is easy to change a process or buy a new technology, but much harder to change yourself.
To move towards proactive population health, we must shift mental models. There is tremendous opportunity to redesign systems and move beyond the iron triangle to the Triple Aim.
The shift you’re talking about, at the heart of it, is a behavioural shift. What behaviours from colleagues encourage or inspire you?
Leadership in clinical medicine revolves around role modelling, apprenticeship and mentorship. But a mentor once pointed out that while doctors’ opinions carry weight, as a manager your opinion does not hold the same weight. That was humbling.
Moving from clinical to managerial leadership means shifting from heroic, individualistic leadership to a more collective, distributed model. It’s challenging but essential.
Peter Senge once told me: “Leadership is not about having a shared vision, but shared visions.” Leadership is about uniting people to build something extraordinary. Peter Drucker also said the purpose of an organisation is for ordinary human beings to achieve extraordinary things together.
At the population health level, you can’t control everything, from social determinants to community factors. You need shared visions to build something greater.
The need to build collective systems and shared visions, where does that leave your personal style as a leader and how do you role model those behaviours?
Exactly, I don’t matter anymore. If I matter, it wouldn’t be a collective.
In warfare, you shoot the general and the army scatters. But if everyone is a general, the movement is hard to stop.
Healthcare is medical, but health is social. To pivot towards population health, especially for vulnerable populations, we need system-wide leadership. If change depends on individuals, it will fail. We need communities and partners sharing ownership.
You need everyone to be a general and you need everyone to build the pyramid. In all leaders at all levels of your organisation, what are the qualities that you look for?
There is no single person with all the qualities. But the fundamental ingredient is relationship building, interpersonal skills, teamwork, and networks across teams and organisations.
People and systems are two sides of the same coin. Strong relationships bind systems together and enable change.
What advice would you give to the young leaders coming through your system?
Take more risk.
Leadership is something you must experience. If you stay in your comfort zone, you won’t grow. Many people are trapped in comfort or on burning platforms.
Leadership is also a relationship, built through shared experiences. I’ve been blessed to work with many inspiring people, including Jonathon, who have given me food for thought beyond anything I could have learned by keeping my head down.
Where have things gone wrong and what have you learned from that?
There have been many things that haven’t worked, but challenges bring renewal and opportunities to rethink.
I’ve experienced SARS, H1N1, Zika and COVID-19. What happens after the pandemic matters more than what happens during it.
We learned that we couldn’t respond just because we had a plan. We could respond because we had relationships, common language and understanding.
People often want to capture what worked and what didn’t, but they miss the point: it is not the plan; it is the planning that matters. Every plan has gone wrong. But planning has gone right.
What does the future look like to you?
Look at the person 30 years younger than you, that is the future.
Through their eyes you see what is possible, and how they want their health system to be. The future depends on giving young leaders opportunities to learn, try, fail and grow quickly.
What advice would you give to a younger Eugene?
Start earlier.
Every young healthcare manager should have an early posting in quality. It teaches improvement, belief in change, and gives the tools to level up. But don’t get stuck there. Quality can become risk-averse and inhibit innovation. Start with quality, but end with the person.
What are you reading at the moment?
A book by Douglas O’Loughlin on polarity thinking called ANDlightenment: Polarity Thinking, from Self to Society. It helps leaders hold polarities, faster, better, safer, cheaper, and why not happier too.
What is the best advice you’ve been given?
The Māori phrase: He tāngata, he tāngata, he tāngata.
What is the most important thing? It is people, it is people, it is people.
Leading Across the Commonwealth and Beyond captures vital conversations between global health leaders and emerging voices. In this blog, we explore how to redefine how we lead with compassion, connectivity, and courage in an increasingly complex world.
Declarations of Interest
Professor Eugene Fidelis Soh: Serves as a member of the International Editorial Board for BMJ Leader.