Twist in Susan Lim case widens affective divide


Ministers can’t be very happy with the Sunday Times for a story the newspaper carried on 26 October 2014. Of course, that’s only if they understand how public opinion is shaped. They may not. Going by the tone-deaf way they have conducted themselves across a whole range of policies, they may have no feel for the public pulse.

The story about the High Court slashing lawyers’ fees may at first seem to have nothing to do with the People’s Action Party. But netizens quickly zoomed in on one name: Alvin Yeo, senior partner of the law firm WongPartnership LLP . Alvin Yeo is also the PAP member of parliament for Choa Chu Kang GRC. WongPartnership was retained by the Singapore Medical Council to represent them in the Susan Lim case.

In this era of heightened political sensitivity to a widening income gap and the way Singapore has become a playground for the self-indulgent rich, causing rents and costs of living to skyrocket, any news about the elite further inflating their incomes can only stoke popular outrage. Now with Alvin Yeo’s name being mentioned in this case providing the bridge, public anger will flow over it, enveloping the PAP.

The Susan Lim case

The Susan Lim case was headline news from 2011 to 2013. The surgeon was accused of overcharging the the Brunei royal family when she billed them $24.8 million (according to the Straits Times) for treating the sister of the Brunei queen. The Singapore Medical Council convened disciplinary hearings.

The Singapore Medical Council has ruled that renowned surgeon Susan Lim be suspended from practising for three years.

She is also to be fined $10,000 in a case involving overcharging a member of the Brunei royal family. She will also be censured in writing and must undertake not to overcharge again.

Dr Lim, 57, is appealing against the punishment, which was revealed in appeal papers she filed in the High Court last week. The punishment is believed to be among the most severe meted out to an errant doctor, short of being struck off.

She will continue to practise pending the outcome of the appeal. The appeal before the Court of Three Judges is due to be heard in the week of Jan 14 next year.

The court papers, seen by The Straits Times on Wednesday, revealed that Dr Lim was found guilty last month of 94 charges of professional misconduct.

This included making false representations in some invoices she sent to other medical specialists she called in to treat the patient.

The dispute centres on the bill she charged for treating Pengiran Anak Hajah Damit, the sister of the Brunei queen, before the patient died of cancer in 2007. The bills for her last seven months came up to about $25 million.

But she has argued the figure was actually lower and included the cost of flying the patient between Singapore and Brunei. The bill size shocked Singapore’s Health Ministry, which filed charges of professional misconduct against her with the Singapore Medical Council (SMC) in 2010.

— Straits Times (Breaking news), 23 August 2012, 3-year suspension for Susan Lim, rules SMC. Link.

As the above story noted, she appealed the SMC’s findings. Eventually, she lost (judgement here), and about a year later, the same newspaper reported:

The highest court in Singapore on Monday dismissed an appeal by general surgeon Susan Lim against her conviction on charges of professional misconduct over the amount she charged a patient from the royal family of Brunei.

In a 109-page written judgment, the three-judge Court of Appeal said Dr Lim’s case was “clearly one of the most serious cases – if not the most serious case so far – of overcharging in the medical profession in the local context”. The court dismissed her claims that she was justified and there was no ethical obligation to charge a fair and reasonable amount and pointed out her approach showed she had shown no remorse.

In the judgment, the court ruled there is an objective ethical limit on medical fees that operates outside contractual and market forces, The court found that, given a doctor’s specialised knowledge and training, there arises an ethical obligation on the part of a doctor not to take advantage of his patient. And this ethical obligation to charge a fair and reasonable fee is not superseded by a valid agreement between the doctor and his patient, the court held.

— Straits Times (Breaking news), 1 July 2013, Dr Susan Lim loses appeal against SMC’s guilty verdict, Link.

The Court of Appeal said that the SMC could recover costs of their proceedings from her, but after receiving the bills, her husband Deepak Sharma appealed to the High Court to review the costs they were being asked to pay. The process is known as a ‘taxation hearing’.

There were apparently two bills from the SMC, for the two disciplinary hearings held and the court hearings that followed. The first, for a shade over $1 million was reduced by the High Court to $370,000 on or around 1 July 2014.

“I believe that the actions by the lawyers in grossly overcharging my wife by $637,009 (the difference between the original bill amount of $1.007 million and the $370,000 allowed by Justice Woo) are dishonourable and constitute grossly improper conduct,” Mr Sharma alleged in his complaint.

—, 3 July 2014, Susan Lim case takes new twist. Link.

Now news has come that the second set of bills, totalling 1.327 million, was also deemed to be excessive. It has been reduced by the High Court to $317,000.

The Alvin Yeo connection

The SMC billed Susan Lim for the legal services they needed from WongPartnership, as one component of costs. These legal fees the SMC claimed they had to pay came to $900,000 for three lawyers, one of whom was Alvin Yeo. The Sunday Times on 26 October 2014 summarised the High Court’s findings thus:

The judgment: A doctor found guilty in an SMC disciplinary hearing can only be charged for the services of one lawyer – unless the proceedings are so complex they call for another lawyer who must be certified by SMC’s disciplinary committee.

This certification was not done in this case.

Assistant Registrar Jacqueline Lee decided what was claimed for both Ms Melanie Ho and Ms Lim Wei Lee should not be allowed, andthe $514,000 claimed for Senior Counsel Alvin Yeo’s work was too high.

The SMC had originally presented a bill of $1,229,804 for 1,900 hours spent by its lawyers on the case, claiming “out of abundance of caution, the amount stated is a reduced figure of the time spent”. The Law Society also has verified that the SMC paid a higher amount to WongPartnership than it is claiming from Dr Lim.

Ms Lee said that SMC’s statement meant little since she had no information on how much time had actually been spent, and criticised the council for not detailing what the lawyers had spent their time on.

She also pointed out that “collectively, Mr Yeo, Ms Ho and Ms Lim allegedly spent 718 hours” – much less than the 1,900 hours claimed for.

Ms Lee added that if the 1,900 hours included two replacement lawyers catching up on what had happened before they joined the team, “it would be unreasonable to make the respondent (Dr Lim) bear the costs arising from any such inefficiency in the conduct of the prosecution”.

— Sunday Times, 26 Oct 2014, Exorbitant, unreasonable.

As you can see from above, the facts are rather more layered and contestable than the headlines might suggest, but the public — as publics tend to be — is not going to bother much with the nuanced details of the above. All people are going to remember a week or more from now, and going into the next general election, is that a PAP member of parliament was connected with a case which the High Court considered to be overbilling. This nugget of news is going to feed into the easily-believed view that the well-off have no conscience, no sense of responsibility to wider society, and are driven by greed. And the well-off includes the ruling elite snuggling within the bosom of the PAP. As I mentioned above, in these times of ever-widening income gap — some might even describe it as obscene — such a view will find much resonance.

Against this, it is going to be virtually impossible for the PAP to convince anyone other than its diehard loyalists that its candidates are standing for election because they identify with ordinary people, or that they sense a calling to serve. Moreover, the claim of immaculate integrity that the party prides itself with is now going to have new mud sticking to it.

That said, the SMC is appealing this decision, so the final outcome may be quite different again.  However, I’d wager that even if the appeal overturns the Assistant Registrar’s finding, no one is going to believe that the $900,000 bill was fair. You can’t force people to change their private opinions; instead they are very likely to take the view that the same elite are circling the wagons defending their own.

The affective divide, a term so famously coined by Catherine Lim two decades ago, will just get wider.

Ministerial salaries

At every election, ministerial salaries are potent rallying cries. Despite the PAP trying election after election to explain that if they didn’t peg salaries to the private sector, no ‘talent’ can be found to lead the country, the issue has never gone away. Firstly, people never believed that successful careers were the only marker for ministerial talent; secondly, it was never a good explanation for the pay given to ex-military bigwigs frantically shovelled into the cabinet; thirdly, people always cast a skeptical eye on anyone who needed to be assured of continued riches to leave the private sector “to serve”.

But with this development, even the very first equation can be called into question. What does “pegging to the private sector” mean when, in the eyes of the public, top private sector earnings are now considered to be the result of inflationary braggadocio?



13 Responses to “Twist in Susan Lim case widens affective divide”

  1. 1 Frank 28 October 2014 at 10:34

    This is the rot that started over twenty years ago when ministerial salaries were pegged to top earner’s pay. First the politicians, then the doctors, now the lawyers. Who next? The whole think stinks!

  2. 2 Lee Fu Sheng 28 October 2014 at 12:44

    So long-winded. I lost interest after two paragraphs. Can summarise the main point?

    • 3 yawningbread 28 October 2014 at 16:18

      Yawning Bread is not Facebook.

      • 4 yuen 29 October 2014 at 13:44

        people get overexcited just because they see the name of a PAP-MP; the highly paid politicians certainly ride the gravy train, but they are merely part of a wider phenomenon of corporate CEOs, investment bankers, hedge fund managers, etc, that benefit from the current flood of liquidity churning around; even cancer doctors and other professionals try to join in, not always successfully

  3. 5 Alan 28 October 2014 at 12:50

    Can someone tell me if a legal firm were to bill their client for spending 1900 hours on any legal case but actually only spent an alleged 718 hours, is that overcharging tantamount to cheating ?

    If that is the case, how come SMC does not proceed to make a complaint about the legal firm of any impropriety while it see it their duty to charge Susan Lim for the same kind of impropriety for overcharging ?

    And whether it is prepared by a legal clerk but not by the managing director as we are told , does it really matter in law anymore ?

  4. 6 ;Annonymous 28 October 2014 at 14:20

    Pegging their salaries to that of the private sector is only half the equation. The other abandoned half is that of private sector governance and discipline. One serious mistake and you are out in the private sector. Has any one been booted out in the public sector? They will have their cake and eat it.

  5. 7 stngiam 28 October 2014 at 16:32

    This case was ill-conceived from the start. Govt cannot on the one hand say that private health care prices are determined by the market and on the other hand accuse a doctor of over-charging. If it were a truly needy case, it would be one thing, but in this case, the patient’s family had more than enough resources to fight their own battles. This was basically a case of governmental arrogance and regulatory over-reach. Ironically, it might have played well to the gallery in the beginning and was used by govt to create the perception that it was reining in salaries at the top, but in the end, it just revealed how self-serving and yet inept Singapore’s elite really is.

  6. 8 Chanel 28 October 2014 at 16:41

    Pegging ministerial pay to top private sector also introduces huge survivorship bias. One can be a top private sector earner this year, but retrenched or made bankrupt the next.

    In fact, people asked this question many years ago. DPM Teo Chee Hean then acknowledged that the survivirship was just 50%. He didn’t disclose what time series data he based his figure on, but you bet that he has data-mined to arrive at the best possible figure.

  7. 9 MaxChew 28 October 2014 at 17:02

    Laughing all the way to their DBS Bank is the credo of our leaders and elites. First the PM and his Ministers and top civil servants, then the doctors and dentists, and now the lawyers……one big happy family enjoying life to the hilt in Singapore! God help the rest, the kersian poor and destitute……

    • 10 Rabbit 29 October 2014 at 16:35

      Well, everybody has a car, we have two – my wife drives one, I drive one. We are both professionals, we need to travel.” Koh Poh Koon

      Now you know why some people, who can be so out of touched with their residents, wanted so badly to become a politician. Obviously not to serve but surely, as Grace Fu has pointed out, the money is good for her to make “sacrifices”.

  8. 11 song heng 29 October 2014 at 14:22

    That’s why we should never let the minority rich rule over the majority poor. Whose interest will these greedy pigs be looking after? Yours? Fat hope, unless you belong to the rich.

  9. 12 Duh 30 October 2014 at 23:09

    The argument given by the PAP to justify for high ministerial salaries was fundamentally flawed to begin with and does not require the supplementary argument of highly paid individuals inflating their financial worth —

    if one uses financial gain to attract people into politics then the people who will be attracted to politics are those motivated by financial gain. This is true by definition. If someone wants to serve the country, then it is the opportunity to serve their country that attracts them. The ‘carrot’ one dangles reflect the main motivation of the person you desire to attract – tells you alot about the mentality of the PAP in terms of political motivation, doesn’t it?

    PAP, through their dominance in Parliament and the influence of one man, have created a situation where fallacious arguments can be put forward without shame and contest such that it has become the norm for them to do so.

  10. 13 Rajiv Chaudhry 5 November 2014 at 02:21

    The idea that ministerial salaries would drop after the 2011 review was always going to be a pie in the sky.

    The Gerard Ee committee reported that ministerial salaries would drop by some 31-36% following the change of formula after the 2011 review. The new formula pegs the entry-level MR4 ministerial salary at a 40% discount to of the median income of the top 1000 singapore citizen earners, regardless of profession or occupation. The report also recommends eight months bonus, subject to targets being met, to make up a total of 20 months salary in a typical year.

    It doesn’t take much imagination to see why Singapore has become a playground for the rich and famous. All it takes to game the system is to attract more billionaires such as Eduardo Saverin of Facebook fame to take up Singapore citizenship. The larger the pool of the ultra-rich in the top-1000, the higher our ministers and parliamentarians salaries. Thus the current formula encourages our ministers to attract ultra high net worth individuals to settle in (or perhaps not even settle in) Singapore and take up citizenship.

    It is a pity the committee passed up the opportunity to link ministers’ salaries to the only rational peg there can be: the median income of Singapore citizens. A formula stated as a multiple of the median income with a commitment to reduce that multiple over time would provide a powerful incentive to boost the income of our citizens. Instead, the incentive now is to find ways and means to boost the income of the top 1000. Is it any wonder then, that the income gap (and Gini) is soaring?

    As a footnote, it may be noted that in the Scandinavian countries, the difference between the bottom and the top in an average company is an order of three ie the salary of a CEO (who is not a businessman) is on average about three times that of an entry-level graduate. Our ministers would do well to keep this in mind as a model for egalitarianism but perhaps that is too much to expect of the PAP.

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