The Issue of National Kidney Foundation Management in Singapore

National Kidney Foundation (NKF) has been part of a controversial topic in Singapore during the early 2000s and previously made headlines for not the best of reasons. In spite of its notable contributions towards helping kidney failure patients and the needy, there were perennial problems that plagued NKF which inadvertently caused its downfall. The root issues where majority of the controversy stemmed from were NKF’s transparency to the public and its poor accountability to matters within its governance structure. The Executive Committee (EC) that was set up was given total power to manage NKF’s affairs. It was made known that the EC automatically approved any proposals made by the members instead of through collective decision-making. The ideology, where all proposals made were in NKF’s best interests and hence need not require proper vetting, is erroneous. By doing so, this potentially means that the Board members would proceed with whatever they wanted without much consideration or opposition. This would not always necessarily lead to the most optimal outcome in managing NKF without a thorough evaluation of each proposal.

The EC should have scrutinized each proposal to its finest details to see if there is anything that could be improved, or whether there is a better alternative to maximise benefits for NKF. If all proposals are accepted by default, the purpose of setting up the EC would be meaningless when it was supposed to be a decision-making body in governing NKF. In an attempt to strengthen NKF’s governance structure, an independent audit committee (AC) was established to improve its system of internal control. The AC was slated to review audit plans and existing internal control systems regularly every three months. However, the AC meetings were inconsistent and did not fulfil its role in keeping NKF in check dutifully. When NKF’s internal auditors recommended for certain internal control measures to be put in place, both EC and AC did not support their implementation for unknown reasons. It is indeed ironic when there are intentions to improve NKF’s administrative processes but the various recommendations made are not being adopted. Hence, it has become questionable to whether the higher management truly wants to ameliorate the situation, or all these efforts were just a façade.

With the disregard of maintaining stringent internal control, this could possibly be a lapse for having greater transparency in its governance and thus provide loopholes to exploit vulnerabilities in NKF’s processes for personal gains. As such, there could be a less efficient use of NKF’s limited resources and its performance might not have been fully optimized to provide the best welfare for its beneficiaries. In addition, the financial committee (FC) set up by the EC to oversee all major financial decisions lacked transparency in their line of work too. The chairman of the FC claimed he had lost all data of the minutes of the FC’s meetings. Such a simple mistake made by the head with no precautionary measures in place is definitely unbecoming of someone helming a high position. In this case, critical information discussed regarding the financial decisions of NKF would be inadvertently withheld from the public. It would be irresponsible in answering to the key stakeholders of NKF, who are the donors financially supporting the foundation, on how funds are being used.

This could lead to less trust from the public without proper accountability, where declining support from donors would only mean that less help is rendered to those who truly need assistance. Other than that, a remuneration sub-committee (RSC) was also created to overlook the decisions regarding salaries, working conditions, overtime payments and employment terms. However, NKF’s Chief Executive Officer (CEO) Thambirajah Tharmadurai, also known as T. T. Durai, was given the ultimatum for these decisions. This would mean that the powers RSC had in influencing such decisions were limited and at most, it was just an advisory. Without a fixed remuneration structure enforced, it would not be completely fair and transparent for all employees. There could be a possibility where an inherent bias made by Durai towards a particular employee translated into more favourable employment terms being offered.