| video_url |
https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/4be73137691ca408910f851cee9479fc570a598ce3c5a9464ce663faeb1c4e2e11952e407ee502b55ea18f28b6918d91.mp4/playlist.m3u8 |
| 委員名稱 |
楊曜 |
| 委員發言時間 |
12:59:22 - 13:10:42 |
| 影片長度 |
680 |
| 會議時間 |
2024-11-04T09:00:00+08:00 |
| 會議名稱 |
立法院第11屆第2會期社會福利及衛生環境委員會第7次全體委員會議（事由：一、繼續處理中華民國113年度中央政府總預算有關衛生福利部主管預算凍結報告案1案。
二、邀請衛生福利部部長針對「社區精神病患照護優化」進行專題報告，並備質詢。） |
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3.505 |
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主席請教邱部長 |
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10.612 |
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各位好,部長好。部長,世衛組織有提出精神疾病應該要朝向社區化的照護發展為目標。那當然這個其中裡面有很多的問題必須要去克服。那我先問一下,就是說根據統計 |
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33.439 |
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34.76 |
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請問一下部長就是使用者不高的主因是什麼? |
| transcript.whisperx[3].start |
63.439 |
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88.364 |
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好,謝謝委員,這隨行因為把精神病患引導向測序化的照護這個是一個很好的目標當然我剛才也說了會引申很多的問題那不過我們還是要既然這是目標還是要有越多人使用越好那 |
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91.343 |
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101.559 |
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使用這個社區式服務的人數不高的主因是什麼?謝謝委員只是這個我們努力的方向那是不是請那個新鮮師跟我們報告 |
| transcript.whisperx[5].start |
103.664 |
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124.632 |
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報告委員不管是心理健康師或是社家屬其實我們對於這個精神病人的社區支持資源的部件我們都非常的努力那委員剛剛有提到就是說目前看起來使用這個服務的人數並不多比例太低了那我想應該是有兩個因素第一個因素就是說我們目前資源還在佈建的路上 |
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124.872 |
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125.172 |
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主席 |
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142.022 |
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160.862 |
| transcript.whisperx[7].text |
﹗ |
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161.022 |
| transcript.whisperx[8].end |
163.064 |
| transcript.whisperx[8].text |
所以你剛剛講的就是你們接下來要怎麼增進然後落實這個政策的方法對不對?是好那這就有一個問題是 |
| transcript.whisperx[9].start |
186.96 |
| transcript.whisperx[9].end |
210.878 |
| transcript.whisperx[9].text |
你們在辦理精神病人社會關懷照護計畫的時候呢他大概是由公衛護理師然後社區的關懷員來做以面試的方式做的建構出來的通報系統對不對那社區訪視員 |
| transcript.whisperx[10].start |
216.071 |
| transcript.whisperx[10].end |
229.001 |
| transcript.whisperx[10].text |
我這邊有的資料是全國社區訪視員的人力包括督導我連督導都算進去大概就只有600人這個人力夠嗎? |
| transcript.whisperx[11].start |
233.082 |
| transcript.whisperx[11].end |
255.615 |
| transcript.whisperx[11].text |
五百九十二人。五百九十二人,對。這個人力夠嗎?沒有夠,不夠的。這個就一直,問題就一直停在這裡,就是我們長期以來明明就是社政這一方面的人力,從照護員、訪視員、社工的人力都很不足。 |
| transcript.whisperx[12].start |
261.06 |
| transcript.whisperx[12].end |
278.619 |
| transcript.whisperx[12].text |
我發現我在這邊質詢這個好像就是一直質詢一個無解的問題啊你知道我國社區訪視員負擔個案的案件量跟日本相比日本是1比10 |
| transcript.whisperx[13].start |
280.731 |
| transcript.whisperx[13].end |
289.938 |
| transcript.whisperx[13].text |
我們目前社區訪視員一個人平均負責訪視的案量大概就有50人是日本的10倍沒有要讓你們說啊這個怎麼解決啊我覺得不應該只是一直在委員會說要增加人力啦增加人力必須要拿出具體的辦法出來而且必須要提高誘因啦 |
| transcript.whisperx[14].start |
311.57 |
| transcript.whisperx[14].end |
326.701 |
| transcript.whisperx[14].text |
是,這也是跟護理師、網絡護理師一樣面對要從多元化來解決今天早上我們已經討論那麼久如果我只是回答說我們在努力我想也不具體啦就是我會認為從剛剛那個連江縣體那個特別的訓練那個也特別的計畫這個也是一個 |
| transcript.whisperx[15].start |
341.281 |
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363.132 |
| transcript.whisperx[15].text |
這個我就提一下就是說你整體的社會你薪資待遇跟社會地位不強化公費生也沒有用因為我們澎湖就離島也有護理系的保送生都沒有人報考 |
| transcript.whisperx[16].start |
368.001 |
| transcript.whisperx[16].end |
377.543 |
| transcript.whisperx[16].text |
你整體的還是必須要從整體的結構上來做使力才有效果啦是是是 |
| transcript.whisperx[17].start |
378.59 |
| transcript.whisperx[17].end |
407.529 |
| transcript.whisperx[17].text |
所以怎麼樣讓在提他的工作環境好,其實社工是我們在醫療團隊裡面一直都是非常重要的,像你在醫院也一樣,醫生做醫生,護士做護士,什麼不做的幾乎都是社工來做的。從社工到照服員都一樣,就是整個社政系統裡面。而且到社區以後都是更需要很龐大的這些人力,那怎麼樣讓這些人力他們因為 |
| transcript.whisperx[18].start |
408.757 |
| transcript.whisperx[18].end |
433.509 |
| transcript.whisperx[18].text |
就是因為他們做這個專業也是很有專業的使命感尊榮感對嘛所以才說國家有多餘稅收的時候不能發現金嘛應該要用來提高某一些人的薪資待遇或者是用來補勞健保嘛這個就是我一直的主張嘛 |
| transcript.whisperx[19].start |
434.704 |
| transcript.whisperx[19].end |
443.761 |
| transcript.whisperx[19].text |
我最後花一點時間跟部長討論一下部長我大概從我在這個委員會第4屆了 |
| transcript.whisperx[20].start |
446.206 |
| transcript.whisperx[20].end |
472.611 |
| transcript.whisperx[20].text |
我大概討論醫學中心因為像剛剛陳雪生委員在這邊講的臺灣的醫療資源分佈太不平均了所以我就是知道醫學中心每增加一家就會把點值稀釋掉一部分所以大概在這邊一直要求 |
| transcript.whisperx[21].start |
474.964 |
| transcript.whisperx[21].end |
499.949 |
| transcript.whisperx[21].text |
醫學中心就是必須要定額只有你們一次評鑑增加了三家把整個除了民眾看病的致富額以外典值整個也吸制那執政黨呢用評鑑送醫院大禮 |
| transcript.whisperx[22].start |
501.598 |
| transcript.whisperx[22].end |
515.712 |
| transcript.whisperx[22].text |
那在野檔就要保障點子多少錢?阿你如果繼續警告我就支持點子保障阿,要報就大家報到阿。不只我講阿,我現在講的是監察院對你們的糾正阿。 |
| transcript.whisperx[23].start |
524.195 |
| transcript.whisperx[23].end |
548.554 |
| transcript.whisperx[23].text |
沒有那種既定的應該有既定的政策就是我就常講我來自離島很深刻的瞭解資源的分布有多不平均你們現在都會區全國還有14個縣市沒有醫學中心不是只有南北差距而已 |
| transcript.whisperx[24].start |
551.769 |
| transcript.whisperx[24].end |
568.887 |
| transcript.whisperx[24].text |
你們真的不要再用憑鑒來送大禮用憑鑒來送醫院大禮我就支持點子保障一口不夠保障1.2部長你有要講一下嗎?還是要聽我講? |
| transcript.whisperx[25].start |
576.876 |
| transcript.whisperx[25].end |
577.557 |
| transcript.whisperx[25].text |
是,這個真的是那個分級醫療 |
| transcript.whisperx[26].start |
597.14 |
| transcript.whisperx[26].end |
597.16 |
| transcript.whisperx[26].text |
對阿 |
| transcript.whisperx[27].start |
626.753 |
| transcript.whisperx[27].end |
641.782 |
| transcript.whisperx[27].text |
但是你現在就是特管期,你也很了解特管期一定要藝術中心嘛我現在不是說應該要特管期,我說你們應該要,就是定額20家的話,就是要有升有降,大家有競爭都有壓力嘛你現在不在講,就一直在講我現在主張有升有降啊,這也是醫學中心必須要納入評鑑 |
| transcript.whisperx[28].start |
653.092 |
| transcript.whisperx[28].end |
653.112 |
| transcript.whisperx[28].text |
謝謝委員 |
| gazette.lineno |
1198 |
| gazette.blocks[0][0] |
楊委員曜：（12時59分）謝謝主席。請邱部長。 |
| gazette.blocks[1][0] |
主席：請部長。 |
| gazette.blocks[2][0] |
邱部長泰源：委員好。 |
| gazette.blocks[3][0] |
楊委員曜：部長好，世衛組織有提出精神疾病應該要朝向社區化的照護發展為目標，當然其中有很多的問題必須要去克服。我先問一下，根據統計，在112年領有慢性精神病障礙手冊的大概有超過13萬，但是這一些人使用社區式服務的人數其實大概只有5,000人，不到一成，請問一下部長，使用者不高的主因是什麼？ |
| gazette.blocks[4][0] |
邱部長泰源：謝謝委員的垂詢…… |
| gazette.blocks[5][0] |
楊委員曜：因為把精神病患引導向社區化的照護是一個很好的目標，當然我剛才也說了，會衍生很多的問題，不過既然這是目標，還是要有越多人使用越好，使用社區式服務人數不高的主因是什麼？ |
| gazette.blocks[6][0] |
邱部長泰源：謝謝委員指出我們努力的方向，是不是請心健司跟我們報告呢？ |
| gazette.blocks[7][0] |
楊委員曜：好。 |
| gazette.blocks[8][0] |
鄭代理司長淑心：報告委員，不管是心理健康司或者是社家署，其實我們對於精神病人的社區支持、資源布建都非常地努力。委員剛剛有提到，目前看起來使用這個服務的人數並不多…… |
| gazette.blocks[9][0] |
楊委員曜：比例太低了。 |
| gazette.blocks[10][0] |
鄭代理司長淑心：對，我想應該是有兩個因素，第一個因素，我們目前資源還在布建的路上，所以有提供這個服務的民間機構是比較少的，這個部分其實我們已經有爭取到資源，希望能夠逐年把補助的機構數跟補助的經費都可以提升，基本上讓我們在服務提供的部分可以更加充足。第二個因素，可能是病人沒有來使用我們的服務方案，所以這個部分我們會加強跟地方政府的一個連結，就是在社區裡面的個案，也會透過我們的關懷訪視員來連結個案跟我們的服務方案之間，希望能夠鼓勵他們出來參加我們的方案，我想大概是這兩個因素。 |
| gazette.blocks[11][0] |
楊委員曜：所以你剛剛講的就是你們接下來要怎麼精進及落實這個政策的方法，對不對？ |
| gazette.blocks[12][0] |
鄭代理司長淑心：是。 |
| gazette.blocks[13][0] |
楊委員曜：好，可是這就有一個問題，你們在辦理精神病人社會關懷照顧計畫的時候，大概是由公衛護理師，然後社區的關懷員來做面試，以面試方式所建構出來的通報系統，對不對？社區訪視員的人力，我這邊有的資料是全國社區訪視員的人力，我連督導都算進去，包括督導大概就只有600人，這個人力夠嗎？ |
| gazette.blocks[14][0] |
邱部長泰源：592人。 |
| gazette.blocks[15][0] |
楊委員曜：592人，這個人力夠嗎？ |
| gazette.blocks[16][0] |
鄭代理司長淑心：是不夠的。 |
| gazette.blocks[17][0] |
楊委員曜：問題就一直停在這裡，長期以來，明明社政這一方面的人力，從照服員、訪視員到社工的人力都很不足，我發現我在這邊質詢這個好像就是一直質詢一個無解的問題啊！你知道我國社區訪視員負擔個案的案件量跟日本相比，日本是1比10，我們呢？目前社區訪視員一個人平均負責訪視的案量大概就有50人，是日本的5倍。我要讓你們說啊，這個怎麼解決？我覺得不應該只是一直在委員會說要增加人力啦！增加人力必須要拿出具體的辦法出來，而且必須要提高誘因啊！ |
| gazette.blocks[18][0] |
邱部長泰源：這也是跟網羅護理師一樣，要從多元化來解決，今天早上我們已經討論那麼久，如果我只是回答說我們再努力，我想也不具體啦！就是我會認為從……剛剛連江縣那個特別的計畫也是一個制度，怎麼樣留…… |
| gazette.blocks[19][0] |
楊委員曜：這個我就提一下，整體的薪資待遇跟社會地位不強化，公費生也沒有用啦！因為離島也有護理系的保送生，都沒有人報考啊！你還是必須要從整體的結構上來使力才有效果啦！ |
| gazette.blocks[20][0] |
邱部長泰源：是，所以怎麼樣讓他的工作環境好，其實社工在我們醫療團隊裡面一直都是非常重要的，像在醫院也一樣…… |
| gazette.blocks[21][0] |
楊委員曜：對，是從…… |
| gazette.blocks[22][0] |
邱部長泰源：醫生做醫生的、護士做護士的…… |
| gazette.blocks[23][0] |
楊委員曜：就從社工…… |
| gazette.blocks[24][0] |
邱部長泰源：什麼不做的幾乎都是社工在做。 |
| gazette.blocks[25][0] |
楊委員曜：從社工到照服員都一樣，就是整個社政系統裡面的…… |
| gazette.blocks[26][0] |
邱部長泰源：而且到社區以後，就更需要很龐大的人力，怎麼樣讓這些人力……因為他們做這個也是很有專業的使命感、尊榮感…… |
| gazette.blocks[27][0] |
楊委員曜：對嘛！所以才說…… |
| gazette.blocks[28][0] |
邱部長泰源：當然還有…… |
| gazette.blocks[29][0] |
楊委員曜：才說國家有多餘稅收的時候不能發現金，應該要用來提高某一些人的薪資待遇，或者是用來補勞健保，這個就是我一直的主張嘛！ |
| gazette.blocks[29][1] |
我最後花一點時間跟部長討論一下，部長，我在這個委員會第4屆了，我大概討論醫學中心，因為像剛剛陳雪生委員在這邊講的，臺灣的醫療資源分布太不平均了，所以我就是知道醫學中心每增加一家就會把點值稀釋掉一部分，因此在這邊一直要求醫學中心必須要定額，結果你們一次評鑑增加了三家，除了民眾看病的自負額以外，把點值整個也稀釋。執政黨用評鑑送醫院大禮，在野黨就要保障點值多少錢，你們如果再繼續增加，我就支持點值保障，要搞就大家搞到倒啊！不只我講，我現在講的是監察院對你們的糾正，沒有那一種應該要有的既定政策，我就常講，我來自離島，很深刻了解資源分布有多不平均，現在都會區，全國還有14個縣市沒有醫學中心，不是只有南北差距而已，你們真的不要再用評鑑來送大禮，用評鑑來送醫院大禮，我就支持點值保障，1塊不夠，保障1.2。部長，你有要講一下嗎？還是只有要聽我說？ |
| gazette.blocks[30][0] |
邱部長泰源：我只是非常…… |
| gazette.blocks[31][0] |
楊委員曜：我這裡只是跟部長報告，不是只有我講，是只要有關心到這個議題的，現在監察院的糾正出來了嘛！ |
| gazette.blocks[32][0] |
邱部長泰源：是，這個真的是分級醫療沒有落實，然後偏鄉醫療的困難，種種相當複雜的問題，只是說醫學中心到底是什麼角色，它要不要跟健保不要那麼密切，稍微脫鉤，也許大家就不會說……而且一結合又增加民眾的負擔…… |
| gazette.blocks[33][0] |
楊委員曜：對啊！ |
| gazette.blocks[34][0] |
邱部長泰源：它看的比較多錢嘛！ |
| gazette.blocks[35][0] |
楊委員曜：對啊！ |
| gazette.blocks[36][0] |
邱部長泰源：但是你也很了解，現在就是各縣市也一直要醫學中心嘛！ |
| gazette.blocks[37][0] |
楊委員曜：不是，我現在不是說應該要各縣市都有。 |
| gazette.blocks[38][0] |
邱部長泰源：我知道、我知道，我的意思是…… |
| gazette.blocks[39][0] |
楊委員曜：我是說你們要定額20家的話，就是要有升有降，大家有競爭才有壓力嘛，你們現在不曾降，只是一直在增加。 |
| gazette.blocks[40][0] |
邱部長泰源：對啦，你說有升有降這個部分…… |
| gazette.blocks[41][0] |
楊委員曜：我向來主張有升有降，這也是醫學中心必須要納入評鑑的理由，假如都不用降，我就主張不用評鑑了啊，讓他們浪費那麼多時間幹嘛？ |
| gazette.blocks[42][0] |
邱部長泰源：當然，要評鑑才能維護品質。 |
| gazette.blocks[43][0] |
楊委員曜：部長，我知道這不是在你任內發生的事。 |
| gazette.blocks[44][0] |
邱部長泰源：對，但是我們真的很關心這個問題。 |
| gazette.blocks[45][0] |
楊委員曜：不過以後不能再發生這種事，哪有在用這個當禮物送的。好，謝謝部長、謝謝主席。 |
| gazette.blocks[46][0] |
邱部長泰源：好，謝謝委員。 |
| gazette.blocks[47][0] |
主席：謝謝楊曜委員、謝謝部長。 |
| gazette.blocks[47][1] |
鄭正鈐委員、鄭正鈐委員、鄭正鈐委員不在。 |
| gazette.blocks[47][2] |
接續我們請陳瑩委員質詢。 |
| gazette.agenda.page_end |
272 |
| gazette.agenda.meet_id |
委員會-11-2-26-7 |
| gazette.agenda.speakers[0] |
蘇清泉 |
| gazette.agenda.speakers[1] |
陳昭姿 |
| gazette.agenda.speakers[2] |
陳菁徽 |
| gazette.agenda.speakers[3] |
林月琴 |
| gazette.agenda.speakers[4] |
廖偉翔 |
| gazette.agenda.speakers[5] |
邱鎮軍 |
| gazette.agenda.speakers[6] |
涂權吉 |
| gazette.agenda.speakers[7] |
王正旭 |
| gazette.agenda.speakers[8] |
鍾佳濱 |
| gazette.agenda.speakers[9] |
林國成 |
| gazette.agenda.speakers[10] |
楊瓊瓔 |
| gazette.agenda.speakers[11] |
林淑芬 |
| gazette.agenda.speakers[12] |
賴士葆 |
| gazette.agenda.speakers[13] |
黃秀芳 |
| gazette.agenda.speakers[14] |
陳雪生 |
| gazette.agenda.speakers[15] |
王育敏 |
| gazette.agenda.speakers[16] |
劉建國 |
| gazette.agenda.speakers[17] |
牛煦庭 |
| gazette.agenda.speakers[18] |
楊曜 |
| gazette.agenda.speakers[19] |
陳瑩 |
| gazette.agenda.speakers[20] |
黃國昌 |
| gazette.agenda.speakers[21] |
盧縣一 |
| gazette.agenda.page_start |
199 |
| gazette.agenda.meetingDate[0] |
2024-11-04 |
| gazette.agenda.gazette_id |
1139301 |
| gazette.agenda.agenda_lcidc_ids[0] |
1139301_00004 |
| gazette.agenda.meet_name |
立法院第11屆第2會期社會福利及衛生環境委員會第7次全體委員會議紀錄 |
| gazette.agenda.content |
一、繼續處理中華民國113年度中央政府總預算有關衛生福利部主管預算凍結報告案1案；二、邀
請衛生福利部部長針對「社區精神病患照護優化」進行專題報告，並備質詢 |
| gazette.agenda.agenda_id |
1139301_00003 |
| IVOD_ID |
156444 |
| IVOD_URL |
https://ivod.ly.gov.tw/Play/Clip/1M/156444 |
| 日期 |
2024-11-04 |
| 會議資料.會議代碼 |
委員會-11-2-26-7 |
| 會議資料.屆 |
11 |
| 會議資料.會期 |
2 |
| 會議資料.會次 |
7 |
| 會議資料.種類 |
委員會 |
| 會議資料.委員會代碼[0] |
26 |
| 會議資料.標題 |
第11屆第2會期社會福利及衛生環境委員會第7次全體委員會議 |
| 影片種類 |
Clip |
| 開始時間 |
2024-11-04T12:59:22+08:00 |
| 結束時間 |
2024-11-04T13:10:42+08:00 |
| 支援功能[0] |
ai-transcript |
| 支援功能[1] |
gazette |