video_url |
https://h264media01.ly.gov.tw:443/vod_1/_definst_/mp4:1M/bfaf9b39ac01a68520f6709a214df6ef4d6e69b556667bbc083084566cc2bdb42fad2892f1b361885ea18f28b6918d91.mp4/playlist.m3u8 |
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。) |
委員名稱 |
完整會議 |
影片長度 |
17951 |
委員發言時間 |
08:30:49 - 13:30:00 |
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測試測試一二三 |
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404.053 |
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432.927 |
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議員議員議員議員 |
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1554.684 |
transcript.whisperx[2].end |
1554.786 |
transcript.whisperx[2].text |
本集完 |
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1586.391 |
transcript.whisperx[3].end |
1586.655 |
transcript.whisperx[3].text |
本集完 |
transcript.whisperx[4].start |
1723.656 |
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1723.696 |
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報告案2 |
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1827.759 |
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大家好我們現在開始開會齁出席委員已足法定人數現在開會請議事人員宣讀上次會議議事錄立法院第11屆第2會期社會福利及衛生環境委員會第6次全體委員會議議事錄時間113年10月30日星期三9時至13時38分地點群賢樓801會議室出席委員陳委員昭之等15人 |
transcript.whisperx[6].start |
1854.267 |
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1872.39 |
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列席委員紅委員孟楷等21人.列席官員10月30日.勞動部部長何佩珊等相關人員.主席黃兆吉委員秀芳.10月30日報告事項.宣讀上次會議議事錄決定確定.邀請勞動部部長就我國全時職位缺工概況.進行專題報告.並備質詢。.本日會議由勞動部部長報告後.委員陳昭芝等25人提出質詢.均經勞動部部長及各相關主管等即席答覆. |
transcript.whisperx[7].start |
1883.112 |
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1912.278 |
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委員吳春成.圖權及所提書面質詢列入紀錄刊登公報。決定一、報告及詢答完畢。二、委員質詢未及答覆或請補充資料者。請相關機關與惡中等以書面答覆。委員另要求期限者從其所定。10月31日因颱風停止上班。該日會議未舉行。宣讀完畢。請問委員會,上次易思路有無錯誤或遺落之處? |
transcript.whisperx[8].start |
1914.022 |
transcript.whisperx[8].end |
1938.93 |
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沒有 那我們議事部確定本日議程為繼續處理中華民國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案另外一個是邀請衛生福利部邱部長針對社區精神病患照護優化進行專題報告.並備質詢 |
transcript.whisperx[9].start |
1945.362 |
transcript.whisperx[9].end |
1970.498 |
transcript.whisperx[9].text |
我先介紹在場的委員李業勤委員王振旭委員陳昭之委員我們介紹出席的歡迎我們邱太元部長心理健康師代理師長鄭淑勳 |
transcript.whisperx[10].start |
1975.492 |
transcript.whisperx[10].end |
1998.852 |
transcript.whisperx[10].text |
保護服務司司長張秀燕社會救治及社公司蘇昭如司長醫事司專門委員郭維中社家屬署長代理署長周道軍 |
transcript.whisperx[11].start |
2002.116 |
transcript.whisperx[11].end |
2006.16 |
transcript.whisperx[11].text |
食藥署副署長莊生宏林金富副署長陳耀瑜會計處處長張玉珍 |
transcript.whisperx[12].start |
2029.136 |
transcript.whisperx[12].end |
2047.844 |
transcript.whisperx[12].text |
行政院主計總署公務預算處專門委員廖玉琳我們先處理衛生福利部的公務預算我剛剛講過了,解凍案那我們先讀 |
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2056.045 |
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2066.674 |
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報告事項二,衛生福利部含為113年度中央政府總預算決議檢送食品藥物管理署決議五、六及21預算凍結書面報告案,宣讀完畢。 |
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2071.271 |
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2099.024 |
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這個解凍案上個禮拜那個有牌但是因為碰到颱風那我這個禮拜是很有誠意的牌啦但是第一案跟第二案跟那個蛋有關所以那個蛋現在還在超市的現在還在爭執上個禮拜還調我們的前農業部長出庭所以我們就是比較單純的第三案 |
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2100.12 |
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2116.723 |
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就是檢訟因為這個案子以前凍結是楊耀有提張玉玟有提上一屆我有瞭解這個衝擊性比較小所以第三案的那個解凍案請問委員有沒有意見要看專題的那個署長你要不要報告一下 |
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2131.55 |
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2132.97 |
transcript.whisperx[16].text |
請問陳委員有哪一個?我先 |
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2166.261 |
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2183.067 |
transcript.whisperx[17].text |
就是今天書面報告的決議事項就是說我對這個有意見對解凍有意見我可以說明嗎就在這裡說明 |
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2186.295 |
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2206.331 |
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我想說的是我相信我是在未還主委員當中我有最多尊敬的朋友跟曾經共事的朋友好朋友在食藥署但是我覺得是非對錯我今天還是要講出來在解凍報告中有提到說有持續這個是在做我們今年的預算的討論 |
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2208.112 |
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2233.57 |
transcript.whisperx[19].text |
持續監測藥品的供應情形還有預先盤點藥品跟原物料的說法但是今年還是發生很多缺藥情形全台灣都知道輸液永豐大廠的輸液違反藥事法勒令停業造成輸液供應大缺貨造成開刀洗腎的問題這麼大大家都那麼擔憂 |
transcript.whisperx[20].start |
2235.56 |
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2253.191 |
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那我要講的是食藥署過去查場的時候就知道永豐藥廠他事上有問題的但是一直讓他做大到最後完全停場我知道這件事是前任的署長發生的事情但是因為今天的食藥署的報告裡面完全沒有提到 |
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2254.315 |
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2259.6 |
transcript.whisperx[21].text |
這件事發生以後第一線醫療人員到次長的臉書留言說我們缺書意我們需要幫忙但是他用非常嘲諷的口氣說 |
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2270.751 |
transcript.whisperx[22].end |
2288.821 |
transcript.whisperx[22].text |
某些人在這說話不腰疼啊誰能找到更便宜的我親自到府簽約我給你2000CC那廠商改成你要2000CC我給你500CC你如果說這個缺貨那我也尊重啦請問這是一個堂堂的次長該說的話嗎做錯事還那麼理直氣壯啊500CC跟2000CC相等嗎你沒有開過刀嗎你是婦產科醫師欸所以我覺得是 |
transcript.whisperx[23].start |
2299.734 |
transcript.whisperx[23].end |
2312.064 |
transcript.whisperx[23].text |
報告我其實在兩次質詢部長的時候我有請部長說就是請你們加速所謂的RCA報告就是Root cause analysis就是根本原因分析不能再出現這樣錯況且今年花了幾億你明年又續編11億那今天怎麼讓他過呢這個解凍怎麼讓他過呢其實我很尊敬莊署長他就是要來善後 |
transcript.whisperx[24].start |
2327.093 |
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2344.192 |
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本席堅決主張這次再沒有辦法直接在今天解凍那就是要提出一份我覺得是誠實坦誠的報告我們未來就不要再花錢也不要讓這個病人醫師在照顧病人的時候非常有很非常大的擔憂謝謝主席 |
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2347.845 |
transcript.whisperx[25].end |
2353.207 |
transcript.whisperx[25].text |
我們現在休息兩分鐘,要署長你去跟陳昭之委員說兩分鐘 |
transcript.whisperx[26].start |
2376.851 |
transcript.whisperx[26].end |
2381.575 |
transcript.whisperx[26].text |
委員會主席 |
transcript.whisperx[27].start |
2675.258 |
transcript.whisperx[27].end |
2699.563 |
transcript.whisperx[27].text |
好謝謝我們陳昭蘇委員有關衛生福利部主管預算凍結報告案請問大家有無異議沒有謝謝大家好無異議那先做一下決定同意動之並提報院會還有陳昭蘇委員要求的請敬書給他報告好謝謝 |
transcript.whisperx[28].start |
2702.818 |
transcript.whisperx[28].end |
2703.24 |
transcript.whisperx[28].text |
接下來我們請邱部長報告時間6分鐘 |
transcript.whisperx[29].start |
2718.959 |
transcript.whisperx[29].end |
2733.669 |
transcript.whisperx[29].text |
主席、各位委員、理事先生今天大宴第11屆第2會期社會福利及衛生環境委員會召開第7次全體委員會議本部成交列寫報告深感榮幸 |
transcript.whisperx[30].start |
2735.45 |
transcript.whisperx[30].end |
2749.819 |
transcript.whisperx[30].text |
社區精神病患照護優化專題報告進行各位委員不吝會議指教前年本部在行政院的指導下積極推動強化社會安全網計畫整合網絡體系串聯中央地方及民間團體社區組織力量 |
transcript.whisperx[31].start |
2752.521 |
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2780.084 |
transcript.whisperx[31].text |
其實其從根本減少風險因子接觸個案及家庭為妥善照護精神病人及支持其家庭我們透過的修法、完善體系、部件支援及跨網絡合作等面向周圍妥善地來照顧精神病人的照護那辦理的狀況以分六大面向來報告第一我們首先研修 |
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2781.109 |
transcript.whisperx[32].end |
2806.095 |
transcript.whisperx[32].text |
精神衛生法規為了更完整促進國人心理健康及照護精神病人以修正精神衛生法並於113年12月14日上路本次修法五大重點強調推動心理健康促進、積極佈建社區心理健康中心多元化社區支援強化病人通報、精進前端預防及危機處理 |
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2807.815 |
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2831.673 |
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強制支援改裁法官保留原則及病人權利保障等。第二,充實精神照護支援,透過醫療網計畫的實施,精神照護支援成長至113年10月底,具有急性慢性精神病床合計20,608床,另外日間醒及住室醒精神 |
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2833.414 |
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2858.281 |
transcript.whisperx[34].text |
護健機構共有287家合計10,435床精神護理自家46家合計4917床是病人並請採取門診、急診、住院、日間照護、社區精神護健、急加治療等不同照護方式並透過機構評鑑確保服務品質。第三部件社區心理衛生中心及人力支援為了提供民眾可敬性的心理健康 |
transcript.whisperx[35].start |
2859.246 |
transcript.whisperx[35].end |
2877.937 |
transcript.whisperx[35].text |
服務以及精神病從醫療到社區的NC性照護已經透過社安網第二期計畫補助地方政府部署社區心理心理中心及金融心理衛生專業人力至113年10月底全會議累計佈置52次每一縣市均已至少設有一次 |
transcript.whisperx[36].start |
2878.917 |
transcript.whisperx[36].end |
2880.857 |
transcript.whisperx[36].text |
第4推動社區精神病人照護服務為了協助住院 |
transcript.whisperx[37].start |
2899.881 |
transcript.whisperx[37].end |
2918.971 |
transcript.whisperx[37].text |
精神病人已出院後無控銜接社區關懷體系精神醫療機構應協助病人擬定出院準備計畫轉介至地方政府衛生局提供社區追蹤保護服務本部並定有社區精神病人說案及結案標準分級照護由新衛社官員及公衛護理事 |
transcript.whisperx[38].start |
2922.332 |
transcript.whisperx[38].end |
2938.682 |
transcript.whisperx[38].text |
關懷皇室、醫病人及家庭需求、連結醫療及其他服務資源。第五,強化前端預防及危機處理機制,為了強化社區儀式精神病人通報及處理本部辦理儀式或社區精神病人照護優化計畫。針對網絡 |
transcript.whisperx[39].start |
2941.583 |
transcript.whisperx[39].end |
2965.525 |
transcript.whisperx[39].text |
單位轉介至社區疑似病人提供精神醫療外展評估服務並輔導個案就醫令警察或消防機關執行指導時發現病人或疑似病人有傷害他人或自己或有傷害之餘者應急護送前往就近適當醫療機構就醫另外協助警消人員處理社區疑似精神病人事件 |
transcript.whisperx[40].start |
2966.225 |
transcript.whisperx[40].end |
2985.706 |
transcript.whisperx[40].text |
本部建置Core Center及24小時資訊專線提供處置建議提升護送就醫效能。第六,發展社區精神病人社區支援支持多元方案,補助民間團體及機構辦理精神病友多元社區生活方案發展計畫,以及 |
transcript.whisperx[41].start |
2987.768 |
transcript.whisperx[41].end |
3006.645 |
transcript.whisperx[41].text |
精神病病人及照顧者社區支持服務支援部件計畫共合計90個案.以本部將持續推動社區精神病人照護服務及其部件社區支援保障精神病人權益,支持於社區平等生活並令將督促地方政府 |
transcript.whisperx[42].start |
3007.566 |
transcript.whisperx[42].end |
3026.459 |
transcript.whisperx[42].text |
假想先導民眾正確認識精神疾病,避免將精神病人與社區危機事件連結,使有需求者更難主動尋求醫療協助。本部呈大院各委員指教及監督,在此靜置謝神,並請各位委員繼續予以致辭。以上,謝謝。 |
transcript.whisperx[43].start |
3032.642 |
transcript.whisperx[43].end |
3053.617 |
transcript.whisperx[43].text |
謝謝部長有關本次會議各項書面資料均列入紀錄刊登公報現在我們開始詢答那剛剛那個解斷案的相關行政人員可以先離席啦那我們做以下宣告本委員會詢答時間 |
transcript.whisperx[44].start |
3056.307 |
transcript.whisperx[44].end |
3083.357 |
transcript.whisperx[44].text |
6加2分鐘,列席委員4分鐘10點30分左右,截止發言登記委員若有書面質詢,請於上會前提出,預期不受理暫定10點半左右,休息10分鐘本次會議不處理臨時提案那中午不休息,直接訓導完畢再休息現在請第一位登記委員陳昭芝,訓導 |
transcript.whisperx[45].start |
3090.589 |
transcript.whisperx[45].end |
3092.09 |
transcript.whisperx[45].text |
麻煩邱部長委員長現在有時間跟你說早安早2022年這個精神衛生法修法那引入了社區支持的這個服務的概念等於承認了長期支持的這個病患的重要性並且要求地方政府也提出相應的這個服務我認為這個非常好 |
transcript.whisperx[46].start |
3120.285 |
transcript.whisperx[46].end |
3120.305 |
transcript.whisperx[46].text |
是,謝謝 |
transcript.whisperx[47].start |
3141.67 |
transcript.whisperx[47].end |
3168.492 |
transcript.whisperx[47].text |
那部長我知道心理健康是近年有所謂的精神病有多元社會生活方案社區生活方案的發展計畫那它這個服務形式限制比較少那比較多元那我也認為是一個很棒的方向部長可以看一下這個左圖它的服務項目包括各管服務就業服務社區居住服務還有同儕支持服務可以讓這些需要幫助的精神病有獲得更全面的照顧我也非常肯定這個計畫 |
transcript.whisperx[48].start |
3169.793 |
transcript.whisperx[48].end |
3191.896 |
transcript.whisperx[48].text |
所以這是我第二個肯定部長這就是以來我很少一開始就給他這麼多的肯定這個是對的方向但是我們還是要知道說再好的計畫都還有要進步的地方那有兩個點我想請部長或市長參考第一個我覺得總預算是不足的因為你目前現在每一個團體只能提一個案 |
transcript.whisperx[49].start |
3192.757 |
transcript.whisperx[49].end |
3206.543 |
transcript.whisperx[49].text |
提個案那非常可惜我覺得這個部分可以到衛環委員會來討論應該給的應該給民眾的幫忙就是說我覺得像本席一定支持就是說你這個預算編的不夠那麼限制一個團體議案 |
transcript.whisperx[50].start |
3207.904 |
transcript.whisperx[50].end |
3233.889 |
transcript.whisperx[50].text |
第二個問題就是說民間組織他需要每年重新提案部長就會讓團體跟這個在其中的工作服務者他會掉一顆心的懸著一顆心的他不知道明年下一年還能不能繼續做這個服務那能不能做下去我們都知道服務不中斷是一個很重要的原則所以想請問部長是不是可能在一個前提就是我們執行好這個執行成果的把關 |
transcript.whisperx[51].start |
3235.009 |
transcript.whisperx[51].end |
3235.069 |
transcript.whisperx[51].text |
謝謝委員關心我們這個 |
transcript.whisperx[52].start |
3259.682 |
transcript.whisperx[52].end |
3259.702 |
transcript.whisperx[52].text |
致詢問 |
transcript.whisperx[53].start |
3280.666 |
transcript.whisperx[53].end |
3286.109 |
transcript.whisperx[53].text |
對於這個藥物治療部分,就長效的這些藥物幫助這病人,我們那邊都OK的。那你這裡呢?那個比例已經相當高了。對,這是醫療,但是生活上的幫助是更重要的。對,所以我們是這樣子,我們在115年期可行嗎? |
transcript.whisperx[54].start |
3308.223 |
transcript.whisperx[54].end |
3315.889 |
transcript.whisperx[54].text |
那你需要預算大家可以幫忙啊我們為了擴大去爭取穩定的裁員從115年病入我們把他病入這個照顧病入身心障礙照顧服務支援部這個計畫從113年到117年這個計畫然後針對精神病人及其家族以5年內將會投資有13億這些事非常重要我們會注意到他的一個聯繫性 |
transcript.whisperx[55].start |
3333.203 |
transcript.whisperx[55].end |
3336.325 |
transcript.whisperx[55].text |
心理健康是他現在在執行廣見這個社區心理衛生中心他的內容很多但我就不一一唸出來包括辦個案處理心理衛生促進教育訓練等等等等等等他其實是包含很多我覺得有點包山包海很辛苦 |
transcript.whisperx[56].start |
3358.803 |
transcript.whisperx[56].end |
3380.571 |
transcript.whisperx[56].text |
那但是所以就會有專家會指出說那我們都要做到什麼程度那目前不太明確那例如這個司法精神醫學會理事長楊天偉院長他有一點隱憂就是說心理衛生中心工作人員他大部分年資比較淺那新法的實踐有一點像把蔡淼推到最前線去當狙擊手 |
transcript.whisperx[57].start |
3381.491 |
transcript.whisperx[57].end |
3393.563 |
transcript.whisperx[57].text |
然後找出這個散落在社區他需要幫助的人那部長、司長針對楊院長提出的他是專家嘛提出的這個隱憂衛福部或這個健康司、新建司有沒有什麼改進的方針 |
transcript.whisperx[58].start |
3394.602 |
transcript.whisperx[58].end |
3423.721 |
transcript.whisperx[58].text |
好謝謝委員的關心也謝謝楊院長長期以來對司法精神方面的投入那因為心理健康中心心理衛生中心我們是這幾年的一個比較新興的一個努力的計畫對於方向呢所以基本上比較難拚到所謂有困難資深那當然我們不是說之前的不好而是說很多這個人生很多有一些歷練之後也許他能夠幫助的而且你內容太廣了太廣了 |
transcript.whisperx[59].start |
3424.181 |
transcript.whisperx[59].end |
3443.376 |
transcript.whisperx[59].text |
我會不會請那個我們那個新建室代理市長 鄭市長謝謝委員關切我們的這個新衛中心的這個人員如果年資太之前的話恐怕沒有能力來推動這麼繁雜的業務那事實上我們在新衛中心裡面我們部件的除了我們的這個心理師、診療師、護理師 |
transcript.whisperx[60].start |
3445.297 |
transcript.whisperx[60].end |
3446.738 |
transcript.whisperx[60].text |
還有關懷訪視員之外還有這個心理衛生社工其實他是多職類的那我們會透過說的這個專業的訓練一些不同專業的人才一起來做我們也會自督導來協助帶領這些戰友們 |
transcript.whisperx[61].start |
3460.851 |
transcript.whisperx[61].end |
3462.132 |
transcript.whisperx[61].text |
部長我上週有進行預算總質詢提了很多問題但時間不夠還是要繼續請教部長部長今天健保說高推估增加大概5.5%這樣有500多億然後還有說主計長說的 |
transcript.whisperx[62].start |
3485.413 |
transcript.whisperx[62].end |
3511.624 |
transcript.whisperx[62].text |
他又說這個健保這個財務協助方案有300多億加起來800多億已經可以來補足點值0.95但是部長我不知道是主計長是被衛福部騙了還是他信口開河部長您知道不是這樣嘛那個非協商因素500多億每年都有啊那個跟點值不相關啊但是這300多億裡面當中有很多是專款欸那個專款就用完還流入流回像罕病啊還有變了11億的那個生理食鹽水啊 |
transcript.whisperx[63].start |
3512.324 |
transcript.whisperx[63].end |
3514.286 |
transcript.whisperx[63].text |
總諮詢社會請教部長說我看不到啊所以我想第一個喊病的這個狀況可不可能留在 |
transcript.whisperx[64].start |
3530.68 |
transcript.whisperx[64].end |
3530.7 |
transcript.whisperx[64].text |
致詢。 |
transcript.whisperx[65].start |
3550.995 |
transcript.whisperx[65].end |
3570.092 |
transcript.whisperx[65].text |
所以你如果這些不做的話那看不出為什麼明年6月底有辦法達到0.95好嗎?部長,因為你要回答我知道有點困難我這個有些可能先回答一下好不好第一個就是說生理生水因為以前真的是很便宜那在這次談價以後共理會議裡面可能從20幾塊現在已經40幾塊嘛 |
transcript.whisperx[66].start |
3573.815 |
transcript.whisperx[66].end |
3587.007 |
transcript.whisperx[66].text |
那所以整個成本就增高,我們不能去負責擠壓到總額嘛,所以我就拜託衛生福利部,拜託鄉親,因為這11億,既開這11億,你如果沒有政府補助,就是在健保要出路。 |
transcript.whisperx[67].start |
3591.751 |
transcript.whisperx[67].end |
3610.165 |
transcript.whisperx[67].text |
部長,我想醫界最擔心的就是請你不要再用斷頭攤扣這個比較誇張的手法來努力讓點值,因為大家最怕攤扣啊,最怕斷頭啊,到了額度就斷掉啊,然後到這個不到目標就事先叫大家繳回錢啊但是你不能因為要達到我們期待的0.95,然後把攤扣弄得更誇張 |
transcript.whisperx[68].start |
3616.75 |
transcript.whisperx[68].end |
3616.85 |
transcript.whisperx[68].text |
發言委員: |
transcript.whisperx[69].start |
3631.766 |
transcript.whisperx[69].end |
3635.628 |
transcript.whisperx[69].text |
主席一直在看我,他覺得我該下去,我今天話太多了。 |
transcript.whisperx[70].start |
3655.02 |
transcript.whisperx[70].end |
3655.841 |
transcript.whisperx[70].text |
請陳慶威委員質詢 |
transcript.whisperx[71].start |
3682.666 |
transcript.whisperx[71].end |
3685.208 |
transcript.whisperx[71].text |
謝謝主席、各位委員、各位官員。我又想請部長,謝謝。 |
transcript.whisperx[72].start |
3691.778 |
transcript.whisperx[72].end |
3721.138 |
transcript.whisperx[72].text |
早部長我要問的問題還沒有還沒有還沒有我要問的問題是跟我們的媽媽手冊孕婦手冊還有寶寶手冊兒童手冊比較相關的一開始因為這個是許許多多臨床個案反映到的那剛好最近我辦公室也有一位同仁晉升為二寶媽好我們現在既然少子化我們就是要鼓勵大家多生我在這邊跟部長講幾個例子這個螢幕前面如果有媽媽在看一定非常有感覺 |
transcript.whisperx[73].start |
3722.058 |
transcript.whisperx[73].end |
3736.989 |
transcript.whisperx[73].text |
今天呢他這個孕婦手冊他一旦懷孕喔他要隨身攜帶這一本好那他會遇到什麼問題比如說他去三天兩夜的花東之旅可是他不一定會帶著嘛結果他到當地的診所去 |
transcript.whisperx[74].start |
3737.91 |
transcript.whisperx[74].end |
3739.692 |
transcript.whisperx[74].text |
衛生福利部長針對〈社區精神病患照護優化》進行專題報告. |
transcript.whisperx[75].start |
3757.432 |
transcript.whisperx[75].end |
3775.458 |
transcript.whisperx[75].text |
如果說他今天是二寶媽,他一邊懷孕一邊帶著大寶,他還要帶一本寶寶手冊,你知道這兩個有多重嗎?部長等一下給你看看起來好像很重你也有穿過這個嘛我有養三個小孩,這個我都抱過 |
transcript.whisperx[76].start |
3776.698 |
transcript.whisperx[76].end |
3778.099 |
transcript.whisperx[76].text |
部長有沒有考慮要把它科技化? |
transcript.whisperx[77].start |
3806.433 |
transcript.whisperx[77].end |
3829.038 |
transcript.whisperx[77].text |
一定要朝著外面來努力。好,你什麼時候?因為是這樣子啦,因為我們當然現在很簡單嘛,現在你去打疫苗也是都要滿意度,上面都用QR code。那我不曉得那個QR code有那麼多病人可以用嗎?會用嗎?所以在國健署這邊就是希望先兩個病型。 |
transcript.whisperx[78].start |
3835.883 |
transcript.whisperx[78].end |
3846.793 |
transcript.whisperx[78].text |
我這邊建議改成電子化有什麼好處?你想要孕婦友善育兒友善你就不要人家一整天都要帶著這兩本趴趴照很重 |
transcript.whisperx[79].start |
3847.97 |
transcript.whisperx[79].end |
3876.093 |
transcript.whisperx[79].text |
那它也很難移動再來如果你可以把它電子化所有的數據上雲端如果一個婦產科醫師很忙小兒科醫師很忙但是數據上去了AI其實可以及時抓到它是不是高風險的認成糖尿病高風險的認成高血壓或是這個寶寶生長曲線是不是有點問題反而有預警的效果你認為呢這跟你們加一顆的概念也是差不多啊 |
transcript.whisperx[80].start |
3876.667 |
transcript.whisperx[80].end |
3902.152 |
transcript.whisperx[80].text |
我想電子化之下一定可以更周全那個也達到我們在怎麼樣讓他更得到保護那在實務上怎麼樣去讓大家方便然後又能夠達到我們的期望我想這個比如說你剛剛你用這個預防接種時程表這個就很有趣啦因為我們每天在看這個當時在養小孩的時候 |
transcript.whisperx[81].start |
3903.345 |
transcript.whisperx[81].end |
3926.416 |
transcript.whisperx[81].text |
每天我都很喜歡看這個第一天我這個是去周正前醫師打這個針下一季我到蘇星前醫師那邊打這個針第三天我到張玉霄那邊打這個針其實有一點親近感但是這個時代在改變這個你如果用APP你也都可以看得到 |
transcript.whisperx[82].start |
3927.655 |
transcript.whisperx[82].end |
3949.626 |
transcript.whisperx[82].text |
你也都看得到是誰打這個針,懂嗎?對,我知道,我是說他們的每個記錄、筆記、印章都琳瑯滿目我們當家長的會覺得很有成就感,因為給小孩子打得這麼完整部長可不可以稍微問當然我們要習慣到,我這個是有點講過去的,但是現在的時代一定是講電子 |
transcript.whisperx[83].start |
3952.788 |
transcript.whisperx[83].end |
3973.741 |
transcript.whisperx[83].text |
可不可以給我們一個簡單的進程,你大概什麼時候可以找這些相關的部會來研擬?是不是考慮把他...這個應該不會很困難嘛,一直有在研究嘛我覺得也不要因為最近真的是年底太多又是... |
transcript.whisperx[84].start |
3974.918 |
transcript.whisperx[84].end |
3978.46 |
transcript.whisperx[84].text |
當然我們今天會在這邊討論就是因為有一位未成年的加害人他同時有身心障礙也有精神疾病他去侵犯了一位未成年的受害人 |
transcript.whisperx[85].start |
4001.554 |
transcript.whisperx[85].end |
4001.754 |
transcript.whisperx[85].text |
先來跟大家講一下第一 |
transcript.whisperx[86].start |
4029.811 |
transcript.whisperx[86].end |
4035.568 |
transcript.whisperx[86].text |
這個不管是加害人或者是受害人都是未成年不就跟衛福部很有關係 |
transcript.whisperx[87].start |
4037.358 |
transcript.whisperx[87].end |
4065.438 |
transcript.whisperx[87].text |
其次呢他領身心上愛手冊也跟衛福部很有關係他做了性相關的犯罪也跟衛福部很有關係最後他因為這個精神疾病的問題他有可能在審判的過程需要精神鑑定有可能被判刑之後需要司法精神病房或者是復健等等的這也跟衛福部很有關係請問部長為什麼至今你們都沒有任何的官方聲明還有解釋呢 |
transcript.whisperx[88].start |
4066.189 |
transcript.whisperx[88].end |
4084.515 |
transcript.whisperx[88].text |
好,非常謝謝委員對民眾受到這樣的一件事件的關心也特別感謝趙偉排這樣的一個社會大家關注的主題那有關於這個精神病這件事情,其實 |
transcript.whisperx[89].start |
4085.816 |
transcript.whisperx[89].end |
4106.33 |
transcript.whisperx[89].text |
我們過去多年來尤其我們在我也在立法院這些年來我們一個很重要的事情就是希望精神病不要被汙名化到時候什麼事情都怪精神病其實不一定是所以第一他報告他的心理說他有精神病其實他是身心障礙 |
transcript.whisperx[90].start |
4107.17 |
transcript.whisperx[90].end |
4107.29 |
transcript.whisperx[90].text |
這已經有報導在這個 |
transcript.whisperx[91].start |
4123.12 |
transcript.whisperx[91].end |
4146.699 |
transcript.whisperx[91].text |
桃園市議員還有桃園市議員是貴黨的市議員以及還有桃園市政府等等都已經有稍微的描述一下他在精神科有多次就診並且有用藥的記錄等等我們今天也沒有要做獵巫或者是說巫民化等等的我們只是單純想要關心我們應該要如何在社區之內輔導他們並且幫助他們協助他們 |
transcript.whisperx[92].start |
4149.321 |
transcript.whisperx[92].end |
4155.681 |
transcript.whisperx[92].text |
好在這邊就要講到您的報告啦這個是您官網裡面講到的喔 |
transcript.whisperx[93].start |
4156.738 |
transcript.whisperx[93].end |
4181.602 |
transcript.whisperx[93].text |
好您的報告裡面啊今天我覺得很可惜的是你有提到你們的社區心理衛生中心2024年52處一直到明年年底會有71處看起來量能是持續的增加但是這個不光是蓋房子你們人數雖然增加但是有一個很重要的東西沒有提到服務比呢你沒有講到服務比啊 |
transcript.whisperx[94].start |
4183.772 |
transcript.whisperx[94].end |
4212.718 |
transcript.whisperx[94].text |
服務比那是不是請那個政府代理市長報告一下報告委員我們現在欣慰中心的確每年的這個點數都在增加那我們的人力呢也是要逐步的這個補助到位那我們現在的這個人員禁用情況呢如果是以這個這個精神病患的關懷訪視員來講的話其實隨著我們的關懷訪視員到位我們去年大概每一個人的案量比大概是1比60左右 |
transcript.whisperx[95].start |
4213.218 |
transcript.whisperx[95].end |
4233.84 |
transcript.whisperx[95].text |
那今年就已經下降到1比50那未來我們人力逐漸到位之後這個關懷訪視的這個負荷比也一定會再持續的下降但是因為我們人員經驗經用都還在路上你們是不是2025你自己有幫自己訂了一個目標服務比在每一類的人員不太一樣關懷訪視員的話我們希望明年年底可以達到1比40 |
transcript.whisperx[96].start |
4234.881 |
transcript.whisperx[96].end |
4238.483 |
transcript.whisperx[96].text |
因為第一線的社工也會跟我反映他們會面臨到什麼的問題他會有結案的KPI壓力 |
transcript.whisperx[97].start |
4253.81 |
transcript.whisperx[97].end |
4274.364 |
transcript.whisperx[97].text |
假使他輔導的個案後來又復發那就會影響到他的KPI他有時候還要身兼各管事他必須要去協助比如說申請失業長照等等的社會福利所以如果說你只是在你的報告中呈現不管是人力或者是地點有增加但你沒有重視到他的服務比他 |
transcript.whisperx[98].start |
4276.886 |
transcript.whisperx[98].end |
4278.328 |
transcript.whisperx[98].text |
本席在這邊預測是有一點點困難,您覺得呢? |
transcript.whisperx[99].start |
4300.885 |
transcript.whisperx[99].end |
4318.211 |
transcript.whisperx[99].text |
有關於人力禁用部分我們也會持續的來督導地方政府要加強但是委員剛剛提到是不是這樣的一個負荷比對我們的新衛社工來講是不是會不會負擔太重那這個我們社安網因為我們即將在2.0我們在研擬中我們會在人力的負荷部分我們也會一併的來做檢討 |
transcript.whisperx[100].start |
4319.591 |
transcript.whisperx[100].end |
4336.302 |
transcript.whisperx[100].text |
那剛陳昭志委員也有關心到的這個精神衛生法到12月部長12月14號就要開始實施精神衛生法可是現在只完成了12個執法的預告還有9個還沒完成這個預告時間你也知道已經 |
transcript.whisperx[101].start |
4338.125 |
transcript.whisperx[101].end |
4358.997 |
transcript.whisperx[101].text |
我們預告大概12個會在同時在12月14號發布那其他還沒有發布的是因為必須要跟法務部司法院來談當時的時候也是有這樣的一個所以其他9個您想要什麼時候開始預告 |
transcript.whisperx[102].start |
4362.242 |
transcript.whisperx[102].end |
4383.293 |
transcript.whisperx[102].text |
報告委員就是說我們今年12月14號要上路的是總共是15個21個裡面有15個今年的12月14號會上路那另外6個主要是跟司法院有關係必須要另訂這個施行的日期那今年要施行的15個執法規裡面我們12個已經完成預告最近就會陸續發布所以你還剩3個對 |
transcript.whisperx[103].start |
4385.274 |
transcript.whisperx[103].end |
4394.395 |
transcript.whisperx[103].text |
另外三個的話我們也希望說能夠在這個月裡面就是完成就是要進行預告然後收集各界的意見之後我們也會盡快的來做一個發布的作業 |
transcript.whisperx[104].start |
4396.385 |
transcript.whisperx[104].end |
4422.342 |
transcript.whisperx[104].text |
下一個我想問一下今天我們有檢討說這位個案他是沒有達到列管的標準但是發生了這件事情以後他達到我們收案的標準我也想知道新建司或是部長的觀點我們需不需要再來調整這個收案的觀點因為他有可能會在回歸家庭之後如果比如說這個個案他可能家庭的量能不足 |
transcript.whisperx[105].start |
4422.842 |
transcript.whisperx[105].end |
4434.036 |
transcript.whisperx[105].text |
沒有人繼續去維持他的吃藥啊狀況是否穩定那就會導致像這樣子遺憾的事情發生所以你們是不是要在收案的條件做一些調整 |
transcript.whisperx[106].start |
4436.167 |
transcript.whisperx[106].end |
4459.234 |
transcript.whisperx[106].text |
目前是有在檢討但是一個社區像這樣的病人他整個從醫院到社區的整體的照顧我們要用多元化來不管是充實精神的一個醫療或者照護還有布置更好的心理衛生中心給他還有一些多元的支持方案給他家庭這些都可以讓我們在品質上會增加那這個標準我們會檢討 |
transcript.whisperx[107].start |
4461.055 |
transcript.whisperx[107].end |
4485.552 |
transcript.whisperx[107].text |
我們什麼時候可以看到您的這個新的標準跟委員報告因為我們已經委託這個心理衛生社工學會進行我們收結案標準的一個檢討那這個委託案呢今年年底會結束那結束之後呢我們會針對他們提出來的草案我們會再找各縣市政府來做一個討論之後我們希望能夠很快的就能夠來這個頒布新的一個收結案標準 |
transcript.whisperx[108].start |
4487.26 |
transcript.whisperx[108].end |
4514.579 |
transcript.whisperx[108].text |
最後這是承接上次有請教過兩位的問題也就是說像我們現在這位加害者他已經被收押了可是如果他未來在審判的過程被判刑等等的他很高的機率都會需要司法精神鑑定也有很高的機率是不能住在一般的精神病床而是放在預證系統言下之意就是說他很高的機率會住進司法精神病房上次您提到說原本我們的 |
transcript.whisperx[109].start |
4515.359 |
transcript.whisperx[109].end |
4542.674 |
transcript.whisperx[109].text |
需求是800多床然後現在做了100多床嗎這100多床都已經開始了嗎跟委員報告我們依據這個相關的法規我們有預估這個司法精神病床的一個需求那我們推估大概是未來的10年應該是大概480床應該是夠用那我們目前呢上次跟委員報告就是說我們到目前為止已經開放了102床 |
transcript.whisperx[110].start |
4544.395 |
transcript.whisperx[110].end |
4563.648 |
transcript.whisperx[110].text |
那其他的這個病房的病床會陸續的開放那我們希望說在這個我們有4個司法精神病房我們希望說到明年可以開放到100明年底之前可以完成183床那另外就是說這個保安處分處所目前也是在興建當中 |
transcript.whisperx[111].start |
4564.008 |
transcript.whisperx[111].end |
4587.404 |
transcript.whisperx[111].text |
那預計也是明年年底會完工所以你這180幾床你有什麼規劃要在幾年內達到快500床明年年底之前這180幾床就全數開放但是實際上你需求是快要500床嗎對實際的需求對那剛剛有跟委員報告除了我們在醫院裡面的司法精神病房之外我們另外也有這個另外一家處所正在興建當中也是明年年底會完工這邊有幾床 |
transcript.whisperx[112].start |
4587.984 |
transcript.whisperx[112].end |
4589.105 |
transcript.whisperx[112].text |
司法精神病床主要是被裁定 |
transcript.whisperx[113].start |
4603.336 |
transcript.whisperx[113].end |
4604.156 |
transcript.whisperx[113].text |
主席,謝謝。好,謝謝陳委員,謝謝部長。那接一夕我們請林業勤委員質詢 |
transcript.whisperx[114].start |
4633.635 |
transcript.whisperx[114].end |
4634.035 |
transcript.whisperx[114].text |
委員早部長早 |
transcript.whisperx[115].start |
4647.115 |
transcript.whisperx[115].end |
4671.821 |
transcript.whisperx[115].text |
臺灣大概在我們的2025年剛才也提到2024年12月14號我們的精神衛生法新法新制就要上路了那要全面上路我想問準備好了嗎為什麼因為過去我們的傳統大概在我們的以藥物住院跟機構安置為主可是新法未來事實上是要符合我們的CRPD以維護我們的 |
transcript.whisperx[116].start |
4673.604 |
transcript.whisperx[116].end |
4677.614 |
transcript.whisperx[116].text |
緊張者人格權那要讓他們可不可以在社區 |
transcript.whisperx[117].start |
4679.079 |
transcript.whisperx[117].end |
4706.897 |
transcript.whisperx[117].text |
融合作為這樣子的一個導向那當然目前現在數據我們看到2021年2024年那大概目前身心障礙者大概超過120萬人以上那其中我們的精神障礙大概占12%左右所以想問就是說我們的精神衛生法第三條定義的嚴重病人目前部長有沒有掌握占全體病人的幾成 |
transcript.whisperx[118].start |
4708.334 |
transcript.whisperx[118].end |
4730.909 |
transcript.whisperx[118].text |
目前大概6、7千人是屬於嚴重病人?屬於嚴重病人大概有6、7千人6、7千人那這群人的醫療需求相對多那佔健保的那個失絕病症支出的幾成?委員的意思是 |
transcript.whisperx[119].start |
4731.809 |
transcript.whisperx[119].end |
4745.704 |
transcript.whisperx[119].text |
就是因為這個嚴重病人事實上他的相對醫療支出會比較多一點那現在健保的那個思覺病症支出占他幾成這個健保室有沒有統計是不是如果現在回答不出來的話那就等 |
transcript.whisperx[120].start |
4753.696 |
transcript.whisperx[120].end |
4780.57 |
transcript.whisperx[120].text |
會後給我資料因為前面我問嚴重的後面大家也要期待就是過去呢事實上大家輕症都在社區儲育裡面大概都比較沒有這麼的多所以未來是不是在健保支出應該對於社區儲育應該要對於輕症的因為如果你的輕症不做你的服務支出少的話那當然未來他在社區裡面沒有得到很好照顧的話未來也是一個 |
transcript.whisperx[121].start |
4781.21 |
transcript.whisperx[121].end |
4783.452 |
transcript.whisperx[121].text |
衛福部事上事實上是主管機關地方包含地方還有各目的事業主管都有些各 |
transcript.whisperx[122].start |
4799.488 |
transcript.whisperx[122].end |
4801.308 |
transcript.whisperx[122].text |
目前你的部件資源部件的如何? |
transcript.whisperx[123].start |
4827.19 |
transcript.whisperx[123].end |
4832.414 |
transcript.whisperx[123].text |
謝謝 謝委員的關心我們在健保的部分其實有增加的大概有40幾%的經費 |
transcript.whisperx[124].start |
4836.141 |
transcript.whisperx[124].end |
4837.821 |
transcript.whisperx[124].text |
時間有限,所以請衛福部一個月內彙整我剛剛講的第一個 |
transcript.whisperx[125].start |
4864.861 |
transcript.whisperx[125].end |
4890.485 |
transcript.whisperx[125].text |
也就是這幾項的狀況部件還有個其他目的事業主管機關配合的狀況請你一個月能夠彙整出來然後提供我這邊是的是是那想問一下就是我們在CRPD的去機構化的倡議下全世界大概先進國家只剩下 |
transcript.whisperx[126].start |
4891.509 |
transcript.whisperx[126].end |
4908.537 |
transcript.whisperx[126].text |
臺灣、日本跟韓國還在衝床位其他的都已經在減床那民間團體也是期待如果事實上是去符合他人格權要以社區為主的話應該也是要減床可是我們現在是增床所以想問部長臺灣有減床的計畫嗎我們市長先生也知道 |
transcript.whisperx[127].start |
4916.25 |
transcript.whisperx[127].end |
4944.671 |
transcript.whisperx[127].text |
跟委員報告的確我們現在全全球的一個對精神病人照顧的趨勢是希望能夠盡量留在社區裡面來接受我們的服務所以臺灣在這幾年呢我們也佈建了非常多的這個社區支持的資源那至於說在床數的部分那的確就像委員所講的我們不管是急性床慢性床其實我們的占床率這幾年看起來是有一些下降的一個趨勢但是這個下降我們我們不會去主動減床但是我們依然是 |
transcript.whisperx[128].start |
4945.271 |
transcript.whisperx[128].end |
4947.693 |
transcript.whisperx[128].text |
委員提到的應該是屬於我們住宿型的精神部件機構部分 |
transcript.whisperx[129].start |
4964.805 |
transcript.whisperx[129].end |
4965.666 |
transcript.whisperx[129].text |
委員指的是哪一類的就是我們的金帳的這樣的 |
transcript.whisperx[130].start |
4989.375 |
transcript.whisperx[130].end |
5015.802 |
transcript.whisperx[130].text |
那有關於社區精神復健機構如果是在日間型的部分我們希望說每萬人至少能夠有兩床那有關於這個住宿型的部分的話大概每萬人口能夠有一床那目前的話其實在住宿型機構的部分呢其實是已經有達到目標了那照護能力呢就包含我們的護理師醫師職能治療師臨床心理師社工師床位增加都一定會醫事人員增加嗎 |
transcript.whisperx[131].start |
5016.622 |
transcript.whisperx[131].end |
5042.95 |
transcript.whisperx[131].text |
所以能夠足夠指引現在你有目前現在的床位的照顧人力嗎?是,各位報告我們的機構要成立必須要依照我們的設置標準所以說他要成立這一家不管是精神住宿型也好或是日間型的精神復健機構也好必須要符合我們的設置標準那設置標準裡面就會定有一定的人力你才能夠來申請設立所以在這個符合設置標準的情況之下他才有可能來設立 |
transcript.whisperx[132].start |
5043.993 |
transcript.whisperx[132].end |
5046.87 |
transcript.whisperx[132].text |
所以醫事人員的部分是要符合標準才能設的? |
transcript.whisperx[133].start |
5048.923 |
transcript.whisperx[133].end |
5073.474 |
transcript.whisperx[133].text |
這次想桃園發生這種事情像遇到緊急事件民眾到底要跟誰通報因為民眾比較關心的問題那因為在2020年大概7月衛福部就有設立24小時專線供相關人員做內部通報可是這機制大概保留在新法的第49條可是一般民眾到底知不知道你內部有可是到底民眾知不知道為什麼會這樣問 |
transcript.whisperx[134].start |
5074.514 |
transcript.whisperx[134].end |
5087.054 |
transcript.whisperx[134].text |
因為我們社區的人可能知道我在做的是這個工作反而是來問我們表示我們政府到底有沒有很讓民眾知道說我到底要尋求要通報說我到底打110打119嗎 |
transcript.whisperx[135].start |
5090.214 |
transcript.whisperx[135].end |
5106.109 |
transcript.whisperx[135].text |
報告委員緊急事件的時候基本上是要打110跟119通報警消當然我們後續如果有需要在精神醫療方面緊急處理的話還有call center是你有沒有加強宣導讓民眾知道延續這一個問題第二個問題也是政府應該加強宣導因為 |
transcript.whisperx[136].start |
5113.435 |
transcript.whisperx[136].end |
5113.575 |
transcript.whisperx[136].text |
有在做嗎? |
transcript.whisperx[137].start |
5129.319 |
transcript.whisperx[137].end |
5154.506 |
transcript.whisperx[137].text |
這個我們也討論過就是基本上我們還是盡量鼓勵通報但是如果那個剛剛委員關心的可能稍微有狀況就是不是會太擾民或者是是民眾知道嗎現在我問部長的是民眾到底知不知道我想我們怎麼樣先導的事情那個心理的心態是不是 |
transcript.whisperx[138].start |
5155.342 |
transcript.whisperx[138].end |
5168.455 |
transcript.whisperx[138].text |
跟委員報告就是您剛提到的這個24小時的這個專線的部分的話我們最主要是提供給警消在做第一線精神病人的危機事件處理的時候我們可以提供專業的一個意見那這支專線的話的確我們一般的網絡的人員譬如說社工村里領長他們也會打來做一個諮詢那我們就會有專業人員在電話這一端提供就是說 |
transcript.whisperx[139].start |
5178.485 |
transcript.whisperx[139].end |
5198.969 |
transcript.whisperx[139].text |
我們會做初步的評估然後給他一些處置的建議那關於這個專線的宣導部分我們也會持續的來跟這個地方政府來合作加強這支專線的一個宣導希望你們要加強宣導我現在問的都是我在社區遇到的一些狀況那再來是為了避免濫用我們的強制住院來剝奪 |
transcript.whisperx[140].start |
5202.49 |
transcript.whisperx[140].end |
5203.931 |
transcript.whisperx[140].text |
未來還是一樣能夠預見未來大概沒有專家學者能夠對於出院的作為做保證 |
transcript.whisperx[141].start |
5217.748 |
transcript.whisperx[141].end |
5247.191 |
transcript.whisperx[141].text |
所以使得住院期間就會不斷延長甚至形同做黑牢所以因此盡量者的法律輔助非常重要這是我們權力保護的必要的一些措施那新法對於62條跟70條都有一些委任非訴訟帶領的規定所以想問部長未來本法專家參審新制的那個審理制度施行後每年預估的案件數你有預估嗎因為這跟預算有關係你預估多少 |
transcript.whisperx[142].start |
5248.908 |
transcript.whisperx[142].end |
5273.036 |
transcript.whisperx[142].text |
報告委員,因為這個是新制,就是說未來精神病人強制住院改由法院來審理,這是新制,那我們目前比較沒有辦法去預估這個案件的多少。所以我們基本上我們就是依照我們今年度的這個案件量來做一個估算。對,那你今年可不可以跟我們講一下你推估大概會多少? |
transcript.whisperx[143].start |
5275.007 |
transcript.whisperx[143].end |
5300.147 |
transcript.whisperx[143].text |
那個我們今年的案件量我們預估這個強制住院部分大概是600件左右那在有沒有就是你未來預計要委託誰來辦理目前進度為了保障病人的權益我們自114年起已經委託法復法律輔助基金只有法復嗎有沒有其他單位來辦理這個這個 |
transcript.whisperx[144].start |
5302.106 |
transcript.whisperx[144].end |
5317.804 |
transcript.whisperx[144].text |
緊急安置嚴重病人法律福祉單位目前就是法服好那這關係到經常者跟家屬的權益有現在有再開始對民眾宣導嗎所以再問你準備好沒像這樣東西已經有再開始讓民眾知道嗎 |
transcript.whisperx[145].start |
5320.115 |
transcript.whisperx[145].end |
5320.195 |
transcript.whisperx[145].text |
預計什麼時候? |
transcript.whisperx[146].start |
5345.102 |
transcript.whisperx[146].end |
5357.371 |
transcript.whisperx[146].text |
這個因為我們可能需要一點時間因為新制包含我們一些相關的流程我們都會把它寫在懶人包裡面讓我們的民眾跟住院病人能夠更加容易的理解希望說到時候人願意在留志在 |
transcript.whisperx[147].start |
5359.648 |
transcript.whisperx[147].end |
5379.459 |
transcript.whisperx[147].text |
出院出獄都要提前準備了所以出院計畫的目的事實上是為了出院前提前連結社會資源來建立服務關係對於受訓人來說建立關係非常重要尤其涉及到我們的服刑期間有時候戶籍事實上是要隨著他轉到當地的戶政單位那所以 |
transcript.whisperx[148].start |
5381.533 |
transcript.whisperx[148].end |
5404.245 |
transcript.whisperx[148].text |
那戶籍法第47條50條是這樣規定的那可是如果說今天在新北市的人在花蓮服刑他期滿之後回到新北市有時候是得不到這樣子的一個所謂的服務不能力嘛像這個人你就找不到了所以在社區處遇應該要提前而且事實上能夠是不是跟 |
transcript.whisperx[149].start |
5405.299 |
transcript.whisperx[149].end |
5405.439 |
transcript.whisperx[149].text |
衛生福利部長 |
transcript.whisperx[150].start |
5422.503 |
transcript.whisperx[150].end |
5438.888 |
transcript.whisperx[150].text |
因為主席都站起來了最後還是要呼籲社會大眾我們經常者比任何人更期待我們的平等公平然後融合到社會當中好生活所以我們希望政府部門可以來協力 |
transcript.whisperx[151].start |
5439.828 |
transcript.whisperx[151].end |
5464.67 |
transcript.whisperx[151].text |
來理解他的困難去包容他了。謝謝委員,我想政府在這方面非常用心。那精神病患照護優化應該也是我當時擔任召委的時候通過的,所以我應該很重視,看怎麼樣把它落實。主席有點不太公平,因為我剛剛前面那個大概都還沒站起來。以上。好,謝謝委員,謝謝召委。謝謝林委員,謝謝部長。那繼續我們請廖偉祥委員質詢。 |
transcript.whisperx[152].start |
5484.012 |
transcript.whisperx[152].end |
5503.194 |
transcript.whisperx[152].text |
謝謝主席 請我們的邱部長部長好部長好 部長早安喔早我想要先問一下喔針對這個人工生殖法的修正草案是否有明確的立法時間表那預計何時能夠完成立法因為 |
transcript.whisperx[153].start |
5505.649 |
transcript.whisperx[153].end |
5522.76 |
transcript.whisperx[153].text |
預告的時候有600多則的意見那當然基本上都在代理應募這個部比較多啦所以經過開了實際場的一個會議大概我們希望在11月底能夠送行政院預計希望在11月底送行政院好OK |
transcript.whisperx[154].start |
5523.325 |
transcript.whisperx[154].end |
5537.612 |
transcript.whisperx[154].text |
那第二個就是在無償代孕中要如何確保這個代理孕母的自主權然後以及對於這個營養費上限的設定是否有足夠會不會出現有商業化的漏洞這個部分可不可以請部長也指教一下 |
transcript.whisperx[155].start |
5538.171 |
transcript.whisperx[155].end |
5559.067 |
transcript.whisperx[155].text |
我想這個就是一直大家所關注的所以我想問一下說目前你們評估的狀況跟要怎麼做我們現在訂出來的標準其實雖然目前還在做討論演繹當中但是我們初步來看他訂出來的都是非常保護母體母親就是懷孕 |
transcript.whisperx[156].start |
5559.807 |
transcript.whisperx[156].end |
5569.415 |
transcript.whisperx[156].text |
所以你目前覺得說那怎麼確保他的這個自主權跟他營養費上限是否足夠那會不會出現商業化漏洞這三個問題 |
transcript.whisperx[157].start |
5571.412 |
transcript.whisperx[157].end |
5598.939 |
transcript.whisperx[157].text |
是這部分有沒有國政署有沒有要跟我們幫忙跟委員報告那目前這個修法草案的設計代孕是以無償的方式去進行的就是禁止商業代孕那習慣有一些相關費用的部分那這個部分我們在如果未來修法通過之後我們還跟相關的專家去做相關的嚴定跟所以目前是還沒有考慮到這些事情等於是細節上還沒有考還沒有還沒有一個比較明確的 |
transcript.whisperx[158].start |
5600.319 |
transcript.whisperx[158].end |
5604.883 |
transcript.whisperx[158].text |
那你覺得這部分會不會出現商業漏洞?商業化的漏洞?我想剛剛部長也談到我們還是以這個代理母的保護當作優先我們會盡量去做這個比較周全的考量 |
transcript.whisperx[159].start |
5625.728 |
transcript.whisperx[159].end |
5628.531 |
transcript.whisperx[159].text |
好再來那如果代孕過程中出現這個醫療風險或法規爭議的話我們衛福部會如何處理跟調解 |
transcript.whisperx[160].start |
5635.034 |
transcript.whisperx[160].end |
5659.227 |
transcript.whisperx[160].text |
我講現在草案設計師要求這個待運的部分有進行相關的評估那也有待運服務機構的機制設計在裡面那就是包括剛提到法律的部分那另外也要投保這個人身保險跟這個健康保險那假設有這個相關的部分在保險上面也能夠獲得給付那這整個懷孕過程那如果有這個 |
transcript.whisperx[161].start |
5661.529 |
transcript.whisperx[161].end |
5683.144 |
transcript.whisperx[161].text |
這個法規規定需要進行這個人工流產的部分那也可以照這個相關法令來做辦理目前草案的設計是這個樣子所以這目前裡面草案都有具體的設計好那再來我想問一下接下來就是回到今天的主題根據這個衛福部自己統計的資料這3年的自殺人數節節攀升 |
transcript.whisperx[162].start |
5685.726 |
transcript.whisperx[162].end |
5698.457 |
transcript.whisperx[162].text |
那其實剛好也是社安網第二期施行的年份等於是社安網二期編列預算後反倒成果越來越差我想要請教一下部長你覺得這次預算不夠還是執行部長導致效果不好 |
transcript.whisperx[163].start |
5701.635 |
transcript.whisperx[163].end |
5726.166 |
transcript.whisperx[163].text |
因為從自殺防治中心開始的時候我就是其中裡面的一個一員所以我我們就知道大家的努力都可以讓自殺在譬如說在但我說從結果結果論來講你看後面三年後面三年你看一下當然這個我們要再分析原因是不是整個社會變遷是預算還是還是因為執行不彰還是可能細節還沒有思考周全 |
transcript.whisperx[164].start |
5727.806 |
transcript.whisperx[164].end |
5752.833 |
transcript.whisperx[164].text |
說執行部長我個人覺得從自殺防治那些那麼用心多年來的這些精神科醫師團隊的其實比較不公平一點可能兩者有互相影響因為中央預算中央政府預算明年稅出是3兆1325億那現在卓院長的預算總諮詢的報告中說社安網二期的預算只有75億 |
transcript.whisperx[165].start |
5754.173 |
transcript.whisperx[165].end |
5756.599 |
transcript.whisperx[165].text |
基本上就是說不到0.24%那我想你認為這樣子的預算夠嗎? |
transcript.whisperx[166].start |
5761.089 |
transcript.whisperx[166].end |
5761.649 |
transcript.whisperx[166].text |
你懂我意思嗎? |
transcript.whisperx[167].start |
5789.38 |
transcript.whisperx[167].end |
5809.872 |
transcript.whisperx[167].text |
報告委員我想社會安全網是社會所重視的不管是朝野:好所以我想要進一步講的就是這個部長前年修正的精神衛生法即將在今年的12月14日實行那請問部長經衛法的第三條定義很清楚但是幾乎都是圍繞在精神疾病 |
transcript.whisperx[168].start |
5810.672 |
transcript.whisperx[168].end |
5838.335 |
transcript.whisperx[168].text |
都是圍繞在精神疾病但是心理健康促進卻是沒有被定義的部長治療基本上已經是最末端的處理但是中階段的預防剛剛講到中階段預防和最初階段的心理健康促進卻沒有被明確的定義清楚那請教部長現在修法當然是可能已經是來不及也不可能但是亡羊補牢還是有機會是不是可以用這個修正施行細則的方式把心理健康促進放進去 |
transcript.whisperx[169].start |
5839.376 |
transcript.whisperx[169].end |
5863.95 |
transcript.whisperx[169].text |
謝謝委員的指教對沒錯我們就是要在精神衛生法施行記者裡面納入心理健康促進是很好啊因為2022年WHO最新的世界心理報告第6.1章節標題就是心理健康促進跟普遍性的預防所以也謝謝這個部長正面回應其實心理健康很重要平常政府就有責任做好心理健康促進 |
transcript.whisperx[170].start |
5864.75 |
transcript.whisperx[170].end |
5889.497 |
transcript.whisperx[170].text |
不是等到發病或是有狀況之後才來做治療跟危機處理所以這個部分我要提醒這個部長在事情細節的部分要盡速的把它列出來謝謝委員的指教這也是符合剛剛委員所講的WHO的一個趨勢對那另外還有一群人的確是被社安網給忽略的依照這個特殊教育法在在學期間這些自閉症或是有情緒障礙 |
transcript.whisperx[171].start |
5890.757 |
transcript.whisperx[171].end |
5905.157 |
transcript.whisperx[171].text |
的部分在學校的期間都有學校的老師可以做輔導那部長我想請問但是這些人如果一旦畢業如果他們沒有去做所謂的身心障礙的鑑定那他在身份上是不是就不會有這個身心障礙族群的身份對嗎 |
transcript.whisperx[172].start |
5908.956 |
transcript.whisperx[172].end |
5932.615 |
transcript.whisperx[172].text |
那個我想齁在...好部長就是對啦好不好我跟你講就是這樣子啦是是是好所以這群人如果沒有去做這個鑑定的話那他其實福利無法獲取之外更重要是社政單位就會漏接所以我在這裡要告訴部長的是如果他們回到社區沒有足夠的支持跟支持管道的時候他就比較容易發生憾事了 |
transcript.whisperx[173].start |
5933.864 |
transcript.whisperx[173].end |
5952.522 |
transcript.whisperx[173].text |
所以部長這部分我想要問你們,你們有什麼方法去加強嗎?加強宣導或者是在校的輔導對象要追蹤這個部分?這部分是不是可以去進一步的去做宣導跟追蹤?你們現在有考慮到這件事情嗎? |
transcript.whisperx[174].start |
5954.349 |
transcript.whisperx[174].end |
5968.878 |
transcript.whisperx[174].text |
看起來是目前沒有對不對所以這部分本席提出來是不是可以請你們回去了解研究評估一下告訴本席這個部分要怎麼處理好是的可以嗎好沒問題好再來我要再討論到一個這個貪扣的問題 |
transcript.whisperx[175].start |
5973.823 |
transcript.whisperx[175].end |
5986.11 |
transcript.whisperx[175].text |
部長你當立委的時候其實針對健保攤扣對當時的反正當時的部長提出質詢所以我想你應該非常清楚攤扣那部長請問你認同和支持攤扣的做法嗎 |
transcript.whisperx[176].start |
5988.768 |
transcript.whisperx[176].end |
6009.778 |
transcript.whisperx[176].text |
因為在總額制度之下真的就是在一定的總額然後成長力如果有限可是醫療的需求對但部長您當初也是有質詢這個我知道醫療需求一直暴漲所以會絕對會呈現點子下降的一種趨勢那如果讓點子不要那麼明顯的下降可能會用 |
transcript.whisperx[177].start |
6010.638 |
transcript.whisperx[177].end |
6029.341 |
transcript.whisperx[177].text |
不管是斷頭或斷尾部長所以你知道這個很有趣喔我等一下還講到我覺得這次是醫院真的醫院的痛啦對嘛我就想要問一下這個邏輯是有問題的對不對臺北區的醫院是採取探戶嘛事後探戶那所以當 |
transcript.whisperx[178].start |
6031.944 |
transcript.whisperx[178].end |
6038.01 |
transcript.whisperx[178].text |
所以我想問部長你是認同支持嗎?所以其實你本身是不認同的對不對?不認同和不支持的?但是你本人是不是不認同和不支持的? |
transcript.whisperx[179].start |
6047.639 |
transcript.whisperx[179].end |
6071.343 |
transcript.whisperx[179].text |
我當然是希望健保能夠永續因為跟委員報告因為我們還是要有時候要站在人民我們也是站在人民的角度所以我要跟你們報告國家的財務狀況那國家的整體發展然後我們醫界自己怎麼樣來創造價值其實簡單來講這個貪扣的部分就是好像是假設健保是買方那醫院算是賣方那 |
transcript.whisperx[180].start |
6072.133 |
transcript.whisperx[180].end |
6088.922 |
transcript.whisperx[180].text |
其實也算是付錢的一方啦健保的部分嘛所以如果一般商品賣方不符合這些商品的這個品質啊或是他的產出有問題那你當然可以要求他驗收不合格退貨可是部長你用貪扣的方式啊你是等於是代表你要求所有的賣家一起減價這個收受 |
transcript.whisperx[181].start |
6091.323 |
transcript.whisperx[181].end |
6113.677 |
transcript.whisperx[181].text |
所以您也知道這個就是這個概念嘛對不對所以這樣子的攤扣制度就會讓這些公司立議院他的不只是無所適從可能會導致他所有經營上面的困難包含著我們後面會提到非常多但我想就不一一贅述但是基本上根據立法院這個決議當初的主決議就是要達到0.95對不對 |
transcript.whisperx[182].start |
6115.618 |
transcript.whisperx[182].end |
6144.938 |
transcript.whisperx[182].text |
那如果說依照憲法規定我們通過的事情行政院只能遵守或是經總統何可提出復議那因此我們在提的這個主決議0.95等於1點這個就是勢必勢在必行不可以有折扣但是實務上你們現在除了公務預算的挹注但是實務上你們卻提高了這個攤扣的金額處理方式我們也接到很多陳情有某醫院他去年同期努力服務成長的金額幾乎全額被扣除 |
transcript.whisperx[183].start |
6145.898 |
transcript.whisperx[183].end |
6165.239 |
transcript.whisperx[183].text |
那還要再倒扣約50%那點值上你說好像我用這種方式去提高了點值但實際上其實是倒貼的部分所以我想要跟你講你看這個是你們全民健保這個各種額部門的結算結果他直接在上面寫攤扣後我想請問部長你有攤扣前的數據嗎?你們有公佈攤扣前的數據嗎? |
transcript.whisperx[184].start |
6167.862 |
transcript.whisperx[184].end |
6184.451 |
transcript.whisperx[184].text |
我想這才可以讓人家了解這個點值真正發生了什麼問題所以你現在就只有這個攤扣後的數據攤扣前攤扣後應該都有資料啦沒有攤扣後有啊我問你攤扣前有沒有因為你這都是攤扣完的資料啊所以沒有辦法真實的反映健保點值到底多少倍 |
transcript.whisperx[185].start |
6186.412 |
transcript.whisperx[185].end |
6188.113 |
transcript.whisperx[185].text |
貪扣請問有法律授權嗎?依法有據嗎? |
transcript.whisperx[186].start |
6209.398 |
transcript.whisperx[186].end |
6235.313 |
transcript.whisperx[186].text |
這個就是各區自主管理的一個機制所以其實是沒有法源嘛對不對像臺北市的臺北區的基層點子比較低所以後來發現說部長太高我知道所以基本上就是就是沒有法源嘛對不對所以比如說健保啊醫療院所是不是有依據健保法全民健康這個保險醫事服務機構特約及管理辦法訂定合約成為特約醫事服務機構那 |
transcript.whisperx[187].start |
6237.974 |
transcript.whisperx[187].end |
6253.6 |
transcript.whisperx[187].text |
請問簽約的合約範本上任何有跟攤扣有關的規定嗎?我還是要講這個,就是你就是沒有法案了嗎?不管是攤扣或者是先各醫院總額,像南區就是醫院總額嘛。沒有,部長你要回答我問題啊。在這個簽約的合約範本裡面有沒有?是不是沒有? |
transcript.whisperx[188].start |
6257.856 |
transcript.whisperx[188].end |
6263.501 |
transcript.whisperx[188].text |
全民健康保險醫療費用申報與核負及醫療服務審查辦法裡面其實是有一個叫做健保核三的法源依據但是完全沒有攤扣相關的規定 |
transcript.whisperx[189].start |
6276.892 |
transcript.whisperx[189].end |
6285.915 |
transcript.whisperx[189].text |
所以這會變成是政府可以用一紙命令就扣錢就扣這個就合扣費用嗎其實這我還是要回過頭來講這樣子的問題就是導致現在這個醫院或是醫療院所經營上面的問題那你可能導致他們在採購或甚至現在要發年終然後因為你攤扣後的數字完全跟他經營上面對不起來所以變成他們很困難甚至間接也導致這個醫護他在家 |
transcript.whisperx[190].start |
6303.821 |
transcript.whisperx[190].end |
6307.843 |
transcript.whisperx[190].text |
這個問題其實也蠻久的然後你們嘴巴上都一直說很重視很重視可是你完全沒有解方啊 |
transcript.whisperx[191].start |
6333.118 |
transcript.whisperx[191].end |
6362.638 |
transcript.whisperx[191].text |
還有總...我們當時會訂總額的制度除非我們好好來檢討總額這件事情我會請部長啊因為時間啊請你深入瞭解攤扣的法律授權還有瞭解攤扣對於公司我想其實這個部分你很清楚啊公司醫院營業經營的影響喔還有攤扣是否對於醫護人員工作獎金發放設備購置甚至這個醫療投資人員禁用等等的進行全方面的瞭解 |
transcript.whisperx[192].start |
6364.16 |
transcript.whisperx[192].end |
6373.253 |
transcript.whisperx[192].text |
我想你們在這部分應該是很清楚所以我其實就是要跟你說你們是這個攤扣是沒有法源依據的請部長深入了解一下攤扣法律授權好不好 |
transcript.whisperx[193].start |
6374.877 |
transcript.whisperx[193].end |
6391.943 |
transcript.whisperx[193].text |
好 這個沒問題 但是就是說其實在管理方面是各區自主性的管理的精神那你可不可以針對我說的這個問題給我一個簡單的說明好不好 給我一份報告說你們的授權到底在哪裡還是你們覺得這個到底有沒有法律的問題我們會回答 回答委員 謝謝 謝謝委員關心謝謝 謝謝廖委員 謝謝部長應該是違法 |
transcript.whisperx[194].start |
6400.748 |
transcript.whisperx[194].end |
6415.072 |
transcript.whisperx[194].text |
那接下來我們請邱政軍委員執行。那我們在竹田局委員執行完畢之後,休息10分鐘。好,主席好。我們一樣請邱部長。邱部長請。委員好。部長好。 |
transcript.whisperx[195].start |
6421.768 |
transcript.whisperx[195].end |
6433.992 |
transcript.whisperx[195].text |
我想請問一下,我們精神衛生法最新修正的部分將在12月14日來開始實行那總共有21項的法規命令跟6項的行政規則,你們預定是不是今年就要修完? |
transcript.whisperx[196].start |
6439.933 |
transcript.whisperx[196].end |
6467.038 |
transcript.whisperx[196].text |
我們有其中15部的一個執法規我們總共有21部15部將在一樣在11、13年的12月14日上路所以現在進度全部好了嗎?我們將以在預計以11月到12月以行政程序辦理發布事宜都已經程序沒有問題了那我看其中第5章預計要到明年下半年才會適用 |
transcript.whisperx[197].start |
6468.939 |
transcript.whisperx[197].end |
6480.816 |
transcript.whisperx[197].text |
因為齁另外有6部齁對阿你剛剛講全部好了嘛那我現在沒有沒有21部裡面只有15部只有15部另外6部要由行政院跟司法院另訂施行日期那誰是主這個主責的機關這個部分說6部呃在6部的話 |
transcript.whisperx[198].start |
6487.195 |
transcript.whisperx[198].end |
6502.109 |
transcript.whisperx[198].text |
跟委員報告就是說我們有關於這個跟司法院相關的是有六部那其中呢主責司法院主責的有兩部那剩下四部的話是本部跟司法院要一起來訂的所以基本上 |
transcript.whisperx[199].start |
6503.41 |
transcript.whisperx[199].end |
6516.718 |
transcript.whisperx[199].text |
所以因為牽扯到司法院我想部長部裡面這邊應該要跟司法院這邊來做好追蹤協調嘛不然你這個東西到時候實施了你有些又沒有跟上怎麼辦 |
transcript.whisperx[200].start |
6518.877 |
transcript.whisperx[200].end |
6519.477 |
transcript.whisperx[200].text |
司法院領選法官有什麼要求嗎? |
transcript.whisperx[201].start |
6537.83 |
transcript.whisperx[201].end |
6562.989 |
transcript.whisperx[201].text |
還是什麼樣的法官都可以?有關於這個法官的部分是由司法院這邊來訂定,包含說在整個參審制裡面的這個參審的醫師跟參審的病權代表的相關的領選資格是由司法院來訂定的。所以司法院來選擇就對了?對。好,那我問你,這個114年涉及司法院權責事項跟規定的部分要召開分區說明會,我們預計要開幾場? |
transcript.whisperx[202].start |
6569.304 |
transcript.whisperx[202].end |
6586.354 |
transcript.whisperx[202].text |
跟委員報告因為司法院因應我們這個新法要上路其實已經規劃了12次的模擬法庭的這個我上個月是開辦在臺北嘛臺北地院其實他是有6個指定法院所以每一個法院會輪兩次總共要開12場現在開了幾場 |
transcript.whisperx[203].start |
6590.939 |
transcript.whisperx[203].end |
6593.722 |
transcript.whisperx[203].text |
我再請教我們心理衛生中心當初113年預估要有53處那10月底已經有52處了算一個多月會達標嗎? |
transcript.whisperx[204].start |
6608.729 |
transcript.whisperx[204].end |
6636.402 |
transcript.whisperx[204].text |
可以啦那精神病有多元社區生活方案發展計畫112年一共合定25家113年合定38家那114年到現在為止我們有提出幾家申請跟委員報告因為我們現在正在公開徵求當中所以還不確定有幾家會投進來但是因為我們的經費有增加我們預估補助的加數也會增加 |
transcript.whisperx[205].start |
6638.237 |
transcript.whisperx[205].end |
6652.78 |
transcript.whisperx[205].text |
我們針對未納入列管的經脹者肇事一再發生社會質疑資源沒有到位您認為針對精神障礙者的發現與照顧優化的資源有沒有到位? |
transcript.whisperx[206].start |
6655.066 |
transcript.whisperx[206].end |
6675.739 |
transcript.whisperx[206].text |
副長你認為勒?我們一直在檢討沒有到你說完全到位當然有包括硬體軟體的一個還有人才的訓練我看了一下就是說全這個全民心理健康這個韌性計畫是說訪視人力要由2021年的183位逐年補時至2025的1001位使負荷比 |
transcript.whisperx[207].start |
6683.78 |
transcript.whisperx[207].end |
6684.88 |
transcript.whisperx[207].text |
不是你什麼時候可以補助? |
transcript.whisperx[208].start |
6714.693 |
transcript.whisperx[208].end |
6740.266 |
transcript.whisperx[208].text |
什麼時候可以補足那個一千零一位一千零一位的話是明年明年我們預計就是要全部都能達到對我們期待可以達到那我看到四年前這個我們本院提倡成立司法精神病院那後來只用司法精神病房替代原本說好像在全台設置480床那目前只有高雄凱旋醫院只有30床 |
transcript.whisperx[209].start |
6741.647 |
transcript.whisperx[209].end |
6758.022 |
transcript.whisperx[209].text |
那所以我們5月從基隆某醫院介乎逃跑的那位思覺失調患者必須從基隆遠送高雄待之行那我請問衛福部為什麼司法精神病房遲遲沒有進度?到底遇到什麼困難? |
transcript.whisperx[210].start |
6759.719 |
transcript.whisperx[210].end |
6775.34 |
transcript.whisperx[210].text |
跟委員報告其實司法精神醫療資源的部件我們都一直持續在進行那我們現在的規劃是在北中南東都要設置一家那司法精神病房部分會有180床那另外還會有這個司法精神醫療保安處分處所 |
transcript.whisperx[211].start |
6780.965 |
transcript.whisperx[211].end |
6799.262 |
transcript.whisperx[211].text |
我相信治療的追蹤目的都是希望我們患者能在穩定的情況下回歸社會但是我們也必須要承認是社會上的支持的系統還是需要努力的尤其是現在殺人犯都拿精神病來當擋箭牌我想這個部分 |
transcript.whisperx[212].start |
6801.644 |
transcript.whisperx[212].end |
6802.184 |
transcript.whisperx[212].text |
國小自殺通報6年來飆升10倍 |
transcript.whisperx[213].start |
6827.51 |
transcript.whisperx[213].end |
6849.48 |
transcript.whisperx[213].text |
111年14歲以下有19個孩子用自殺結束自己的生命那其中73.7%的個案自殺通報日就是死亡日這表示社會安全網沒有接觸這些孩子那14歲以下自殺的死亡人數110年大概有14人111年有19112年有24那我看到資料只有112年那113年現在有多少 |
transcript.whisperx[214].start |
6857.954 |
transcript.whisperx[214].end |
6871.833 |
transcript.whisperx[214].text |
因為我們的這個自殺通報跟死亡的數據都是我們都有在做一些關切但是死亡的數據的話要到明年大概5月底6月才會有最終的數字出來 |
transcript.whisperx[215].start |
6873.31 |
transcript.whisperx[215].end |
6888.708 |
transcript.whisperx[215].text |
市長,我這樣講,我不要把這個責任丟給教育部,我想這個強化精神疾病或是自殺防治的服務,衛福部都是主責機關,我希望由衛福部來主導這個事情,把這個 |
transcript.whisperx[216].start |
6891.327 |
transcript.whisperx[216].end |
6907.153 |
transcript.whisperx[216].text |
這個學生的自殺率來降低那學生其實學生受網路的影響是非常大的那如果未來出現這樣子的這個現象來引誘鼓勵自殺或自殘的網站或網頁衛福部可以要求我們速發部來封網嗎 |
transcript.whisperx[217].start |
6913.566 |
transcript.whisperx[217].end |
6937.543 |
transcript.whisperx[217].text |
有關於這個在媒體上面去做一些監測的這個事情的話其實我們也有在委託這個臺北市的電腦商業同業工會來幫我們去做一些這個偵測那另外就是說如果民眾發現這個跟速發部沒有關係是嗎他們不負責查報就對了或者是你們查報了請他處理也沒辦法 |
transcript.whisperx[218].start |
6939.142 |
transcript.whisperx[218].end |
6967.421 |
transcript.whisperx[218].text |
我們如果接到民眾的這個通報或是機關的通報你剛剛講你委託臺北的那個什麼電腦公司啊臺北的什麼臺北電腦商業同業公會他有權利去封網嗎沒有他只是說他只是通報而已啊所以我想說我們要有實際的作為啊不對嗎其實這個我們衛福部很注重這個對啦注重我是說那到底是最後誰能夠解決這個事情能夠把這個東西拉下來 |
transcript.whisperx[219].start |
6969.104 |
transcript.whisperx[219].end |
6969.344 |
transcript.whisperx[219].text |
是跟委員說明 |
transcript.whisperx[220].start |
6992.513 |
transcript.whisperx[220].end |
7009.831 |
transcript.whisperx[220].text |
繼而紹最佳利益他是違法行為自殺是一個犯罪行為是違法行為可以要求也就是IWIN網路防護機構他政府授權給他可以通知網路業者要移除下架不移除下架有裁罰 |
transcript.whisperx[221].start |
7010.632 |
transcript.whisperx[221].end |
7028.672 |
transcript.whisperx[221].text |
好 那就好 那這個就是我要問的嘛我希望這個部長你也要掌握這樣的一個資訊才在下達指令的時候才不會出現錯誤好不好那最後一個就是說我們上次有講到法務部已經同意升級那個依托米子為二級毒品 |
transcript.whisperx[222].start |
7029.733 |
transcript.whisperx[222].end |
7040.162 |
transcript.whisperx[222].text |
那我看到了就是說我們警政署也行文給食藥署希望食藥署盡快研擬依托米子類毒價的這個尿液檢驗這個預值以利毒價的檢驗請問什麼時候可以訂出來 |
transcript.whisperx[223].start |
7047.133 |
transcript.whisperx[223].end |
7071.432 |
transcript.whisperx[223].text |
好 謝謝 我們施耀使來回答一下是 跟委員報告 這個我們正在做科學資料收集希望在年底以前可以開會可以有這個共識的結論 以上報告好 儘快啦 因為這個東西不能拖齁因為改為二級毒品之後我又發現一個問題啊就是對醫護人員有沒有影響就是說因為他是平常是在醫院做這個麻醉藥品的使用 |
transcript.whisperx[224].start |
7072.313 |
transcript.whisperx[224].end |
7091.921 |
transcript.whisperx[224].text |
那會不會影響這個我們這個辦案人員的辦案或者讓我們的醫護人員不小心就成了持有毒品的這個嫌犯好謝謝委員關心這個這是我們一直很注意的事情在很多的藥其實在醫療上是非常重要的對啊很多政策下來它是一體面我想這個部分我希望部長不理面這個部分應該是不會去 |
transcript.whisperx[225].start |
7094.604 |
transcript.whisperx[225].end |
7097.266 |
transcript.whisperx[225].text |
好,謝謝邱正清委員我們請下一位我們蘇清泉委員謝謝,謝謝主席,我們請邱部長好,我們請邱部長 |
transcript.whisperx[226].start |
7125.256 |
transcript.whisperx[226].end |
7132.085 |
transcript.whisperx[226].text |
社會福利部長辛苦了是精神衛生法這是你做照護的算通過嗎 |
transcript.whisperx[227].start |
7135.86 |
transcript.whisperx[227].end |
7163.151 |
transcript.whisperx[227].text |
有通過的法案太多了到底那個時候是不是有擔任召委員有擔任7次的召委員所以很多的法案都是我跟大家報告現在有精神相關的官能證的什麼的有就醫有紀錄的差不多100多萬人差不多150、160萬人那裡面有精神疾病娘殘障手冊的是13萬是不是這樣 |
transcript.whisperx[228].start |
7165.563 |
transcript.whisperx[228].end |
7169.124 |
transcript.whisperx[228].text |
總床數集滿性有幾床?現在我們現在集滿性的病床總共有2萬608床 |
transcript.whisperx[229].start |
7187.512 |
transcript.whisperx[229].end |
7214.62 |
transcript.whisperx[229].text |
那你現在這個新的法是要把這些我們以前叫精神分裂症現在就是失絕失調嘛把這些人盡量推回家裡嘛回到社區嘛這是人權的關係那你的人你的輔導啊社工啊這些人看起來還有缺口嘛現在的缺口差不多有兩萬人還是更多 |
transcript.whisperx[230].start |
7215.949 |
transcript.whisperx[230].end |
7232.856 |
transcript.whisperx[230].text |
應該沒有。我們叫到114人將增加到2489人。所以以現在的努力還,現在還有差1000人。 |
transcript.whisperx[231].start |
7233.598 |
transcript.whisperx[231].end |
7254.267 |
transcript.whisperx[231].text |
你如果照日本阿加拿大阿他們那種一個人負擔的譬如說訪視員阿什麼你的名稱什麼不管anyway就是英國差不多1比35阿香港差不多1比50日本是比較誇張日本是1比10啦那我們台灣是1比300還是400 |
transcript.whisperx[232].start |
7257.863 |
transcript.whisperx[232].end |
7287.052 |
transcript.whisperx[232].text |
那個是4年前4年前現在嗎對跟委員報告跟委員報告您剛提到的1比300那個是在109年的時候那當時我們的關懷訪視員人數的確是比較少當時才100多位那我們現在的關懷訪視員已經來到了500多位將近600位了所以這個案量比到去年為止是1比60所以已經有大幅度的改善那今年到年底的話會應該會降到1比50左右 |
transcript.whisperx[233].start |
7288.053 |
transcript.whisperx[233].end |
7298.563 |
transcript.whisperx[233].text |
那你這一筆五十是把醫生、心理師、社工師都攬攬做一個來平行的嗎?只有關懷訪視員只有關懷,那所以你的關懷訪視員是訪視的對象是就是這13萬個人 |
transcript.whisperx[234].start |
7303.468 |
transcript.whisperx[234].end |
7327 |
transcript.whisperx[234].text |
各位委員報告您剛剛提到的是零有身心障礙手冊的慢性精神病人那在我們這個全國的精神病人的追蹤關懷系統裡面我們現在追蹤的是9萬5千人那剛剛提到的關懷訪視員這500多位呢其實他是訪視我們在這個9萬多人裡面的第一級跟第二級的個案大概2萬6千人左右所以剛剛的1比60是這樣算出來的 |
transcript.whisperx[235].start |
7330.683 |
transcript.whisperx[235].end |
7359.722 |
transcript.whisperx[235].text |
因為像屏東在兩年多前有一個就是思覺失調的然後在高速箱打一個女電眼黑眼鏡那件事震驚全台灣那在長庚演課幫他開刀的時候是我媳婦給打開了所以我印象很深那個女孩子也因為失禮也救了大部分都救回來了所以是很不簡單大家都很用心 |
transcript.whisperx[236].start |
7361.003 |
transcript.whisperx[236].end |
7374.735 |
transcript.whisperx[236].text |
那像這一種的,現在是打長效針嘛,打長效針,啊我們打長效針,你現在是寬列預算,那一支很有效的耶,那一支很有效的,那煮下去之後都疊著疊著齁,啊那支檢報有出嗎?有,那一支不是多少支? |
transcript.whisperx[237].start |
7381.539 |
transcript.whisperx[237].end |
7402.903 |
transcript.whisperx[237].text |
稍微報告一下,其實我們請那個以前有很多公務預算是好像公務預算可以來支付的,我們最近都把它清出來,但是我們把這個針特別留在健保裡面,裝潢裡面,因為這個是對台灣很重要的事情,這是唯一留下來的罕病跟這個長效症 |
transcript.whisperx[238].start |
7406.357 |
transcript.whisperx[238].end |
7407.017 |
transcript.whisperx[238].text |
跟委員報告我們健保其實是針對這個專款專用27億 |
transcript.whisperx[239].start |
7424.824 |
transcript.whisperx[239].end |
7424.964 |
transcript.whisperx[239].text |
以上補充,謝謝 |
transcript.whisperx[240].start |
7451.524 |
transcript.whisperx[240].end |
7452.144 |
transcript.whisperx[240].text |
那是一針可以撐幾個月 |
transcript.whisperx[241].start |
7473.919 |
transcript.whisperx[241].end |
7501.837 |
transcript.whisperx[241].text |
一針目前有三種有一個月的、三個月的、六個月的所以最長的甚至可以到六個月以上六個月那所以一個人差不多一針是多少六個月一針是健保是多少點那個藥費嘛我們藥費1.1元那有不同的廠牌大概是九千多點到一萬出頭多點所以才特別專款專用所以一個人差不多一年要兩萬多塊的藥費那有需要施打的有多少人 |
transcript.whisperx[242].start |
7502.797 |
transcript.whisperx[242].end |
7505.7 |
transcript.whisperx[242].text |
跟委員報告我們在去年的這個施打有接受這個施打的是3.2萬人 |
transcript.whisperx[243].start |
7517.877 |
transcript.whisperx[243].end |
7532.607 |
transcript.whisperx[243].text |
3.2萬,所以你的預算是夠的那你健保局很會殺價,你就去殺價再去殺啊每一個打啊,因為打那個藥我個人觀察是很有效的,真的大家做得很乖乖啊不然你現在讓他回去家,你溫死的啊 |
transcript.whisperx[244].start |
7534.309 |
transcript.whisperx[244].end |
7548.53 |
transcript.whisperx[244].text |
這對家屬是一個很沉重的負擔啊家屬大家社區看到這種病人那真的大家不都要大了稍微這個專業的見解跟我們先母親來努力的方向是一致的 |
transcript.whisperx[245].start |
7549.798 |
transcript.whisperx[245].end |
7578.725 |
transcript.whisperx[245].text |
所以該打的就打啦你是精神科專科你是該打就打啦要把他殺低一點以後這些你有重大傷病的或是山上所致大家都住處乖乖的這樣就沒問題了不然你有滑滑照不定時照彈的那是很危險的事情這兩天這個桃園這個軒然大波是抱一個小孩子嘛我有傷害到那個小孩子嗎有沒有抓到的時候還好 |
transcript.whisperx[246].start |
7583.446 |
transcript.whisperx[246].end |
7583.606 |
transcript.whisperx[246].text |
再來就 |
transcript.whisperx[247].start |
7606.556 |
transcript.whisperx[247].end |
7631.511 |
transcript.whisperx[247].text |
回到家裡之後我們是不是有專家、醫師、團隊組成一個team就好像我們癌症病人這樣是一個team work到家裡去訪視那由醫生帶隊還是怎麼樣我們要做這個重點現在是有外展的一個服務嗎如果有必要的話是有外展的服務那這個可以做得更完善一點嗎現在 |
transcript.whisperx[248].start |
7634.037 |
transcript.whisperx[248].end |
7660.206 |
transcript.whisperx[248].text |
跟委員報告其實我們目前對於這個病人的治療方式有非常多種那剛剛委員提到的就是說居家治療就是我們的醫療團隊外展到病人的家裡面那搭配剛剛所提到的長效徵記的話其實效果是會很好的那居家治療這個部分目前也是由健保在做那你剛剛講的這些社工員、心理師這個都是正職的公務的缺還是都是約聘的還是外包的 |
transcript.whisperx[249].start |
7661.271 |
transcript.whisperx[249].end |
7687.832 |
transcript.whisperx[249].text |
這個都是聘用人員是由地方政府來禁用那經費是我們中央政府經費是由中央部分補助但是我們是補助的這個7成以上啦看每個地方政府的一個財力狀況所以待遇是OK不要最最大的那個那個低薪是中央造成的不會的因為他們的這個條薪呢也是跟著公務人員的這個條薪那休假是比較勞保 |
transcript.whisperx[250].start |
7689.652 |
transcript.whisperx[250].end |
7691.192 |
transcript.whisperx[250].text |
我們努力爭取謝謝召委 |
transcript.whisperx[251].start |
7720.836 |
transcript.whisperx[251].end |
7735.181 |
transcript.whisperx[251].text |
那心理這邊OK嗎?這邊沒問題吧?該寬烈就要寬烈啦!我們不會無理的來刪,我們一定是全力支持啦!不該發的當然不要發啦!好!謝謝!謝謝部長!好!謝謝蘇欽前委員! |
transcript.whisperx[252].start |
7752.239 |
transcript.whisperx[252].end |
7758.446 |
transcript.whisperx[252].text |
來,我們接續請圖千玺委員質詢。好,謝謝主席,那請我們邱部長。部長請。 |
transcript.whisperx[253].start |
7763.976 |
transcript.whisperx[253].end |
7790.761 |
transcript.whisperx[253].text |
委員好部長辛苦那也感謝你在假日期間也這麼關心我們基層跑了那麼多行程辛苦感謝委員對桃園醫界那麼的關懷大家都非常感動謝謝部長那我們今天專案報告是主要是針對社區精神病患照護優化這個部分那我們也看了一下我們這幾年來針對這些 |
transcript.whisperx[254].start |
7793.001 |
transcript.whisperx[254].end |
7817.366 |
transcript.whisperx[254].text |
像我們這一部分的預算都有增加嘛那不知道增加以後這一部分部長覺得這一部分的成效如何我想由今天找到的報告從不管是從人力的一個點的建置人力的增加數字的提升我想還有預算的增加都是一直符合社會的需求的桌前性來邁進更正常來邁進 |
transcript.whisperx[255].start |
7820.988 |
transcript.whisperx[255].end |
7842.165 |
transcript.whisperx[255].text |
事實上其實我也知道我看到大家都在努力可是其實我們目前看到實際的成效感覺還是不足而且這些社會事件還是不斷的發生那我們先看一下我們上禮拜這個影片相信最近大家都很關注這個社會事件我們先看一下這部影片 |
transcript.whisperx[256].start |
7852.864 |
transcript.whisperx[256].end |
7865.415 |
transcript.whisperx[256].text |
那這部影片也是最近大家很關心在我們桃園龜山那有一個18歲的中度生長那搶乳的9歲女童的事件 |
transcript.whisperx[257].start |
7877.362 |
transcript.whisperx[257].end |
7906.442 |
transcript.whisperx[257].text |
部長 這個影片雖然只有26秒但是你看這個影片我相信對這個女童一定是一輩子的噩夢那本系也了解當然這個加害人他是中度的身心障礙者但是依照我們身心障礙權益保障法主管單位當然是地方政府但是我們中央機關主管單位是衛福部那針對這部分我們衛福部有去關心受害者還有這個家屬嗎 |
transcript.whisperx[258].start |
7907.142 |
transcript.whisperx[258].end |
7907.176 |
transcript.whisperx[258].text |
本集完 |
transcript.whisperx[259].start |
7908.567 |
transcript.whisperx[259].end |
7936.694 |
transcript.whisperx[259].text |
我想我們看到這個影片真的是很難過啦我想我們後續都一定是很努力在關注跟看應該要做的錯我們新建室跟社家屬有去了解嗎有保護福斯來回應因為這一案子涉及疑似性侵害所以第一時間社工有到場陪同被害人的這個家屬那可以簡單說明一下 |
transcript.whisperx[260].start |
7937.674 |
transcript.whisperx[260].end |
7941.698 |
transcript.whisperx[260].text |
對,我們希望衛福部針對協同相關單位來關心女童不要讓她這個未來一輩子造成很大的因緣 |
transcript.whisperx[261].start |
7958.556 |
transcript.whisperx[261].end |
7960.497 |
transcript.whisperx[261].text |
所以當初處理員警是沒有去要求社工說要和解嗎? |
transcript.whisperx[262].start |
7988.738 |
transcript.whisperx[262].end |
8010.429 |
transcript.whisperx[262].text |
所以針對這部分我相信衛福部應該也很重視這個案件那近年來針對精神疾病身心障礙因為刑事犯罪案件常常上這個社會版面那當然也對我們社會對精神病患者還有身心障礙者造成很大的誤解那當然我覺得也暴露 |
transcript.whisperx[263].start |
8011.637 |
transcript.whisperx[263].end |
8019.223 |
transcript.whisperx[263].text |
衛福部在立法上還有我們執行前端我覺得在預防作業上好像看起來有很大的疏失 |
transcript.whisperx[264].start |
8020.523 |
transcript.whisperx[264].end |
8048.434 |
transcript.whisperx[264].text |
那部長針對這部分有沒有你覺得這部分是不是有很大改進的空間謝謝委員我們在針對精神病或身心障礙的照護其實是要多元化來處理那我們是希望往前來減低一個危險那所以在國際間其實在社工啊怎麼樣都希望不是 |
transcript.whisperx[265].start |
8049.332 |
transcript.whisperx[265].end |
8074.951 |
transcript.whisperx[265].text |
不是好像去檢查檢查員而是說平常就要去照顧的一個深入在那邊瞭解整個社區的狀況這樣才能夠減少risk對啊所以我覺得這部分我們覺得這個預防真的是非常非常的重要那而且針對我們衛福部統計國內零有身心障礙慢性精神疾病患者已經突破13萬人對不對 |
transcript.whisperx[266].start |
8076.992 |
transcript.whisperx[266].end |
8089.83 |
transcript.whisperx[266].text |
那我們看到這不僅這個患者一直增加而且相關精神病患者殺人致死的案件也增加對不對看起來這個數據好像都是逐年在增加可能要看一下確實的數據 |
transcript.whisperx[267].start |
8092.554 |
transcript.whisperx[267].end |
8106.973 |
transcript.whisperx[267].text |
好那沒關係因為法務部那邊對因為我們這個根據我們有統計啦齁這個看起來都沒有減少而且感覺都在增加那本系列看到我們針對衛福部新建師 |
transcript.whisperx[268].start |
8108.094 |
transcript.whisperx[268].end |
8128.684 |
transcript.whisperx[268].text |
他在有關強化精神醫療還有精神病患收治這一部分他的預算是減編的那減編的理由是怎麼樣這案件一直增加那這預算減編是成效不好還是怎麼樣不管為什麼這案件一直增加這個數量一直增加結果這預算反而是減少的你看一下從113年到114年這預算 |
transcript.whisperx[269].start |
8138.522 |
transcript.whisperx[269].end |
8144.35 |
transcript.whisperx[269].text |
減少3.7%新建室在強化精神醫療及社會資源經費的部分是減少2.7%那 |
transcript.whisperx[270].start |
8148.127 |
transcript.whisperx[270].end |
8168.021 |
transcript.whisperx[270].text |
我不了解在案件一直增加然後預算減少是什麼情形有些事在其他的計畫有編我們是不是請市長跟委員報告我這邊是社公司我説明一下關於那個小康計畫的經費減少的原因那小康計畫他收支的對樣是早期的那個找不到家屬沒有身分的入島病人 |
transcript.whisperx[271].start |
8168.541 |
transcript.whisperx[271].end |
8168.941 |
transcript.whisperx[271].text |
那從客觀的預算來看我們 |
transcript.whisperx[272].start |
8197.817 |
transcript.whisperx[272].end |
8214.27 |
transcript.whisperx[272].text |
這一部分我看精神病人我看好像我們針對這些收容好像這些精神病人對於好像這些治療都是抗拒或者不敢就醫那針對社家屬針對這一部分有沒有提出解決的辦法 |
transcript.whisperx[273].start |
8220.322 |
transcript.whisperx[273].end |
8248.131 |
transcript.whisperx[273].text |
委員的意思是...對啊,其實這些精神病患據我們了解啦可能也因為社會給他們造成汙名化也造成很多的誤解所以我們目前了解到好像他實質的成效並不是太好是不是因為這些精神病的患者家屬沒有讓他們去就醫而且還是這些精神病患會有抗拒的問題社家屬有了解這部分嗎? |
transcript.whisperx[274].start |
8249.737 |
transcript.whisperx[274].end |
8275.774 |
transcript.whisperx[274].text |
這個的確以我一個醫師的經驗的確是有會發生這種情況我在30年前在偏鄉在做服務的時候也常常會看到這樣的病人他有些是被關在家裡旁邊的小房子關了30年對啊那我們衛福部社家屬這部分是不是有推展身心障礙照顧服務資源的部件計畫是不是有提這部分的計畫 |
transcript.whisperx[275].start |
8278.018 |
transcript.whisperx[275].end |
8278.839 |
transcript.whisperx[275].text |
對,可是看你們預算中心的報告齁 |
transcript.whisperx[276].start |
8307.518 |
transcript.whisperx[276].end |
8322.347 |
transcript.whisperx[276].text |
我們針對身心障礙服務據點安置的情形這個安置率整體不到八成而且在我們花蓮宜蘭甚至只有六成六成多所以針對這部分覺得成效如何 |
transcript.whisperx[277].start |
8323.953 |
transcript.whisperx[277].end |
8348.619 |
transcript.whisperx[277].text |
看起來這個成效如果在針對身心障礙精神病患者他本身又抗拒又不敢就醫那這個八成的安置率是整體的那我們針對身心障礙精神病患者我們覺得他就醫的比例可能又更低對不對那針對這部分看起來這安置率更低我們有沒有什麼因應改善的措施啊 |
transcript.whisperx[278].start |
8350.185 |
transcript.whisperx[278].end |
8366.79 |
transcript.whisperx[278].text |
跟委員報告服務的安置率的部分我們是每一個年度在新年度開始會重新開始來計算他的服務人數跟統計那以我們現在統計到今年的6月我們的服務的使用率是到85.4%那其實是一直會持續的穩定的來增長 |
transcript.whisperx[279].start |
8370.891 |
transcript.whisperx[279].end |
8398.283 |
transcript.whisperx[279].text |
好我希望注意一下因為你這是整體的安置率所以我剛剛有特別講針對精神病身心障礙的應該是更低所以你整體都只有八成甚至有些根本只有六成多所以這部分應該要特別注意那以他們來講應該這個安置率應該是更低那還有像我們桃園龜山這一類身心障礙犯罪的案例我們看過去也蠻多的還有特別就是像我們 |
transcript.whisperx[280].start |
8400.009 |
transcript.whisperx[280].end |
8401.05 |
transcript.whisperx[280].text |
年底以前絕對沒問題嘛對不對 |
transcript.whisperx[281].start |
8423.372 |
transcript.whisperx[281].end |
8438.207 |
transcript.whisperx[281].text |
12月14日那我們有看針對我們這部分要在社區廣設心理衛生中心衛福部的方針是這樣嗎那而且好像平均在33萬人我們設一個 |
transcript.whisperx[282].start |
8441.536 |
transcript.whisperx[282].end |
8455.765 |
transcript.whisperx[282].text |
新衛中心那針對這一部分當然我們也希望能夠多增設那預防重疑治療可是據我們看喔從2023年我們身心障礙社工的缺額大概有300個 |
transcript.whisperx[283].start |
8457.206 |
transcript.whisperx[283].end |
8474.536 |
transcript.whisperx[283].text |
新衛中心社工的缺額有748個而且看起來他的離職率跟流動率也是居高不下那我們社家屬針對這一部分你一直增加新衛中心可是這社工數的缺額還是一直在增加我們 |
transcript.whisperx[284].start |
8475.396 |
transcript.whisperx[284].end |
8479.639 |
transcript.whisperx[284].text |
謝謝委員的關心這個我們也透過了改善薪資的結構強化專業的信任還有督導協助輔導的一個方式來提升他的留任的意願 |
transcript.whisperx[285].start |
8505.255 |
transcript.whisperx[285].end |
8532.742 |
transcript.whisperx[285].text |
我們希望這新版的精神衛生法請部長一定要在年底前如期上路那針對身心障礙還有心胃中心社工缺額的問題我們一個月內可不可以提出因應社工缺額問題的改善計畫好我們會提出改善計畫好那請部長我們一個月能不能提出這改善計畫因為這之前已經講很多了好沒問題好謝謝謝謝委員好謝謝杜委員謝謝部長現在休息10分鐘 |
transcript.whisperx[286].start |
8543.328 |
transcript.whisperx[286].end |
8543.368 |
transcript.whisperx[286].text |
主席 |
transcript.whisperx[287].start |
9137.315 |
transcript.whisperx[287].end |
9142.078 |
transcript.whisperx[287].text |
好,我們繼續開會請王振旭委員質詢好,非常感謝主席我們有請部長部長好部長 |
transcript.whisperx[288].start |
9162.628 |
transcript.whisperx[288].end |
9182.283 |
transcript.whisperx[288].text |
你好你好謝謝你今天早上有做相當完整的報告包括人力啦或者是一些對峙地點的部件的確能夠強化有關於我們對於這個精神病患在各方面的照顧不過我相信今天的這個安排應該是針對於 |
transcript.whisperx[289].start |
9184.204 |
transcript.whisperx[289].end |
9210.663 |
transcript.whisperx[289].text |
我們在10月底的個案出現了這種困擾希望能夠更有效的來加強如果能夠把這些在現場發生的問題看如何做有效的解決這個當然就會牽扯到通報機制所以我們今天就希望能夠利用這個機會來請教一下部長還有相關的主管我們的這些長官們來了解 |
transcript.whisperx[290].start |
9211.323 |
transcript.whisperx[290].end |
9235.38 |
transcript.whisperx[290].text |
在現場的話我們還有沒有其他更好的機制來處理我們也知道其實很多的專家學者都會告訴我們說出現問題的現場裡面我們如何能夠去避免所謂的旁觀者效應還有在現場我們也觀察到公民參與的這個能力其實相對是不夠 |
transcript.whisperx[291].start |
9237.173 |
transcript.whisperx[291].end |
9259.79 |
transcript.whisperx[291].text |
所謂旁觀者效應就是當我們看到一個事件的時候可能就這樣路過了因為這個10歲的女童剛剛也了解相信這個女童需要後續的關懷那我們也期待這樣的影響不至於對她終生造成不當的影響那如果能夠有更多的旁觀者在第一時間就能夠努力的來 |
transcript.whisperx[292].start |
9260.811 |
transcript.whisperx[292].end |
9279.043 |
transcript.whisperx[292].text |
主角這個事情的話我想對這個女童應該有很大的幫忙所以目前有網路通報當然還有電話通報那不知道除了這兩個通報以外那有沒有曾經演練過到底這種網路通報的迅速性是如何那電話通報通常都是以110為這個通報的 |
transcript.whisperx[293].start |
9281.084 |
transcript.whisperx[293].end |
9281.164 |
transcript.whisperx[293].text |
衛生福利部長針對 |
transcript.whisperx[294].start |
9298.004 |
transcript.whisperx[294].end |
9319.118 |
transcript.whisperx[294].text |
常見的一種處理方法那LINE的有沒有機會透過衛福部這邊一起來合作的一些方案出來讓民眾在使用LINE的時候也可以有機會來增強這方面的更綿密的這個通報體系這邊不知道部長或者相關的主管同仁有沒有相關一些意見可以提供參考 |
transcript.whisperx[295].start |
9319.929 |
transcript.whisperx[295].end |
9334.656 |
transcript.whisperx[295].text |
好 謝謝委員這麼對這個議題提出這麼精闢的一些方向跟指教那我想我們從強化社會安全往計畫第一期就開始一直都在 |
transcript.whisperx[296].start |
9335.656 |
transcript.whisperx[296].end |
9353.462 |
transcript.whisperx[296].text |
用線上通報這個部分也透過各個單位跟民眾各網路單位跟民眾都能夠透過這個系統來通報當然這個也包括警政、衛政、民政、教育、勞動、人民等單位那有各個專...整合各個專機 |
transcript.whisperx[297].start |
9355.323 |
transcript.whisperx[297].end |
9372.919 |
transcript.whisperx[297].text |
來求助專線那當然後續我們更像這樣的事情我們目前來講就是網路跟民眾的通報如果緊急的話當然就是110跟119通報警消那我們也設立了call center做專業的一個 |
transcript.whisperx[298].start |
9375.7 |
transcript.whisperx[298].end |
9391.586 |
transcript.whisperx[298].text |
希望在第一線能夠有能夠馬上得到很好的處理那剛剛委員提的旁觀者這個部分的確是我們社會我們要大家一起來努力的我們過去在推CPR或怎麼樣也都 |
transcript.whisperx[299].start |
9392.546 |
transcript.whisperx[299].end |
9420.063 |
transcript.whisperx[299].text |
也都希望大家能夠隨時都不要當參與者這個部分也是我們要努力的至於比較具體有沒有要那個新認識跟委員報告一下謝謝委員的確透過民眾的一個通報讓我們在社區裡面還沒有機會接觸到我們的醫療體系的可以透過民眾的通報或者是說我們的第一線網路的服務人力在服務的過程裡面發現有疑似精神病人的話 |
transcript.whisperx[300].start |
9420.503 |
transcript.whisperx[300].end |
9447.227 |
transcript.whisperx[300].text |
﹗ |
transcript.whisperx[301].start |
9447.5 |
transcript.whisperx[301].end |
9467.496 |
transcript.whisperx[301].text |
好,基本上就是希望大家比較潔薄啦尤其是如果看到社區有相關這些精神不是很穩定啦或者是他有可能傷人或是自傷的話那如果大家比較潔薄就能夠把這個網絡做得更綿密可以減少家庭這方面的負擔 |
transcript.whisperx[302].start |
9468.537 |
transcript.whisperx[302].end |
9491.332 |
transcript.whisperx[302].text |
也期待大家都能夠共同來關心我們這些在思學試調上有適應上有困難的這些民眾我想社會是一體的我們期待大家的這些安全都能夠達到比較完整的一個保護好 謝謝再來就要請教我們上個禮拜五有跟院長討論了一些跨部會的議題跟這個 |
transcript.whisperx[303].start |
9494.534 |
transcript.whisperx[303].end |
9509.966 |
transcript.whisperx[303].text |
有三個比較大的議題在這個地方來請教一下部長包括這個推動智慧醫療的部分我們知道基層診所的VPN相關的系統真的非常非常的緩慢這部分再來部長 |
transcript.whisperx[304].start |
9511.087 |
transcript.whisperx[304].end |
9531.283 |
transcript.whisperx[304].text |
有沒有更好的方式來改善因為我們知道在這個導致健康台灣的策略八裡面是要加速醫療資訊的升級智慧醫療服務要轉型這個VPN速度如果做不好要提高這個真的是很困難而且反不及急因為 |
transcript.whisperx[305].start |
9532.344 |
transcript.whisperx[305].end |
9550.474 |
transcript.whisperx[305].text |
整所通常要健保醫療服務打疫苗做篩檢這東西尤其你要登錄影像的時候真的需要有更快速的這些網路系統的作業這部分部長有沒有更好的方式或者是有哪些在加強中 |
transcript.whisperx[306].start |
9550.874 |
transcript.whisperx[306].end |
9568.326 |
transcript.whisperx[306].text |
我想這個都是要資源來建構了那謝謝委員這麼關心我們第一線守護人民健康的基層的一個醫療院所而且他們的確就是一直這個問題一直 |
transcript.whisperx[307].start |
9570.527 |
transcript.whisperx[307].end |
9597.299 |
transcript.whisperx[307].text |
是他們的訴求我想在政府方面我們在其中明年也編了8億元將要來補助醫療院所的一個網路的頻寬那其中有2億元會放在基層那我們真的很希望把基層的一個整個VPN的系統讓他們不管是跟資料的整理或跟要取得或者跟大醫院的一個 |
transcript.whisperx[308].start |
9599.783 |
transcript.whisperx[308].end |
9623.892 |
transcript.whisperx[308].text |
結合這個部分的資訊環境能夠獲得改善這個我們希望明年應該會有具體的改善希望這個改善至少讓所有的醫療從業人員可以很迅速的來處理他們一些行政措施再來第一點就是有關於這個醫療院所電價動漲的部分我相信很多委員真的非常非常的關心阿妹你 |
transcript.whisperx[309].start |
9626.033 |
transcript.whisperx[309].end |
9648.136 |
transcript.whisperx[309].text |
還有其他要注意的地方嗎?因為我們也知道醫療院所都已經被同意是需要這個電價凍漲還有其他相關的部門包括一些製藥的行業還有一些社福NGO當然也都是在提供醫療服務給民眾的話這部分不知道有其他的做法嗎? |
transcript.whisperx[310].start |
9648.957 |
transcript.whisperx[310].end |
9662.503 |
transcript.whisperx[310].text |
當然才在長照體系方面,當然他有他的規定,如果是公益的才方便的,會有可能在動作或補助這個部分。 |
transcript.whisperx[311].start |
9666.525 |
transcript.whisperx[311].end |
9692.014 |
transcript.whisperx[311].text |
那製藥部門呢?因為那個工廠要行善嘛他的那個電力的使用其實也很需要關注我們對於來爭取的那個的行業我們都基於關心而且但是要尊重那個在經濟部他們的委員會的一個審查還有他們的規定那我們會衛福部會當然站在照顧 |
transcript.whisperx[312].start |
9693.118 |
transcript.whisperx[312].end |
9720.335 |
transcript.whisperx[312].text |
只要是公益又照顧人民健康需要的而且譬如說藥品方面他當然不能讓藥品做不下去又切藥藥產業都應該是要共同關心真的都是要關心的那這個部分只要有反應我們都會來了解那看看幫怎麼樣來一起爭取那這個食藥不曉得有沒有什麼要補充 |
transcript.whisperx[313].start |
9721.796 |
transcript.whisperx[313].end |
9745.538 |
transcript.whisperx[313].text |
謝謝委員我們會把這個製藥還有相關的醫療的產業納進來一併做跨部會的討論謝謝那就麻煩還有最後有關於這個國人健檢的費用有沒有機會納入這個稅有的扣除那這部分不曉得部長有沒有哪一些的比較具體的想法如何能夠跟財政部做一些溝通 |
transcript.whisperx[314].start |
9746.567 |
transcript.whisperx[314].end |
9769.816 |
transcript.whisperx[314].text |
我8年前在第一會期剛進立法院就是在財政委員會我第一個提案可能就是除了承襲我們蘇昭偉這個醫療法行者合理化這個努力以外提出的案當然也提出了分級醫療相關的事情另外就是提這個 |
transcript.whisperx[315].start |
9770.536 |
transcript.whisperx[315].end |
9792.441 |
transcript.whisperx[315].text |
因為我覺得這對人民的健康是重要的但是應該沒有後來在財政委員會沒有出委員會那個時候的財政部長其實他自己也是生病的人他自己很覺得很需要但是可能那個時候氣氛還沒有到成熟那我個人覺得我很敬佩王委員 |
transcript.whisperx[316].start |
9793.661 |
transcript.whisperx[316].end |
9822.318 |
transcript.whisperx[316].text |
能夠再度提出來那尤其是在健康臺灣推展當中特別著重在身體的健康能夠早期發現對個人對家庭是很幸福的所以我也希望這個將來應該會在財政委員會方面去討論我想那也拜託在那一邊的能夠幫忙那這個對人民的健康幸福能夠我們現在在看很多很多像大腸癌你如果有早期 |
transcript.whisperx[317].start |
9824.357 |
transcript.whisperx[317].end |
9848.189 |
transcript.whisperx[317].text |
發現幾乎都是第1期、第2期讓他留正頭看來像第三期、第4期那個大概就那個死亡率就不一樣了那我們現在2030年你要想要降低癌症的死亡率三分之一篩檢是非常困難的篩檢是非常重要的如果能夠加上這個的話我相信一定有鼓勵的作用 |
transcript.whisperx[318].start |
9849.529 |
transcript.whisperx[318].end |
9872.067 |
transcript.whisperx[318].text |
也讓民眾、也讓醫院都能夠共同來完成這個比較好的一個健康照顧因為這是一個必要的支出嘛我們是很支持啦我們初衷不變啦就是為了人民的健康來看看怎麼樣更健康啦好,這樣感謝部長感謝聖和烈士的官員們謝謝主席 |
transcript.whisperx[319].start |
9877.977 |
transcript.whisperx[319].end |
9905.254 |
transcript.whisperx[319].text |
好,謝謝王委員、謝謝部長。繼續我們請嘉賓、封家賓委員質詢。主席、在場的委員、先進、列席的總監事長、官員、會長、工作夥伴。有請邱部長及心理健康室的政司長。 |
transcript.whisperx[320].start |
9911.283 |
transcript.whisperx[320].end |
9927.72 |
transcript.whisperx[320].text |
委員好!部長好!市長好!我過去在擔任地方政府副首長、副縣長的時候,常常有人問到我這個問題。考一下,部長,如果有人說在社區發現有攻擊性的疑似精神疾患者,要怎麼處理?是打119找救護車,還是打110叫警車? |
transcript.whisperx[321].start |
9932.497 |
transcript.whisperx[321].end |
9958.282 |
transcript.whisperx[321].text |
應該是先,如果以民眾來講,應該是要先打119跟119我再問你要打119,好我這樣直接講好了啦因為一般民眾他搞不清楚,說有人拿棍子亂打人,他第一個忙想叫警察但是有代理人知道這個可能是精神疾患者,可能就叫救護車但是呢通常警察跟消防局接到之後都會問說應該是叫對方去啦 |
transcript.whisperx[322].start |
9959.604 |
transcript.whisperx[322].end |
9979.106 |
transcript.whisperx[322].text |
那我想今天我們關心社區精神衛生,不只是要解決我們精神衛生疾患者的需求,也要去處理誰?處理這些應戶,要去面對處置這些精神疾患者的這些工作人員,對不對?包括醫護人員,也可能包括警察,也可能包括下方員,是不是這樣? |
transcript.whisperx[323].start |
9980.551 |
transcript.whisperx[323].end |
10006.116 |
transcript.whisperx[323].text |
我們來看一下英雄有淚不輕彈這是一個火神的眼淚這個年輕的消防員說我沒有生病我就是工作壓力太大請問部長你會不會認為說消防員會有心理創傷你認為造成心理創傷的原因是什麼譬如說我們屏東名陽的大火你覺得這些消防員火場上眼見自己的好弟兄失去了生命你覺得他們受得了嗎當然受不了那怎麼辦 |
transcript.whisperx[324].start |
10008.12 |
transcript.whisperx[324].end |
10032.907 |
transcript.whisperx[324].text |
一定要有一個輔導的機制要有一個心理上的輔導好往下看其實呢消防會有沒有心理創傷我們剛剛到了加害搶救啦、急難救助啦、搜救、災害預防等等等火場會遇到這個情況你認為醫護人員會不會有類似的情況重大的嬌生事故、重大的天然災害在急診處一大堆的傷患在哀嚎你覺得醫護人員會不會也有心理創傷所以所謂的PTSD |
transcript.whisperx[325].start |
10034.744 |
transcript.whisperx[325].end |
10048.896 |
transcript.whisperx[325].text |
就是創傷後壓力症候群我想任何人都會有尤其是從事這種面對高風險高張力壓力的不管是消防員還是醫護人員對不對是的那請問你過去長久在醫界醫界怎麼去面對這個問題醫護人員的所謂的PDSD |
transcript.whisperx[326].start |
10055.462 |
transcript.whisperx[326].end |
10057.844 |
transcript.whisperx[326].text |
我們醫療體制有沒有來協助我們的醫護人員去面對這個問題?一定有,你好像是推測,你是部長欸 |
transcript.whisperx[327].start |
10070.772 |
transcript.whisperx[327].end |
10086.165 |
transcript.whisperx[327].text |
我現在要問你為什麼我會先問你這個因為我問你說如果是消防署長我問他消防員工作權益促進會他們在2021年的統計臺灣的消防員罹患PTSD的盛行率高達了9.2%你覺得跟我們臺灣的醫護人員相較起來哪一個比較高可能沒有答案是不是我覺得消防員的 |
transcript.whisperx[328].start |
10095.601 |
transcript.whisperx[328].end |
10102.385 |
transcript.whisperx[328].text |
壓力更大因為它是蠻急性的所以你覺得要怎麼樣去協助下方員面對這個PTSD |
transcript.whisperx[329].start |
10107.37 |
transcript.whisperx[329].end |
10131.972 |
transcript.whisperx[329].text |
這個應該提出一個協助的方案好很好我想衛福部應該有對我們醫護人員這樣的協助方案但是我們看一下地方的縣市政府的員工協助方案他就是說一個在任何的職場員工都可以去協助他解決這些問題很籠統啦請問部長你覺得像這樣的一個地方政府的員工協助方案他可以配合消防員的排班時間可以適用在消防員的工作情境嗎 |
transcript.whisperx[330].start |
10132.853 |
transcript.whisperx[330].end |
10152.46 |
transcript.whisperx[330].text |
或者將心比心,你覺得如果這樣的通用方案可以適合我們的醫護人員嗎?防範還不足不夠?好,那你知道消防署一年他只有6次的個別諮商那消防員有時候需要是短期的,有時候需要長期的你覺得以目前內政部的政策足以滿足消防員需要的這個心理諮商服務嗎? |
transcript.whisperx[331].start |
10154.709 |
transcript.whisperx[331].end |
10176.94 |
transcript.whisperx[331].text |
這個當然就是要專家來做評論如果可能要精神或者心理師專家來討論看看幾次是比較適合因為你是我們內閣當中你能掌握這些醫療的專業資源你可以清楚的告訴內政部長告訴消防署長 |
transcript.whisperx[332].start |
10178.414 |
transcript.whisperx[332].end |
10198.18 |
transcript.whisperx[332].text |
為了避免我們消防員罹患的這個PTSD,我們應該怎麼去安排這些心理諮商的服務?對不對?你同不同意?內閣要看你啊。你可以來給他們一些建議嗎?我願意承擔這個專業的一個順序。好,很好。那既然這樣成立,我也問問內政部長。你知道為什麼消防員不願意使用現有的資源嗎?第一個,他們排班時間沒辦法配合。 |
transcript.whisperx[333].start |
10198.88 |
transcript.whisperx[333].end |
10223.15 |
transcript.whisperx[333].text |
第二他們怕同儕長官的異樣眼光你覺得他會承認說我只能去打火看到那個焦黑的屍體抬出來我受不了我需要休息三天很難講啊英雄有淚不輕彈啊所以呢但我呢他就去面對一個他沒有陌生的諮商師他可能也不談講講那你覺得你如果要協助我們的行政院協助內政部協助消防署你覺得要怎麼提升消防員對心理資源輔導的接受度和使用率 |
transcript.whisperx[334].start |
10226.163 |
transcript.whisperx[334].end |
10245.595 |
transcript.whisperx[334].text |
市長簡單的答問因為時間的關係謝謝委員關切我們消防員的心理健康的確不管是警察或是消防或是我們醫護人員在執行業務的過程裡面一定會面臨到類似的狀況那最近其實消防署是沒有找我們談但是警政署有 |
transcript.whisperx[335].start |
10246.275 |
transcript.whisperx[335].end |
10250.938 |
transcript.whisperx[335].text |
有擔當的司長,現在希望有擔當的部長來往下看。最後的結論,我們所有的執法人員,所有的公務員,包括醫護人員,包括警察,包括消防員,你必須是一個健全的人,才會是一個有溫度的執法者。 |
transcript.whisperx[336].start |
10268.268 |
transcript.whisperx[336].end |
10295.549 |
transcript.whisperx[336].text |
我為什麼今天問這個議題呢?我當然是長期關心我們社區精神衛生健康但是我曾經遇到一位心理諮商師他輔導過消防員他說那個救護車開出去啊那個年輕的消防員呢他開始有一些心理障礙為什麼?他在一次出行當中沒想到救來的是他的阿嬤而且Oka那他從此之後呢他就覺得人家心理諮商師問他說啊你會不會覺得難過需要我幫你怎麼樣他說沒有啊我沒有感覺了 |
transcript.whisperx[337].start |
10296.877 |
transcript.whisperx[337].end |
10313.111 |
transcript.whisperx[337].text |
一個第一線的工作者當他對人沒有感覺的時候不只對他傷害啊對他的工作對他的對象也是個很嚴重的傷害我們希望我們所有的醫護人員、執法人員包括消防員是一個健全的人他才會是一個有溫度的對待他的服務對象的你同意嗎 |
transcript.whisperx[338].start |
10313.812 |
transcript.whisperx[338].end |
10334.761 |
transcript.whisperx[338].text |
同意,而且一定要往這方面來進行做。好,所以最後的結論,我希望說您要協助我們的消防署,要跟民間智商來特約合作,提供消防員長期的心腹資源,讓消防員能夠跟我們心腹師建立信任關係,來協助他穩定他的情緒。所以結論呢,希望你們來協助內政部消防署,定期調查消防員罹犯PTSD的情況。 |
transcript.whisperx[339].start |
10335.521 |
transcript.whisperx[339].end |
10350.152 |
transcript.whisperx[339].text |
而且與內政部來合作建立跨部會消防員的關懷機制,主動提供長期的,而不是被動的,是主動的心理輔導資源,可以嗎?可以,這個應該要做的。好,謝謝,謝謝部長。謝謝委員。謝謝曾委員,謝謝部長。那繼續我們請林國成委員質詢。好,謝謝主席,我請邱部長。 |
transcript.whisperx[340].start |
10365.25 |
transcript.whisperx[340].end |
10366.03 |
transcript.whisperx[340].text |
邀請衛生福利部長針對 |
transcript.whisperx[341].start |
10386.482 |
transcript.whisperx[341].end |
10410.44 |
transcript.whisperx[341].text |
可是這個問題是牽涉到社會安全網的一個大問題但是醫療的問題當然是衛福部所以當然啦所有的問題也不能苛責邱部長這邊但最起碼整個社會網社會網的司令是一定要去檢討的 |
transcript.whisperx[342].start |
10412.802 |
transcript.whisperx[342].end |
10434.661 |
transcript.whisperx[342].text |
所以啊我從台北啊10月9號有一個一名女子啊無緣無故坐了公車就被人家推下去這個就是精神有問題那然後然後這個不是只有一次喔他有推人推下車的紀錄12次 |
transcript.whisperx[343].start |
10437.338 |
transcript.whisperx[343].end |
10458.009 |
transcript.whisperx[343].text |
在10月12號在台南也是列館的精神病患但是季節就醫持刀啊祭補對抗警察這個接下來10月27在桃園也是發生一個女童被一個中度身心障礙 |
transcript.whisperx[344].start |
10460.03 |
transcript.whisperx[344].end |
10478.74 |
transcript.whisperx[344].text |
強弩的案件這等等10月份喔就有三件這個當然跟社區啊這些醫療網當然有關所以要讓部長啊瞭解這整整個社區醫療網的重要性重要性所以啊我在這裡啊特別 |
transcript.whisperx[345].start |
10479.58 |
transcript.whisperx[345].end |
10505.807 |
transcript.whisperx[345].text |
要強調我們不是對這些生病身經障礙有歧視不是可是這個是一個問題所以我們該怎麼樣來解決所以我在想這社會網的問題很重要但是我們醫療網的治療就醫也是非常重要所以我要特別提醒部長在這裡只要只要 |
transcript.whisperx[346].start |
10506.647 |
transcript.whisperx[346].end |
10522.016 |
transcript.whisperx[346].text |
有這個機會當然這個是行政院要跨部會把它當成真正一個問題所以我在這裡就要請教我們社工師你認為這個社工人力以及他的流動力你認為 |
transcript.whisperx[347].start |
10524.078 |
transcript.whisperx[347].end |
10538.025 |
transcript.whisperx[347].text |
針對這個部分當然社工還要做很多事啦在這個部分可以看得出來地方政府的社工啊在等等這些確確實實流動力是很高的人力是不足的你看針對這個問題 |
transcript.whisperx[348].start |
10540.046 |
transcript.whisperx[348].end |
10556.722 |
transcript.whisperx[348].text |
對於這些社區醫療丸你有什麼看法來市長在市長回答前我先報告一下我想感謝我們委員過去在臺北市擔任議座的時候協助我們臺北市醫師公會跟社會來邁出腳步來跟社會安全網 |
transcript.whisperx[349].start |
10560.505 |
transcript.whisperx[349].end |
10560.685 |
transcript.whisperx[349].text |
來,來,那個市長 |
transcript.whisperx[350].start |
10584.984 |
transcript.whisperx[350].end |
10605.278 |
transcript.whisperx[350].text |
謝謝委員的關心那的確這些社會問題除了我們社工專業人員之外因為個案的問題跟家庭比較複雜所以其實我們在社安網的第二期除了社工人力我們也增加了其他的專業人員包括心理師還有相關的復健師還有觀訪員等等一起來努力那在整個 |
transcript.whisperx[351].start |
10605.618 |
transcript.whisperx[351].end |
10605.638 |
transcript.whisperx[351].text |
好 |
transcript.whisperx[352].start |
10624.813 |
transcript.whisperx[352].end |
10625.073 |
transcript.whisperx[352].text |
市長我知道了 |
transcript.whisperx[353].start |
10639.915 |
transcript.whisperx[353].end |
10659.194 |
transcript.whisperx[353].text |
我主要的問題點出兩點一個人力不足的問題流動力偏高的問題這個你要幫部長去把問題找出來懲告給部長來做你的後盾其實社工不足是一個非常重要還有流動力之高為什麼流動力之高因為高危險欸 |
transcript.whisperx[354].start |
10660.535 |
transcript.whisperx[354].end |
10660.976 |
transcript.whisperx[354].text |
最後我要特別提醒 |
transcript.whisperx[355].start |
10682.276 |
transcript.whisperx[355].end |
10712.116 |
transcript.whisperx[355].text |
我說實在有時候你們責任很重大現在大法官做成解釋死刑連精神病患也不能判死刑全部責任丟給你們這是對你們當然不公平但是你們要面對啊沒辦法精神病患不能判死刑等等這些這個我們也知道病人家屬那種千頭萬系的那種痛苦是非常痛苦的 |
transcript.whisperx[356].start |
10713.097 |
transcript.whisperx[356].end |
10736.176 |
transcript.whisperx[356].text |
但是不要忘了社區只要有一個精神病患那整個社區也不得安寧所以我在這裡要特別跟部長建議第一個法令三個月的觀察期這個部分該強制的就要強制就是用暫時性的這些就醫也是一個辦法 |
transcript.whisperx[357].start |
10736.977 |
transcript.whisperx[357].end |
10757.372 |
transcript.whisperx[357].text |
你這個人不把他放出來他什麼時候為非作歹他根本就是精神失掉控制所以這些用暫時性的東西不要在那邊三個月觀察再來去做這些我跟你講一個正常人說實在的被殺死了以後講快點以現在的這種法律制度來講 |
transcript.whisperx[358].start |
10759.433 |
transcript.whisperx[358].end |
10783.945 |
transcript.whisperx[358].text |
該死的人不死不該死的人死這是很殘忍的事啊所以拜託部長在這個部分法令不足的地方拜託社區安全的這個部分部長你要拿出因應之道不要說還有觀察期才可以就醫該暫時就醫就要就醫這樣可以緩緩很多事情好不好部長謝謝委員指教我們來好不好我們來演繹 |
transcript.whisperx[359].start |
10785.766 |
transcript.whisperx[359].end |
10789.527 |
transcript.whisperx[359].text |
謝謝部長、謝謝主席、謝謝林委員、謝謝部長。接下來我們請楊瓊英委員質詢。謝謝主席。楊瓊英發言,邀請部長。 |
transcript.whisperx[360].start |
10809.716 |
transcript.whisperx[360].end |
10826.095 |
transcript.whisperx[360].text |
今天主席安排的這個議題我覺得非常的有意義而且也是我們整個臺灣非常重要關鍵的這個議題所以本席首先請教在上個禮拜呢那這個桃園龜山有發生女童被這個當街 |
transcript.whisperx[361].start |
10828.158 |
transcript.whisperx[361].end |
10846.558 |
transcript.whisperx[361].text |
強行的來這個強暴被擄在這樣的情況之下還好有路人來幫忙有路人來幫忙但是他的心裡已經是心生恐懼那我們看到了這個加害者呢是什麼呢是18歲的中度智障這個障礙人士 |
transcript.whisperx[362].start |
10847.259 |
transcript.whisperx[362].end |
10870.936 |
transcript.whisperx[362].text |
那當然相關的單位他會去做評估是不是要需要加強的醫療也會請社會單位來介入孩子需不需要這個心理輔導但是目前整個案件偵查中進度只有有限量的去透露在這樣子的案件我們實在是看到很不捨而且層出不窮 |
transcript.whisperx[363].start |
10871.916 |
transcript.whisperx[363].end |
10890.457 |
transcript.whisperx[363].text |
這是我們社會不定時的炸彈不定時的炸彈那所以我們的整個政府的這個社會安全網他到底出了什麼狀況為什麼會如此所以我首先要請教部長在精神病患社區照護的困境 |
transcript.whisperx[364].start |
10891.198 |
transcript.whisperx[364].end |
10892.059 |
transcript.whisperx[364].text |
請教部長 |
transcript.whisperx[365].start |
10913.194 |
transcript.whisperx[365].end |
10939.547 |
transcript.whisperx[365].text |
好,非常謝謝委員那我們衛生法、精神衛生法在今年12月14號實行那也是過去兩年前也是委員的指導大家的努力把它通過整個修法那我們希望更周全那當然實行到現在我們就講直接的困境第一個就是當然對精神疾病的認知不足還有汙名化那這個部分我們希望能夠 |
transcript.whisperx[366].start |
10941.537 |
transcript.whisperx[366].end |
10967.826 |
transcript.whisperx[366].text |
從衛教、各級政府來讓民眾能夠正確認識精神病的一個建立一個友善的支持環境。第二個我們的儀式個案的通報這個機制要再加強強化社區儀式精神病的通報及轉介特別是醫療外展的一個服務這個部分我們在衛福部也很努力在做社區支援的部件也需要來加強我們會爭取預算 |
transcript.whisperx[367].start |
10970.485 |
transcript.whisperx[367].end |
10986.188 |
transcript.whisperx[367].text |
也在5年內我們也預註了13.9億將要強化精神病人社區資源的服務部長你現在所說的這一些就是我們非常明顯導致目前的漏洞是非常的清楚 |
transcript.whisperx[368].start |
10986.869 |
transcript.whisperx[368].end |
11003.834 |
transcript.whisperx[368].text |
你所說的這五項包括認知不足你要怎麼做你是不是應該到整個我們的社團團體裡頭趕快去做宣導加強宣導你如果沒有這麼做大家當然認知不足啊第二個你說通報機制 |
transcript.whisperx[369].start |
11005.903 |
transcript.whisperx[369].end |
11026.784 |
transcript.whisperx[369].text |
這個部分要怎麼樣去做調整要怎麼去做調整第三個你說外展非常的重要這個外展非常的重要要怎麼去能夠銜接的上接下來你說社區你到底在12月14號你12月14號你所謂的要修法後要上路 |
transcript.whisperx[370].start |
11027.901 |
transcript.whisperx[370].end |
11049.681 |
transcript.whisperx[370].text |
那你支援你剛才說的5年13.92億是不是是5年13.92億你怎麼有辦法去解決目前台灣現在所面臨的困境那當然只是強化這是不夠嘛社區而已啦對啊當然很多疾病當然我們的剛剛有報告所以部長本期認為我們在12月14號直接討論12月14號 |
transcript.whisperx[371].start |
11053.985 |
transcript.whisperx[371].end |
11073.145 |
transcript.whisperx[371].text |
你這個上路有關係到整個嚴重病人強制住院那你要怎麼樣去做你強制住院強制就醫你強制就醫的部分你要由兩名的精神科醫師來提出申請但是你改為向法院去申請 |
transcript.whisperx[372].start |
11074.839 |
transcript.whisperx[372].end |
11095.655 |
transcript.whisperx[372].text |
兩名醫師那你現在改為由法院去申請而且你還要由法官據醫師身份來做參選員參審員而且跟病人的權益代表來組成一個合議體由過半意見來決定之針對於強制住院的延長次數有限制 |
transcript.whisperx[373].start |
11096.786 |
transcript.whisperx[373].end |
11119.742 |
transcript.whisperx[373].text |
部長這一個有限制我提出高度的懷疑你應該是針對他所需而不是去限制他的次數那這樣子沒有辦法去落實所以本席針對這個議題我非常的關心也就是說你把它改為由兩名精神科醫師提出由剛剛本席所說的這個合議制 |
transcript.whisperx[374].start |
11121.403 |
transcript.whisperx[374].end |
11148.246 |
transcript.whisperx[374].text |
和議會裡頭來做決定而且還要限制他強制住院這個一個那所以本席首先要請教也就是你針對於你的相關的教育訓練教育訓練還有你的治療所需的這個資源那因為12月14號現在已經是11月了我們剩下一個月左右的時間就要上路你的 |
transcript.whisperx[375].start |
11150.135 |
transcript.whisperx[375].end |
11152.089 |
transcript.whisperx[375].text |
這一個教育訓練你做足了功課嗎? |
transcript.whisperx[376].start |
11154.358 |
transcript.whisperx[376].end |
11181.298 |
transcript.whisperx[376].text |
請教消息信念的話我們行政司請行政司跟委員報告委員剛剛特別關切的就是有關於這個強制住院改由法院來做審理我們準備好了沒有這件事情因為跟司法院相關的這個部分我們的施行日期是要行政院會同司法院訂定所以他的施行日期目前還沒有確定你看今年12月14號要上路的是針對強制住院以外的這些 |
transcript.whisperx[377].start |
11182.478 |
transcript.whisperx[377].end |
11204.268 |
transcript.whisperx[377].text |
這個相關的條文會在今年的12月14號12月14部長我再跟你討論以外的部分就是外展那未來醫院他這個機構他會背負著越來越多越來越多你的法定責任跟公衛的業務對不對是不是部長是那你要怎麼樣去增加他們相關的醫療這個資源 |
transcript.whisperx[378].start |
11210.123 |
transcript.whisperx[378].end |
11229.675 |
transcript.whisperx[378].text |
請說你不能只有做半套嘛你剛才說的第三點很重要你的外展啊那你的相關的資源要放下去啊那你的訓練也要啊我們不只在人力跟機構機構跟人力都一直在增加一直在增加部長我請你 |
transcript.whisperx[379].start |
11230.515 |
transcript.whisperx[379].end |
11231.676 |
transcript.whisperx[379].text |
你應該有一套配套嘛 |
transcript.whisperx[380].start |
11253.115 |
transcript.whisperx[380].end |
11267.546 |
transcript.whisperx[380].text |
對不對才能夠真正就落實嘛你把這個書面資料給本席喔但是我還是要告訴你一句話也就是我們現在社會面臨到這麼大的挑戰黑數因為漏洞導致黑數沒有辦法去糾正 |
transcript.whisperx[381].start |
11268.707 |
transcript.whisperx[381].end |
11291.675 |
transcript.whisperx[381].text |
這一塊是我非常的關心因為從社會學的角度去看這個是社會面向非常迫切需要非常迫切需要怎麼樣讓我們的社會安全網能夠真正的安全這是全民的共識全民的希望所以因此我要特別的來告訴你也就是你要怎麼樣的我剛剛特別講了精神復健 |
transcript.whisperx[382].start |
11292.435 |
transcript.whisperx[382].end |
11309.667 |
transcript.whisperx[382].text |
也就是他的資源你要怎麼做分配所以我告訴你從醫院到你的社區到你的社區的照護你有沒有個管的平台因為最佳的漏洞點就是在這個醫院到社區這個空窗期 |
transcript.whisperx[383].start |
11310.347 |
transcript.whisperx[383].end |
11334.153 |
transcript.whisperx[383].text |
你有沒有個管的平台?你建構了個管的平台嗎?你們目前掌控的情況到底是怎麼樣?因為必須要從社政、從勞政、從衛政以及從教育的行政這些要聯合成一個一個整體的一個安全網才能夠真正落實所以本需要請教到底你們個管的平台建構了沒? |
transcript.whisperx[384].start |
11334.713 |
transcript.whisperx[384].end |
11360.707 |
transcript.whisperx[384].text |
報告委員,那個公館平臺我們非常努力在建立請說說你,跟委員報告我們為了要銜接從醫院出院之後回到社區希望他能夠無縫銜接對,現在我們12月14號即將這個上路的這個法規裡面就有規定就是說醫院必須要做出院準備計畫而且通報到衛生局讓我們能夠把這些出院病人能夠把他接下來不要讓他在出院之後 |
transcript.whisperx[385].start |
11361.187 |
transcript.whisperx[385].end |
11367.39 |
transcript.whisperx[385].text |
行程一個這個空窗期沒有人去這個是最恐怖的空窗期是所以我們現在法定法規裡面已經有明定了那我們現在關於社區的訪視人力我們也是逐年在做一個補助補助地方政府能夠禁用 |
transcript.whisperx[386].start |
11376.354 |
transcript.whisperx[386].end |
11377.115 |
transcript.whisperx[386].text |
部長我一個結論也就是從醫院到社區你這個銜接 |
transcript.whisperx[387].start |
11393.775 |
transcript.whisperx[387].end |
11406.569 |
transcript.whisperx[387].text |
這個銜接的個管平台是非常的重要因為你必須要透過社區關懷照護而且你要掌控這一位精神病患者他在就醫、就學、就養以及就業的這個型態 |
transcript.whisperx[388].start |
11408.131 |
transcript.whisperx[388].end |
11408.551 |
transcript.whisperx[388].text |
接下來我們請林淑芬委員質詢 |
transcript.whisperx[389].start |
11455.311 |
transcript.whisperx[389].end |
11457.043 |
transcript.whisperx[389].text |
謝謝主席,是不是請我們邱部長。 |
transcript.whisperx[390].start |
11462.355 |
transcript.whisperx[390].end |
11467.899 |
transcript.whisperx[390].text |
委員好部長10月9號的時候我在這裡質詢過你就是說衛福部有沒有去盤點目前有公安問題的醫院有幾家因為我當時就說了根據醫策會網站106到112年醫院評鑑及教學醫院評鑑合格名單有一共有417家而醫院評鑑效期到今年12月31到期的 |
transcript.whisperx[391].start |
11489.072 |
transcript.whisperx[391].end |
11504.184 |
transcript.whisperx[391].text |
這個醫院要重新做評鑑的有117家換言之有1⁄4的家屬將在今年年底都要做那甚至有的已經開始做了就像我們之前講的失火的醫院事實上也都做了 |
transcript.whisperx[392].start |
11505.345 |
transcript.whisperx[392].end |
11509.75 |
transcript.whisperx[392].text |
那你們到底有沒有掌握117家醫院有沒有跟我們屏東失火的醫院一樣有一些管線的問題啦、疏散動線的問題啊這種公安的問題的存在 |
transcript.whisperx[393].start |
11521.283 |
transcript.whisperx[393].end |
11540.686 |
transcript.whisperx[393].text |
那如果有的話已經有前車之鑑我我在11月9號也談一次現在又談一次那我要問你說有到底有問題的有幾家我沒有問題是哪幾家我問的是一共有幾家而評鑑結果出來以前如果有一些問題那你要如何處置 |
transcript.whisperx[394].start |
11542.315 |
transcript.whisperx[394].end |
11558.722 |
transcript.whisperx[394].text |
好 謝謝委員那我的新聞齁那第一個就是說我們相關的事件發生以後我們當然就啟動了補典你直接回答就好了到底有問題還幾經啦你發言沒有為什麼要談這個呢你知道嗎你們從10月9號我補典你也可以再請聽你們從10月9號我質詢問你到現在你們連回答都沒回答 |
transcript.whisperx[395].start |
11570.146 |
transcript.whisperx[395].end |
11573.108 |
transcript.whisperx[395].text |
將近一個月了,連書面的資料都沒有。你們當我們立法院是啥?我們都在這裡問你,你沒說。結束了質詢,也沒有任何書面資料提供給我們。所以你們現在是裝睡的人叫不行呢?還是說直接就不予理會立法院立委的質詢,直接忽略? |
transcript.whisperx[396].start |
11592.199 |
transcript.whisperx[396].end |
11609.625 |
transcript.whisperx[396].text |
所以今天在這裡我再問你一次你到底能不能告訴我一共有多少的醫院有病安、有公安、醫律而你的補強作為是什麼你們到底盤點了沒你不要扯東扯西你告訴我到底有多少 |
transcript.whisperx[397].start |
11610.973 |
transcript.whisperx[397].end |
11622.101 |
transcript.whisperx[397].text |
因為這個事務應該是要地方政府跟消防局方面阿你以為在這裡諮詢過你們,你們都沒有去盤點,沒有跟地方聯絡,你們醫政會都沒有去看一下所以在這裡連告白話才會公認就沒有了嗎?你不也記住在這裡當不當一回事啊? |
transcript.whisperx[398].start |
11631.018 |
transcript.whisperx[398].end |
11641.225 |
transcript.whisperx[398].text |
我們在的確也有啟動那個在預測...你告訴我這個答案是什麼立委從10月9號問你到現在將近一個月了你們現在還是回答不出來保證你是說不出來啊還是沒有掌握有類似病安或公安疑慮的有管線問題有疏散動線問題這種公安疑慮的 |
transcript.whisperx[399].start |
11658.783 |
transcript.whisperx[399].end |
11661.924 |
transcript.whisperx[399].text |
我們當然很關心117家有幾家我們很關心醫院的一個保定你答非所問不要在這裡胡說八道我現在問你是一共有幾家有公安的疑慮啦這個恐怕要再調查一下10月9號問你到現在還在恐怕要調查10月9號諮詢過一次了勒所以這個是不曉得你們是 |
transcript.whisperx[400].start |
11688.342 |
transcript.whisperx[400].end |
11693.406 |
transcript.whisperx[400].text |
我們會去調查各個地方政府跟還有消防局他們所調查的結果對啦,什麼時候可以給答案一個月之內好了 |
transcript.whisperx[401].start |
11710.64 |
transcript.whisperx[401].end |
11717.762 |
transcript.whisperx[401].text |
好就再給你一個月希望在一個月裡面大家都平安那我現在不是要繼續談這個我現在要談的是說你們從去年7月1號去年衛福部調整了部分負擔的心智針對門診藥品部分負擔還有急診的部分負擔進行調整 |
transcript.whisperx[402].start |
11730.686 |
transcript.whisperx[402].end |
11757.081 |
transcript.whisperx[402].text |
你們的目的是說要落實分級醫療、珍惜健保資源事實上你們就是希望我們解決急診擁捨還有你們希望大家要分級醫療到地區醫院不要全部擠到這個教學醫院裡面來你們的目的啊就希望大家珍惜醫療資源期待就醫分流解決急診人馬為患的這個狀況然後讓穩定的慢性的病人鼓勵他們到急診診所 |
transcript.whisperx[403].start |
11758.522 |
transcript.whisperx[403].end |
11766.494 |
transcript.whisperx[403].text |
那這種狀況裡面我來看一下這個部長實施一年以後已經一年了成效如何成效如何我們 |
transcript.whisperx[404].start |
11772.165 |
transcript.whisperx[404].end |
11790.693 |
transcript.whisperx[404].text |
實施了以後基層門診的就診案件的佔利從有多的不多啦0.22%那慢性病以及診所就醫率從大概增加了4.61%這個也是比較正面的一個成果的確是有改 |
transcript.whisperx[405].start |
11791.253 |
transcript.whisperx[405].end |
11793.754 |
transcript.whisperx[405].text |
來來部長我替你回答啦因為你現在照稿念嘛因為你們健保署發布新聞稿有五個觀察有初步的成效第一個促進了分級醫療啦 |
transcript.whisperx[406].start |
11813.604 |
transcript.whisperx[406].end |
11838.119 |
transcript.whisperx[406].text |
第二個改善了急診泳舍第三個避免藥品的浪費第四改善付費公平性及健保財務第五持續保障弱勢這個是你們健保署的新聞稿你們的新聞稿其實是來自於健保會第113年第9次的委員會會議資料就是第一案新制部分負擔監測指標的監測結果及成效檢討報告的內容部長你自己有看過嗎? |
transcript.whisperx[407].start |
11843.487 |
transcript.whisperx[407].end |
11862.715 |
transcript.whisperx[407].text |
新制的部分負擔你這樣子從你當立委到當部長這樣子一路走來這是一個大的政策因為就是長這個部分負擔嘛那你自己有沒有看過這麼重要的這麼重大的政策上的調整一年了有好還是沒有好你自己有看過這個報告嗎? |
transcript.whisperx[408].start |
11867.529 |
transcript.whisperx[408].end |
11874.278 |
transcript.whisperx[408].text |
由初步的這些成效我認為是有改善,委員也知道我們...所以你們有改善來急診永設嗎?以統計的數字是有進步 |
transcript.whisperx[409].start |
11879.246 |
transcript.whisperx[409].end |
11905.203 |
transcript.whisperx[409].text |
一統計的數字是有進步來我就跟你分享這一些來來來來來來我自己在7月1號就質詢時就跟你分享有我的朋友的家人在急診區等很久一直遲遲等不到病床結果在急診的急診區直接進行插管治療而且除了我以外王正旭委員今年的 |
transcript.whisperx[410].start |
11905.763 |
transcript.whisperx[410].end |
11911.208 |
transcript.whisperx[410].text |
也特別提到好多急診量能滿載王委員很客氣然後國民黨的委員也講了那部長當時也有回答說如果你聽台大吳明顯院長講這個急診的時候後床是日常的事情那我們都知道說民眾要問的不是這樣子民眾要問的是要等多久 |
transcript.whisperx[411].start |
11932.546 |
transcript.whisperx[411].end |
11952.345 |
transcript.whisperx[411].text |
你們認為有改善急診的這個候診時間急診的勇懾有改善那為什麼這一年來等待的時間卻越來越長然後呢調整部分負擔叫大家都不要去然後就說 |
transcript.whisperx[412].start |
11954.026 |
transcript.whisperx[412].end |
11967.377 |
transcript.whisperx[412].text |
一定會改善,而且你們報告說已經有改善,但事實真的那樣子嗎?這個根據健保署的報告,實施條長部分負擔以後每個人負擔的金額比2022年這個第一張 |
transcript.whisperx[413].start |
11976.889 |
transcript.whisperx[413].end |
12002.619 |
transcript.whisperx[413].text |
比2022年來比增加了149人價格調漲了沒有錯這一張來但是呢急診的平均每人就醫次數來到2019年來的歷史新高大概幾到急診裡面的次數創下歷史新高反而是負擔金額最低的2022年的平均每人就醫次數是相對低的 |
transcript.whisperx[414].start |
12003.539 |
transcript.whisperx[414].end |
12013.19 |
transcript.whisperx[414].text |
一百一十一年1.46次到今年次數創新高1.56然後有了漲價啦我們看得出來漲價啦那部長漲價的是事實但是你 |
transcript.whisperx[415].start |
12018.456 |
transcript.whisperx[415].end |
12044.875 |
transcript.whisperx[415].text |
平均國人每人就醫到急診就醫的次數創歷史新高你漲了部分負擔了可是就醫的次數創新高那你們說要以價值量的這個政策手段你說是有效啦這個是有效嗎等待的時間增加錢付的更多品質更下降這個政策就是你們說的急診永設有改善嗎 |
transcript.whisperx[416].start |
12051.68 |
transcript.whisperx[416].end |
12072.608 |
transcript.whisperx[416].text |
謝謝委員指教我了解那個因為會有這樣的趨勢大幅上升阿你們說有效阿他的原因真的是要多元化來分析阿對多元化分析可以好這樣講阿所以你現在又有原因因為可能不是只有一個原因而且這個是不是說我們這樣我們過去也常常在談嘛你到底以價 |
transcript.whisperx[417].start |
12073.706 |
transcript.whisperx[417].end |
12079.952 |
transcript.whisperx[417].text |
以價來質量到底有沒有效?你講得很好欸可是你們當時告訴人家我就是要以價質量啊我要跟你講部分負擔啊要以價質量一定可以控制急診勇社啊可以導引人民到正確的路上去分級醫療啊你們當時就這樣錢都漲了結果你們的政策目的是什麼漲價是手段欸 |
transcript.whisperx[418].start |
12098.948 |
transcript.whisperx[418].end |
12122.946 |
transcript.whisperx[418].text |
你是要大家解決急診涌射的狀況要分級醫療的政策能夠落實結果你的目的是這兩個政策有達到嗎?你的信訊稿說你們達到了所以我問你有達到嗎?你現在又說淡輸了我想我們多年來一直在推展分級醫療改善體系我想我原來...我不要說這個數據就好他提出這個...古年提出這個方法並不是我 |
transcript.whisperx[419].start |
12130.491 |
transcript.whisperx[419].end |
12134.294 |
transcript.whisperx[419].text |
你不要為那個政策買單的意思?那你要調整嗎?不是,我應該是要改善加強基層意見 |
transcript.whisperx[420].start |
12144.54 |
transcript.whisperx[420].end |
12147.602 |
transcript.whisperx[420].text |
我希望民眾真的要相信我們基層醫師基層醫師的能力基層醫療的可靠性然後信任感是叫人民相信就相信的嗎 |
transcript.whisperx[421].start |
12161.07 |
transcript.whisperx[421].end |
12189.289 |
transcript.whisperx[421].text |
你用什麼有效的手段然後再講下一張醫學中心的急診申報件數從疫情以來都是有增無減調整部分負擔以後急診申報件數也是創新高而相對的地區醫院從疫情以來的戰略卻來到新低所以你們自己說我們解決了其實你比較的年度是比較最差的你說你看綠色的地區醫院成長了你怎麼不比109年 |
transcript.whisperx[422].start |
12191.07 |
transcript.whisperx[422].end |
12206.329 |
transcript.whisperx[422].text |
你怎麼不比這個112年112年的去年沒有那個COVID-19的疫情啦他還是下降啊對地區醫院、基層醫院他的就診率下降欸 |
transcript.whisperx[423].start |
12207.31 |
transcript.whisperx[423].end |
12209.732 |
transcript.whisperx[423].text |
反而你來看他粉紅色的醫學中心跟去年比還屢創新高 |
transcript.whisperx[424].start |
12224.088 |
transcript.whisperx[424].end |
12230.013 |
transcript.whisperx[424].text |
所以在這種狀況裡面難怪有這種民間團體在質疑啊你漲部分負擔只是為了填補這個健保財務空洞可是呢醫療品質沒有提升急診的等待時間越來越長越來越長所以你剛剛講不是漲價可以解決的漲價的手段你不能把它當成目的啊 |
transcript.whisperx[425].start |
12252.912 |
transcript.whisperx[425].end |
12255.033 |
transcript.whisperx[425].text |
沒有下降啊好再下一張那你們在講說急診減傷戰略你們講說你們有效解決你們剛才那個還報告說健保署還說你們已經解決了這個急診擁捨的狀況我們就來看一般急診我們在減傷一級跟二級我們就看他戰流時間 |
transcript.whisperx[426].start |
12278.735 |
transcript.whisperx[426].end |
12300.421 |
transcript.whisperx[426].text |
一級跟二級就是要命的啦 最急的可是它暫留的時間越來越長而你們自己都知道2019到2024醫學中心急診的相關指標就是減傷一級的急診病人要轉入病房要小於8小時減傷一級要幾分鐘以內馬上立即處理 來 報告 減傷一級是多嚴重 |
transcript.whisperx[427].start |
12306.503 |
transcript.whisperx[427].end |
12325.664 |
transcript.whisperx[427].text |
要立即處理他們要轉入病房內能夠在8個小時裡面轉入不管家戶病房還是什麼病房是時間停留時間他們在8小時裡面就轉到病房的比例越來越少所以他們都暫留的時間越來越多 |
transcript.whisperx[428].start |
12327.606 |
transcript.whisperx[428].end |
12332.649 |
transcript.whisperx[428].text |
所以這種狀況裡面急診暫留時間上升然後減上一級在2024年上半年比2023年的下半年還要多出一個小時來到平均要15.43小時已經是你們建議的8小時的健保品質的兩倍的時間所以上不去所以才有我說的啊直接在急診區直接插管 |
transcript.whisperx[429].start |
12359.887 |
transcript.whisperx[429].end |
12370.649 |
transcript.whisperx[429].text |
這像話嗎?像話嗎?以前八小時裡面就轉到病房去然後馬上處理的以前至少五成而且是作五忘六你看作五忘六急診插管是在救命所以是常見的啊當然即使要上病床也要插管最好是沒有感染的風險啦等一下一堆人走到人來人往可以直接好啦沒關係啦你不要跟我說插管的轉移焦點啦 |
transcript.whisperx[430].start |
12384.972 |
transcript.whisperx[430].end |
12414.111 |
transcript.whisperx[430].text |
我跟您講的是以前一級減傷一級要馬上進到病房裡面可以8小時裡面就進到病房至少都還有65%、55%而到今年剩下47%以前是做五忘六現在要保四不曉得能不能保得住四成而這個現象都是基層湧射的問題已經不是說這個輕症的病人太多啦其實它的原因很複雜 |
transcript.whisperx[431].start |
12415.132 |
transcript.whisperx[431].end |
12415.652 |
transcript.whisperx[431].text |
下一張來我們再看喔所以我們來講一下啦齁 |
transcript.whisperx[432].start |
12443.755 |
transcript.whisperx[432].end |
12444.657 |
transcript.whisperx[432].text |
你們在這種狀況裡面部分負擔漲了漲了漲了然後再下一張不是這一張 |
transcript.whisperx[433].start |
12453.51 |
transcript.whisperx[433].end |
12474.329 |
transcript.whisperx[433].text |
好,沒關係,我自己講結論好了啦在這種狀況裡面,調整部分募單的政策要以佳質量沒有發生那對分級醫療來講也沒有效,地區醫院、基層醫院看診的、就診的人數越來越少所以沒有發生啊,錢有啊,錢啊 |
transcript.whisperx[434].start |
12476.37 |
transcript.whisperx[434].end |
12488.837 |
transcript.whisperx[434].text |
錢增加了人民繳的錢增加了那盒包扁了民眾的盒包扁了但是門診的負擔每年平均增加了299元上一張但門診就醫的次數也這個創下了這個 |
transcript.whisperx[435].start |
12495.76 |
transcript.whisperx[435].end |
12495.78 |
transcript.whisperx[435].text |
致電話 |
transcript.whisperx[436].start |
12526 |
transcript.whisperx[436].end |
12528.401 |
transcript.whisperx[436].text |
報告委員醫療界如果對於要增加人民負擔我們真的也都不忍心 |
transcript.whisperx[437].start |
12550.145 |
transcript.whisperx[437].end |
12569.46 |
transcript.whisperx[437].text |
所以大家講說部分負擔叫做殭屍理論啦長部分負擔就被人家稱之為是殭屍理論第二個最後講一個對分級醫療也無效我們剛剛已經講了就是說基層這個在基層門診的就醫建樹占有率在今年 |
transcript.whisperx[438].start |
12570.541 |
transcript.whisperx[438].end |
12590.332 |
transcript.whisperx[438].text |
而下半年之後有增加但是實際上基層戰略比以前2019年以前2020年上半年都還來的低所以在這種狀況裡面你們忽視了疫情造成的就醫量下滑並用低標來當作年度的比較在這種狀況裡面我們來講健保署東拼西湊騙了 |
transcript.whisperx[439].start |
12594.674 |
transcript.whisperx[439].end |
12617.101 |
transcript.whisperx[439].text |
聽了這篇新聞稿,調整了參考的年度,然後講了最有利自己的擦紙抹粉的政策的有效性那其實就是要去突顯說你們是有效的假象這不是保險人應該有的這個應該有應有之局啊所以部長你剛才講說這個手段恐怕是有問題的 |
transcript.whisperx[440].start |
12617.921 |
transcript.whisperx[440].end |
12634.257 |
transcript.whisperx[440].text |
那如果有問題的話,你的檢討政策、你的手段跟結果之間的落差,那你要怎麼調整呢?報告委員,我不是說有問題,我是說在整體的各種策略裡面,它也是一個策略。我剛剛講已經告訴你沒有效啦。那我們都會檢討。我就跟你講,剛剛這些數據我們告訴你沒有效。 |
transcript.whisperx[441].start |
12642.486 |
transcript.whisperx[441].end |
12667.276 |
transcript.whisperx[441].text |
阿你只是讓人民的荷包變得更扁因為要改善醫療體系不是那麼一個簡單的對 非常複雜那你要拿出一個比較有效的手段而不是在那裡讓我們等了更久非常願意來拿出手段那這個要考慮阿你的手段是什麼考慮議制考慮政府對啦你的手段可能我們在這裡聽一下我們可能的手段會是什麼錢都讓你漲了除了漲錢以外 |
transcript.whisperx[442].start |
12669.497 |
transcript.whisperx[442].end |
12693.592 |
transcript.whisperx[442].text |
你還有什麼有效的手段我們第一個一定要維護那個病人的品質第二個也要有醫療人員醫療人員也要好的工作環境啊他不是醫療人員也需要薪水也需要好的一個環境第三個醫療院所你講的這個都是我們的理想你不用講這不是你的政策這個不是政策啦才會來一個一個來看怎麼去達到然後我們 |
transcript.whisperx[443].start |
12698.595 |
transcript.whisperx[443].end |
12703.499 |
transcript.whisperx[443].text |
我們部分負擔在急診從450讓你漲到750內,然後我們這個讓你漲到750,漲這麼多,啊你現在拿不出手段來,你就要趕快宣誓信再念一遍。 |
transcript.whisperx[444].start |
12715.829 |
transcript.whisperx[444].end |
12734.473 |
transcript.whisperx[444].text |
這不是在這裡虛偽行李如意的在那裡呼嚨立委嗎好啦我們陳學生立委一直在趕了啦你都書面交一篇書面報告啦還有還有那個有公安疑慮的那些醫院的資料一個月內提供好沒問題謝謝謝謝林委員謝謝部長接續我們請賴世保委員 |
transcript.whisperx[445].start |
12753.203 |
transcript.whisperx[445].end |
12769.278 |
transcript.whisperx[445].text |
謝謝主席 有請邱部長有關於今天的題目有看了一個資料請你看一下 |
transcript.whisperx[446].start |
12777.882 |
transcript.whisperx[446].end |
12788.553 |
transcript.whisperx[446].text |
105年到112年各年齡層自殺的死亡率針對女生你可以看到這裡面15歲到24歲15歲到24歲一路攀升了一路攀升了你看這個紅色這一塊一路攀升了 |
transcript.whisperx[447].start |
12802.584 |
transcript.whisperx[447].end |
12810.554 |
transcript.whisperx[447].text |
而且全國的自殺死亡的人數也是一路攀升了對這個土你有什麼看法沒有 |
transcript.whisperx[448].start |
12811.957 |
transcript.whisperx[448].end |
12836.235 |
transcript.whisperx[448].text |
我只是心理衛生室要我先跟委員報告齁我們真的很重視因為跟委員報告因為你也你也長久也一直關心醫療也很蠻了解我的啦齁因為我這十幾年來也參與自殺防治中心的工作齁那在我在台北市的醫師公會也非常推推這個部分所以有一陣子好好的推的確下來在 |
transcript.whisperx[449].start |
12837.836 |
transcript.whisperx[449].end |
12864.019 |
transcript.whisperx[449].text |
跑出了十大死因之一那後來當然是不是事實上的原因可能比較複雜最近什麼原因又上來你看這幾年特別是15歲到24歲的女生你看4.8一路每10萬人死4.8一路判到10.7你看到青少年的自殺真的非常讓我們都很痛心所以我想不管是教育部或者是衛福部我們會用專業的 |
transcript.whisperx[450].start |
12866.68 |
transcript.whisperx[450].end |
12881.285 |
transcript.whisperx[450].text |
來研究看看怎麼樣來研因那我們也增加SEL的教學就是讓他社會智商能夠學習從小就能夠學習面對挑戰的時候能夠調適 |
transcript.whisperx[451].start |
12883.225 |
transcript.whisperx[451].end |
12885.708 |
transcript.whisperx[451].text |
社區的心理衛生中心是不是一個重要的一個單位 |
transcript.whisperx[452].start |
12908.234 |
transcript.whisperx[452].end |
12924.771 |
transcript.whisperx[452].text |
社區的心理中心那也是另外一個體系那自殺防治中心他可能會比較著重在政策的一個 那個時候我們在上一屆通過了自殺防治法所以我們真的很努力在處理這個問題 |
transcript.whisperx[453].start |
12927.293 |
transcript.whisperx[453].end |
12948.506 |
transcript.whisperx[453].text |
其實這樣看齁這個現在大家爭取了長照機構療養機構都是電價凍漲但是這個單位沒有就是社區心理衛生中心沒有你們要不要這個部長這個沒有多少錢你要不要在這裡承諾這個社區心理衛生中心他的電價漲得未無不法的系統所以你承諾了你承諾你這個電價不要給他漲嗎就這個啊就這個意思啊 |
transcript.whisperx[454].start |
12955.911 |
transcript.whisperx[454].end |
12964.279 |
transcript.whisperx[454].text |
地方政府的嘛齁所以我們現在長照法裡面是不是有公益的啦齁公益性質的那個如果有 |
transcript.whisperx[455].start |
12966.708 |
transcript.whisperx[455].end |
12993.528 |
transcript.whisperx[455].text |
這個沒有動長是不是?動長啦!療養機構的動長不是嗎?跟委員報告還沒有?那根本應該要動長喔這個我們社區心理衛生中心依法是由地方政府來設置所以說他們通常都是會找一些公用的建物本身就是公用的建物來設置我講店家店家店家是是他們本身就是公家單位所以沒有所謂的說要要要去等於說漲價啊店家還是漲啊 |
transcript.whisperx[456].start |
12996.264 |
transcript.whisperx[456].end |
13015.502 |
transcript.whisperx[456].text |
這都是屬於政府的公交單位的機構建築物裡面去設立那這個部分好像應該就算政府請問你好請問你好你現在長照機構電架你有沒有吸收讓他動作有沒有只有公益性質的才有私立的不行 |
transcript.whisperx[457].start |
13016.885 |
transcript.whisperx[457].end |
13018.768 |
transcript.whisperx[457].text |
這個部長啊這個那個沒有多少天啊這個你們要cover啦 |
transcript.whisperx[458].start |
13026.147 |
transcript.whisperx[458].end |
13048.076 |
transcript.whisperx[458].text |
我這三個單位都應該cover不管是公立私立的當然私立一定要一定的規矩一定的標準超過那個標準都要給他要照顧啦這個東西對於精神的必成我們對於長道機構能夠照顧我們的老人齁真的我們真的很感佩啦齁因為他也是跟醫療機構一樣的辛苦齁所以這個部分我們 |
transcript.whisperx[459].start |
13049.296 |
transcript.whisperx[459].end |
13072.005 |
transcript.whisperx[459].text |
但是過去長照法問題是長照法現在是寫這樣子要公益性質所以我們是不是這個意思我們非常關心的公益性質不在公家機關阿民間不是公益阿基本上都是公益的阿盈利的就不在這裡面啦私人的盈利的那這個部分如果委員或者大家覺得說有這個部分也許是在服務我們 |
transcript.whisperx[460].start |
13072.965 |
transcript.whisperx[460].end |
13096.442 |
transcript.whisperx[460].text |
請你們請你們這三個啦一個療養機構、長照機構、心理衛生中心啦好不好這個你們有沒有算過這個定價多少啊這個漲價要漲多少啊有沒有算過有沒有算過對有沒有算過新聞中心是沒算過沒有算過新聞中心是沒算過長照可能要欸長照長照事務來吧 |
transcript.whisperx[461].start |
13097.523 |
transcript.whisperx[461].end |
13097.843 |
transcript.whisperx[461].text |
謝謝主席,我們請部長 |
transcript.whisperx[462].start |
13130.99 |
transcript.whisperx[462].end |
13150.042 |
transcript.whisperx[462].text |
委員好部長好,從早上到現在委員都非常的關心就是有關我們社區精神病患的照護優化的這個狀況那我們在這個這幾年當中我們也修了一個這個精神衛生法那強化了社會安全網 |
transcript.whisperx[463].start |
13150.822 |
transcript.whisperx[463].end |
13151.382 |
transcript.whisperx[463].text |
首先我們非常感謝我們 |
transcript.whisperx[464].start |
13177.31 |
transcript.whisperx[464].end |
13177.47 |
transcript.whisperx[464].text |
市長檢調報告 |
transcript.whisperx[465].start |
13196.724 |
transcript.whisperx[465].end |
13207.789 |
transcript.whisperx[465].text |
各位委員報告我們目前社區心理衛生中心全國設置合計是52點那我們的心衛中心會禁用各類的人力包含我們的心衛社工關懷訪視員還有這個心理師職能治療師跟護理師到目前為止52個點裡面我們禁用的專業人力大概1400多人 |
transcript.whisperx[466].start |
13216.713 |
transcript.whisperx[466].end |
13234.745 |
transcript.whisperx[466].text |
我們預計到明年年底,能夠增加到2400多人,所以大概還有1000人左右的差距。那據點呢?52個據點其實根本是不夠的。是,我們明年希望能夠增加到71點。是,那你們現在由各縣市這邊,還是由我們衛福部? |
transcript.whisperx[467].start |
13237.907 |
transcript.whisperx[467].end |
13256.661 |
transcript.whisperx[467].text |
各縣市政府這邊自己提出來那我想請教就是說其實在地方的這個社區心理衛生中心有一些民眾他們也會擔心就是說這個心理衛生中心設置之後 |
transcript.whisperx[468].start |
13257.822 |
transcript.whisperx[468].end |
13268.369 |
transcript.whisperx[468].text |
有的人會擔心就是說這個地方是不是也會成為一個民眾住在附近居民的一個擔心的一個據點那你們現在目前有碰到這樣的一個狀況嗎 |
transcript.whisperx[469].start |
13271.747 |
transcript.whisperx[469].end |
13294.723 |
transcript.whisperx[469].text |
跟委員報告因為我們社區心衛中心其實他是我們服務的對象不是只有精神病人其實他是一般民眾也有服務所以說我們是我們跟地方政府這邊我們是把我們的社區心衛中心當作類似像我們心理的衛生所的概念就是希望說民眾他可以就是走進去不會有任何的心理上面的一個 |
transcript.whisperx[470].start |
13295.043 |
transcript.whisperx[470].end |
13295.383 |
transcript.whisperx[470].text |
新卫中心的部件,我們如果是以 |
transcript.whisperx[471].start |
13310.913 |
transcript.whisperx[471].end |
13340.913 |
transcript.whisperx[471].text |
﹗ |
transcript.whisperx[472].start |
13341.013 |
transcript.whisperx[472].end |
13366.681 |
transcript.whisperx[472].text |
所以剛剛有委員提到就是說我們這個青少年自殺或者是自殺率逐年在這個攀升當中或者是我們可能有一些這個像前陣子桃園的一個案例就是說這個在路上把一個女童這樣抓住的這種類似這樣的一個狀況也許她可能是一個這個精神疾病的患者或是其他的狀況那像這樣子的話 |
transcript.whisperx[473].start |
13367.982 |
transcript.whisperx[473].end |
13387.278 |
transcript.whisperx[473].text |
我們也希望就是說未來我們這個行為中心設置之後確實能夠發揮它的功效而不是就是說我們據點設了很多然後你原本你需要達到的它的預期的這個效果是沒有達到我覺得這樣是非常的可惜的所以我希望說能夠 |
transcript.whisperx[474].start |
13388.619 |
transcript.whisperx[474].end |
13410.014 |
transcript.whisperx[474].text |
一方面可能我們衛福部也要去討論一下為什麼這幾年的這個自殺率是這樣子逐年在攀升的那另外一方面可能我們每一次碰到事情之後可能這個在捷運上的殺人事件啊或者是在馬路上就可能被這個無緣無故就被殺或被刺啊類似這樣的一個狀況那怎麼樣做預防 |
transcript.whisperx[475].start |
13412.776 |
transcript.whisperx[475].end |
13430.171 |
transcript.whisperx[475].text |
或者是發生之後我們要怎麼去做心理的一個輔導我覺得這個可能也需要我們這個衛福部這邊跟所有的單位相關單位可能大家要做一個討論那另外接下來我再想請教一下就是說 |
transcript.whisperx[476].start |
13431.573 |
transcript.whisperx[476].end |
13455.115 |
transcript.whisperx[476].text |
前陣子那個桃園龜山那個強拉幼童的這個事件那我沒有聽到我也沒有看到就是衛福部針對這個事件後續我們要怎麼去做預防或者是你們有什麼樣的回應我是在網路上在媒體上我是完全沒有看到衛福部針對這件事情有做什麼樣的回應我是不是可以先請那個部長先做簡單的回答 |
transcript.whisperx[477].start |
13456.311 |
transcript.whisperx[477].end |
13477.906 |
transcript.whisperx[477].text |
因為第一個我們很小心在精神病的汙名化這件事情其實媒體有時候或警方所提出來的那個並不是實際上他的病況他應該不是屬於精神病他是和中度智能 |
transcript.whisperx[478].start |
13479.838 |
transcript.whisperx[478].end |
13493.863 |
transcript.whisperx[478].text |
所以我們也是擔心就會變成一個障礙的歧視所以我們就是很小心按照法律來處理當然我們一定是去請地方政府馬上啟動社工 |
transcript.whisperx[479].start |
13498.808 |
transcript.whisperx[479].end |
13510.105 |
transcript.whisperx[479].text |
實際上的動作去做那至於說因為他牽涉到一個媒體的話或公告的做什麼聲明的話我想這個部分我們是比較的確是比較謹慎的其實我 |
transcript.whisperx[480].start |
13512.108 |
transcript.whisperx[480].end |
13530.222 |
transcript.whisperx[480].text |
每次這個事件發生之後比如是在立法院或在媒體上面我們看到會有一些很多的一個檢討的聲音那有時候立法院會因為一件事情發生之後就覺得說哪一個法還不完備然後就是又要啟動修法當然我們會認為就是說可能預防會更重要那其實 |
transcript.whisperx[481].start |
13536.687 |
transcript.whisperx[481].end |
13558.475 |
transcript.whisperx[481].text |
法律的在完整在完備其實還是有它一些不足的地方或者是隨時要發生事情也是沒辦法去就是有時候是很難去預防那當然就是我們要怎麼從這個預防的角度或者是從這個家庭教育的這個角度然後去切入我覺得有時候我們看到這個發生事情 |
transcript.whisperx[482].start |
13560.871 |
transcript.whisperx[482].end |
13561.232 |
transcript.whisperx[482].text |
委員會主席 |
transcript.whisperx[483].start |
13579.122 |
transcript.whisperx[483].end |
13605.942 |
transcript.whisperx[483].text |
我更認為就是說也許在這個家庭教育或者是在這個教育上面可能也是要著重蠻多的所以我也希望就是說衛福部針對這一部分可能也還需要結合我們這個地方政府結合這個教育單位大家一起來努力什麼讓這個事情不要發生或者是萬一如果不幸發生之後那後續要怎麼去做檢討怎麼去做 |
transcript.whisperx[484].start |
13606.963 |
transcript.whisperx[484].end |
13607.263 |
transcript.whisperx[484].text |
是,了解。我們 |
transcript.whisperx[485].start |
13635.117 |
transcript.whisperx[485].end |
13648.896 |
transcript.whisperx[485].text |
本部將會同教育部從學校跟社會教育層面那個強化心理的健康提升民眾的心理韌性這個在健康台灣裡面也會列為一個很重要的SEL的一個 |
transcript.whisperx[486].start |
13652.819 |
transcript.whisperx[486].end |
13677.54 |
transcript.whisperx[486].text |
對,我們當然就是說看到這個事情發生之後可能這個加害人他可能可能就有也許就被判刑或被收押那判刑收押完之後呢這個是他如果又回到社區那怎麼樣去怎麼樣去做處置我覺得這個應該是後續後續應該是最重要的對,我們會把銜接的很好對,好好好謝謝,謝謝委員 |
transcript.whisperx[487].start |
13681.772 |
transcript.whisperx[487].end |
13708.292 |
transcript.whisperx[487].text |
謝謝黃委員、謝謝部長。接下來我們請陳雪生委員質詢。謝謝主席。是不是請部長。委員好。部長好。你是我的兄弟這首歌你會不會唱?你是我的兄弟啊? |
transcript.whisperx[488].start |
13709.909 |
transcript.whisperx[488].end |
13727.605 |
transcript.whisperx[488].text |
我講這句話是希望部長把我們馬祖的每一個鄉親都當作你的親人我一向都是這種情懷因為早上我林柱芬委員質詢到急診室的狀況我也非常感慨 |
transcript.whisperx[489].start |
13729.363 |
transcript.whisperx[489].end |
13750.289 |
transcript.whisperx[489].text |
我弟弟的小孩肺發炎去臺大醫院暫留了多少天你知道嗎?7天7天才進入病房因為你當部長我不好意思再麻煩你所以我們也不想用特權那另外我就想請問部長797的斷層掃描你做過沒有? |
transcript.whisperx[490].start |
13755.89 |
transcript.whisperx[490].end |
13777.886 |
transcript.whisperx[490].text |
640我為什麼跟你講790你知道嗎?你看馬祖是落後地區嗎?馬祖是不是落後地區?馬祖絕對不是落後地區我們做完150切的電腦斷層然後拿過來給醫生看模糊不清不清楚再做一次做多少?做640切 |
transcript.whisperx[491].start |
13779.605 |
transcript.whisperx[491].end |
13802.17 |
transcript.whisperx[491].text |
不是兩個加起來790切嗎?我們做X光照一次啊,就已經那個輻射就已經不得了了。你看做多好吃。所以部長,我想之前跟你討論過,640切的電腦端程給我們一步好不好?你看所有台灣的部立醫院有150切的嗎? |
transcript.whisperx[492].start |
13804.383 |
transcript.whisperx[492].end |
13817.265 |
transcript.whisperx[492].text |
你家人去買東西都是買最好的電器用品嘛,怎麼會買最爛的呢?現在台灣醫學已經發達到這種地步了,是不是?所以我昨天詢問我們衛生局,他說委員會在討論 |
transcript.whisperx[493].start |
13818.939 |
transcript.whisperx[493].end |
13847.316 |
transcript.whisperx[493].text |
你告訴你的委員會還要討論什麼我不知道報告委員我們已經收到醫院嘛醫院這一邊的文那我們會用收到文沒有用啊你要答應我啊好不好醫化基金怎麼處理因為我們通常跟委員報告就是那個要動用到醫化基金的話我們有一個醫化基金審議委員會那我們目前已經那個在排那個委員的可出席時間已經在11月底您是市長是不是 |
transcript.whisperx[494].start |
13850.417 |
transcript.whisperx[494].end |
13875.805 |
transcript.whisperx[494].text |
我們去跟你什麼委員會去討論事情太遙遠了啦,你知道嗎?我也不曉得你們成員是誰?因為他必須要有一個預算的來源啊我的兄弟邱部長比較快啦,你知道嗎?預算來源,你全國的部立醫院有150間的嗎?你講給我聽為什麼我們要享受...我最近才去落成澎湖醫院的醫院他是... |
transcript.whisperx[495].start |
13877.799 |
transcript.whisperx[495].end |
13880.706 |
transcript.whisperx[495].text |
一百二十八期我找楊耀委員來質詢你喔楊耀委員去那邊很高興 |
transcript.whisperx[496].start |
13885.598 |
transcript.whisperx[496].end |
13913.223 |
transcript.whisperx[496].text |
因為他配合AI,所以其實是非常的清楚,然後效果也非常好,是新的喔,他換掉也乃是60次切的嘛,所以因為他的價錢其實是我改天找癌藥委員質詢你,他一定會要個640切的,你放心沒問題沒問題,因為他去看了以後他覺得很滿意很滿意喔?你改天看病跑到馬祖來看,我保證你做790切我跟你講 |
transcript.whisperx[497].start |
13915.219 |
transcript.whisperx[497].end |
13922.754 |
transcript.whisperx[497].text |
那個馬祖現在的是幾千?一百五十千一百五十千快幾年了?已經十幾年了 |
transcript.whisperx[498].start |
13927.411 |
transcript.whisperx[498].end |
13928.072 |
transcript.whisperx[498].text |
你也答應我了 |
transcript.whisperx[499].start |
13952.331 |
transcript.whisperx[499].end |
13953.653 |
transcript.whisperx[499].text |
賴總統到金門去,他說我們對離島居民的醫療一定要提升 |
transcript.whisperx[500].start |
13968.291 |
transcript.whisperx[500].end |
13996.603 |
transcript.whisperx[500].text |
我們有緊急醫療後送金門現在有部立醫院對不對他緊急醫療後送的人員是我們的差不多10倍送的更多我們用直升機送他用運輸機送西凹山洞送整個裡面都是所以這個部立醫院有部立醫院水準嘛那我們連鄉縣黨部民進黨的連鄉縣黨部提出來說要部立醫院部長你的看法怎麼樣 |
transcript.whisperx[501].start |
13997.745 |
transcript.whisperx[501].end |
13998.898 |
transcript.whisperx[501].text |
要不要給我們一個不立院? |
transcript.whisperx[502].start |
14000.936 |
transcript.whisperx[502].end |
14027.064 |
transcript.whisperx[502].text |
布立醫院這個問題以前討論過啦後來從縣政府那邊也不放掉啊還是要縣立醫院啊誰不放掉?不會啊你如果給我布立醫院給我30億、50億多一個神經那顆、神經外科、心臟那顆、多一個醫生把金門醫院改製成布立醫院嗎?還是另外?另外早就布立啦澎湖也布立啊 |
transcript.whisperx[503].start |
14032.265 |
transcript.whisperx[503].end |
14054.829 |
transcript.whisperx[503].text |
你要改部例嗎?我跟你評估至少30億跑不掉你要蓋病床、病房、設備然後神經內科、神經外科、心臟內科、心臟外科這些統統都要配備當然我們人數很少一個月可能一兩個人這些醫生平常也可以給他一點福利去釣魚他可以去釣魚 |
transcript.whisperx[504].start |
14056.553 |
transcript.whisperx[504].end |
14076.843 |
transcript.whisperx[504].text |
是不是這樣?事實上就如此嘛我有到馬祖去行為醫療都順便打網球,我都怕馬祖的地方還可以打網球對啊,所以是不是達到成立,需要成立部立院是值得討論的?我想部長你重視這個問題,有機會部裡面去討論一下好不好?如果成立部立院我 |
transcript.whisperx[505].start |
14079.572 |
transcript.whisperx[505].end |
14094.918 |
transcript.whisperx[505].text |
我跟委員報告部立醫院所有的醫療人員都是我的好朋友所以我們都很清楚他們的努力有時候還要到其他的島去做很多的公共衛生各方面的醫療真的令人非常感併 |
transcript.whisperx[506].start |
14097.492 |
transcript.whisperx[506].end |
14110.939 |
transcript.whisperx[506].text |
你稍微提升一下醫療的等級好不好?這個我們一定遵守當時我們一起在討論的事那你今天長照師有沒有來我不知道長照師沒有?沒關係長照師我們要4900坪的土地要蓋4900坪然後你們答應給我們100床我們的造價跟台灣的建築費用 |
transcript.whisperx[507].start |
14124.083 |
transcript.whisperx[507].end |
14145.455 |
transcript.whisperx[507].text |
這個醫院算特殊建築嘛,對不對?我們一坪要27萬,台灣只要十幾萬,一坪27萬還沒有人要蓋喔?在台灣這邊還有黑道的回扣、白道的回扣,我們回扣都沒有,縣長要去跪求他們來蓋,沒有人要來蓋啊,缺工缺料。 |
transcript.whisperx[508].start |
14149.033 |
transcript.whisperx[508].end |
14173.398 |
transcript.whisperx[508].text |
這個延遲完成驗收的風險太大太大了所以他們商人要精打細算一瓶要27萬那你們現在說很像講說一瓶一瓶多少錢啊你們一瓶十幾萬給我們100間只給我們4億很像那100床100床的面積啊我們的需求是38瓶一個床要38瓶 |
transcript.whisperx[509].start |
14174.977 |
transcript.whisperx[509].end |
14201.235 |
transcript.whisperx[509].text |
你們常常提出來說一床27瓶,這個差距很大。我說你部長是不是請你特別重視一下,因為時間的關係。報告委員,我們一定把你的所有的需求,我們相關的團隊,再度來好好的針對你現在提出來的來好好的研究。我們的交情我不會擔心。 |
transcript.whisperx[510].start |
14202.861 |
transcript.whisperx[510].end |
14208.746 |
transcript.whisperx[510].text |
我是擔心什麼呢?你回去以後就把我忘了?永遠不會忘記你,在你的07當了8年,沒有聞到你的體會,聞到你的菸味沒有沒有,這裡不能講這個吧 |
transcript.whisperx[511].start |
14221.181 |
transcript.whisperx[511].end |
14249.937 |
transcript.whisperx[511].text |
我最近都在適當的場所對啦就是說我們接觸的非常頻繁啦所以感謝您對馬祖人民的我也感佩啦真的是對馬祖人民部長以前跟我在立法院是我們是鄰居啦我們感情非常好沒有因為黨派的問題嘛部長我也拜託好不好這個640間一定要幫我完成任務第一個第二個長照師的床位啊病床啊 |
transcript.whisperx[512].start |
14251.124 |
transcript.whisperx[512].end |
14260.749 |
transcript.whisperx[512].text |
部長,祝你身體健康、精神愉快,謝謝!好,謝謝委員!好,謝謝主席!好,謝謝!謝謝陳雪森委員!真的馬祖真的順序,我有去過好幾次,那邊真的是條件不好!部長,你給他答應就好,你是咧? |
transcript.whisperx[513].start |
14285.195 |
transcript.whisperx[513].end |
14285.496 |
transcript.whisperx[513].text |
王毅民議員 |
transcript.whisperx[514].start |
14302.552 |
transcript.whisperx[514].end |
14322.033 |
transcript.whisperx[514].text |
蘇丹紅時安風暴再起,到目前為止有查清楚是什麼原因了嗎?我這邊有列出來,當時上半年的時候發生蘇丹紅事件,你們在3月13號的時候已經宣布邊境管制的措施而且要阻絕於境外。 |
transcript.whisperx[515].start |
14322.794 |
transcript.whisperx[515].end |
14347.012 |
transcript.whisperx[515].text |
之前你們也說這個後市場統統都清乾淨了統統都清完畢了沒想到現在蘇丹紅食安風暴又再起而且又是同一家公司寄生公司請問你們查到目前為止你們查到的真相到底是什麼為什麼現在咖哩粉裡面又有蘇丹紅又爆發出來了 |
transcript.whisperx[516].start |
14349.427 |
transcript.whisperx[516].end |
14372.577 |
transcript.whisperx[516].text |
我先解釋一下,這個我們當時就阻絕於境外對,逐批查驗,阻絕境外怎麼還會流進來據我了解是因為原來在阻絕之前的就流進來了的原料,是不是我們請副處長好來副處長委員好,跟委員報告,這一次 |
transcript.whisperx[517].start |
14373.908 |
transcript.whisperx[517].end |
14385.843 |
transcript.whisperx[517].text |
就是我們食藥署跟地方衛生局持續在後市場都沒有停的在查核那查核的結果這一次是寄生的特條咖哩粉 |
transcript.whisperx[518].start |
14386.653 |
transcript.whisperx[518].end |
14403.642 |
transcript.whisperx[518].text |
那他做的產品5000多盒現在回收了1700多盒那基本上原物料目前都在我們食藥署的國家實驗室做再次的確認那初步懷疑是他的其中一個原料 |
transcript.whisperx[519].start |
14406.102 |
transcript.whisperx[519].end |
14422.168 |
transcript.whisperx[519].text |
將黃粉遺失有這個遭受蘇丹色素的污染那目前如果確定以後那這個產品是從印度進來的我們會把印度整個國家輸入的咖哩粉目前印度的咖哩粉有色了但是將黃 |
transcript.whisperx[520].start |
14423.348 |
transcript.whisperx[520].end |
14423.628 |
transcript.whisperx[520].text |
以上報告 |
transcript.whisperx[521].start |
14440.811 |
transcript.whisperx[521].end |
14468.401 |
transcript.whisperx[521].text |
好那薑黃粉的話現在國內其實運用的蠻普遍的喔特別是在咖哩那咖哩的那個產品又非常的多你們現在發現的是從印度進來的這一批那請問我們薑黃粉有沒有從其他國家進口的只有印度嗎會不會又有漏網之魚因為之前你們查辣椒粉的時候逐批檢驗是對岸中國大陸那現在又出來薑黃粉 |
transcript.whisperx[522].start |
14469.881 |
transcript.whisperx[522].end |
14486.506 |
transcript.whisperx[522].text |
又有蘇丹紅是從印度但是只有印度這個國家嗎那你們現在採取的措施是要逐批檢驗嗎來自印度的那其他國家會不會有別的薑黃粉流入你們現在掌握到的從其他國家進來的薑黃粉還有哪些國家 |
transcript.whisperx[523].start |
14488.407 |
transcript.whisperx[523].end |
14488.907 |
transcript.whisperx[523].text |
所以表示有漏網之魚流入市場嗎?對不對? |
transcript.whisperx[524].start |
14514.082 |
transcript.whisperx[524].end |
14522.855 |
transcript.whisperx[524].text |
到底我問你一個問題蘇丹紅他可以衍生的添加的到底有哪一些的調味粉之前說是辣椒粉現在連薑黃粉也可以到底還有什麼種類 |
transcript.whisperx[525].start |
14526.821 |
transcript.whisperx[525].end |
14555.454 |
transcript.whisperx[525].text |
跟我們報告目前國際警訊上面有的我們都已經設了包括辣椒粉、咖哩粉這些都有我們是把過去10年國際上曾經有檢出疑似有蘇丹色素違規的項目在邊境都設立查驗那當然一開始是百分之百那驗了大概半年多以後結果都沒有發現有的我們就會回歸到風險的管理那這一次 |
transcript.whisperx[526].start |
14556.174 |
transcript.whisperx[526].end |
14559.976 |
transcript.whisperx[526].text |
明天開始100%的抽驗那我問你現在已經在市場上面的你還有繼續去抽樣嗎我高度懷疑的是之前流進來的因為之前沒有100%嘛 |
transcript.whisperx[527].start |
14586.01 |
transcript.whisperx[527].end |
14601.326 |
transcript.whisperx[527].text |
會不會不只寄生這一家因為其實薑黃粉有非常多那如果別的陸續都有進口的你們要怎麼樣去清你們上次去清這個辣椒粉的時候是回溯就是每一批你們再去回溯那你們這一次薑黃粉你們的做法是什麼 |
transcript.whisperx[528].start |
14602.077 |
transcript.whisperx[528].end |
14617.333 |
transcript.whisperx[528].text |
各位報告只要確定是薑黃粉的話我們就會比照今年年初的做法會去全面清查只要是在後市場還在校期內的我們就會去清查會比照年初的做法你們多久會完成這項工作 |
transcript.whisperx[529].start |
14619.035 |
transcript.whisperx[529].end |
14637.867 |
transcript.whisperx[529].text |
跟我們報告其實蘇丹社是今年發生以來我們邊境是由食藥署負責後市場跟衛生局都沒有停都是持續在查持續在查對都沒有停所以才會發現有這一批但是但是代表說也沒有斷啊就是說你們的查算沒有停你們當時信誓旦旦是說 |
transcript.whisperx[530].start |
14638.968 |
transcript.whisperx[530].end |
14662.054 |
transcript.whisperx[530].text |
整個市場都很乾淨了然後外面也阻絕於境外結果就是破功現在看起來就不是這麼回事所以我要求這個食藥署在這件事情上面你們查緝的力道其實還是要很強的包括你們抽菸的比例其實還要增加因為這關乎食安要不然你們的保證大家就沒有信心了你們上半年信誓旦旦的保證現在又爆出而且這個數量還是蠻龐大的你說五千多件 |
transcript.whisperx[531].start |
14667.376 |
transcript.whisperx[531].end |
14692.616 |
transcript.whisperx[531].text |
現在只下架一千多件很多可能都已經是流入這個市場所以這個食安我希望這個部長來我要問部長部長你這個剛上任這個食安問題我希望你也要等同重視就是這一個事情我覺得它整個在市場是沒有真正的斷掉的所以你們應該那個敏感度要更高我們今年的主結是應該是完全主結那就是可能 |
transcript.whisperx[532].start |
14695.478 |
transcript.whisperx[532].end |
14696.439 |
transcript.whisperx[532].text |
接下來我問是今天的有關於我們這個精神 |
transcript.whisperx[533].start |
14714.662 |
transcript.whisperx[533].end |
14714.682 |
transcript.whisperx[533].text |
致詢問題 |
transcript.whisperx[534].start |
14734.436 |
transcript.whisperx[534].end |
14762.439 |
transcript.whisperx[534].text |
兩千七百一十八人服務率只有兩趴多那像嘉義縣這種資源比較高度匱乏的地方他連一家在地的協會都沒有還是靠嘉義市的那這樣子的一個情況底下你說你所有的服務要回歸社區然後要做得很好怎麼做你你基本的服務量能就完全不夠啊而且你還有這個縣市資源落差的問題像嘉義縣這樣的一個地方連協會都沒有啊 |
transcript.whisperx[535].start |
14763.62 |
transcript.whisperx[535].end |
14764.421 |
transcript.whisperx[535].text |
請問要怎麼提供服務 |
transcript.whisperx[536].start |
14769.934 |
transcript.whisperx[536].end |
14791.3 |
transcript.whisperx[536].text |
謝謝委員關切就是說我們社區的這個精神病人服務的資源相對不足這一帶那其實我們除了我們爭取經費來補助民間團體可以來增加精神病人社區支持資源之外其實我們也在關切能夠提供這樣的服務的團體並不多所以我們透過公財回饋金這邊我們有一個團體的一個賠利計畫我們希望能夠 |
transcript.whisperx[537].start |
14794.901 |
transcript.whisperx[537].end |
14811.593 |
transcript.whisperx[537].text |
有一些團體目前沒有在提供精神病人的社區支持服務我們希望能夠來培力他可以提供這種服務所以我們是同步在進行一方面那你們目前響應的有多少人你們有沒有針對資源匱乏就像我講的嘉義縣連一家都沒有啊有在你們重點的培養嗎 |
transcript.whisperx[538].start |
14812.774 |
transcript.whisperx[538].end |
14813.735 |
transcript.whisperx[538].text |
加一線就有超過萬名的精神病友 |
transcript.whisperx[539].start |
14832.13 |
transcript.whisperx[539].end |
14857.58 |
transcript.whisperx[539].text |
那這樣子極度匱乏的區域我要知道是說那你們的強化措施是什麼要不然這個其實縣市資源資源充足的比如說首都這麼多的團體這麼多的資源那他會得到很好的照顧那像嘉義縣資源這麼匱乏的地方那他就顯得他可能有需求但是沒有人可以來服務啊你們要怎麼去平衡那個城鄉的落差這個可能是重點嗎 |
transcript.whisperx[540].start |
14858.28 |
transcript.whisperx[540].end |
14882.172 |
transcript.whisperx[540].text |
是沒有錯齁其實我們做團體的一個賠利齁我們並不是說只有補助給團體請他們來做這件事情我們有一個專門的團隊去輔導我們的團體因為時間的關係喔部長我要求齁這個衛福部必須去盤點我今天已經具體指出來了像嘉義縣它就是嚴重資源匱乏的地方連一家的服務的協會都沒有你們要去盤點那你們如果說有輔導的計畫 |
transcript.whisperx[541].start |
14887.395 |
transcript.whisperx[541].end |
14911.177 |
transcript.whisperx[541].text |
我要求要看到你們輔導的成效而且你們服務的量能要有效的成長跟提供要不然我覺得對於在嘉義縣的這些精神病友其實是不公平的他們得不到你計畫寫得很好看但是他們得不到資源好不好那一個月之後可不可以把你們具體的想要改善的這個計畫給本席好不好怎麼樣去提升可以好謝謝 |
transcript.whisperx[542].start |
14912.718 |
transcript.whisperx[542].end |
14917.521 |
transcript.whisperx[542].text |
謝謝委員謝謝王委員、謝謝部長。繼續我們請劉建國委員質詢。謝謝主席、也謝謝召委。今天排這個有關這個社區思覺治療症的病患。我們應該是用這樣的名稱比較正確。這個提醒一下主席。來,有請部長,謝謝。 |
transcript.whisperx[543].start |
14943.226 |
transcript.whisperx[543].end |
14971.385 |
transcript.whisperx[543].text |
委員好部長好部長辛苦了這個不到百惠待舉不過真的事情真的是很多今天今天找我又排這個思覺治療症的這個病患的照護優化這確實也非常重要一件事情我想到立院還是面對立院的時候要就是要要面對事實有些數據可能我們要小心也不要去美化部長可以看這個資料很清楚 |
transcript.whisperx[544].start |
14972.305 |
transcript.whisperx[544].end |
14994.123 |
transcript.whisperx[544].text |
就是說我們有強化這個社會安全網第二期計畫那分年來補助地方政府部建社區心理衛生中心及充實心衛中心能力至113年10月底就今年10月底全國社區心理衛生中心已累計52處那每一縣市均以至少設有1處那預計114年要將部建到71處 |
transcript.whisperx[545].start |
14997.365 |
transcript.whisperx[545].end |
14997.505 |
transcript.whisperx[545].text |
這個總共有6個類別的 |
transcript.whisperx[546].start |
15027.208 |
transcript.whisperx[546].end |
15032.436 |
transcript.whisperx[546].text |
這些專業人士齁那那那這個報告你把它從全部都混在一塊 |
transcript.whisperx[547].start |
15033.24 |
transcript.whisperx[547].end |
15056.257 |
transcript.whisperx[547].text |
我不曉得這是什麼意思然後我們也很難去精算到底是心理輔導員你要增進多少然後這個心理衛生的社工生你要增加多少我看不出來但是我如果說以明年來平均每一個職業別基本上就是會增加到414人嘛對不對他們要來照顧這個全國的心理衛生問題喔這樣夠不夠 |
transcript.whisperx[548].start |
15059.534 |
transcript.whisperx[548].end |
15081.745 |
transcript.whisperx[548].text |
每一個人的承擔負擔的這個以往的這樣的一個件數即便你增加到這樣的夠不夠因為你寫這樣我只有籠統的來跟你跟你跟你跟你請教嘛我不曉得真教室要負責多少啊護理師要負責多少然後心理護長負責多少對不對然後再給部長看第二個資料啦就一樣強化這第二期裡面 |
transcript.whisperx[549].start |
15083.146 |
transcript.whisperx[549].end |
15107.605 |
transcript.whisperx[549].text |
112年的這個衛福部直接補助地方政府禁用心理衛生社工含督導是291人那提供精神疾病與自殺防治合併多重議題各案的服務人次已經來到了21萬6349人次簡單講也就是平均一個社工一個社工要處理743人次這個承受得起來嗎? |
transcript.whisperx[550].start |
15112.712 |
transcript.whisperx[550].end |
15113.136 |
transcript.whisperx[550].text |
這承受值起來嗎? |
transcript.whisperx[551].start |
15115.401 |
transcript.whisperx[551].end |
15144.443 |
transcript.whisperx[551].text |
那個委員 白委員是不是我們請針對這個問題跟你報告一下謝謝委員關切我們新衛社工的工作負擔那我的確沒有錯委員這邊提呃這個呈現出來是我們新衛社工的人數是291人是在112年的時候那這個服務呢是指我去仿試的次數不是仿試的人數仿試的次數對因為每一個人可能會仿好幾次所以他不是人數是次數 |
transcript.whisperx[552].start |
15147.43 |
transcript.whisperx[552].end |
15152.281 |
transcript.whisperx[552].text |
所以因為這樣區分起來壓力就不一樣了壓力就落差很大 |
transcript.whisperx[553].start |
15153.348 |
transcript.whisperx[553].end |
15169.241 |
transcript.whisperx[553].text |
是這樣嗎?你要打呼我是這樣嗎?你現在是要緩博我嗎?是不是?不是。不然你這個想法就我聽起來就有點怪怪的啊。這邊是。對。他的人次就是2169216嘛對不對?21萬多嘛對不對?216349你講沒關係你再講一次。這個是服務量。我們提供了這麼多訪視的次數。那就更糟糕了。你這些人要做這麼多的事情。 |
transcript.whisperx[554].start |
15179.623 |
transcript.whisperx[554].end |
15199.029 |
transcript.whisperx[554].text |
跟委員報告,如果是以這個個案的負擔的那個案量比來講的話,我們一個新衛社工在去年平均下來大概是1比28也就是說我一個新衛社工我大概服務28個這個合併有保護案件的這個精神病人所以你現在答問我是說1比28是合理的一個比例 |
transcript.whisperx[555].start |
15202.967 |
transcript.whisperx[555].end |
15212.023 |
transcript.whisperx[555].text |
這個離我們的目標還是要再加油因為我們希望說我們希望能夠把這個比例降到1比25左右1比25喔對你這麼講好像 |
transcript.whisperx[556].start |
15215.885 |
transcript.whisperx[556].end |
15236.515 |
transcript.whisperx[556].text |
好像不是這麼嚴重的感覺齁一比二是巴士現狀那你們要加油到可以調可以來調到一比二十五所以應該這些心理社公司基本上壓力都沒有這麼大是這樣嗎這個都有現場轉播的你小心打呼其實不是這個意思齁因為我們是希望說你打呼我就是這個意思啊 |
transcript.whisperx[557].start |
15236.795 |
transcript.whisperx[557].end |
15262.431 |
transcript.whisperx[557].text |
每一個社工的這個要有一個合理的這個負擔的案量那目前我們是把我們的目標是設在明年要達成的目標你先講合理的負擔的比例是多少你要達成的目標明年要達成目標1比25這是另外一件事情正常的情況之下參照先進的國家這個心理事公司應該要比例是多少1比多少是正常的 |
transcript.whisperx[558].start |
15263.856 |
transcript.whisperx[558].end |
15280.554 |
transcript.whisperx[558].text |
我們有參考國外的資料一比二十的是比較常見所以我們現在就是說當然我們目前國內的人力還是相對不足但是也沒有辦法一步到位所以我們是逐年的來禁用我們新衛社工的人力 |
transcript.whisperx[559].start |
15282.356 |
transcript.whisperx[559].end |
15296.023 |
transcript.whisperx[559].text |
對,所以1比28到1比20你明年要到1比25對不對那你什麼時候可以到1比20才是一個參考國外的這樣的一個經驗是比較合理的 |
transcript.whisperx[560].start |
15296.969 |
transcript.whisperx[560].end |
15297.57 |
transcript.whisperx[560].text |
這個期整到什麼時候? |
transcript.whisperx[561].start |
15328.009 |
transcript.whisperx[561].end |
15330.33 |
transcript.whisperx[561].text |
社安網二期計畫是到明年底結束所以新的一期會在1、15年開始 |
transcript.whisperx[562].start |
15350.283 |
transcript.whisperx[562].end |
15373.444 |
transcript.whisperx[562].text |
所以我們1月5年就可以達到1比20,是不是這樣?明年是1比25嗎?希望,希望我們會努力,因為這個人員的禁用可是你是行政機關,你不能跟我講做希望,你跟我講希望我就覺得沒有希望了我們要禁用的人數,然後地方政府馬上就可以禁用到,他們還是有實務的禁用的一個期程,所以不可能說我們一下子補 |
transcript.whisperx[563].start |
15376.086 |
transcript.whisperx[563].end |
15403.004 |
transcript.whisperx[563].text |
我讓部長知道有這個事情啦好不好我覺得我們一定努力因為部長你現在是社公司的社公司的大家長你現在身份嘛對不對跟以前不一樣我要講你們講說有機會才有機會這個寫的這個報導出來的嘛有機會好好去處理每一個個案的狀況是要降到1比20嘛那等於緩資嘛對不對現在跟明年 |
transcript.whisperx[564].start |
15404.269 |
transcript.whisperx[564].end |
15407.914 |
transcript.whisperx[564].text |
甚至於未來的後年115年都沒有機會好好去處理每一個個案我這樣講你應該沒有辦法反駁我吧 |
transcript.whisperx[565].start |
15416.937 |
transcript.whisperx[565].end |
15417.077 |
transcript.whisperx[565].text |
我想那個 |
transcript.whisperx[566].start |
15440.618 |
transcript.whisperx[566].end |
15465.779 |
transcript.whisperx[566].text |
一下子剛剛市長這邊報告一下子要達到這個目標恐怕的確困難那的確這是事實好好如果要降到1.2才能好好去處理這是每一個個案這也是我們工作同仁的因為我們強化這個社會安全網明年明年是到第二期有各種管道來幫助這些個案讓我們的某一個譬如說心理社會這一個 |
transcript.whisperx[567].start |
15467.06 |
transcript.whisperx[567].end |
15494.269 |
transcript.whisperx[567].text |
負擔不要那麼重,多元化大家互相來支持。現在都是講這個團隊作戰的啦。沒有啦,柏中,我時間在管的啦。我跟他說,因為我講好好的處理每一個個案,我現在講兩件好好的沒有辦法處理每一個個案。第一個就突然發生這個事件嘛,就從事身上者在這邊的社工直接詢問受害者家屬要不要去和解啦。其實做法上是非常粗糙嘛,引起社會嘩然,但是我不忍苛責。 |
transcript.whisperx[568].start |
15496.14 |
transcript.whisperx[568].end |
15520.325 |
transcript.whisperx[568].text |
第二個改改案也是這樣這個社工被起訴過失致死業務登載不實其中這個過失致死的理由部長應該還有記憶猶新吧這個社工是有親自到現場去訪視但未能及時發掘到這一個保姆所羅織的謊言不只如此也未能辨識這個傷勢系受虐所致進而去做額內通報 |
transcript.whisperx[569].start |
15521.718 |
transcript.whisperx[569].end |
15531.182 |
transcript.whisperx[569].text |
那這個社工未能因應或用即時來因應受傷狀況增加訪視頻率或進行不定期的訪視以發掘這個虐待情勢故認為這個社工社工社患過失致死罪這個是多麼沉重的指控我不曉得你現在是社工社大家長你的感受是什麼你看喔 |
transcript.whisperx[570].start |
15549.222 |
transcript.whisperx[570].end |
15575.322 |
transcript.whisperx[570].text |
當這個社工被靠上所靠的那一剎那我相信衛生部很多同仁應該心有戚戚焉吧怎麼會這樣我再講一個數據 2020年有兩成的社工在執行業務時遭受人身的危害每五名就有一個社工遭受安全危害每三天就有一位社工受到這個威脅 |
transcript.whisperx[571].start |
15577 |
transcript.whisperx[571].end |
15601.198 |
transcript.whisperx[571].text |
這個時候這個數據都沒有應該不誇張嘛對不對反正就是社區精神病患照護優化這缺點是長期以來這個問題那我們當然希望換了新的部長就有不一樣針對這個部分有更積極的應用作為嘛但是這樣的數據你必須要去盤整起來部長非常的清楚去掌握嘛然後北市喔臺北市社會局統計去年113年社工總人數是563人但是就有94人離職 |
transcript.whisperx[572].start |
15605.277 |
transcript.whisperx[572].end |
15613.644 |
transcript.whisperx[572].text |
離職率有20%,19.3%左右然後這是太多了,替問我的地方就對了連新北市都有36個人離職 |
transcript.whisperx[573].start |
15615.976 |
transcript.whisperx[573].end |
15644.551 |
transcript.whisperx[573].text |
持續這樣下去,我們不只有人才斷層,也有經驗的斷層,這會接不上來,這會出大問題。所以你們要降到1比5,你還是有辦法招到那些人,也有辦法要做下去,不然你的1比25,我怕都很難達成,不要講到1比20。我今天要推詢你們的意思,因為時間有限,但是大致上就講了幾個重點,也給部長能夠理解。 |
transcript.whisperx[574].start |
15645.511 |
transcript.whisperx[574].end |
15667.172 |
transcript.whisperx[574].text |
我這邊最後一個具體的建議其實我們在這個有對這個連江縣社會工作人力培訓期獎勵計畫是109年到115年這個離老人力當然離老的社工人力當然會比本島更難培養但是如果透過公費的方式為離老來培養這個社工人力我覺得 |
transcript.whisperx[575].start |
15668.086 |
transcript.whisperx[575].end |
15688.021 |
transcript.whisperx[575].text |
我覺得有某種程度的效益存在那今年首屆的國衛生有3人在6月畢業之後7月會返鄉來到這個連江縣託入服務這個計畫已經執行4年了啦要不要去擴大嘛該不該擴大有沒有原理擴大你的2.0裡面有沒有含帶這一項 |
transcript.whisperx[576].start |
15690.509 |
transcript.whisperx[576].end |
15709.742 |
transcript.whisperx[576].text |
我想這個是有意義的一個工作,那就是看需求,需求面方面我們來規劃,不曉得這公司有沒有規劃?是,跟委員報告,就是這一次今年我到連江去看這些學生跟縣府交換意見,那他們縣府也提出就是說 |
transcript.whisperx[577].start |
15710.402 |
transcript.whisperx[577].end |
15730.846 |
transcript.whisperx[577].text |
在這一期結束後他們會再評估提出第二期再繼續讓中央來支持所以因此我們在等他的報告來之後我們會再報給行政委員來做這個就是林江縣他提出了嘛全國要不要一體適用嘛你的能力才有辦法短期內去補足嘛你的1比25才有辦法達標嘛為了1比20才有機會有辦法去實現嘛就這樣而已嘛 |
transcript.whisperx[578].start |
15735.339 |
transcript.whisperx[578].end |
15750.677 |
transcript.whisperx[578].text |
一個月給我們報告跟政府溝通一下好不好?部長可以嗎?好,謝謝!謝謝!謝謝!謝謝劉委員!不過我的社工師我建議你們在聚會的時候還是說在做年度的時候請外商科的醫師來幫你們 |
transcript.whisperx[579].start |
15752.279 |
transcript.whisperx[579].end |
15753.761 |
transcript.whisperx[579].text |
接續我們請劉許廷委員 |
transcript.whisperx[580].start |
15777.968 |
transcript.whisperx[580].end |
15781.954 |
transcript.whisperx[580].text |
謝謝主席部長跟這個社會救助跟社工吧市長有請 |
transcript.whisperx[581].start |
15786.86 |
transcript.whisperx[581].end |
15806.58 |
transcript.whisperx[581].text |
委員好,這部長無安喔,這無安,大家今天都談龜山這件事,又發生在本席選區喔,是,這非常煎熬啊,是,就剛剛劉建國委員講得很清楚吧,就說像這樣子案例非常特殊啊,如果說大家要這個加強列管等等,它其實某一些層面來講可能會造成社工更進一步的負擔,但這事就發生了嘛。 |
transcript.whisperx[582].start |
15807.04 |
transcript.whisperx[582].end |
15830.314 |
transcript.whisperx[582].text |
那這次發生的時候選區是極度恐慌的狀態自然的狀態我是很為難啦我當然不希望不管是智能障礙也好或者是精神障礙被汙名化可是這社區的恐慌它確實造成然後當大家都講說要把它關起來或什麼的時候其實本期非常為難所以我們今天一定要花一點時間討論這件事情啦剛剛本期有講非常清楚這一案的狀況非常特殊就是說它並不一開始並不是所謂屬於的精神障礙對不對 |
transcript.whisperx[583].start |
15831.596 |
transcript.whisperx[583].end |
15840.088 |
transcript.whisperx[583].text |
他只是中度智能障礙而已對不對好那我想請問以現行的制度啦這個相關的官員可以做補充不屬於精神障礙的情況之下有沒有開案列管制度上規定要不要開案列管 |
transcript.whisperx[584].start |
15847.668 |
transcript.whisperx[584].end |
15875.539 |
transcript.whisperx[584].text |
報告委員我們這個全國的精神病人這邊來收案做關懷訪視不是因為他有沒有零有手冊而是說針對病情比較嚴重的一些對我現在講這個案例他之所以特別就是因為他一開始不是所謂的精神疾病的狀況他是智能障礙情況那智能障礙有沒有列管在我們這個精神衛生這邊是沒有是沒有列管對不對那那個社政方面的有沒有列管現在的制度是什麼 |
transcript.whisperx[585].start |
15877.128 |
transcript.whisperx[585].end |
15880.403 |
transcript.whisperx[585].text |
好 身上 我剛剛不太確定 沒關係上來說明一下就好請 |
transcript.whisperx[586].start |
15881.938 |
transcript.whisperx[586].end |
15908.221 |
transcript.whisperx[586].text |
根為報告,他這個如果說經過身心障礙鑑定的話,他如果符合資格,他是可以在用身心障礙的部分,他是拿進來列管的?當然是有列管所謂的身心障礙的這個名額嘛,但我的意思是說列管之後他的管理是什麼?比如說我只是提供一項生活輔助或什麼之類的,或者說他可以請領相關補助,這是大家普遍的了解嘛,可是針對特殊個案的這些行為或什麼,他現在有特別的規矩嗎?或者是有特別的規制嗎? |
transcript.whisperx[587].start |
15910.234 |
transcript.whisperx[587].end |
15935.538 |
transcript.whisperx[587].text |
生意障礙的部分的話他是用各管的方式也就是說他可以想做相關的福利服務跟現在都還是從福利的角度出發所以現在問題就在這個地方就是說他沒有在沒有特殊行為之前他當然就不屬於要特定的開案列管就規範行為的一個模式嘛對不對那不列管的情況之下所以其實就等於是在行為方面是沒有列管那不列管的情況之下我們是不是只能期待就是說當事人的家庭給予合適的照顧跟支持 |
transcript.whisperx[588].start |
15936.564 |
transcript.whisperx[588].end |
15960.769 |
transcript.whisperx[588].text |
對不對現行的狀況是不是就是這樣好那這個案子因為他已經變成全國矚目他上了全國新聞剛剛還有影片放出來真的是慘不忍睹對不對那我想了解一下你們現在中央各部會有沒有去了解這個個案的狀況請問這個個案的狀況是他的家庭照護是屬於百密一疏平常很好但是發生這樣的事情還是說平常就疏於照顧等於家庭在支持系統方面是不合格的請問是屬於哪一種你們有了解嗎 |
transcript.whisperx[589].start |
15962.825 |
transcript.whisperx[589].end |
15977.851 |
transcript.whisperx[589].text |
委員其實分析得很好,那不曉得我們在這個部分有沒有去聊?沒有,現在看起來暫時回答不出來,好沒關係,請你用最快的速度,你也跟桃園社會局聯繫一下好不好?是,被害人部分我們有掌握,行為人部分 |
transcript.whisperx[590].start |
15978.951 |
transcript.whisperx[590].end |
15999.364 |
transcript.whisperx[590].text |
現在大家都做把被害人做心理輔導這是本來就應該做的事情嘛然後你盡量去撫平他的傷痛這本身就沒有問題了但現在問題就是這樣就是說現在這個加害者這個個案是他家庭是屬於長期失能的狀況還是他其實是正常但就是漏了那個第一個這個事情要先做先做釐清第二個我要講的也結合剛剛很多委員在問的就是說如果因為發生一次這樣的事情 |
transcript.whisperx[591].start |
15999.784 |
transcript.whisperx[591].end |
16016.409 |
transcript.whisperx[591].text |
然後我們就說好全面列管然後又增加社工的工作負擔恐怕不見得從政策的方面能夠有效執行但是但是是不是針對類似的狀況可以做一個檢討那讓先至少讓政府去了解他的家庭狀況我用家庭狀況來區分嘛 |
transcript.whisperx[592].start |
16017.529 |
transcript.whisperx[592].end |
16046.418 |
transcript.whisperx[592].text |
如果這個人是有身心障礙的不管是智能也好精神也好然後他的家庭是足以支持的那我們應該想辦法鼓勵或加強家庭管理的力道這樣去減低你們社政的負擔如果你經過了盤查跟調查之後發現很多個案的家庭狀況是不OK的他很有可能就是特別的他可能就是隱形的炸彈我現在這樣講有一點點有一點點無名化的意思但事實發生在這個地方所以我至少希望要求中央政府部委針對這個案子去做一個盤查身心障礙者可能行為 |
transcript.whisperx[593].start |
16047.498 |
transcript.whisperx[593].end |
16063.745 |
transcript.whisperx[593].text |
你不能等事情發生之後再列管我是覺得就來不及了事前先了解他們的家庭支持狀況你這樣才有辦法大家可以有效的去跟社會做溝通比如守望相助或什麼也透過把家庭的環節拉進來你才能減低你社工跟相關行政人員的負擔嘛 |
transcript.whisperx[594].start |
16064.085 |
transcript.whisperx[594].end |
16081.989 |
transcript.whisperx[594].text |
我想這個才是解決這個個案長遠之道那我不希望說今天質詢的時候只是說我對個案還不是很瞭解既然都上了新聞是矚目公開今天都還排了專案報告那就要對個案要有深刻的瞭解啦好不好這是後續處理就針對加害人的這一部分後續的處理希望競速啊跟本席答覆可以嗎 |
transcript.whisperx[595].start |
16083.573 |
transcript.whisperx[595].end |
16100.76 |
transcript.whisperx[595].text |
謝謝委員提醒這個部分我們希望一個事件就能夠做系統性的一個系統性的就是把家庭拉進來用家庭為單位來做能夠因為這樣改善好不好本期的建議是這樣希望衛福部可以來執行好不好我們會把這個部分的一個報告再給委員好謝謝謝謝林委員謝謝部長那接續我們請楊耀委員質詢 |
transcript.whisperx[596].start |
16114.568 |
transcript.whisperx[596].end |
16115.897 |
transcript.whisperx[596].text |
主席請一下邱部長 |
transcript.whisperx[597].start |
16123.811 |
transcript.whisperx[597].end |
16141.916 |
transcript.whisperx[597].text |
市委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這個其中裡面有很多的問題必須要去克服我先問一下就是說根據統計 |
transcript.whisperx[598].start |
16145.278 |
transcript.whisperx[598].end |
16172.737 |
transcript.whisperx[598].text |
112年領有慢性精神病身障手冊的大概有超過13萬但是這一些人使用我們社區式服務的人數其實大概只有5000人大概不到一成請問一下部長就是使用者不高的主因是什麼 |
transcript.whisperx[599].start |
16174.497 |
transcript.whisperx[599].end |
16199.422 |
transcript.whisperx[599].text |
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 |
transcript.whisperx[600].start |
16202.401 |
transcript.whisperx[600].end |
16205.989 |
transcript.whisperx[600].text |
使用這個社區式服務的人數不高的主因是什麼? |
transcript.whisperx[601].start |
16214.722 |
transcript.whisperx[601].end |
16235.687 |
transcript.whisperx[601].text |
報告委員不管是心理健康室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 |
transcript.whisperx[602].start |
16236.187 |
transcript.whisperx[602].end |
16236.227 |
transcript.whisperx[602].text |
主席 |
transcript.whisperx[603].start |
16253.097 |
transcript.whisperx[603].end |
16271.903 |
transcript.whisperx[603].text |
﹗ |
transcript.whisperx[604].start |
16273.465 |
transcript.whisperx[604].end |
16293.404 |
transcript.whisperx[604].text |
來連結個案跟我們這個服務方案之間希望能夠鼓勵他們出來參加我們的方案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好那這就有一個問題 |
transcript.whisperx[605].start |
16297.998 |
transcript.whisperx[605].end |
16321.919 |
transcript.whisperx[605].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[606].start |
16324.847 |
transcript.whisperx[606].end |
16340.066 |
transcript.whisperx[606].text |
的人力的人力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[607].start |
16344.14 |
transcript.whisperx[607].end |
16366.67 |
transcript.whisperx[607].text |
五百九十二人五百九十二人對這個人力夠嗎?不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[608].start |
16372.118 |
transcript.whisperx[608].end |
16389.677 |
transcript.whisperx[608].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[609].start |
16391.789 |
transcript.whisperx[609].end |
16400.996 |
transcript.whisperx[609].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[610].start |
16422.628 |
transcript.whisperx[610].end |
16437.759 |
transcript.whisperx[610].text |
是,這也是跟護理師、網絡護理師一樣,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特別的計畫這個也是一個 |
transcript.whisperx[611].start |
16448.317 |
transcript.whisperx[611].end |
16474.19 |
transcript.whisperx[611].text |
一個制度那怎麼樣留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[612].start |
16479.059 |
transcript.whisperx[612].end |
16488.6 |
transcript.whisperx[612].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[613].start |
16489.648 |
transcript.whisperx[613].end |
16505.031 |
transcript.whisperx[613].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 像你在醫院也一樣啦 從社工到照服員都一樣啦 而且到社區以後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[614].start |
16519.815 |
transcript.whisperx[614].end |
16544.567 |
transcript.whisperx[614].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[615].start |
16545.762 |
transcript.whisperx[615].end |
16555.117 |
transcript.whisperx[615].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[616].start |
16557.264 |
transcript.whisperx[616].end |
16583.669 |
transcript.whisperx[616].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[617].start |
16586.022 |
transcript.whisperx[617].end |
16610.99 |
transcript.whisperx[617].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資那執政黨呢用評鑑送醫院大禮 |
transcript.whisperx[618].start |
16612.639 |
transcript.whisperx[618].end |
16626.773 |
transcript.whisperx[618].text |
那在野黨就要保障點子多少錢?阿你如果繼續撐高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[619].start |
16635.253 |
transcript.whisperx[619].end |
16659.659 |
transcript.whisperx[619].text |
沒有那種沒有那種既定的應該要有既定的政策就是我就常講我來自離島很深刻的的了解資源的分布有多不平均啊你們現在都會區全國還有14個縣市沒有沒有醫學中心啊不是只有南北差距而已啊 |
transcript.whisperx[620].start |
16662.827 |
transcript.whisperx[620].end |
16679.945 |
transcript.whisperx[620].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[621].start |
16687.933 |
transcript.whisperx[621].end |
16688.613 |
transcript.whisperx[621].text |
是,這個真的是那個分級醫療 |
transcript.whisperx[622].start |
16708.018 |
transcript.whisperx[622].end |
16708.198 |
transcript.whisperx[622].text |
對阿對阿 |
transcript.whisperx[623].start |
16737.811 |
transcript.whisperx[623].end |
16753.235 |
transcript.whisperx[623].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,大家有競爭才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的理由嘛 |
transcript.whisperx[624].start |
16766.325 |
transcript.whisperx[624].end |
16770.33 |
transcript.whisperx[624].text |
阿假如都不用這樣我就主張不用評鑑阿讓他們浪費那麼多時間幹嘛 |
transcript.whisperx[625].start |
16772.352 |
transcript.whisperx[625].end |
16775.014 |
transcript.whisperx[625].text |
正正前委員正正前委員正正前委員不在繼續我們請陳穎委員質詢 |
transcript.whisperx[626].start |
16807.812 |
transcript.whisperx[626].end |
16808.713 |
transcript.whisperx[626].text |
主席 麻煩請部長委員好 |
transcript.whisperx[627].start |
16815.826 |
transcript.whisperx[627].end |
16841.558 |
transcript.whisperx[627].text |
部長好,因為不小心瞄到了一個新聞所以來關心一下這件事情那這個桃園青埔這一帶就是交通也非常便利那目前也是整個桃園發展的主要的一個重點所以未來的這個人口移入就是非常多也會越來越多那醫療需求也是隨之增加 |
transcript.whisperx[628].start |
16842.358 |
transcript.whisperx[628].end |
16865.444 |
transcript.whisperx[628].text |
那當然在鄭文燦擔任市長的時期在2019年的時候他還蠻有遠見的就跟了這個市政府就跟這個清華大學簽訂了合作意向書那由市政府無償提供7.2公頃的土地那由這個高雄醫學大學負責興建醫院還有營運 |
transcript.whisperx[629].start |
16868.005 |
transcript.whisperx[629].end |
16882.538 |
transcript.whisperx[629].text |
這個不只是可以解決未來桃園青埔醫療需求問題還有醫學教育研發的功能而且清華大學跟高一大也在去年簽約了 |
transcript.whisperx[630].start |
16885.28 |
transcript.whisperx[630].end |
16903.513 |
transcript.whisperx[630].text |
他們就簽約了那我想整件事情的規劃其實這是一個非常非常棒也是桃園市民非常引頸期盼的事情那我不曉得就是說但是就是說這件事情這個好事情呢現在卻傳出聲變了 |
transcript.whisperx[631].start |
16905.034 |
transcript.whisperx[631].end |
16926.988 |
transcript.whisperx[631].text |
那高一呢,高一大他突然在9月的時候就跟清大解約那上個禮拜五呢桃園市長張善政也落下重話說如果清大仍然沒有找到一起合作興建醫院的對象那桃園市會把土地收回那我不曉得部長有沒有掌握這個狀況還是有誰 |
transcript.whisperx[632].start |
16931.65 |
transcript.whisperx[632].end |
16955.982 |
transcript.whisperx[632].text |
不太清楚這樣一個變化那你們那個誰可以來回答一下根文報告齁據我們了解是目前清大跟高一之間還有一些合約上的問題等一下不好意思你講得很高麥克風那個不好意思就是那個因為我們目前了解的是那個清大跟高一之間有一些合約的關係還沒有釐清所以他們目前有這些問題存在我想是這樣子齁 |
transcript.whisperx[633].start |
16959.266 |
transcript.whisperx[633].end |
16975.217 |
transcript.whisperx[633].text |
接著今天質詢那也麻煩部長要關心一下這個狀況我們來看一下這個臺北市跟桃園市的人口臺北市的人口已經將近250萬了桃園市的人口也是230幾萬其實 |
transcript.whisperx[634].start |
16979.36 |
transcript.whisperx[634].end |
17006.507 |
transcript.whisperx[634].text |
這個兩個直轄市人口是差不多了但是呢這個醫學中心的這個以台北市來講有時間例如像台大榮總三總馬街等等那桃園呢目前我們看他就是除了這個準部立醫院的這個部立醫院的準醫學中心那再外加一個 |
transcript.whisperx[635].start |
17007.387 |
transcript.whisperx[635].end |
17023.665 |
transcript.whisperx[635].text |
名稱叫林口長庚的但是位在龜山那我是不曉得說這個命名是很奇怪所以這個林口長庚他到底是要算在哪裡他的位置就是龜他的地址就是龜山鄉 |
transcript.whisperx[636].start |
17025.236 |
transcript.whisperx[636].end |
17028.279 |
transcript.whisperx[636].text |
那我再請教就是說那南桃園還有靠海線的部分有沒有教學醫院 |
transcript.whisperx[637].start |
17054.409 |
transcript.whisperx[637].end |
17055.61 |
transcript.whisperx[637].text |
藍濤教學醫院藍濤 |
transcript.whisperx[638].start |
17078.767 |
transcript.whisperx[638].end |
17101.868 |
transcript.whisperx[638].text |
當然沒有,因為以桃園來講就是只有林口長庚醫院是醫學公司嘛好,那現在齁,就是說你們剛剛講說打退堂鼓只是單純的合約不清嗎?還有其他原因嗎?我們中央沒有問題啦 |
transcript.whisperx[639].start |
17104.54 |
transcript.whisperx[639].end |
17128.297 |
transcript.whisperx[639].text |
不是等一下我是請教他們就是高益達退堂鼓只是說什麼到底是什麼原因因為你講說合約不清我想知道什麼原因啊比較具體的那個醫師師幫忙一下不是因為部長他不是很清楚你就直接回答就好了好不好醫師師這邊也因為沒有兩兆還沒有找到我們醫師師這邊來 |
transcript.whisperx[640].start |
17130.903 |
transcript.whisperx[640].end |
17149.282 |
transcript.whisperx[640].text |
你就這樣講就好啦,這樣我們才知道說這個問題我們接下來應該下個步驟是什麼?有時候外面傳出來的不一定是實際上的狀況,但是至少我們醫事室還沒有處理對,所以醫事室剛剛回答是外面傳出來的消息 |
transcript.whisperx[641].start |
17150.342 |
transcript.whisperx[641].end |
17151.423 |
transcript.whisperx[641].text |
其實這個合作原本是個好事啦 |
transcript.whisperx[642].start |
17168.125 |
transcript.whisperx[642].end |
17180.985 |
transcript.whisperx[642].text |
我們暫且不論說你們核定了多少不管是這個醫學中心到底這個點子問題我在這裡我先不討論但是就整個桃園來講他那個分布我這樣攤開來其實是 |
transcript.whisperx[643].start |
17183.488 |
transcript.whisperx[643].end |
17208.555 |
transcript.whisperx[643].text |
就是這個需求供需上是失衡的那我現在就是說這個桃園市政府我想那個張市長他剛剛說落下狠話然後提了他們提出兩個方案那第一個他有提到就是說要把這個清大來跟這個市府合作一起蓋市立醫院 |
transcript.whisperx[644].start |
17210.532 |
transcript.whisperx[644].end |
17228.1 |
transcript.whisperx[644].text |
但這個等級當然是醫學中心的一個市立醫院那我是想請教說第一個這樣子因為這個副市長有做這樣子的公開發表那他們這樣子的這個要求可不可行因為 |
transcript.whisperx[645].start |
17228.88 |
transcript.whisperx[645].end |
17239.787 |
transcript.whisperx[645].text |
整體的這個醫療人力他要從哪裡來他們有沒有能力是否有沒有能力處理這個事情醫學院醫師護理師好這個都是個問題不是嗎 |
transcript.whisperx[646].start |
17243.461 |
transcript.whisperx[646].end |
17265.334 |
transcript.whisperx[646].text |
當然是這樣,最重要是要評估,真的要去評估當地的醫療資源不是說,因為要看他是不是區域醫院,有區域醫院,有地區醫院那個部長是這樣子,就是說其實我有很多選民在,他們在大溪嘛,也很南邊的那常常就是說,當然這個區域、地區醫院 |
transcript.whisperx[647].start |
17267.615 |
transcript.whisperx[647].end |
17288.969 |
transcript.whisperx[647].text |
那為什麼又這個醫學中心那主要是那個就是說大醫院那個急重症難症就是可以這個在區醫院就可以完成全部都可以完成你看我們所有的部立醫院都是區醫院或者是地區醫院那你們都不用再繼續核定了當時就都可以監護起急重症如果說 |
transcript.whisperx[648].start |
17298.115 |
transcript.whisperx[648].end |
17323.74 |
transcript.whisperx[648].text |
部長我剛剛第一個問題就是說他們這樣子我們有很多的擔憂啦他市府有沒有能力去統籌整理這些看起來其實是有點天方夜譚然後第二個就是說清華大學第二個市府提的方案就是說要清華大學要另外找尋這個合作的對象 |
transcript.whisperx[649].start |
17324.56 |
transcript.whisperx[649].end |
17336.837 |
transcript.whisperx[649].text |
那清華大學他們在前天有表示就是說他們將將會就是說採取這個BOT的方式招標然後在桃園清普新建醫院的這件事情 |
transcript.whisperx[650].start |
17340.322 |
transcript.whisperx[650].end |
17354.952 |
transcript.whisperx[650].text |
就是我想是說那衛福部這裡既然本席在這裡提出來了那是不是可以請你們可以主動去多加關心看看有沒有什麼可以協助的地方 |
transcript.whisperx[651].start |
17355.728 |
transcript.whisperx[651].end |
17374.814 |
transcript.whisperx[651].text |
好,我們一定去關心,因為所有的地區的醫療資源,如果均衡,如果對民眾是適當的,如果協助來增加醫療資源,都是我們應該要去關心的。所以既然委員有提出這個問題,我們會請醫師師馬上去了解,那了解了以後的狀況再隨時跟委員報告。 |
transcript.whisperx[652].start |
17377.64 |
transcript.whisperx[652].end |
17399.712 |
transcript.whisperx[652].text |
對嘛那如果說按照部長的講法那根本也都完全不需要啊那到時候又會產生很多問題那這個到底需不需要這不是我質詢的重點啦只是因為需要不是你說那個區域醫院地區醫院全部都可以處理了嗎所以他們的訴求現在是醫學中心 |
transcript.whisperx[653].start |
17402.795 |
transcript.whisperx[653].end |
17405.217 |
transcript.whisperx[653].text |
因為你醫學中心在那裡那裡也要競爭你要競爭部桃以那個區域這次部桃就輸給臺大新竹訓練其實因為是還有他們還 |
transcript.whisperx[654].start |
17418.146 |
transcript.whisperx[654].end |
17435.467 |
transcript.whisperx[654].text |
這個整個園區它是還有這個醫學教育研發的功能所以部長你先瞭解它那個整個區的規劃之後你們再好好的去評估因為我想有需求大家才敢去推這個這麼大的一個計畫嘛是但我覺得是好事情 |
transcript.whisperx[655].start |
17437.629 |
transcript.whisperx[655].end |
17452.001 |
transcript.whisperx[655].text |
也要請你們同步關心一下那個人口的移動因為那個區域最近真的超級無敵大爆滿的瞭解瞭解瞭解我們一定要給他們最好的一個醫療照顧好謝謝謝謝陳委員謝謝部長繼續我們請黃國昌委員質詢 |
transcript.whisperx[656].start |
17471.496 |
transcript.whisperx[656].end |
17486.224 |
transcript.whisperx[656].text |
謝謝主席,麻煩有請部長委員好部長好我們整個護理同仁很辛苦勞動條件很差所以流失率很高我相信這個 |
transcript.whisperx[657].start |
17487.56 |
transcript.whisperx[657].end |
17515.158 |
transcript.whisperx[657].text |
已經是共識了啦也是客觀的事實我們都不用再正文我們就從這個基礎往上談我們現在已經實施了一些措施未來說要實施的一些措施我們怎麼樣有效的保障護人員他們的權益來我先請給部長看在今年1月的時候我們的衛福部有公告為了要留任護理人員所以有啟動夜班護理人員的獎勵 |
transcript.whisperx[658].start |
17517.121 |
transcript.whisperx[658].end |
17540.728 |
transcript.whisperx[658].text |
這個部長應該很熟啦然後呢公告的時候當初是這個是我們的衛福部護理及健康照護師對外公告的內容上面我特別框起來包括了專科護理師包括專科護理師但我最近接到很多專科護理師的陳情 |
transcript.whisperx[659].start |
17543.244 |
transcript.whisperx[659].end |
17566.158 |
transcript.whisperx[659].text |
說當初公告他們明明在裡面當初公告他們明明在裡面結果拖到什麼時候拖到今年8月才開始納入啊獎勵方案那專科護理師他們心裡啊都不平我相信部長應該可以感同身受啦當初公告有我們啊一直拖拖到8月才給錢大家的心裡是說啊我是比較小害羞 |
transcript.whisperx[660].start |
17567.552 |
transcript.whisperx[660].end |
17583.929 |
transcript.whisperx[660].text |
我前幾個月做的是白做嗎一般的護理師可以拿到我專科護理師拿不到重點是衛福部一開始公告的專案就包括專科護理師啊為什麼到8月才發之前該給人家沒有給的部長應不應該補回去 |
transcript.whisperx[661].start |
17586.121 |
transcript.whisperx[661].end |
17605.271 |
transcript.whisperx[661].text |
報告委員我們這個來瞭解如果當時是有有啦有啦部長我跟你講我執行絕對不會做偽造變造的圖卡瞭解瞭解請你放心我不是側翼網軍我絕對不會做偽造變造的圖卡那就是你們衛福部公告的內容甚至來我再給部長看一下是 |
transcript.whisperx[662].start |
17605.791 |
transcript.whisperx[662].end |
17619.026 |
transcript.whisperx[662].text |
公文113年度全民健康保險強化住院護理照護量能方案這個是衛福部發的公文嘛全民健保會啦來你看一下實施日期113年1月1號到113年12月31號嘛 |
transcript.whisperx[663].start |
17622.677 |
transcript.whisperx[663].end |
17649.465 |
transcript.whisperx[663].text |
左手邊的公文衛福部的函專科護理師也放在裡面不過就是他有講一個輪值夜班的啦是啦當然是一樣的條件嘛阿現在人就是沒拿到錢嘛所以人夜班的專科醫師沒有拿到錢沒有啊那這個當然就你要補嘛今天承諾囉不要跟我講我回去研究了一下說沒有錢發不出來 |
transcript.whisperx[664].start |
17656.806 |
transcript.whisperx[664].end |
17659.087 |
transcript.whisperx[664].text |
我今天只要一個承諾該給人家的給人家有沒有問題 |
transcript.whisperx[665].start |
17680.333 |
transcript.whisperx[665].end |
17704.187 |
transcript.whisperx[665].text |
當然該給人家 這個當然要這樣做我接下來就看 部長你回去了解完了以後這件事情要怎麼處理可不可以一個禮拜之內 給我書面回覆我覺得公平性是很重要的對啦 因為這些專科護理師加起來有一萬多個人嘛大家心裡都不平啦 想說我們是比較小人還是我晚上都沒有在做 我做了別人就領 我沒有 現在是什麼狀況 |
transcript.whisperx[666].start |
17705.97 |
transcript.whisperx[666].end |
17719.715 |
transcript.whisperx[666].text |
部長我這樣講你聽得懂啦齁完全聽得懂好第二個齁就是說現在齁護理界在反映的齁就是說三班護病比阿專科護理師的護病比要不要有一些規劃 |
transcript.whisperx[667].start |
17725.911 |
transcript.whisperx[667].end |
17740.192 |
transcript.whisperx[667].text |
因為我們先回到最基本的觀念啦所謂護病比就是說我們要照顧護理師跟病患兩者之間的權益嘛所以會有護病比這個概念嘛那這個概念在專科護理師不適用嗎 |
transcript.whisperx[668].start |
17741.537 |
transcript.whisperx[668].end |
17761.345 |
transcript.whisperx[668].text |
專科護理師應該是比一般的護理師更細膩你說的都沒有錯就六個大科嘛六大科的專科護理師要不要有關話當時在補這個夜班所以他如果上夜班他的上夜班的方式 |
transcript.whisperx[669].start |
17762.645 |
transcript.whisperx[669].end |
17784.862 |
transcript.whisperx[669].text |
部長對不起齁,你要跟上問題。夜班今天齁,我們已經game over了。現在再講到第二個問題。第二個問題是專科護理師的護病比要不要有所規範?專科護理師他的工作性質齁,跟第一線的護理師其實是不太一樣。所以他到底要不要算護理的人力? |
transcript.whisperx[670].start |
17786.308 |
transcript.whisperx[670].end |
17810.479 |
transcript.whisperx[670].text |
所以我才回去跟部長講最根本的問題就是說一個人一般的護理師有他的工作職長這個我了解專科護理師有他的工作職長這個我也了解我們從保護醫護他們的權益保護病人權益角度的觀點你從專科護理師工作的性質 |
transcript.whisperx[671].start |
17811.76 |
transcript.whisperx[671].end |
17820.378 |
transcript.whisperx[671].text |
護病比要不要有一定的規範這個是他們的問題還是說因為他們是專科護理師這件事情就不要規範完全不需要有管制 |
transcript.whisperx[672].start |
17821.716 |
transcript.whisperx[672].end |
17844.567 |
transcript.whisperx[672].text |
現在這個是他們跟我陳情的問題啦他們沒有機會直接請教部長所以我來這邊請教你放心專科護理師協會是我跟我有幫忙有幫忙有到啦那個都是阿成立的時候你有去嗎?有去沒去我是不會去的啦那是久的事但是他在成立這邊你如果有去你要去的啦專科護理師 |
transcript.whisperx[673].start |
17845.956 |
transcript.whisperx[673].end |
17846.616 |
transcript.whisperx[673].text |
沒辦法算嘛 |
transcript.whisperx[674].start |
17873.935 |
transcript.whisperx[674].end |
17882.179 |
transcript.whisperx[674].text |
我只要一個答案第一個要不要如果不要理由是什麼啊第三個怎麼保障他們的權益一樣因為我時間的關係我也不要 |
transcript.whisperx[675].start |
17898.644 |
transcript.whisperx[675].end |
17921.545 |
transcript.whisperx[675].text |
讓主席不好意思這麼多議事人員聽我在上面跟你要逼一個答案出來這麼的痛苦這麼的花時間沒有關係我們一個禮拜之內你用書面回覆我那我們下一次喔你回去準備好喔下一次我再來的時候我的問題就會更直接喔希望那時候部長對問題的掌握會更清楚OK好謝謝 |
transcript.whisperx[676].start |
17924.948 |
transcript.whisperx[676].end |
17951.346 |
transcript.whisperx[676].text |
好,謝謝,謝謝委員。謝謝黃國昌委員、謝謝部長。張家俊委員、張家俊委員、張家俊委員不在。何欣淳委員、何欣淳委員、何欣淳委員不在。高金素梅委員、高金素梅、高金素梅委員不在。葉元之、葉元之委員、葉元之委員不在。 |
transcript.whisperx[677].start |
17953.078 |
transcript.whisperx[677].end |
17971.733 |
transcript.whisperx[677].text |
黃孟楷委員不在本日會議詢答全部結束委員盧憲一所提書面質詢列入紀錄刊登公報現在做以下決定 |
transcript.whisperx[678].start |
17973.041 |
transcript.whisperx[678].end |
17990.473 |
transcript.whisperx[678].text |
報告舉行答完畢委員執行為其答覆或請補充資料者請相關機關於兩週內以書面答覆委員另要求期限者從其鎖定本次會議到此結束現在上會 |
transcript.whisperx[679].start |
18024.904 |
transcript.whisperx[679].end |
18025.384 |
transcript.whisperx[679].text |
委員會主席 |
transcript.whisperx[680].start |
18043.221 |
transcript.whisperx[680].end |
18043.621 |
transcript.whisperx[680].text |
委員會主席 |
IVOD_ID |
16224 |
IVOD_URL |
https://ivod.ly.gov.tw/Play/Full/1M/16224 |
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 |
Full |
開始時間 |
2024-11-04T08:30:49+08:00 |
結束時間 |
2024-11-04T13:30:00+08:00 |
支援功能[0] |
ai-transcript |