| IVOD_ID |
16510 |
| IVOD_URL |
https://ivod.ly.gov.tw/Play/Full/1M/16510 |
| 日期 |
2025-03-13 |
| 會議資料.會議代碼 |
委員會-11-3-26-2 |
| 會議資料.會議代碼:str |
第11屆第3會期社會福利及衛生環境委員會第2次全體委員會議 |
| 會議資料.屆 |
11 |
| 會議資料.會期 |
3 |
| 會議資料.會次 |
2 |
| 會議資料.種類 |
委員會 |
| 會議資料.委員會代碼[0] |
26 |
| 會議資料.委員會代碼:str[0] |
社會福利及衛生環境委員會 |
| 會議資料.標題 |
第11屆第3會期社會福利及衛生環境委員會第2次全體委員會議 |
| 影片種類 |
Full |
| 開始時間 |
2025-03-13T08:31:07+08:00 |
| 結束時間 |
2025-03-13T14:19:00+08:00 |
| 影片長度 |
05:47:53 |
| 支援功能[0] |
ai-transcript |
| video_url |
https://h264media01.ly.gov.tw:443/vod_1/_definst_/mp4:1M/bfaf9b39ac01a6856d254b92567b84cebdae56b7a60aa52c7a524d1b3d409a1a460d120dae727c155ea18f28b6918d91.mp4/playlist.m3u8 |
| 會議時間 |
2025-03-13T09:00:00+08:00 |
| 會議名稱 |
立法院第11屆第3會期社會福利及衛生環境委員會第2次全體委員會議（事由：邀請衛生福利部部長就「有關全國急重症醫療量能」進行專題報告，並備質詢。
【如遇加開院會本次會議取消，不再另行通知】） |
| 委員名稱 |
完整會議 |
| 委員發言時間 |
08:31:07 - 14:19:00 |
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696.798 |
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712.088 |
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謝謝大家 |
| transcript.whisperx[1].start |
724.89 |
| transcript.whisperx[1].end |
744.186 |
| transcript.whisperx[1].text |
哎 你等我一会儿 |
| transcript.whisperx[2].start |
762.961 |
| transcript.whisperx[2].end |
765.886 |
| transcript.whisperx[2].text |
哎呦 真是來不及了 |
| transcript.whisperx[3].start |
1786.906 |
| transcript.whisperx[3].end |
1792.251 |
| transcript.whisperx[3].text |
報告委員會 出席委員11人 已組法定人數 請主席宣布開會現在開會請議事人員宣讀上次會議議事錄 |
| transcript.whisperx[4].start |
1804.793 |
| transcript.whisperx[4].end |
1829.821 |
| transcript.whisperx[4].text |
立法院第十一屆第三會期社會福利及衛生環境委員會第一次全體委員會議議事錄時間一百一十四年三月五日星期三九十至九十三分地點群閒樓八零一會議室出席委員邱委員鄭鈞等十五人主席劉委員建國報告事項一本院第十一屆第三會期各委員會召集委員選舉時間及地點業經提報本院第十一屆第三會期第二次會議決定照案通過再案 |
| transcript.whisperx[5].start |
1830.481 |
| transcript.whisperx[5].end |
1858.429 |
| transcript.whisperx[5].text |
二一立法院各委員會組織法第三條之四規定本會應至召集委員二人三宣讀本會期本會召集委員選舉人名冊選舉事項選舉第十一屆第三會期本會召集委員主席宣告推選蘇委員清泉及劉委員建國委本會召集委員一立法院各委員會召集委員選舉辦法第五條之規定本次召集委員之選舉以推選行之召集委員當選人依同 |
| transcript.whisperx[6].start |
1858.929 |
| transcript.whisperx[6].end |
1863.371 |
| transcript.whisperx[6].text |
同法第八條之規定由國民黨黨團民進黨黨團及台灣民眾黨黨團書面同意推選定之宣讀完畢請問委員會上次議事錄有錯誤或遺漏之處 |
| transcript.whisperx[7].start |
1876.124 |
| transcript.whisperx[7].end |
1902.172 |
| transcript.whisperx[7].text |
沒有那我們議事錄確定本日的會議議程為邀請衛生福利部部長就有關全國集中症醫療量能進行專案報告並備諮詢好我們現在介紹在場的委員陳昭志委員林業勤委員王振旭委員 |
| transcript.whisperx[8].start |
1906.846 |
| transcript.whisperx[8].end |
1932.173 |
| transcript.whisperx[8].text |
好 那我們介紹我們今天出席的行政官員部長邱太元醫事司司長劉業平護理及健康照護司司長劉淑鳳蔡淑鳳 謝謝 謝謝護署醫療及社會福利機構管理委員會執行長林慶豐 |
| transcript.whisperx[9].start |
1936.448 |
| transcript.whisperx[9].end |
1948.971 |
| transcript.whisperx[9].text |
中央健康保險署署長石崇良郭建署署長各有食藥署的署長姜治康署長 |
| transcript.whisperx[10].start |
1966.934 |
| transcript.whisperx[10].end |
1987.331 |
| transcript.whisperx[10].text |
石耀石市長江志剛還有我們國民健康署署長吳昭君好好 接著我們請邱部長報告 6分鐘 |
| transcript.whisperx[11].start |
1997.333 |
| transcript.whisperx[11].end |
2019.193 |
| transcript.whisperx[11].text |
主席、各位委員、女士先生今天大院第11屆第三會期社會福利及衛生環境委員會召開前提委員會議本部呈邀列席報告深感榮幸此就有關全國集中症醫療量能提出專題報告敬請各位委員不吝會議指教為應應大量緊急傷患傷病患的醫療處理 |
| transcript.whisperx[12].start |
2021.114 |
| transcript.whisperx[12].end |
2035.683 |
| transcript.whisperx[12].text |
送醫途中及現場的緊急救護以及傷病患的轉診問題民國84年制定了緊急醫療救護法並建構全國緊急醫療體系以確保緊急傷病患的生命及健康 |
| transcript.whisperx[13].start |
2036.789 |
| transcript.whisperx[13].end |
2056.922 |
| transcript.whisperx[13].text |
一 緊急醫療應變體系 全國緊急醫療應變量能醫院可提供的醫療緊急總列人力設施作為量能等區分為重度級、中度級及一般級急救責任醫院截至114年共有203家急救責任醫院51家重度級、75家中度級 |
| transcript.whisperx[14].start |
2058.383 |
| transcript.whisperx[14].end |
2074.972 |
| transcript.whisperx[14].text |
及77家一班級急救責任醫院提供前天後緊急傷病患醫療照護為了使急重症病人頭上轉診全國監視14個急診轉診網絡以區域聯防概念提供急診病人即時、順暢、有效的轉診作業二、緊急醫療應變監測及應變行為為確保緊急醫療收治量能每日持續監測急重症醫療量能包括 |
| transcript.whisperx[15].start |
2088.064 |
| transcript.whisperx[15].end |
2111.646 |
| transcript.whisperx[15].text |
醫院急診就診人次等待住院人數、加護病患數等如臨近警戒指及通知醫院啟動院內調床及轉診合作機制相關急診及時資訊信息公布於衛生部、衛護部網站 |
| transcript.whisperx[16].start |
2114.119 |
| transcript.whisperx[16].end |
2130.129 |
| transcript.whisperx[16].text |
健保快易通APP醫院網站及醫院明顯處供民眾查詢了解應用春節假期本部疾病管制署每年訂定因應農曆春節呼吸到傳染病疫情應變 |
| transcript.whisperx[17].start |
2131.69 |
| transcript.whisperx[17].end |
2141.175 |
| transcript.whisperx[17].text |
準備計畫以確保農曆春節期間醫療服務量能以民眾就醫前意以農曆春節期間鼓勵基層醫療機構開設假日門診如亦即使量能增 |
| transcript.whisperx[18].start |
2146.403 |
| transcript.whisperx[18].end |
2162.82 |
| transcript.whisperx[18].text |
急診量增加立即啟動院內調床機制提高急診遷床比例特殊病房彈性調整為一般病床來收治我們加強區域醫院聯訪機制落實醫療分級機制減緩 |
| transcript.whisperx[19].start |
2166.343 |
| transcript.whisperx[19].end |
2185.383 |
| transcript.whisperx[19].text |
急診用色情形進入醫院用色造成醫護人員工作負擔過重本部已召開五場會議收集各專業團體意見積極制定短期三大強化應用策略以及持續中長程的兩個大改革方向 |
| transcript.whisperx[20].start |
2186.71 |
| transcript.whisperx[20].end |
2205.292 |
| transcript.whisperx[20].text |
三大短期應用策略為一 醫學中心強化院內病床調度二 加強區域醫院聯訪機制三 強化民眾分歧就醫資訊兩大改革方向為我們持續強化護理人力整備及鼓勵醫院投入集中症 |
| transcript.whisperx[21].start |
2206.417 |
| transcript.whisperx[21].end |
2231.844 |
| transcript.whisperx[21].text |
另外研議健保調整幾戶三 中長期規劃 針對中長期照護人力問題行政院於113年以核定護理人力十二項策略計畫114年以編列公務預算約六十六點八五億衛護部於113年透過十二次公開會議與巡迴論壇收集護理人員意見且以達初步最大共識 |
| transcript.whisperx[22].start |
2233.811 |
| transcript.whisperx[22].end |
2245.647 |
| transcript.whisperx[22].text |
是預算程序完成後即啟動執行與留任醫院護理人員令急診護理人員之月班獎勵將與急性一般病床護理人員 |
| transcript.whisperx[23].start |
2247.068 |
| transcript.whisperx[23].end |
2267.105 |
| transcript.whisperx[23].text |
直接獎勵相同二 屬外健保屬意邀集相關學會及基準專家共同研商調整健保知乎己乎為提升病房效力擴大推動在宅急症照顧ACAH研議新增門診靜脈抗生素的治療 |
| transcript.whisperx[24].start |
2268.43 |
| transcript.whisperx[24].end |
2291.222 |
| transcript.whisperx[24].text |
OPAT以及提早出院在家治療ESD等計畫以減少住院需求及提升病房周轉率並落實分級醫療為應用高齡化帶來的醫療需求增加的挑戰本部將多館旗下協助解決病床調度落實分級轉整分流強化區域聯防車類 |
| transcript.whisperx[25].start |
2293.043 |
| transcript.whisperx[25].end |
2320.478 |
| transcript.whisperx[25].text |
並調整健保支付標準落實分級醫療制度確保集中症醫療量能供給以解決醫院擁捨問題本部曾答應各委員支持教育監督在此靜置謝陳並期各位委員繼續予以支持 以上報告好 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 |
| transcript.whisperx[26].start |
2324.085 |
| transcript.whisperx[26].end |
2352.034 |
| transcript.whisperx[26].text |
現在我們開始巡打做以下宣告本委員會委員8分鐘列席委員4分鐘10點半截止發言登記委員如有書面執行請於上會前提出欲取不受理暫定10點30分休息9點半休息10分鐘原則上11點半處理臨時提案現在我們請第一位登記委員陳昭之委員發言 |
| transcript.whisperx[27].start |
2360.219 |
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2361.9 |
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謝謝主席有請邱部長委員長部長早安部長衛福部公布的這個雙倍醫學中心的護理師薪資統計被護理人員有引起很大的質疑他們說是跟現況是不符合那這個數據怎麼來的請教部長這個薪資你是怎麼來的得到的數字 |
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2387.703 |
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2417.083 |
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是的我們這個從民國112年11月我們衛護部請那個各縣市衛生局邀請各轄內的各醫院醫療醫院醫院能夠上網去填寫他的薪資是就是說是醫院通報的醫院自己報出來醫院通報的而且當時的目的真的只是希望讓護理人員能夠知道各醫院的一個薪資的狀況求職比較方便請問你有制定格式標準或是說有勾擊制度嗎 |
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2419.143 |
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2442.667 |
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我們的確是有一定有就是你讓他通報但是可能沒有做這樣的事情所以現在這個引起護理界的大反彈這個跟之前我向貴部這個要求那個看護病筆資料是結果就一樣就是由官方提供的護病筆資料因為當時他好像醫學中心就區醫院跟地區醫院是三塊然後三塊都是平均值那大概就這樣一個月數就時間的當這個另外一個座標 |
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2446.168 |
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2468.111 |
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當時那個整個這個又毀滅華然說他們官方資料跟他們感受是不一樣那回到這個薪資因為已經有工作十幾年護理師告訴我說他都頂多落在一到五年這個區塊那部長所以就是說這個是長期通報但是並沒有一個標準的方式或是勾結的制度那其實薪資高低是一件事我覺得會 |
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2468.632 |
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2492.718 |
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你公佈之後引起反彈那是另外一件事如果衛福部真的關心護理人員的這個待遇問題我覺得要用很小心不要用誤導的數字去處理而且要拿出具體的改善方案部長你還記得我們在第一個會期我們談健保法第62條我的第一個附帶決議就是說醫院有盈餘醫院有盈餘就是要用來改善尤其是護理師 |
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2494.058 |
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2503.827 |
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這個工作環境跟這個薪資待遇這個是首先要做的那部長這一次就是社群平台看到你的數字他整個跳起來他說這個數字經不起反驗為什麼呢因為看起來不錯嘛所以這個媒體有一些他就會讓他們 |
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2511.314 |
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2540.576 |
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看成是寫成說是這個質疑說這個好像作用高薪那這樣子這個讓他們會覺得受到一些委屈因為部長我要談的是一個平均薪資是非常危險的因為你一旦公佈的話會有很多後遺症為什麼因為台灣專科護理師產業工會指出這個因為衛福部公佈薪資的數據是平均月薪但是沒有區分說什麼叫基本的薪水那還有其他的這個津貼那這個津貼包括夜班 |
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2541.337 |
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2563.145 |
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加班危險津貼還有額外的工作補助所以他們就說你們提供的資料剛好包含大量的加班費加班費跟津貼的數據其實正是代表了他們其實工作是超時的結果才能得到這樣的薪資就是也正坐實的說護理師是過勞的而且還有一點 |
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2564.125 |
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2586.42 |
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部長你們把這個專科護理師跟一般護理師都混在一起了其實專科護理師是有他的一個專業價值跟他不同的承擔所以以後處理這些數字是要非常小心因為護理界他們最在意的說因為媒體把它報導出心智這麼優渥你們還在爭執或是重點是什麼呢這個會讓人家已經很寶貝的我們很珍惜的護理人員用這種獨到這個說法 |
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2594.185 |
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2610.36 |
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他們會生氣他們會很不滿所以是不是這樣部長我就跟您討論一下我們要公佈這個護理人員薪資結構的時候是不是應該合理一下就基本薪資還有他 overtime他工作其他的種種因素這樣子加起來這樣就不會覺得是去掩蓋 |
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2611.761 |
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2622.264 |
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就實施他們是超時工作的事實我再跟您舉個例子以前國發會發布那個國人的平均薪資都是從平均數你看那幾百萬勞工勞工大概將近千萬當時那幾百萬勞工他們看了很不開心他們覺得我怎麼距離那麼遙遠後來我有一位好朋友擔任國發會主委就陳美玲主委我就建議他說以後你不要公佈平均數你要公佈中位數 |
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2636.307 |
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2659.569 |
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因為總是有一些超級收入的人把真的帶動影響了結果你知道嗎相差一萬元那你要知道對賺三四萬跟賺四五萬差一萬塊是差很大所以你要處理數字真的是要非常的小心所以你這次公佈是醫學中心然後你又把相對讓它呈現是高的數字其實還有一個後遺症部長 |
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2660.53 |
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2687.276 |
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這樣很多護理師要去大醫院你這個公佈結果有後遺症也有不實的地方包委員第一個我們上網的有400多家所以表示說各個醫院幾乎都有第二個公佈了以後有些醫院發現我的薪資是比別人低所以紛紛提升所以其實是有正面的效果但是我絕對 |
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2688.949 |
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2709.319 |
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我必須 我跟委員一樣我們都是長期在醫療第一線服務的我覺得我們完全了解到醫療團隊的辛苦特別是在護理人員所以他們的薪水如果待遇能夠一直提高是我們受的部長您接觸的都管理面嗎沒有啦 我也從陰診開始當期的陰診現在當時的護理人員都是幾十年的朋友 |
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2716.363 |
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2720.664 |
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因為時間有限我拜託台灣的醫院協會理事長拜託你去查一下他們這樣是不是真實的至少我問過大概七八家但是真的這個數據出來 |
| transcript.whisperx[42].start |
2736.588 |
| transcript.whisperx[42].end |
2739.913 |
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那讓大家說 我就沒那麼多人了我真的不好意思我們回到今天的急診的問題所以我想我們一定全力來再繼續改善物理的待遇 |
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2752.691 |
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2757.536 |
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因為急診問題跟你口中你講出來過說改善中或趨緩中其實差很大那我就以臨近的臺大醫院我們兩個都服務過的醫院為例其實不時都有人就給我他們其實長期的那個急診病床流管床是整個湧到正門大廳那正門大廳有個舞臺 |
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2771.63 |
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甚至會辦音樂會跟活動它可以同時辦這個數字我有請教過台大他們來跟我說一個副院長跟一個急診部副主任他們就跟我說這個就是我問他們護理師夠不夠他跟我說護理師是足夠的不過這個跟鋼灰跟我反應的不太一樣後來我又請教吳院長 |
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2790.299 |
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2804.186 |
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無願而復無可奈何就是說這個就是常態啦病人就是要往我們這邊來因為神醫院嘛台灣人心腹中心醫院其實市長您上來我其實有把照片傳給你啊我知道你也沒有辦法暫時沒有辦法無力回天啦因為市長說這個就是一個常態啦那部長我在質詢的時候跟你說你跟我說拜他比較嚴重拜你會比較好 |
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2811.77 |
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2837.74 |
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就是說大家都說我大驚小怪小題大作結果不到一年就爆炸了急診的問題就爆炸了所以很多人認為說急診的這個看診收費要可以有機會改善這個崩壞的醫療分級那我覺得再進一步區分今天好像報告是還沒辦法處理我知道處理錢的費用不會這麼快就可以處理我已經轉轉就到大醫院接著輕症病人提高收費因為韓國等等其他國家有這個做法 |
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2838.22 |
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2852.939 |
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就反而你當時視察過後你寫的那個就醫執印那個沒法律效力啊那只是參考看看聽聽看啦好嗎那個跟委員報告我不是去視察這間醫院每一個都是好朋友所以沒有什麼好視察我是去跟他們 |
| transcript.whisperx[48].start |
2853.66 |
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2856.984 |
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第43條我想石組長很清楚不經轉轉到地區醫院去醫院醫學中心就醫應該有30、40、50%的分攤這個部分請你就是我今天實業有限本來就一條法律在這裡你想辦法都不好才會一直惡化 |
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2873.104 |
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2882.386 |
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那另外就是你鼓勵大家轉型用指引但只有一成人會接受我今天回家請你做個功課因為原來只有一成人他會接受這個醫護的建議就轉到相對輕症到比較小的醫院去看但是只有一成根據報就一成人會接受那請你告訴我今天你們想了一些辦法有指引然後有些鼓勵 |
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2892.509 |
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2901.372 |
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那到底會進步多少就麻煩你這個幫我好沒問題 報告委員這個齁就麻煩我都等這個報告齁聰明就醫其實是國際的趨勢所以我們做無聯乃也一直在努力 |
| transcript.whisperx[51].start |
2908.834 |
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2928.424 |
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江署長謝謝你今天你專程來謝謝你因為對於食藥署對藥品特別是口服定劑跟膠囊保存的方法跟期限怎麼說署長您知道嗎就是你們貴署是怎麼來說的請你看我這張投影片他就寫了一個說開封或調劑日算半年內要服用完畢 |
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2929.665 |
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2956.869 |
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署長這個說法太簡化了應該要有更科學性的做法因為美國醫院要是有各種指引那我今天為什麼這樣講呢其實藥品那個效期也是你核定啊也是食藥署核定的啊藥品在他原包裝裡面只要按照他規定的儲存的條件比如溫度啊等等那他這個效期就是就是按照那個標示的效期啊那為什麼現在每一家醫院呢他買藥的時候購買藥的時候都要求提供 |
| transcript.whisperx[53].start |
2958.03 |
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2977.104 |
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像衛福部醫院八個月以上的這個有效期間然後剩下兩個月的時候叫人家買回去買回去再換新的回來你又要賺取要價差又要占人家便宜但是這個源頭魚他們就拿這個資料來當作藉口署長怎麼辦這怎麼辦那藥廠是怎麼樣他要製造什麼樣藥品給大家用呢 |
| transcript.whisperx[54].start |
2982.657 |
| transcript.whisperx[54].end |
3001.578 |
| transcript.whisperx[54].text |
謝謝委員的提問那我看到網站這部分裡面藥物食品安全週報我們特別稍微去了解一下那個利潤的基礎大概是這樣子那是應該是大包裝的不是那種一排一排已經標示安全期限那個很標準大包裝也是效期啊 還是有效的效期 |
| transcript.whisperx[55].start |
3003.86 |
| transcript.whisperx[55].end |
3010.524 |
| transcript.whisperx[55].text |
無菌固體製劑開封因為已經打開來了打開來就破壞原來的一個狀況市長我要先給你修正一下如果打開以後會縮短的話都會寫這個要求都要寫就像我們知道眼藥一個月就不能用以前Nitroglycerin那個消息一年內不能用沒有規範的時候按照這個標準不然你核准的那個消息是假的參考用嗎這個被醫院拿來利用等一下我要請這個 |
| transcript.whisperx[56].start |
3030.894 |
| transcript.whisperx[56].end |
3033.097 |
| transcript.whisperx[56].text |
我們參考的是打開來是USP795調製後的BUD為六個月的體驗所以這個已經是定季的我們打開覺得可能已經跟原來的有一點點 |
| transcript.whisperx[57].start |
3051.218 |
| transcript.whisperx[57].end |
3064.868 |
| transcript.whisperx[57].text |
所以這個是這樣的想法第二部分是有些異變值的確像阿布敏我們大概4個小時啊這個部分麻煩我們用科學性然後處理我現在可以造成後遺症但是我請執行長上來執行長你們這個衛福部的聯標醫院這個麻煩你先留著就了解你們衛福聯標醫院那個也是這樣規範說要8個月以上的留有8個月以上的效期 |
| transcript.whisperx[58].start |
3073.735 |
| transcript.whisperx[58].end |
3090.046 |
| transcript.whisperx[58].text |
那你這個第一個就是說我請教他們他第一個問題跟我說因為別的醫院也這樣做你們副執行長來我嚇一跳衛福部醫院竟然說別的醫院也這樣做別的醫院就是對的別的醫院這樣做你就要跟著這樣子做嗎然後他給我第二個理由說這個什麼連陽愚公 |
| transcript.whisperx[59].start |
3093.228 |
| transcript.whisperx[59].end |
3113.038 |
| transcript.whisperx[59].text |
他要到這個遠洋去要領6個月所以我們校期要留很久遠洋移工根本就是政府欺負遠洋移工因為事實上他在那個環境那個環境又高濕又高熱然後那個環境根本他那個校期你就把丟給他去管理他根本還要更短才對你還跟他算到這個時候所以如果一個醫院3月買藥那5月有個遠洋移工來那你照你的規矩8個月你就不用了 |
| transcript.whisperx[60].start |
3116.96 |
| transcript.whisperx[60].end |
3122.973 |
| transcript.whisperx[60].text |
那你還要不要把藥給這個遠洋漁工所以你就以偏概全你這個醫院的管理完全轉嫁到 |
| transcript.whisperx[61].start |
3124.019 |
| transcript.whisperx[61].end |
3128.441 |
| transcript.whisperx[61].text |
藥廠身上 你要賣的時候要賣一個效期這麼長的等到差兩個月你就叫他買回去然後又說什麼偏鄉藥師人力不足盤點困難所以效期是八個月你把管理的責任這個結構性問題偏鄉也缺醫師啊你就不只是缺藥師那你整個都丟給那個藥廠去承擔還要吃藥 藥價差要再叫人家說效期還很久很久的藥然後等到效期靠近都還可以用你就叫人家買回去買回去換過來 |
| transcript.whisperx[62].start |
3152.271 |
| transcript.whisperx[62].end |
3179.564 |
| transcript.whisperx[62].text |
那吃人狗狗欺負人太累了執行長我跟他們溝通他們不接受欸那署長你要講公道話藥食品的安定區是你在管的啊那第一個就是說跟委員說明實在有三項第一個就是說我們的藥品聯標是一個委員會是由各個醫院代表還有一些外部專家那特別是這個藥品聯標是所有的我們的偏鄉離島包含都會區的醫院再加上有一些衛生局衛生所所以裡面他有需求的管理問題你是一般全部都是這樣 |
| transcript.whisperx[63].start |
3179.804 |
| transcript.whisperx[63].end |
3193.67 |
| transcript.whisperx[63].text |
那第二個就是說 剛剛提到其實在我們過去 您提到的8個月其實我們是不是有超過6個月其實在這個部分裡面只佔非常小的比例不到1%啦所以在這個部分裡面那你今天可不可以承諾6個月 |
| transcript.whisperx[64].start |
3195.412 |
| transcript.whisperx[64].end |
3210.051 |
| transcript.whisperx[64].text |
兩千又六個月你這樣太為難人家了八個月一年的都有啊你太為難人家了而且你也知道吧兩個月靠近兩個月你管理不善放了那麼久兩個月內你就叫人家換回去叫人家買回去有這種情形的只佔百分之一這兩邊佔比較便宜啊 |
| transcript.whisperx[65].start |
3210.692 |
| transcript.whisperx[65].end |
3223.404 |
| transcript.whisperx[65].text |
跟委員報告就只佔百分之一 不是很高的比例那可不可以回到六個月 執行長你一句話 因為我已經跟他們溝通過了他們沒有人敢做決定這個是經過我們那個聯標但是我就是跟你討論專業啊 我跟你討論專業跟管理啊醫院有關的 你不要把管理全部丟給他們啊你把它丟給別人嘛 反正我在證明嘛 |
| transcript.whisperx[66].start |
3231.992 |
| transcript.whisperx[66].end |
3236.194 |
| transcript.whisperx[66].text |
你可以處理這個問題嗎 執行長你一句話我們再帶給聯標委員裡面 因為裡面還有一些外部的委員我已經跟他們溝通過了剩你一句話 執行長你一句話科學性是要那個就是說你要有一個科學性 會不會你那個藥品標識是假的嗎假的嗎我們會去評估剛剛您提到的這一塊 但是因為在要聯標的委員會裡面 他們也要拿去討論 |
| transcript.whisperx[67].start |
3260.044 |
| transcript.whisperx[67].end |
3275.516 |
| transcript.whisperx[67].text |
我想委員是專家啦,你一定希望它運轉得很順利那藥廠的一個管理跟醫院也有管理,藥局的管理,這兩個怎麼樣取得一個平衡那得到一個應該的對人民最保障的部分我會請執行長待會兒去檢討好不好 |
| transcript.whisperx[68].start |
3281.601 |
| transcript.whisperx[68].end |
3304.085 |
| transcript.whisperx[68].text |
好那江署長你這個科學性的部分要很清楚喔校期是你們標示你們同意的東西喔那你形同虛設 各位委員只要校期內的其實在使用上都沒有問題的那這個調製麻煩你除了這個reconstitution還是什麼調製跟調劑是不一樣喔你經過泡水都不一樣喔所以要科學性的不要一致性的好嗎那執行長可以嗎部長也從你要檢討為什麼一定要做這樣那你要帶頭做你要帶頭做嗎好謝謝 |
| transcript.whisperx[69].start |
3311.266 |
| transcript.whisperx[69].end |
3323.729 |
| transcript.whisperx[69].text |
我們部立醫院永遠有帶頭的作用一定要 不要因為說別的醫院這樣做所以你就跟著這樣做他們給我第一個理由是這個好嗎 要帶頭非常謝謝委員好 謝謝謝謝陳委員 謝謝部長那繼續我們請林業勤委員質詢麻煩邱部長 |
| transcript.whisperx[70].start |
3340.964 |
| transcript.whisperx[70].end |
3341.104 |
| transcript.whisperx[70].text |
邱部長請 |
| transcript.whisperx[71].start |
3350.914 |
| transcript.whisperx[71].end |
3375.789 |
| transcript.whisperx[71].text |
今年2月22號我們臺灣急診醫學會就發出我們的政策聲明表示我們的急診用篩已達到前所未有的嚴重程度如果這問題持續的話大概會引發到我們的醫護人員大規模的離職甚至會進一步削弱我們醫療體系的承受能力所以急診室用篩有原因事實上是 |
| transcript.whisperx[72].start |
3377.591 |
| transcript.whisperx[72].end |
3397.563 |
| transcript.whisperx[72].text |
醫療擁塞跟我們的病床擁塞不過這次事件大概是春節期間大概七天很多門診事實上是休診所以導致了我們的延伸到的醫療擁塞可是隨著假期結束之後照理來講應該是緩解可是到2月22號還不能紓解的應該事實上是病床擁塞 |
| transcript.whisperx[73].start |
3400.345 |
| transcript.whisperx[73].end |
3429.807 |
| transcript.whisperx[73].text |
一直以來我們看到是過去本來就是這個就存在的一種現象也就是醫護人員招不滿的話就導致病床開不出來所以民眾平日的預約住院就要排隊個三五天那這一次的我們的普通病床跟ICU一路回堵到急診室問題才會這麼嚴重所以想問部長事件持續這麼長的時間那外界對衛福部處理的動作覺得太緩慢 |
| transcript.whisperx[74].start |
3430.598 |
| transcript.whisperx[74].end |
3431.501 |
| transcript.whisperx[74].text |
你作何解釋其實 |
| transcript.whisperx[75].start |
3435.895 |
| transcript.whisperx[75].end |
3464.855 |
| transcript.whisperx[75].text |
我們都有預防性的處理,譬如說在春節前其實不只公部門,我們也都有醫師公會已經連續七八年了都在急診前都要譬如說要大家打預防針,要大家就診的一個怎麼樣分流然後我們在不管是健保署或疾管署都有提供經費給急診去開譬如說專人病房一個門診另外有一個人力然後也鼓勵我們的急診診所能夠在 |
| transcript.whisperx[76].start |
3465.755 |
| transcript.whisperx[76].end |
3490.428 |
| transcript.whisperx[76].text |
假日的時候能夠多開診 而且都給他多一點 譬如說三成的一個補助這個就是比較預防性的 然後也當時政府也多買了10萬劑的流感疫苗讓大家能夠希望避免得到相關的傳染病我想預防的措施是非常重要的那長期來講怎麼樣 我們國家本來就一直在做分級分流 |
| transcript.whisperx[77].start |
3491.908 |
| transcript.whisperx[77].end |
3513.698 |
| transcript.whisperx[77].text |
區域聯防的體系這個一直在做面對急診的困境到年後還是這樣子的時候當然我們就必須要更積極所以從大概3月2號開始連續我們到現在也有至少5次的會議出席的人是包括各衛生局各醫院院長幾乎幾百個用線上的在討論怎麼來解決這個問題當然也包括急診醫學會 |
| transcript.whisperx[78].start |
3519.74 |
| transcript.whisperx[78].end |
3540.051 |
| transcript.whisperx[78].text |
所以我們提出了三個緊急趕快處理的,持續再做兩個中長程的第一個你院內趕快調度,拜託院方能夠看看譬如說門診住院,哪一檔比較慢的就比較慢的,去進行梳洗我們有一個理念,急診你說到底要待多久 |
| transcript.whisperx[79].start |
3540.891 |
| transcript.whisperx[79].end |
3556.918 |
| transcript.whisperx[79].text |
居德病能夠越快住院越好就是最重要的理念部長你剛剛提你們開了很多會可是2月3號年假就結束了可是衛福部到2月8號才邀集我們的疾管署和22個縣市衛生局跟14個轉診的網絡醫院主持人 |
| transcript.whisperx[80].start |
3559.264 |
| transcript.whisperx[80].end |
3567.626 |
| transcript.whisperx[80].text |
跟六區的緊急醫療應變中心執行長來召開會議討論那這個時間點我們當然看到衛福部自己講說急診量從4.5萬人次就是降為2.1萬人次可是等待住院的人還是偏高所以2月22號我們的急診醫學會才會出來發表聲明那衛福部自己也承認說病床擁塞的問題還是很嚴重 |
| transcript.whisperx[81].start |
3586.551 |
| transcript.whisperx[81].end |
3596.858 |
| transcript.whisperx[81].text |
今天春節期間在急診室最擁塞的時候民眾等待床位超過一天是常態急診擁塞事件當下衛福部有掌握嗎 |
| transcript.whisperx[82].start |
3598.129 |
| transcript.whisperx[82].end |
3625.539 |
| transcript.whisperx[82].text |
就在春節期間我們每一天都每15分鐘那衛福部做了什麼樣的應變措施當然一定是努力去應變那你的應變措施到底是什麼應變措施我剛剛跟委員報告第一個就是說希望讓急診的後床的人能夠減少第二個希望當然還有等候看診結果等候看診的人都不是那麼長我們每天可以去追溯data大概 |
| transcript.whisperx[83].start |
3626.559 |
| transcript.whisperx[83].end |
3652.346 |
| transcript.whisperx[83].text |
委員所講的超過1000個就是51家的一個醫院我們說統計51家大概如果平均有20個後床的大概就會超過1000個那基本上還是在那幾家啦我們第一名的永遠都是林和長庚台大啦 高一啦 高雄長庚其實看起來都比較常例前茅啦那這個部分我們當然很希望 |
| transcript.whisperx[84].start |
3654.566 |
| transcript.whisperx[84].end |
3680.851 |
| transcript.whisperx[84].text |
這些醫院能夠去積極的去處理那剛剛講的三個緊急的處理第一個就是說院內去調配這個部分有些醫院做得還不錯當然有些婦女人覺得說會承受更多的壓力這個部分我們也瞭解但是就是院方一定要去好好的溝通平常也要訓練好第二個我們當然區域聯訪很重要所以我們這個時候26家醫院也跟五個訓練也站出來 |
| transcript.whisperx[85].start |
3681.651 |
| transcript.whisperx[85].end |
3704.011 |
| transcript.whisperx[85].text |
呈上啟下不管是上面的那這個部分也吸收了不少那另外就是說我們要鼓勵給民眾提供分流分級的一個就醫的一個資訊這是緊急趕快處理啦因為醫院遵守那麼多遵守醫師公會也發表過幾度的聲明所以我們希望就是說如果只有 |
| transcript.whisperx[86].start |
3704.571 |
| transcript.whisperx[86].end |
3721.284 |
| transcript.whisperx[86].text |
一般的感冒症狀可以先到診所來那如果這樣才不會影響到急診的一個量能所以部長上年假期間就春節年假期間就已經知道我們的就醫人數因為流感而增加了所以按理來講要放假了 |
| transcript.whisperx[87].start |
3722.37 |
| transcript.whisperx[87].end |
3749.231 |
| transcript.whisperx[87].text |
前面有沒有預期就是在這個假期期間本來這個醫療的那個需求就是比較大的如果事前緊急我們的疫苗採購鼓勵施打並鼓勵過年期間減少休整的數量是不是就會比較不嚴重所以想問說你過年前有沒有看到這樣子預料到這些問題會發生因為已經前面就已經開始過年前已經有人開始事實上 |
| transcript.whisperx[88].start |
3749.611 |
| transcript.whisperx[88].end |
3777.181 |
| transcript.whisperx[88].text |
感冒然後就醫的比例上也比較高一點所以會不會做了什麼在事前準備這一塊好謝謝我剛剛有跟委員報告我們在事前就是有發表記者會宣稱說那個大概要打疫苗過年的時候要洗手戴口罩到處都是這個都是常規大概這十年來每一次都有的對常規可是有沒有更加強去做宣導公司部門那當然我們疫情如果 |
| transcript.whisperx[89].start |
3777.981 |
| transcript.whisperx[89].end |
3806.3 |
| transcript.whisperx[89].text |
如果說有可能會尤其是這次會有免疫負債的現象我們COVID下來以後可能我們很擔心所以我們這次的確有加強包括成立傳染病在急診成立傳染病的門診包括我們鼓勵所有的院所如果你開診假日開診增加30%等等這都是屬於預防性的措施那但是我們的民眾還是會比較直接到大醫院來那其實有些是不是可以考慮 |
| transcript.whisperx[90].start |
3808.601 |
| transcript.whisperx[90].end |
3834.961 |
| transcript.whisperx[90].text |
給民眾說其實我們診所都是非常優秀的說實在的我們在急診看的醫師全部都是在開業的醫師的學生所以我會鼓勵說大家還是有不舒服其實不是說鼓勵了應該就應該大家都有一個家庭醫師的一個制度他就去問他的家庭醫師我們在COVID的時候疫情台北市 |
| transcript.whisperx[91].start |
3836.062 |
| transcript.whisperx[91].end |
3862.152 |
| transcript.whisperx[91].text |
一天有曾經一萬個infected的可是他可以在家裡為什麼因為他都有熟悉的醫師用視訊來看他來穩定他所以我們度過了大流行的一個難關剛剛講的事實上是我們的醫療用塞可是現在我們還在看病床的所以急診室在調度病床主要是透過我們為服務部建置的 |
| transcript.whisperx[92].start |
3862.881 |
| transcript.whisperx[92].end |
3891.419 |
| transcript.whisperx[92].text |
重度級的急診急救責任醫院的急診及時訊息查詢跟14急診轉診的網絡跟六區緊急的醫療應變中心可是但是即時系統沒有辦法隨時更新所以注意不大那急診轉診網絡應變中心針對的特殊疾病並不一定有效最終最後呢就變成事實上是醫學中心自己自行相互聯絡 |
| transcript.whisperx[93].start |
3892.979 |
| transcript.whisperx[93].end |
3917.008 |
| transcript.whisperx[93].text |
來致力救濟所以也想問一下副長順利轉院便可避免擁塞那只要醫院缺床缺ICU那特殊疾病的醫治的病床就有轉院的需求的時候這個問題一直沒有解決也沒有一直沒有提出來討論所以衛福部到底有什麼樣的對策 |
| transcript.whisperx[94].start |
3918.248 |
| transcript.whisperx[94].end |
3934.202 |
| transcript.whisperx[94].text |
我們在中,謝謝委員對醫療狀況相當的了解,那我們除了預防急性以外,當然改善護理人力的一個工作環境,跟怎麼樣留任護理人力是我們國家重要政策,我們有十二項的措施 |
| transcript.whisperx[95].start |
3934.96 |
| transcript.whisperx[95].end |
3964.746 |
| transcript.whisperx[95].text |
那提供 政府也提供經費那當然這製作站設置我們也非常樂意跟護理的團體來陸續因為護理團體有幾個護理團體我們都可以非常歡迎大家一起來討論總是把它改善到這個措施是真的能夠改善護理的待遇跟人力所以希望部長也要動作快好否則我覺得接下來還是一樣會面對同樣的問題對 我們這個部分一定加強努力好那上下轉診做得好的話就可以紓解 |
| transcript.whisperx[96].start |
3966.031 |
| transcript.whisperx[96].end |
3991.416 |
| transcript.whisperx[96].text |
醫院的負擔可是台灣缺乏我們的醫院的守門員的一個角色民眾可以自由選擇就醫的醫院所以就一直導致民眾常常不分輕重的習慣就到醫學中心去了或區域醫院看病也往往造成我們的醫院擁塞衛福部向下轉診的分級醫院一直都沒有做好所以請問一下部長這一次我們的急診擁塞事件急診醫院似乎 |
| transcript.whisperx[97].start |
3992.196 |
| transcript.whisperx[97].end |
4008.119 |
| transcript.whisperx[97].text |
沒有被納入在轉診的體系裡面 尤其是分級醫療的架構裡面 輕症本來就是基層的醫療的範疇所以衛福部對這個有沒有改善的措施?我們非常重視各層級的角色 |
| transcript.whisperx[98].start |
4009.212 |
| transcript.whisperx[98].end |
4024.663 |
| transcript.whisperx[98].text |
區醫院的區醫院他的重要的分流角色第七院更是有燈塔型的味道而且他可以協助基層醫療很多的不管是住院或者是急診的部分所以我們在第七院方面不管是在幾乎在怎麼樣都會跟第七院的 |
| transcript.whisperx[99].start |
4025.393 |
| transcript.whisperx[99].end |
4039.276 |
| transcript.whisperx[99].text |
的一個協會做最好的一個處理我想這個陸續都溝通的相當的好重點是在基層醫療其實是有我們台灣的基層醫療是世界有名也強大的所以如何讓民眾也能夠 |
| transcript.whisperx[100].start |
4041.018 |
| transcript.whisperx[100].end |
4068.655 |
| transcript.whisperx[100].text |
第一線就先使用基層藥你就有一個醫生的好朋友引後發燒引後肚子不舒服你如果有一個在就近的醫療院所仍然能夠幫你解決問題我相信他有必要的話轉診的也會比較快不然你叫一個白人跟你便宜也不太適合因為要掛對科我肚子有點不舒服到底是要掛心臟科不肚子科如果有一個先面有一個鎖門眼幫你鎖住 |
| transcript.whisperx[101].start |
4069.875 |
| transcript.whisperx[101].end |
4090.563 |
| transcript.whisperx[101].text |
這個才是世界所說的聰明就醫啦謝謝委員的提醒我們每一個級每一個層級都有它重要的角色我們都會去發揮所以最後希望廉價你的準備應該要確實所以未來避免有廉價的期間造成急診的擁塞還有醫院轉診這個問題要及時要因應整個的緊急狀況 |
| transcript.whisperx[102].start |
4094.994 |
| transcript.whisperx[102].end |
4106.72 |
| transcript.whisperx[102].text |
那分級醫院還是期待趕快讓民眾瞭解然後這個可以到他適合的去就診那在病床量能要提升來強化人力 |
| transcript.whisperx[103].start |
4107.216 |
| transcript.whisperx[103].end |
4129.788 |
| transcript.whisperx[103].text |
床位監控還有預防擁塞所以委員您的指教就是我過去幾十年來從醫學院從醫師公會理事長從當立委到現在所希望幫國家做的事情我們一定有堅定的意志一定要去把它徹底解決這個問題希望大家一起來所以今天的質詢 |
| transcript.whisperx[104].start |
4132.75 |
| transcript.whisperx[104].end |
4152.842 |
| transcript.whisperx[104].text |
今天我那四個主張在兩週內請馬反法這個訴求能夠提出書面報告好沒問題然後還是要跟主席抗議一下因為前面是可以講到20分鐘以上謝謝他超過4分鐘你也超過4分鐘謝謝林委員謝謝部長那接續我們請陳慶威委員質詢 |
| transcript.whisperx[105].start |
4164.902 |
| transcript.whisperx[105].end |
4165.083 |
| transcript.whisperx[105].text |
謝謝請邱部長 |
| transcript.whisperx[106].start |
4171.187 |
| transcript.whisperx[106].end |
4198.915 |
| transcript.whisperx[106].text |
委員好部長好我們放第一張表第一張表是其實也是您親自傳給我的啦那當然我跟陳昭志委員也問的東西有點不太一樣我是很想知道說您會覺得這個表的統計方式是不是有欠改善因為有護理師跟我反映說這個年資一年啊到底是在這個醫院上班一年還是他當的護理師一年 |
| transcript.whisperx[107].start |
4200.168 |
| transcript.whisperx[107].end |
4221.983 |
| transcript.whisperx[107].text |
的年資因為他們認為如果你真的有問到這樣子的數據也許他之前已經職業非常久了那他可能在目前你調查這家醫院一年所以才會到達這樣子的一般民眾覺得這樣是有感的高薪啊我想知道您對於這個統計方法有沒有什麼看法比如說你的樣本數是怎麼取的 |
| transcript.whisperx[108].start |
4222.935 |
| transcript.whisperx[108].end |
4251.31 |
| transcript.whisperx[108].text |
好 包委員我昨天在看一下我傳給您的這個line是傳到這個但是其實我們好像沒有傳到一個網站那個網站是在民國122年11月的時候衛福部請各縣市衛生局邀請全國的醫院去把他的收入因為那是要展示給外國人我跟你一樣我們都覺得護理人員非常辛苦他的薪水如果能夠再提升 |
| transcript.whisperx[109].start |
4252.15 |
| transcript.whisperx[109].end |
4267.581 |
| transcript.whisperx[109].text |
再提升再提升如果說今天真的是他們很滿意了我想也不會有人才流失的問題嘛大家會離開職場表示不夠嘛表示我們必須要大家再努力嘛我想這個部分是基本觀念所以我從來沒有講過一或乎 |
| transcript.whisperx[110].start |
4270.679 |
| transcript.whisperx[110].end |
4291.745 |
| transcript.whisperx[110].text |
現在的待遇是OK的所以您未來我想主席在這也知道我們都一直在努力幫醫療醫護的一個職場做得更好那其實裡面的報告112年以後那400多家包括醫學中心區醫院應該也有地區醫院有地區醫院其實那個大家正面思考 |
| transcript.whisperx[111].start |
4292.385 |
| transcript.whisperx[111].end |
4317.042 |
| transcript.whisperx[111].text |
他的呈現是讓我們的護理人員能夠我要去台大申請比較好或是要買這個我看到買這個情緒比較高福利比較好我就去另外現在那個後來以前大家不注意這個網站現在注意這個網站以後發現中部有很多醫院就說我好像比人家低所以他們就會提升所以是有見錢思齊的效果那如果說造成大家有些 |
| transcript.whisperx[112].start |
4317.802 |
| transcript.whisperx[112].end |
4330.411 |
| transcript.whisperx[112].text |
比較可能沒有領到那麼多收入建銜時期這個我好像我們必須要在公衛裡面是沒有覺得有領到這個錢的為什麼我們會質疑是因為你放這張表但是晚上在這些機關裡面上班的人並沒有人說他們有拿到這樣子的薪資所以他們才會另外在他們的這個官方的粉專做一些發文 |
| transcript.whisperx[113].start |
4347.543 |
| transcript.whisperx[113].end |
4362.774 |
| transcript.whisperx[113].text |
所以我想用健嫻私企這個好像有點難怪的比如說我們看這一張好了啦如果他是在私立醫院的最小值是42336而且這個值應該是總收入嘛包括就是說你去報課交評單的時候你年度課交評單的時候 |
| transcript.whisperx[114].start |
4366.69 |
| transcript.whisperx[114].end |
4387.55 |
| transcript.whisperx[114].text |
像我以前在台大當第五連署製衣師的時候我的基本薪是六萬多可是我有專業加給五萬多然後再加上績效獎金大概十八萬好了我出去外面我報稅是報十八萬我不是報六萬多所以不好意思那是一種看你是總收入 |
| transcript.whisperx[115].start |
4388.371 |
| transcript.whisperx[115].end |
4407.69 |
| transcript.whisperx[115].text |
還是看年資的 還是看那個薪資 基本薪資的一個概念那如果讓大家一起誤解 我在這邊還是要道歉因為這個data本來我們就好意讓醫院自己去填那我有問過所有醫院的院長我昨天也要求醫院協會的李輝鵬理事長我問拜託你聽他查看 |
| transcript.whisperx[116].start |
4413.834 |
| transcript.whisperx[116].end |
4427.24 |
| transcript.whisperx[116].text |
所以部長您願意跟辛苦的護理師說真的很不好意思這個表格可能沒有如果大家的薪水還是低我覺得我很難過也願意來努力 |
| transcript.whisperx[117].start |
4431.799 |
| transcript.whisperx[117].end |
4459.135 |
| transcript.whisperx[117].text |
那數據的呈現讓大家產生誤解這個我當然可以跟大家抱歉但是你放心不管是在你在任何一個職位不管你在醫護包括診所我們現在診所診所很多醫生說他四萬幾塊他也請不上來現在我們前幾天其實洪孟海委員也有質詢這個議題但是你始終沒有正面回答所以我稍微播放一下那一天你們的對談 |
| transcript.whisperx[118].start |
4464.804 |
| transcript.whisperx[118].end |
4466.245 |
| transcript.whisperx[118].text |
有聲音嗎當天呢我看一下字幕卓院長是跟您講說平均看下來的話他覺得應該要很說明的清楚並且不是用這樣子的數字還有社會做一個假象的宣示所以卓院長表示這是一個假象的宣示那當天我有聽您的答詢 |
| transcript.whisperx[119].start |
4492.265 |
| transcript.whisperx[119].end |
4509.823 |
| transcript.whisperx[119].text |
您說其實你有多方的跟醫院管理端討論過所以這個數據是千真萬確也並不是醫院管理端要欺騙你的或是什麼對 但是你有沒有想過從剛剛這張表的統計方式比如說你的抽樣的樣本到底公不公允 |
| transcript.whisperx[120].start |
4510.444 |
| transcript.whisperx[120].end |
4525.714 |
| transcript.whisperx[120].text |
另外你有沒有跟這個基層的勞方代表來討論過然後你有沒有在多方查證您認為這個會不會是你未來還要再做這些統計的改善方法呢好一定我想第一個我們一定非常歡迎 |
| transcript.whisperx[121].start |
4527.715 |
| transcript.whisperx[121].end |
4541.494 |
| transcript.whisperx[121].text |
相關的醫事團體如果您覺得在衛務部可以幫大家做什麼事情都可以排時間我們來好好的來討論一下我們歡迎尤其是婦女的同仁婦女有好幾個團體意見有稍微有一點不一樣但是我們絕對都願意第二個這個數據的算法 |
| transcript.whisperx[122].start |
4545.499 |
| transcript.whisperx[122].end |
4571.198 |
| transcript.whisperx[122].text |
是從112年那個時候就用這種算法用總收入的一個概念在算如果引起大家的誤解我馬上要趙復師再去重新的請各醫院寫清楚就比如說您剛講的把這些津貼再分開不用給我們一個加總的數字就是給我們一個大概的數字但是有可能加到其他的津貼我未來是這樣建議啦不知道您採不採納 |
| transcript.whisperx[123].start |
4575.066 |
| transcript.whisperx[123].end |
4591.178 |
| transcript.whisperx[123].text |
我們希望我們希望朝著這個我們會請不是邀請我們我們是要拜託醫院一定要去呈現呈現那個真實的數據因為只有公開透明才是解決問題的最基本的一個 |
| transcript.whisperx[124].start |
4591.598 |
| transcript.whisperx[124].end |
4615.4 |
| transcript.whisperx[124].text |
那也希望您多方查證這邊當然也是幫護理師請願因為非常多人傳來他們真實的薪水單等等另外他們也在網路上寫了很多他們在護理工作上比如說被家屬質疑態度被病人呼來喚去等等等等但是最近也有一批另外的網軍說喊話的這些醫護人員其實是敵國的網軍可不可以幫他們講幾句話 |
| transcript.whisperx[125].start |
4617.242 |
| transcript.whisperx[125].end |
4630.941 |
| transcript.whisperx[125].text |
您知道現在的離職率是真的很高有院長說他是來不及簽離職單前幾天也有一位護理師說他在排隊簽離職單的時候等了一個小時我想問您會不會真的覺得現在這個離職潮是應該要解決的問題了 |
| transcript.whisperx[126].start |
4635.517 |
| transcript.whisperx[126].end |
4655.639 |
| transcript.whisperx[126].text |
我們要用科學的根據來看至於每一個離職的頭人我們都很心痛包括我以前在病房我們一起訓練的一個台大護理系很優秀的學生想說這個將來我們一定是在護理界花光花熱可是他工作了半年以後畢業以後工作半年竟然要離職 |
| transcript.whisperx[127].start |
4657.148 |
| transcript.whisperx[127].end |
4679.498 |
| transcript.whisperx[127].text |
我們是會非常心痛所以任何一個離職我們都非常重視不是整批那至於說要等一個小時我們也去問台北市護理師公會他說那一天3月3號剛好是最最多人的時候因為有些要直登有些要入離職有些要所以那個部分我們去我們可以來分析我們也問過台中市長其實 |
| transcript.whisperx[128].start |
4681.039 |
| transcript.whisperx[128].end |
4698.87 |
| transcript.whisperx[128].text |
都可能剛好有一坡比較起來因為每個時段不太一樣尤其在過年後會有離職坡可是在七八月又會有入來那去年的時候越到比一年以前我們增加的大概有留任的護理人員大概增加有3800個左右那其中有1200個是在醫院所以我們會繼續努力啦絕對這樣不夠 |
| transcript.whisperx[129].start |
4703.874 |
| transcript.whisperx[129].end |
4712.665 |
| transcript.whisperx[129].text |
我們會繼續努力那你有想要這個去年年初就已經前一任行政長都答應的白板津貼今年應該就是可以發出來了吧 |
| transcript.whisperx[130].start |
4713.393 |
| transcript.whisperx[130].end |
4732.983 |
| transcript.whisperx[130].text |
我們現在跟護理界的一個長期的討論是說我們在那個三班護病比的獎勵你一定要去顧及到要給白班現在先這樣做所以白班等於其實是會領到三班當然這個因為公務預算也希望 |
| transcript.whisperx[131].start |
4733.843 |
| transcript.whisperx[131].end |
4761.201 |
| transcript.whisperx[131].text |
那個在預算的順利的通過啦三班互併筆的入法是賴總統的政見您會把這件事情也當成您在任以內的一件當務之急嗎我們當然是很這個當然是重要的任務而這個任務我們必須瞭解護理的心聲當然我們也會跟相關譬如說醫院的院方大家來談一下怎麼樣在一種 |
| transcript.whisperx[132].start |
4762.634 |
| transcript.whisperx[132].end |
4780.356 |
| transcript.whisperx[132].text |
所謂的無痛學習我們學習到無痛學習嘛那這個就是說能夠維繫病床的一個情況之下我常常在講我們醫療改革有三個第一個要提供給民眾最高的醫療品質第二個要給醫事人員最好的尊嚴第三個也要給醫療人員可以亂嘛 |
| transcript.whisperx[133].start |
4781.918 |
| transcript.whisperx[133].end |
4802.485 |
| transcript.whisperx[133].text |
可以順利的應轉我會再跟部長您追進度部長這個有許許多的官員在外面致詞甚至是賴總統呢在2月4號的世界癌症日上是直接說癌症篩檢行政費用刪了一成凍結三成請問您這件事情到底是不是事實嗯 |
| transcript.whisperx[134].start |
4813.993 |
| transcript.whisperx[134].end |
4837.881 |
| transcript.whisperx[134].text |
癌症這個部分當然是國健署國健署只要是凍結業務會其實對於推動各種因為我們那個衛福部七成是委辦經過到底是不是一成跟三成這件事情到底是不是事實統三一成 凍三成這樣子所以還是會有影響的看起來是會有影響 |
| transcript.whisperx[135].start |
4839.52 |
| transcript.whisperx[135].end |
4863.006 |
| transcript.whisperx[135].text |
我弄下一張給你看這個是你們新增了41億的癌症篩檢預算喔重要的科子目包含業務費獎勵助費是不是到現在其實你們也還沒有確定這筆新的大預算還沒有核實分配是不是最主要這一次來講在鄧山的部分就是在5.93億的那個部分 |
| transcript.whisperx[136].start |
4866.863 |
| transcript.whisperx[136].end |
4881.674 |
| transcript.whisperx[136].text |
所以不是一層跟三層嗎就是5.93%裡面的一層跟三層如果是整體的那一層跟三層影響就可能小一點所以不是癌症篩檢我們講的是AEU會的推動所以不是癌症篩檢嗎 |
| transcript.whisperx[137].start |
4883.371 |
| transcript.whisperx[137].end |
4885.292 |
| transcript.whisperx[137].text |
所以兩位其實現在就是說2月4號賴總統講的那句話不屬實嘛因為2月5號我發了這個公文我也是詢問說到底是不是這樣子結果你們回的是說 |
| transcript.whisperx[138].start |
4904.244 |
| transcript.whisperx[138].end |
4921.075 |
| transcript.whisperx[138].text |
因為未獲得具體的結論故總預算稅出稅入三減凍結金額與立法院朝野協商達成共識後即可具體核算這是你們給我的公文耶但是你們怎麼可以在外面說這樣子的說法呢好我想我們在邊各個司署在邊內預算除了業務會當然還有實質上的付給付給那個 |
| transcript.whisperx[139].start |
4934.527 |
| transcript.whisperx[139].end |
4949.88 |
| transcript.whisperx[139].text |
這是連在一起的啦 只要算那個當然就會影響到我是希望啦 來部長這張你前幾天也看過了我們衛生福利部已經增加了3000億的預算國民健康署已經增加了 |
| transcript.whisperx[140].start |
4952.803 |
| transcript.whisperx[140].end |
4968.524 |
| transcript.whisperx[140].text |
55億的預算如果你們繼續在外面講根本還沒有算出來的比例我覺得真的是有失公允我希望各位官員包括但可能我沒辦法勸告總統但是我真的希望各位官員出去說話的時候還是要有所本啊 |
| transcript.whisperx[141].start |
4969.125 |
| transcript.whisperx[141].end |
4972.55 |
| transcript.whisperx[141].text |
這個是我看我們第一輪我們只有減列15萬第二輪我們還讓你我們還提案讓你可以科目自行調整所以當你多拿了3000億多拿了55億然後你一直說這個做不到那個做不到我覺得情何以堪 |
| transcript.whisperx[142].start |
4987.372 |
| transcript.whisperx[142].end |
5004.737 |
| transcript.whisperx[142].text |
部長我們其實去年3月在這邊排了解凍案我回去算了一下我們總共排了22個解凍案您只要好好的報告其實我們這22個解凍案也都排也都解凍了你們去年3月提出4月就已經解凍了如果你們今年還要復議然後還會因為這樣子去延宕的話又把 |
| transcript.whisperx[143].start |
5008.499 |
| transcript.whisperx[143].end |
5023.18 |
| transcript.whisperx[143].text |
這個解凍沒有癱瘓國政又到處出去宣講我覺得這樣真的是很不對的思維我覺得委員會因為我們大家都是未完長久的比較了解到人民健康需要的資源所以大家真的很感謝在委員會裡面 |
| transcript.whisperx[144].start |
5024.381 |
| transcript.whisperx[144].end |
5041.68 |
| transcript.whisperx[144].text |
大家可以注意到慢慢可是在桶山桶洞這個部分大概就會比較真的會影響到業務相當的執行譬如說你少了你說好幾月以後才解凍可是我現在就要去買疫苗啦就要去跟人家簽約現在所有的人都知道我 |
| transcript.whisperx[145].start |
5042.541 |
| transcript.whisperx[145].end |
5059.905 |
| transcript.whisperx[145].text |
只好不敢不曉得當然你說3月1日其實如果你不要提復一案這個洞前不就有就現在就要排了嗎這非常是一個未知是對我們計畫到底要合出去合不合出去以及在那邊期待建設的的確是真的部長我最後真的啦具體建議啦 |
| transcript.whisperx[146].start |
5062.346 |
| transcript.whisperx[146].end |
5075.706 |
| transcript.whisperx[146].text |
如果你們真的沒有核算出核實的金額或者是比例的話也很希望你們出去在做一些演講公開的說明的時候真的可以說保守一點說實話我還是拜託我們委員能夠盡量讓我們因為 |
| transcript.whisperx[147].start |
5079.01 |
| transcript.whisperx[147].end |
5089.517 |
| transcript.whisperx[147].text |
國健署他增加的預算其實就是我們已經多年來在前面在癌症篩檢其實你看我剛剛講第一輪我們減劣15萬你編了111億我們減劣15萬其實各朝野的委員是非常支持你們的看得出來啊對吧111億我們減劣15萬 |
| transcript.whisperx[148].start |
5101.888 |
| transcript.whisperx[148].end |
5126.261 |
| transcript.whisperx[148].text |
對,我想在委員會裡面,我想值得大家給人民的健康很大的支持,這個真的非常感謝但是在桶山桶洞這個部分,仍然已經造成了現在的在業務上需要比較再要努力去調整我知道,其實大家也有在聽前幾天的質詢多了三千億、多了五十五億還是知愛難行,這個大家都聽懂了好,謝謝委員謝謝陳委員,謝謝部長 |
| transcript.whisperx[149].start |
5131.621 |
| transcript.whisperx[149].end |
5132.902 |
| transcript.whisperx[149].text |
接下來我們請王一鳴委員質詢好 謝謝主席 我們有請部長委員好 |
| transcript.whisperx[150].start |
5155.931 |
| transcript.whisperx[150].end |
5167.843 |
| transcript.whisperx[150].text |
最近這個護理師的離職潮在Yahoo的線上民調有高達七成八的民眾他擔心的是醫療會崩潰請問你會不會擔心我們護理師一再的出走我們的醫療體系會崩潰你擔心嗎 |
| transcript.whisperx[151].start |
5177.129 |
| transcript.whisperx[151].end |
5200.805 |
| transcript.whisperx[151].text |
我當然擔心我們從大概20年前日本就寫出一個醫療崩潰的一個書以後我們台灣就一直在檢討我當時當然是擔任台大醫學的老師也是醫師我們當然希望醫療不要崩潰所以我們也跟不管是在民間跟政府其實一直攜手在解決這個問題 |
| transcript.whisperx[152].start |
5202.466 |
| transcript.whisperx[152].end |
5228.256 |
| transcript.whisperx[152].text |
但是現在你看到的客觀的數據我們來看這幾年公司立護理人員的離職率他呈現出來的都是一個上升的情況平均離職率是12.61那這個空缺率因為離職率高空缺率就是當然也是隨著上升但是剛剛你們在回答委員問題的時候好像是說有改善 |
| transcript.whisperx[153].start |
5229.917 |
| transcript.whisperx[153].end |
5234.883 |
| transcript.whisperx[153].text |
講說今年這個護理人員有新增進來所以這個情況有改善是嗎 |
| transcript.whisperx[154].start |
5236.721 |
| transcript.whisperx[154].end |
5260.485 |
| transcript.whisperx[154].text |
包委員那因為有鑒於這樣一個趨勢所以在大概一年多前政府就提出了十二項改善計畫由四個面向包括人才的培育怎麼樣提高薪資等等的當然包括獎勵業但是有沒有成效我要問的是說我跟委員報告去年的就是去年的十二月 |
| transcript.whisperx[155].start |
5261.025 |
| transcript.whisperx[155].end |
5278.167 |
| transcript.whisperx[155].text |
比前期的時候 護理人員多了大概3800多個其中有1200多個是在醫院裡面所以我們在這樣的一個狂流當中一直在力挽狂瀾我知道 但是我要你 |
| transcript.whisperx[156].start |
5278.667 |
| transcript.whisperx[156].end |
5292.367 |
| transcript.whisperx[156].text |
回覆本席就是說那目前的離職率我這邊統計到是112年度嘛那根據你剛剛的說法如果最新的數據你們這個最新的說法你的離職率是多少你的那個空缺率是多少好來市長請說 |
| transcript.whisperx[157].start |
5295.231 |
| transcript.whisperx[157].end |
5317.796 |
| transcript.whisperx[157].text |
好 這個離子率跟空缺率是我們每年跟醫院做調查的所以今年我們會調查去年的所以現在最新的就是112年的 因為是去年的嘛那我們今年就會起動調查去年的因為所有離子率跟空缺率是醫院這邊提出的所以你剛剛講那個數據也不能證明你的離子率跟空缺率有改善 |
| transcript.whisperx[158].start |
5318.856 |
| transcript.whisperx[158].end |
5332.845 |
| transcript.whisperx[158].text |
那剛才部長講的意思是這樣就是因為這是疫情後特別在護理人員留任遇到很大的困境那也因為疫情後的這個那走的有多少因為特別是這一波裡面我們總量是增加的每年總量一定會增加但是原來就不夠對原來就不夠那所以不夠現在醫院的狀態就是一個復循環因為人不夠他又會走是對所以這12項進來之後 |
| transcript.whisperx[159].start |
5345.773 |
| transcript.whisperx[159].end |
5371.188 |
| transcript.whisperx[159].text |
在穩定 那我們現在就是要穩定為主嗎你現在有穩定嗎 我要問的是你現在現場的情況有穩定嗎 因為這一波這個急診篩報之後你們這個很多民眾可能有很多的抱怨 你們緊急又再提出一些的對策但是到上個禮拜就是立法院這邊有在工作的同仁 他到了那個台大醫院 半夜的時候就是 |
| transcript.whisperx[160].start |
5371.963 |
| transcript.whisperx[160].end |
5392.043 |
| transcript.whisperx[160].text |
就是有朋友不舒服看急診到現場看的狀況是只有兩個護理師但是有40個病患你一般的互併比就是醫學中心大業班的互併比是多少我們現在的這個在監測的這個指標是這樣護理人員他的移動他 |
| transcript.whisperx[161].start |
5392.915 |
| transcript.whisperx[161].end |
5413.747 |
| transcript.whisperx[161].text |
又有所謂直燈所以我們在線上是看得到直燈的那我們每個月會做一次統計那每個月會跟上個月比也每個月會跟同期的每個月比那剛才我們講說有這個增加的部分是去年的12月跟去年的1月以及今年的2月跟去年的2月這樣來比全國來講如果最新的啦剛才部長是講 |
| transcript.whisperx[162].start |
5418.69 |
| transcript.whisperx[162].end |
5438.871 |
| transcript.whisperx[162].text |
去年的12月跟1月比那我現在再提供一個新的就是說今年的2月跟去年的2月比那總共是3500個人那醫院大概是1400好1400增加這樣但是這樣夠不夠是不夠的因為過去三幫互併比的目的就是要讓醫院增加人那人的目標如果要達到這個三幫互併比是要7500到8000人 |
| transcript.whisperx[163].start |
5441.454 |
| transcript.whisperx[163].end |
5449.521 |
| transcript.whisperx[163].text |
所以差很多所以才要需要12項政策來支持他差很多耶現在距離那個目標還非常的遙遠因為是去年3月開始執行的去年3月所以現在在醫院有增加了大概1400那我們看的指標是這樣一個是人體的增加嘛那第二個就是三班戶並比 |
| transcript.whisperx[164].start |
5459.689 |
| transcript.whisperx[164].end |
5464.631 |
| transcript.whisperx[164].text |
各班的達成的狀況以及整體達成的狀況我就讓你看一個數據一樣是113年你可以看到醫學中心他的那個互併比就是他沒有達到的比例112年是14家佔56結果113年12月又變16家變成59所以如果如司長你說的其實是 |
| transcript.whisperx[165].start |
5486.577 |
| transcript.whisperx[165].end |
5505.612 |
| transcript.whisperx[165].text |
再朝穩住跟改善的話為什麼醫學中心這個數據看起來在大夜班的這個部分是惡化的小夜班也沒有好到哪裡去就是說他未打的比例其實還是一樣是高而我剛剛提供的最新的數據就是上個禮拜有人到這個醫學中心去看到現場 |
| transcript.whisperx[166].start |
5506.573 |
| transcript.whisperx[166].end |
5522.984 |
| transcript.whisperx[166].text |
他的大夜班的比如果是兩個護士40個病人就是1比20一樣是沒有達標所以我要講的是事實上現場的情況真的是狀況是很不好了我是很擔心喔就是說如果我們這個狀況沒有穩住的話一再的離開出走 |
| transcript.whisperx[167].start |
5526.887 |
| transcript.whisperx[167].end |
5552.264 |
| transcript.whisperx[167].text |
真的台灣我們就是最驕傲的全民健保以後你要去醫院看就會像這一次突然湧入大量病人的時候急診病患一多的時候那個現場看起來像個災難片那麼多人都在這個走廊上面但是沒有足夠的醫護沒有辦法就是消化不了沒有護理人員你病床又沒有辦法開這個真的是一個很大的惡性循環所以我覺得這個問題真的是要 |
| transcript.whisperx[168].start |
5554.985 |
| transcript.whisperx[168].end |
5577.136 |
| transcript.whisperx[168].text |
從根本就是好好的去解決那當然這個牽涉到一個剛剛大家提到的薪資的問題這次你們公布的這個薪資就是也讓這個護理界跳腳就是說怎麼能公布的比他領到的薪水單的還要高那這邊勞動部他之前就有根據職業別他已經統計過了112年護理人員每個月經常性薪資 |
| transcript.whisperx[169].start |
5581.958 |
| transcript.whisperx[169].end |
5606.25 |
| transcript.whisperx[169].text |
是49202那為什麼勞動部統計出來的跟你們公布出來的就是有落差啊人家就說你們灌水啊你們為了讓數字好看啊就是大家拼命報就是把所有的其他的履歷口口通通都加起來但那不是經常性薪資啊我們講一個人的薪水應該是以經常性薪資為基準吧你們把很多非經常性的全部通通都要灌進來 |
| transcript.whisperx[170].start |
5607.19 |
| transcript.whisperx[170].end |
5635.224 |
| transcript.whisperx[170].text |
那難怪這個他們跳腳啊因為你非經常性的薪資請問像有一些護理人員他是投這個可能還是是他不見得是有公務人員他可能是勞保對不對請問他會算在他的退休金裡面嗎不會啊有些是不會算進來那你那些硬要這樣把他灌進來當然他跳腳啊我就問部長你認為護理人員合理的月薪是多少錢你認為 |
| transcript.whisperx[171].start |
5636.96 |
| transcript.whisperx[171].end |
5652.237 |
| transcript.whisperx[171].text |
未滿一年的護理人員你認為他的那個月薪你認為給多少合理我覺得只要在醫院能夠接能下去的話越高越好講一個最基本的要達到多少嗎是不是你們自己公布的5370我真的對 |
| transcript.whisperx[172].start |
5654.711 |
| transcript.whisperx[172].end |
5679.005 |
| transcript.whisperx[172].text |
我這20年來永遠只是想的是醫護醫事人員怎麼一直去提升到底要提升到多少總是有一個平衡點那我就問你勞動部公布的每月經常性薪資49202這個數字你滿意嗎你覺得如果他平均是這樣子領到的是這一個如果以現在護理人員現場的情況護理人員平均每月經常性所值49202 |
| transcript.whisperx[173].start |
5681.817 |
| transcript.whisperx[173].end |
5696.786 |
| transcript.whisperx[173].text |
202這是勞動部公布的,你覺得這個數字滿意嗎?要不要再往上加?就有包括一般會嗎?經常信你滿意嗎?包括哪些啦?就是說薪資,還有沒有包括獎勵金?有沒有包括那個臨終獎金?有沒有包括臨終獎金? |
| transcript.whisperx[174].start |
5701.471 |
| transcript.whisperx[174].end |
5722.151 |
| transcript.whisperx[174].text |
我覺得如果這樣子 包括年終獎金 這樣是太低了太低嘛 如果你是可以加薪的 你要幫他加多少薪加一萬塊好不好那應該要問主席吧護理師公會的理事長他已經公開講 他認為再加一萬塊的津貼 |
| transcript.whisperx[175].start |
5727.294 |
| transcript.whisperx[175].end |
5740.099 |
| transcript.whisperx[175].text |
這個才是他認為比較是合理的因為現在平均下來就是4萬多了他認為再加1萬是合理的這個部分你們有沒有去研究過他們的訴求你們應該都清楚啊這個是解決根本的問題但是你們要不要去回應就是說如果我們要標榜健康台灣賴總統很喜歡講健康台灣沒有健康的醫護拿來健康台灣 |
| transcript.whisperx[176].start |
5750.623 |
| transcript.whisperx[176].end |
5764.461 |
| transcript.whisperx[176].text |
那最根本的問題如果幫他加薪你做不到他還是一再出走啊你的人還是一再流失啊我覺得這個問題才是你們應該是治本要好好去看待的應該好好去研議吧這跟他們的訴求提出這麼久了 |
| transcript.whisperx[177].start |
5765.803 |
| transcript.whisperx[177].end |
5785.824 |
| transcript.whisperx[177].text |
但是你們好像一直都不肯證明這個的確是在他們一兩年前就有一直提出這個事情因為高體市長這個跟我幾乎是情同兄妹所以我們非常的瞭解你現在當部長了你有權利啦那到底用什麼方式來增加譬如說 |
| transcript.whisperx[178].start |
5786.445 |
| transcript.whisperx[178].end |
5803.993 |
| transcript.whisperx[178].text |
你們有健康台灣委員會嘛時候向的一個策略是不是就能夠整體性來改善好不好那至於要怎麼加薪我覺得待意努力來提高這就是我誠懇的話那怎麼樣來提高你把它列為健康台灣裡面該討論的議題好好討論那的確是 直接是重點那最後我問一個因為你現在人力不足你說你們要讓外籍看護工來擔任中階護佐 |
| transcript.whisperx[179].start |
5816.338 |
| transcript.whisperx[179].end |
5838.492 |
| transcript.whisperx[179].text |
這一個政策是要上路了嗎?預備什麼時候上路?這個請市長先說明這是一個已經成熟的計畫還是只是在試試看風向我們有事辦了兩年半的這個叫做醫院的住院整合照護計畫那就有護理師跟一個護佐 |
| transcript.whisperx[180].start |
5840.549 |
| transcript.whisperx[180].end |
5846.697 |
| transcript.whisperx[180].text |
一起成為一個team來提高這個照顧效率是那這個這個戶左目前都是本級的我們九成都本級只有10%是新住民目前大概2000多位是這樣那未來因為這個 |
| transcript.whisperx[181].start |
5856.391 |
| transcript.whisperx[181].end |
5860.272 |
| transcript.whisperx[181].text |
不只是這個他也可以減輕民眾的負擔就是住院照顧到卡丘民眾的這個負擔會減一半那同時也是讓整個醫院照顧的效率大大提高那這個大家很希望能夠擴大 |
| transcript.whisperx[182].start |
5873.217 |
| transcript.whisperx[182].end |
5887.51 |
| transcript.whisperx[182].text |
目前因為受限於經費的關係只有5.6億有111家在試辦而已5000多床在試辦那未來大家很希望說能夠擴大到一般的急性病房那就會有人力來源人力來源的這個需求所以我們目前對這個人力不斷在盤點 |
| transcript.whisperx[183].start |
5893.835 |
| transcript.whisperx[183].end |
5897.118 |
| transcript.whisperx[183].text |
他可能性的來源有哪些那其中有一項是國發會跟勞動部他們有一個外籍看護工已經在台灣六年了他本來就在台灣六年了那他有一個流用就是長期流用的一個 |
| transcript.whisperx[184].start |
5911.499 |
| transcript.whisperx[184].end |
5940.1 |
| transcript.whisperx[184].text |
如果雇主推薦他們就可以繼續在台灣來工作所以這個人力也是我們所以你們要往資深的這個外籍看護工來找人嗎但是這個部分會不會衝擊到現在的就是說這一些資深的外籍看護工同時他可能也是很多家裡面他有中症在照顧的這一群人會不會產生這個移轉的效果我覺得這個部分因為時間的關係我希望這一個家庭他已經不需要用了他才推薦他出來 |
| transcript.whisperx[185].start |
5941.817 |
| transcript.whisperx[185].end |
5967.938 |
| transcript.whisperx[185].text |
對 所以因為現在已經有這個民間團體他們擔心這一點所以我希望你可以跟他們好好的溝通會不會產生這樣一個排擠的效應就是私人雇主協會他們已經有提出來公衛提出來的時候其實我們第一個時間就跟他溝通我希望你們要好好的溝通好不好就是溝通完整之後這樣的政策你們要施行才不會遭受到一些批評或者是造成一些負面的影響 |
| transcript.whisperx[186].start |
5969.038 |
| transcript.whisperx[186].end |
5986.806 |
| transcript.whisperx[186].text |
有關於這個部分我們會溝通,那我再重申一下,另外有在傳說我們會重進外籍人力,那個完全不一樣的事情而且那個沒有要做,這本來就已經在台灣,而且這已經談了一兩年,談了六年了 |
| transcript.whisperx[187].start |
5988.423 |
| transcript.whisperx[187].end |
6014.501 |
| transcript.whisperx[187].text |
她已經是六年的在台灣已經工作六年的資深的移工那真的是希望讓那個住院整合性照護多人力啦那如果說大家擔心會去擠壓擠壓這麼人力這個我們都會來溝通對你們一定要好好溝通好不好好謝謝委員的指教好謝謝部長好謝謝王委員那接著我們請邱政軍委員執行我們在圖前舉委員執行完畢後休息十分鐘 |
| transcript.whisperx[188].start |
6020.765 |
| transcript.whisperx[188].end |
6050.137 |
| transcript.whisperx[188].text |
好,我們有請我們的邱部長委員好部長好我想請問一下,我們部裡面有一個次長叫側翼次長,你知道是誰嗎?次長?我們衛福部有三位次長都是你現在有帶手機嗎?我們幫他查一下手機收一下就知道了 |
| transcript.whisperx[189].start |
6051.951 |
| transcript.whisperx[189].end |
6078.227 |
| transcript.whisperx[189].text |
是,現在我專心聆聽委員的指教不敢動用手機我跟你講,就是我們林靜儀次長那他今天沒來是怎麼樣?我聽說昨天召委有邀請他來嗎?對不起,因為時間有點緊,所以他今天有很多的行程各位都知道部長在這裡真的都要靠三位次長 |
| transcript.whisperx[190].start |
6079.608 |
| transcript.whisperx[190].end |
6100.589 |
| transcript.whisperx[190].text |
你也知道衛福部的業務太多了,有的社福那邊也要去所以是部長允許他不來就對了那我有跟趙偉親自請假,感謝趙偉那我知道他去年到現在有總共三次了去年點滴事件,點滴的事件他跟醫護對嗆 |
| transcript.whisperx[191].start |
6102.49 |
| transcript.whisperx[191].end |
6129.21 |
| transcript.whisperx[191].text |
這個某些人站著說話不腰疼你要的2000CC廠商沒在做改給你500CC堅持這樣說堅持這樣沒貨那最終的結果又是就是沒有嘛就是缺嘛那種預算他當過立法委員還配合我們民進黨在做這個造謠帶風向更扯的是連數字都不看凍結預算 |
| transcript.whisperx[192].start |
6131.172 |
| transcript.whisperx[192].end |
6158.98 |
| transcript.whisperx[192].text |
不在乎什麼任性國家醫療部長你也當過立法委員,你認為他講的這個對嗎?我想林次長也有針對他講的話有些不得體他都有深切檢討有嗎?像上一次他上一次他不是槍中醫生嗎?我們行政院長也有特別要求要緊人慎刑他已經三次了,你們還繼續想保他? |
| transcript.whisperx[193].start |
6162.029 |
| transcript.whisperx[193].end |
6183.22 |
| transcript.whisperx[193].text |
我們留下他的,我們是沒有人才了是嗎?衛福部沒有人了嗎?我們國家的人才很多啊對啊,那為什麼出了那麼多狀況,我們部裡面都沒有反應?還是你動不了他?他有不但聲勢減少,而且更加工作努力他的工作能力是專業的側翼? |
| transcript.whisperx[194].start |
6186.687 |
| transcript.whisperx[194].end |
6193.333 |
| transcript.whisperx[194].text |
那個他的專業說實在比我強很多啦所以部長你不會當側翼不會當網軍就對了這點你輸他 |
| transcript.whisperx[195].start |
6197.67 |
| transcript.whisperx[195].end |
6224.806 |
| transcript.whisperx[195].text |
不是專業啦,專業他的工作效率啦,以及對事情的一個分析能力啦,都給我們衛福部很多的好啦,我還是覺得啦,部長你還是要多管管底下的人啦如果真的在這樣子,不是任應該該讓他走就讓他走我們一定深切檢討,謹言慎行那我再請問部長,那個前幾天你有到那個 |
| transcript.whisperx[196].start |
6226.483 |
| transcript.whisperx[196].end |
6243.081 |
| transcript.whisperx[196].text |
醫院去嘛 到急診室去看我真的實實是在那邊打氣絕對不是視察 我不需要視察因為數據 急診的數據都在我們手上所以你也相信我們現在這個急診室的狀況那個媒體拍的 你相信嗎 |
| transcript.whisperx[197].start |
6245.788 |
| transcript.whisperx[197].end |
6272.397 |
| transcript.whisperx[197].text |
顧委員報告我在台大醫院出入40年我的出入幾乎不是正門都是從急診旁邊側門急車路進去所以急診每天發生的情況我跟那個石崇良他也是台大急診出身的應該都深切的了解你應該都知道嘛深切的了解他的一個辛苦那你為什麼那時候去看的時候你去打氣然後然後搞得人仰馬翻所有人都要移走呢所有病人都要往 |
| transcript.whisperx[198].start |
6273.658 |
| transcript.whisperx[198].end |
6288.577 |
| transcript.whisperx[198].text |
那個 報告委員那個所有的所有的醫院都有發聲明說他們完全沒有去做任何完全都是正常的程序而且把時間點都寫得清清楚楚後來 後來媒體再去啊他去了林口 台大 |
| transcript.whisperx[199].start |
6289.678 |
| transcript.whisperx[199].end |
6316.732 |
| transcript.whisperx[199].text |
我沒有去林口長庚啦林口長庚永遠都是非常擁擠的但是因為時間的關係我已經到我本來沒有要去看雙河啦但是到已經四點多的時候我想說雙河還是聽說也是也是屬於比較擁擠的所以特別那個時候才打電話跟他說要去部長以後如果你要去視察這個你上我車我們直接上你也不要問我去哪裡我帶你去看可以嗎 |
| transcript.whisperx[200].start |
6317.915 |
| transcript.whisperx[200].end |
6334.724 |
| transcript.whisperx[200].text |
我可以隨時配合委員如果可以的話那個古代青菜大臣要微服出訪他一定不會驚動地方這樣我們才看得到民間的真正的狀況這樣好不好我沒有要去看我沒有說實在我不是去視察我是真的去打氣而已然後 |
| transcript.whisperx[201].start |
6336.005 |
| transcript.whisperx[201].end |
6354.212 |
| transcript.whisperx[201].text |
也給那些在努力的不管是給他院長督導督導你也是醫生啦我相信你也知道說我們醫院為什麼要分科那護理人員也是啦那急診需要內科床位內科床位滿床的時候婦婦產科有床 |
| transcript.whisperx[202].start |
6355.112 |
| transcript.whisperx[202].end |
6383.721 |
| transcript.whisperx[202].text |
內科病人可能就會轉到婦產科你要醫護人員去執行他不熟悉的業務這樣對醫護人員其實來講說他的壓力是非常非常的大這個不是比喻這是現實發生的狀況那我也聽說你們說要推這個早期出院在宅接受治療照顧這個有嗎那人力呢有想過嗎一個團隊出去車程一天那個要算車程他一天能夠去幾家好這個我想 |
| transcript.whisperx[203].start |
6385.026 |
| transcript.whisperx[203].end |
6406.938 |
| transcript.whisperx[203].text |
Hospital at home就是說我真的很感佩委員對這個醫療的了解跟關心那這個是其實在國際已經推很久了啦我知道啦但是我們現況我們也以台灣的現況來講我們僅有的人力就是要去做更有效率的事情如果讓我們一切都站在病人的立場如果他只是為了一個打個抗生素 |
| transcript.whisperx[204].start |
6409.085 |
| transcript.whisperx[204].end |
6425.602 |
| transcript.whisperx[204].text |
這個我想大家都很有經驗我們也常常在服務打個抗生素如果一定要急診打一個禮拜大概就...您的想法跟用意出發點我覺得都不錯但是我覺得要回歸現實面就是說我們如果做這件事情的時候那如果這些人配置在醫院 |
| transcript.whisperx[205].start |
6426.644 |
| transcript.whisperx[205].end |
6440.167 |
| transcript.whisperx[205].text |
他又可以照顧多少治療的這個患者我們這個不只醫院的團隊我們的基層團隊我們也希望地區醫院人力比較如果人力比較夠都可以投入這樣的我們現在的重點就是沒有人 |
| transcript.whisperx[206].start |
6441.515 |
| transcript.whisperx[206].end |
6464.784 |
| transcript.whisperx[206].text |
不是沒有床有時候是不均的問題我們自己當民意代表我們每天可能要接幾十通的電話一、二十通電話就是沒有床的事情我們也很痛苦所以我們在去年就一直希望把健保點子提高讓醫護人員能夠留下來但是我們部裡面它又自動打折了我請問部長你那天有講到說 |
| transcript.whisperx[207].start |
6468.513 |
| transcript.whisperx[207].end |
6479.186 |
| transcript.whisperx[207].text |
那個你突然公布說我們護理人員的薪資的數據你的目的是什麼你是說有7萬嗎是這樣子各位報告這個網站其實在112年的11月就已經 |
| transcript.whisperx[208].start |
6485.474 |
| transcript.whisperx[208].end |
6503.653 |
| transcript.whisperx[208].text |
各醫院有400多家的醫院填上去那我在確認當時照護師邀請各醫院填上去的目的事實上不是這樣子啊是說是希望能夠讓護理人員知道各個醫院的薪資是怎麼樣可是你7萬是怎麼來的那當然是 |
| transcript.whisperx[209].start |
6506.212 |
| transcript.whisperx[209].end |
6517.509 |
| transcript.whisperx[209].text |
包委你可以看一下這裡有個非公子齁如果是年資一年以下的最低值其實是四萬二也是相當低啦對啊所以我要問的是七萬是怎麼來的 |
| transcript.whisperx[210].start |
6519.689 |
| transcript.whisperx[210].end |
6534.507 |
| transcript.whisperx[210].text |
所有的數據都是醫院他們那邊填的我們後來104薪資情報顯示一年以下的護理師年平均才58.4萬一到三年才達到62.5萬薪資根本就沒有你說的7萬 |
| transcript.whisperx[211].start |
6539.543 |
| transcript.whisperx[211].end |
6553.679 |
| transcript.whisperx[211].text |
不是啦 7萬是因為那個網站上面我本來以為部長你說的7萬是今年你要把它調到7萬是這樣嗎這個是醫院他把固定收入跟會固定收入通通加起來除以2 |
| transcript.whisperx[212].start |
6554.88 |
| transcript.whisperx[212].end |
6582.208 |
| transcript.whisperx[212].text |
的一個數字的成績我拜託委員齁能夠上一個醫照護師的網站比這個更詳細啦他裡面有寫各個醫院400多家醫院裡面的所有薪資我覺得那個薪資我問過所有醫院的院長他們說他們哪裡敢造假但是只是呈現方式的不一樣因為他呈現的是可能把所有的所有的醫院支出給護理人員的都把他加進去啦齁 |
| transcript.whisperx[213].start |
6583.268 |
| transcript.whisperx[213].end |
6589.129 |
| transcript.whisperx[213].text |
所以真正護理的人員我們現在問的是護理師拿到的說我好像沒那麼高啊我的薪資就沒那麼高啊所以這樣的差距讓大家誤解我想我必須要真的感到抱歉那這個數據跟實際上拿的這個東西如果站在議案的立場他會覺得說這就是我付出給護理同仁的嘛我看到這七萬的數字這個部長宣布七萬的時候我很高興我從來沒有宣布多少 |
| transcript.whisperx[214].start |
6611.733 |
| transcript.whisperx[214].end |
6631.138 |
| transcript.whisperx[214].text |
我要帶這些護理人員跟部長說謝謝你要把他調到7萬因為是有記者會說要尋找7萬我們只是把數據公費說實在如果能夠讓護理人員更高或達到這個似乎是我們也是日夜以求的事情7年的1260億的計畫有沒有那個113年執行哪些 |
| transcript.whisperx[215].start |
6638.717 |
| transcript.whisperx[215].end |
6663.054 |
| transcript.whisperx[215].text |
不好意思 去年那個1260億的計畫那個叫...那個說像計畫嗎還是...護理人員那個護理人員政策準備12年這個策略 說像策略啦說像策略我想市長跟委員報告一下說像策略的一個做法 |
| transcript.whisperx[216].start |
6663.376 |
| transcript.whisperx[216].end |
6687.217 |
| transcript.whisperx[216].text |
我們12項策略有4項是有公務預算的有4項一個就是這就包含了三班醫護比入法嘛對對那現在做的怎麼樣夜班獎勵夜班獎勵三班先達標先獎勵那因為去年是3月1號開始執行所以去年有用了40億你們不是說要讓三班護病比這個入法嗎 |
| transcript.whisperx[217].start |
6688.65 |
| transcript.whisperx[217].end |
6706.04 |
| transcript.whisperx[217].text |
對我們先講因為現在如果要達到這樣的標準還要7000到8000人所以我們現在去年開始執行嘛就是因為人員不夠嘛對不對人員不夠所以你現在不能錄啊要增加的因為你錄了之後馬上這個船先獎勵然後朝著這個方向走這樣子 |
| transcript.whisperx[218].start |
6706.73 |
| transcript.whisperx[218].end |
6715.179 |
| transcript.whisperx[218].text |
所以我們第一階段一定是留人才嘛那去年我們又核定政策準備中長程計畫護理人員的政策準備中長程計畫我們也編了248億每年68億 |
| transcript.whisperx[219].start |
6726.91 |
| transcript.whisperx[219].end |
6740.337 |
| transcript.whisperx[219].text |
每年68億啦 4年是275億也就是說我們家前項計畫是總共護理人 這個投資護理是248億那我請教部長 這些計畫裡面哪些是護理人員直接能拿到的 |
| transcript.whisperx[220].start |
6741.004 |
| transcript.whisperx[220].end |
6756.795 |
| transcript.whisperx[220].text |
夜班獎其實這都要用在護理人員的這個都要用在護理人員的這個職場環境的改善那夜班獎勵是直接到護理人員的薪資裡面夜班獎勵那先達標先獎勵呢原則上是要給白班然後沒關係因為時間的問題時間的關係那你現在不用急著回答我你們把這個113年180億執行的成效 |
| transcript.whisperx[221].start |
6771.164 |
| transcript.whisperx[221].end |
6786.471 |
| transcript.whisperx[221].text |
多少錢花在提升醫護人員的待遇?把資料給我好嗎?好沒問題這多久可以給我?沒問題多久?兩個禮拜內兩個禮拜內好謝謝部長好謝謝委員對護理職場的關心非常感謝好謝謝邱委員謝謝部長繼續請廖偉強委員質詢 |
| transcript.whisperx[222].start |
6806.628 |
| transcript.whisperx[222].end |
6808.35 |
| transcript.whisperx[222].text |
謝謝主席 那有請邱部長委員好 |
| transcript.whisperx[223].start |
6816.431 |
| transcript.whisperx[223].end |
6839.074 |
| transcript.whisperx[223].text |
部長好首先要先給您看這是去年亞東醫院急診的主醫師在臉書上PO的燃燒殆盡的一頁他當時就說大量護理師離職小夜班排不出人力連續兩個O卡患者進來同時還要心肌梗塞、中風等病化 |
| transcript.whisperx[224].start |
6839.955 |
| transcript.whisperx[224].end |
6865.648 |
| transcript.whisperx[224].text |
的病患人創下零死亡的紀錄是燃燒殆盡的一夜其實就凸顯了這個問題已經正在發生中那去年這張照片也引發了相當大的震撼今年以來這個急診還是一樣塞爆那醫師護理師病人也是一樣痛苦那最主要會造成這樣急診大塞車的問題我想你我都知道就是醫院中的護理人員的嚴重不足 |
| transcript.whisperx[225].start |
6866.388 |
| transcript.whisperx[225].end |
6878.334 |
| transcript.whisperx[225].text |
那請教部長根據衛福部的統計台灣目前約有截至2月約有309,410名的持有護理證照的人員但實際職業的人員僅有193,503人那職業率僅62.5%請教一下部長職業率低的主要有哪些原因 |
| transcript.whisperx[226].start |
6891.926 |
| transcript.whisperx[226].end |
6907.789 |
| transcript.whisperx[226].text |
我想從我的角度來講我來看市長要不要再補充那個當然市長當然職場的不夠力讓大家太辛苦那是不是待遇方面需要加強部長沒關係好我想這個知道我們先給你看一下上一頁的圖二基本上就是整個醫療的崩潰了並且持續惡化的這個循環就是醫療人力不足那其實我想要問的事情進一步 |
| transcript.whisperx[227].start |
6921.397 |
| transcript.whisperx[227].end |
6935.705 |
| transcript.whisperx[227].text |
你剛剛講的這些問題可是今年以來你們總共召開了五場的營運會議對不對是的那請教部長我們剛剛都知道護理師是很重要的一個因素那這幾場會議找護理師去護理師全聯會或是護理師相關的團體去參加的有幾場 |
| transcript.whisperx[228].start |
6941.667 |
| transcript.whisperx[228].end |
6958.642 |
| transcript.whisperx[228].text |
前面三場是因為要解決急診的整個運作的問題好部長我目前因為時間有限了第四次第五次我直接公布就是五場裡面你只有一場我目前掌握到只有在健保署在3月7日的時候有找護理師相關團體去那是因為要針對要真的針對他們的問題去解決所以當然 |
| transcript.whisperx[229].start |
6963.246 |
| transcript.whisperx[229].end |
6987.779 |
| transcript.whisperx[229].text |
是對嘛但是有時候是前面是站在院方跟整個系統的改善當然但是我覺得部長但是我們明天我們昨天也跟那個醫療工會裡面大部分都是護理同仁做了非常詳盡的溝通是這個部分我要提醒您的就是這個因為其實前幾天你也來拜訪我也跟你講過其實這個明明大家都知道護理師人員人力不足的問題剛剛你也講到很多相關的好情況 |
| transcript.whisperx[230].start |
6988.706 |
| transcript.whisperx[230].end |
7007.919 |
| transcript.whisperx[230].text |
所以現在這個護理師這個護士工會全聯會也指出台灣護理人力從2019年就已經出現了流出量大於流入量的現象那離職率以及空缺率從110年就開始持續的上升那今年的一二月 |
| transcript.whisperx[231].start |
7008.92 |
| transcript.whisperx[231].end |
7024.15 |
| transcript.whisperx[231].text |
也已經超過550位護理師離職那預計3月份的這個數據會更恐怖那也不少的報導有說護理師到各地的護理師公會還有醫院內辦理離職手續居然出現排隊人潮至少等一個小時 |
| transcript.whisperx[232].start |
7025.251 |
| transcript.whisperx[232].end |
7047.198 |
| transcript.whisperx[232].text |
所以現在不只是離職潮而已其實更是一個離職海嘯那請教部長目前對於這樣嚴重的護理人員流失你覺得現在的因應措施對護理人員來說有感嗎能挽回護理人員的心嗎那我也知道你很努力的找錢但是到五月份才有這些緊急應急的措施會不會又發生這期間啊 |
| transcript.whisperx[233].start |
7048.078 |
| transcript.whisperx[233].end |
7055.391 |
| transcript.whisperx[233].text |
重點是這期間會不會又發生像高雄這個重症病患轉診150公里外成大醫院人死亡的悲劇 |
| transcript.whisperx[234].start |
7057.004 |
| transcript.whisperx[234].end |
7078.565 |
| transcript.whisperx[234].text |
謝謝委員的關心齁我一個一個回答第一個剛剛你提的個案它是成大在成大發生的不是在高雄成大醫院的沒有沒有沒有它就是在成大看診它沒有完全跟高雄沒關係那在成大看診以後因為沒有ICU那開刀因為他開刀必須要加入病房所以他找的他的朵六院朵六院區齁過去 |
| transcript.whisperx[235].start |
7080.046 |
| transcript.whisperx[235].end |
7105.084 |
| transcript.whisperx[235].text |
那他是不是到很遠的地方去轉診時間拖到了基本上是在成大的體系啦當然距離是有比較遠的是嗎我們所謂的高雄不是高雄醫院啦是他的距離很遠嘛對啊 那個跟高雄沒有關係啦對啊 當然但是我的意思就是說他從那邊要到150公里外很遠嘛 對不對那這是不是也是因為有同樣的問題發生就是它是整個系統結構裡面的問題嘛 |
| transcript.whisperx[236].start |
7108.392 |
| transcript.whisperx[236].end |
7126.562 |
| transcript.whisperx[236].text |
所以現在部長我想不是解釋我的重點不是針對這個個案我們是在檢討是整個系統性的問題嘛 是吧我剛剛以前有講任何到急診我跟所有院長的心願就是到急診能住院就趕快住院 |
| transcript.whisperx[237].start |
7127.592 |
| transcript.whisperx[237].end |
7149.878 |
| transcript.whisperx[237].text |
老部長 就越快越好我跟你說你剛有提到護理師的待遇不佳的問題啦外部的拉力也是護理師流失的主因那首先根據這個護理師工會的統計啊也可以看到護理師人員你看這個線圖喔在醫院的比例就是歷年來連續的降低喔那診所的比例也連續的升高 |
| transcript.whisperx[238].start |
7150.646 |
| transcript.whisperx[238].end |
7174.822 |
| transcript.whisperx[238].text |
那另外臺灣護理人員卻選擇赴美國、澳洲、紐西蘭、新加坡等外國去工作那澳洲的註冊護理師第一年的年薪大概是170萬台幣那美國護理師月薪大概是10萬至少那年薪就是120萬以上那我想這種巨大的薪資差距也是人才外流的主要原因之一 |
| transcript.whisperx[239].start |
7175.703 |
| transcript.whisperx[239].end |
7185.361 |
| transcript.whisperx[239].text |
那我想要請教一下部長不 衛福部是否有計畫調整護理人員薪資結構讓確保這些薪資政府能夠真正留住這些人才 |
| transcript.whisperx[240].start |
7186.724 |
| transcript.whisperx[240].end |
7208.529 |
| transcript.whisperx[240].text |
我們一定全力來增加我想政府也一直在努力在我們國家的財源之下還有在健保的有限的健保的資源之下怎麼樣給同仁增加待遇很好謝謝不只護理人員如果你要比較的話連醫師也比其他國家薪水少很多是沒錯所以我們現在現在看一下你剛剛有講到一些前提對不對 |
| transcript.whisperx[241].start |
7211.81 |
| transcript.whisperx[241].end |
7230.517 |
| transcript.whisperx[241].text |
所以日前媒体报道有预办诊所的护理人员加薪我们是很乐见乐见这些护理人员都能够加薪不过也要进一步去看你刚刚有讲到资源有限当然在什么情况之下我们对于国家对于健保或者是医疗的投资可能不足的情况之下 |
| transcript.whisperx[242].start |
7231.499 |
| transcript.whisperx[242].end |
7256.615 |
| transcript.whisperx[242].text |
我們再進一步去看細看從統計數字上來看醫院等級尤其是醫學中心的護理人員流失嚴重如果要更細緻的去分析資料恐怕是醫院中的資深護理師的流失更嚴重資深護理師的流失更嚴重而去年7月的時候行政院這裡有一個護理人力政策整備中長程計畫裡面 |
| transcript.whisperx[243].start |
7259.036 |
| transcript.whisperx[243].end |
7281.121 |
| transcript.whisperx[243].text |
第10頁有提到這個護理人員的流失與回流的值與量其中流失是以年資10年以上30歲到40歲已有豐富經驗的護理人員護理的離職為主所以我想衛福部也清楚資深護理師人員流失情況的嚴重那請教部長這群 |
| transcript.whisperx[244].start |
7282.501 |
| transcript.whisperx[244].end |
7300.501 |
| transcript.whisperx[244].text |
我想這群護理師資深的人員留不住不只可能不只是關病床的問題甚至也有可能造成整個醫療團隊的銜接甚至配合產生問題也進一步影響工作的成效照顧品質病人安全意外事件甚至醫療錯誤等等未來也有可能有更多的醫療糾紛那部長 |
| transcript.whisperx[245].start |
7303.384 |
| transcript.whisperx[245].end |
7331.325 |
| transcript.whisperx[245].text |
離職的資深護理人員如果願意重回職場其實是對於整個這個醫療體系來講不僅引擎成本比較低那又是集戰力又可以馬上緩解人力不足的情況嘛對不對所以我也去看了一下這個而且他還可以去訓練新人那我也去看了一下這本這個中長城的計畫的12項主要項目裡面其實跟這個關係比較有關的工作項目是所謂的護理新手臨床教師制度 |
| transcript.whisperx[246].start |
7332.233 |
| transcript.whisperx[246].end |
7361.573 |
| transcript.whisperx[246].text |
好那他也是主要是要減緩新任護理人員的離職率而不是而非這個提高資深有經驗的護理人員繼續留任的意願他不是他主要是他主要裡面有講說減緩新任護理人員的離職率那所以我想要請教部長是有沒有可能在另密裁員為這個作為增加現職的資深人員的這個9任獎金或鼓勵醫院提出9任獎金制度 |
| transcript.whisperx[247].start |
7362.473 |
| transcript.whisperx[247].end |
7378.401 |
| transcript.whisperx[247].text |
因為這個中長城的計劃裡面的護理新手臨床的制度裡面他這裡面是有寫預計要找1000位護理新手的臨床指導教師但是這項經費一年大概是編3.6億那也就是說每人每月是3萬元的訓練費可是我想要問說請教這樣子的 |
| transcript.whisperx[248].start |
7382.583 |
| transcript.whisperx[248].end |
7408.936 |
| transcript.whisperx[248].text |
你覺得這樣子的三萬元的這個去吸引已經離職而且有經驗的護理師回任是有辦法的嗎是有足夠的吸引力的嗎再者裡面有提到是這個全職或兼職都可以那你在實務上在全職上是不是有困難因為他本身就已經能量能量能就有限了你又說全職再給你這個那在實務上是不是可行的我想這部長請問你怎麼看 |
| transcript.whisperx[249].start |
7410.557 |
| transcript.whisperx[249].end |
7433.806 |
| transcript.whisperx[249].text |
非常感謝我們委員對這個護理的狀況掌握得非常精闢 令人敬佩那這個有關於這個部分臨床導師這部分是不一定要專任的對 我知道我剛剛說全職會兼任嘛對 那另外就是說您提到的說我們提到的那個是不是我們另外來闢財源來希望那個離職因為那個孩子當時跟30歲結婚 |
| transcript.whisperx[250].start |
7438.069 |
| transcript.whisperx[250].end |
7463.043 |
| transcript.whisperx[250].text |
他的生小孩的確是真的是兩頭煎熬啦有時候離開可是不要離開永遠離開所以部長這件事情我剛有講他邏輯很清楚啦就是說你們之前的報告也知道說資深離職的其實是其中一個重要人物如果他能夠在某一個小孩子比較比較大的不理你的時候那你當然就回歸他自己所以部長其實主要是兩個問題第一個是不是應該要利命財源去 |
| transcript.whisperx[251].start |
7463.963 |
| transcript.whisperx[251].end |
7485.515 |
| transcript.whisperx[251].text |
吸引這些之爭的 這個我們我們有在做喔我們有在做 對然後第二個所以我剛剛講的就是這個嘛就是說你們是不是要另辟財源讓這些讓九任獎金鼓勵他們留下來然後還有一個是吸引他們回流就吸引他們回流吸引他們回流都可以來演對不對那所以我想要講的事情是這件事情因為你們還沒執行嘛對不對這個計畫還沒執行對不對那個 |
| transcript.whisperx[252].start |
7491.098 |
| transcript.whisperx[252].end |
7519.214 |
| transcript.whisperx[252].text |
如果你执行的话是不是应该要我其实想要这样说你们应该要去追踪成效然后滚动式的检讨因为这是一个必须要做的事情那卫福部我想要问一下这个卫福部刚刚大家很多人也提到你们公告统计护理人员平均薪资是7万但是这也很奇怪是主技处统计医疗保健行业每人月这个经常性薪资大概是5.9万那劳动部统计的是4.98万 |
| transcript.whisperx[253].start |
7520.495 |
| transcript.whisperx[253].end |
7536.554 |
| transcript.whisperx[253].text |
那人力銀行的薪資調查台灣一年以下的護理師平均月薪更只有4.6萬所以我想這也是大家很好奇的你這個時候在那個情況之下你公布這個然後為什麼會跟其他的單位的數據差這麼多那 |
| transcript.whisperx[254].start |
7539.313 |
| transcript.whisperx[254].end |
7558.736 |
| transcript.whisperx[254].text |
這個平均7萬的公告也讓很多的媒體或是這些社群媒體就說來賽心之擔那根據我們大概了解的狀況算是資深的護理師都在5到6萬左右那所以請教部長這7萬到底是怎麼出來的那難道你當初看到這個數據的時候你不會也覺得說怎麼會跟想像中差了這麼多 |
| transcript.whisperx[255].start |
7560.27 |
| transcript.whisperx[255].end |
7576.639 |
| transcript.whisperx[255].text |
的確我們看到那個各醫院那個一個網站讓他各醫院自己上去報有400多家醫院報的時候他所呈現出來的的確是有給我感覺surprise的你也覺得surprise嗎以前好像 |
| transcript.whisperx[256].start |
7577.319 |
| transcript.whisperx[256].end |
7599.148 |
| transcript.whisperx[256].text |
因為我感覺以前真的是偏低有這樣的數據我當然好奇嘛當然就去看它裡面是包括固定收入跟匯固定收入所以在醫院裡面它幾乎可能第一個它把所有的收入包括你譬如說報稅的時候的收入部長我想要講這件事你前面可能已經有解釋了我想要講一個重點 |
| transcript.whisperx[257].start |
7602.679 |
| transcript.whisperx[257].end |
7626.837 |
| transcript.whisperx[257].text |
就是一定要先面對問題才能夠解決問題那你面對這個問題的時候你身為主管機關你應該要更精確的去了解其中的確切的數字所以這部分你們一定要回去改進然後才可以把這個確切數字搞清楚你也才知道如何對症下藥當然當然包圍我們只是公布這個網站而已啦 |
| transcript.whisperx[258].start |
7627.958 |
| transcript.whisperx[258].end |
7646.964 |
| transcript.whisperx[258].text |
有些有些媒體有什麼就要去自己平清自己怎麼樣沒有我跟你講我們是公佈公佈那個是醫院舔的啦那這個當時112年的用意的確只是希望去求職某會員求職是有所以你應該要回去回查就是到底這個數據到底精不精確會導致我已經今天已經講過了如果導致讓基層會員就我心情就不太管啊這個算法的不一樣所導致的困擾所以你現在要做的事情我在這邊跟大家道歉好 |
| transcript.whisperx[259].start |
7657.489 |
| transcript.whisperx[259].end |
7679.886 |
| transcript.whisperx[259].text |
那但是請我們會再去釐清楚對你要去釐清楚這件事情而且我真的保證我們一定全力去增加不管是工作的環境尊嚴還有待遇很好剛剛我們是講待遇所以接下來就講工作環境嘛那台灣醫院的戶邊比也是遠高國際喔那業務量也很繁重那所以台灣醫學中心目前是說 |
| transcript.whisperx[260].start |
7681.141 |
| transcript.whisperx[260].end |
7709.655 |
| transcript.whisperx[260].text |
大概全日護病比是1比9區域醫院是1比12地區醫院1比15那像反觀國際上像我找到資料是澳洲公立醫院的護病比是1比4那美國南加州的內外科病房是1比5我想這種工作負擔的巨大差異就是你剛說的我們一定要改善我們工作環境的因素而且你改善除了要讓他們流質之外其實現在的這個數據也會嚴重的影響病人的就醫的醫療品質 |
| transcript.whisperx[261].start |
7711.016 |
| transcript.whisperx[261].end |
7734.877 |
| transcript.whisperx[261].text |
那我也想要跟你說一個根據一篇在2014年發表的這個Lancet的研究顯示護病比如果超過1比6的時候每增加一名病患死亡率會高7%所以這不僅是負擔過重的問題還是傷害國民健康安全的問題那我就想要請教那請問你們的三班護病比現在的進度到底是什麼 |
| transcript.whisperx[262].start |
7736.08 |
| transcript.whisperx[262].end |
7758.82 |
| transcript.whisperx[262].text |
那你以前他們說要兩年內入法四年達標作為目標你們現在有辦法達成嗎這目標會沒有嗎包委員我想要達到三班戶變比的一個比例甚至有更好的一個規定我想都是我們朝向的目標這中間必須第一個護理人力也要盡量我們來努力讓他加強 |
| transcript.whisperx[263].start |
7759.801 |
| transcript.whisperx[263].end |
7774.136 |
| transcript.whisperx[263].text |
但是我們在三班互動筆的努力之下的確我們在從譬如說醫學中心的三班整體達到利用我們從去年的三類到今年的一類從36%變成59%沒有那你可以達成嗎你們原本目標兩年內入法四年內達標可以做到嗎 |
| transcript.whisperx[264].start |
7775.357 |
| transcript.whisperx[264].end |
7797.903 |
| transcript.whisperx[264].text |
我想這個部分可以做到嗎應該重點是來增加護理的人力是不然的話不然的話你達不到標準所以我其實我整個邏輯是有層次的所以我們一步一步來啦國家的進步也希望大家所以你也要盡速提高護理師護理人員的待遇對不對我們日以繼夜來努力啦所以你要有具體的方案你到底要怎麼幫他加喔 |
| transcript.whisperx[265].start |
7798.303 |
| transcript.whisperx[265].end |
7820.358 |
| transcript.whisperx[265].text |
所以基本上現在剛剛講到針對護理人員的條件惡化除了你們現在三班護病比沒有達標或者是你沒有在不知道你到底可不可以達標的情況之下已經改善非常多了我想跟你說還有跨科資源的政策你也讓他們壓力更大那比如說比起外國美國他可能大部分護理師一週三到四天所以相對我們就是 |
| transcript.whisperx[266].start |
7821.098 |
| transcript.whisperx[266].end |
7845.183 |
| transcript.whisperx[266].text |
有這樣的問題所以你們是不是也應該要有計劃的建立護理人員的勞動權益保障機制也確保合理的工時當然當然當然合理的工作負荷然後建立明確的申訴管道和獎懲制度好這個部分因為時間關係我給護理人員真的就好像我們自己的女兒啦愛惜都來不及了但不能嘴巴上這樣講啊這個問題不是今天才發生啦部長我們一定盡量讓她一個更好的環境 |
| transcript.whisperx[267].start |
7845.523 |
| transcript.whisperx[267].end |
7865.551 |
| transcript.whisperx[267].text |
不是 你不能喊口號因為這就是不是喊口號是一步一步非常的努力對 你剛剛這樣講就是要很重視所以現在有幾個建議是不是具體的行動立即編列一些專項的預算盡速的大幅提高護理人員的薪資待遇確保新進的人員至少也可以達到 |
| transcript.whisperx[268].start |
7867.192 |
| transcript.whisperx[268].end |
7882.951 |
| transcript.whisperx[268].text |
那個年薪台幣70萬以上我想這是護理師公會也很希望看到的哪有加速我們的友善職場所以你的三班戶並比的立法進程你不能夠說因為人你一直找不足就用這個理由那這樣永遠都找不足你永遠就沒辦法推動嘛 |
| transcript.whisperx[269].start |
7883.692 |
| transcript.whisperx[269].end |
7904.711 |
| transcript.whisperx[269].text |
那所以你應該這雞生蛋誕生雞的問題嘛你是不是應該要訂定明確的時間表跟你們這個罰則或時間到了有什麼樣的責任要追究你總是要互相的去給自己一個目標才可以做到嘛那還有第三個是增加9任的獎金鼓勵資深的護理師留任或生育後回任 |
| transcript.whisperx[270].start |
7905.994 |
| transcript.whisperx[270].end |
7930.535 |
| transcript.whisperx[270].text |
第四個 建立護理師人員的職涯發展跟專業自主的制度性保障提升護理專業在醫療體系中的地位如果部長再不趕快的有效的採取這個措施我們大家都看到已經面臨崩潰的台灣的醫療體系它不只是護理人員而已它也是讓百姓面對到醫療品質不佳的狀況而且其實我要跟你講的就是這個 |
| transcript.whisperx[271].start |
7931.195 |
| transcript.whisperx[271].end |
7942.826 |
| transcript.whisperx[271].text |
本席在去年一年多前我面對陳建仁院長的時候就已經跟他講過了這個問題當時還要被他三娘教子就說你不專業結果一年後還是發生了 |
| transcript.whisperx[272].start |
7943.991 |
| transcript.whisperx[272].end |
7962.889 |
| transcript.whisperx[272].text |
對不對所以這個東西我覺得不能政治化部長請你我相信你也是願意做事的部長但是我覺得你要正視現在亡羊補牢還有一點機會是希望你可以拿出魄力解決問題是的我想委員提出的這些訴求我們一定努力來嚴厲來一直 |
| transcript.whisperx[273].start |
7966.816 |
| transcript.whisperx[273].end |
7985.346 |
| transcript.whisperx[273].text |
來盡量把它達成這樣子好 謝謝謝謝 謝謝廖委員去年被陳建成委員修理了他耿耿於懷好 我們請胡田綺委員質詢好 謝謝主席 那請問邱部長 |
| transcript.whisperx[274].start |
8001.488 |
| transcript.whisperx[274].end |
8030.817 |
| transcript.whisperx[274].text |
好部長辛苦我相信最近因為我們針對急診室滿床還有護理師離職潮這部分問題我相信我們衛福部應該也是今天很多委員來提出質詢那我們現在面臨這個醫療困境針對急診室滿床還有護理師離職潮這部分我們認為這不外乎就是錢跟人跟政策大概就這三個面向是是是 |
| transcript.whisperx[275].start |
8031.297 |
| transcript.whisperx[275].end |
8045.307 |
| transcript.whisperx[275].text |
那針對錢的部分我們去年立法院有三讀通過組決議就是承諾健保點值1點達0.95那期限是到今年的6月那時候 |
| transcript.whisperx[276].start |
8046.448 |
| transcript.whisperx[276].end |
8065.546 |
| transcript.whisperx[276].text |
部長也有針對媒體的訪問說針對這部分部長說有信心能夠做到那目前這部分部長覺得現在的進度怎麼樣跟委員報告一下感謝大會的一個大院的幫忙讓我們在 |
| transcript.whisperx[277].start |
8068.248 |
| transcript.whisperx[277].end |
8088.5 |
| transcript.whisperx[277].text |
我們還有就是大家的努力之下所以我們今年啦今年114年的健保總額的高推估到達5.5所以增加了500多億然後把一些原來塞在總額裡面的公衛的方面拿出來這個部分我們也補充了100多億特別針對 |
| transcript.whisperx[278].start |
8089.901 |
| transcript.whisperx[278].end |
8109.839 |
| transcript.whisperx[278].text |
罕變各方面政府也給他額外的公務預算所以總共有700多億所以這個的確增加了700多億這是有史以來最高的所以應該是最有機會來達到0095而且以現在我們大家的努力在今年的第四季預估 |
| transcript.whisperx[279].start |
8111.48 |
| transcript.whisperx[279].end |
8120.707 |
| transcript.whisperx[279].text |
有很多都已經快要達到0.95%了所以這部分其實我們也是都支持你看今年我們健保總額成長率5.5%就多了531億那實質我們是成長8.13%總共多了 |
| transcript.whisperx[280].start |
8128.773 |
| transcript.whisperx[280].end |
8155.007 |
| transcript.whisperx[280].text |
712億那今年的健保總值總共達到9400多億所以我們認為說基本上應該難怪部長會說有信心應該我們也是樂觀其成因為這健保點值達到0.95就是希望醫院有更多的資源能夠運用也讓硬體能夠更新最主要就是讓這個人員加薪希望對這部分護理人員的離職潮希望有 |
| transcript.whisperx[281].start |
8155.347 |
| transcript.whisperx[281].end |
8159.878 |
| transcript.whisperx[281].text |
最正面實質的我們用各種方法來把要給護理人員的就要 |
| transcript.whisperx[282].start |
8160.936 |
| transcript.whisperx[282].end |
8188.587 |
| transcript.whisperx[282].text |
直接給護理人員對 因為我們希望這健保點子的提升最主要也是希望能夠解決這護理師的離職潮這個我們會公開透明來處理這一塊好 那這是經費的部分問題看起來經費的部分我們也都是支持的嘛是 感謝那針對護理方的部分還有一個就是我們了解到就是心血短缺還有既有人力流失那我們看我們教育部歷年的統計喔 |
| transcript.whisperx[283].start |
8190.748 |
| transcript.whisperx[283].end |
8196.271 |
| transcript.whisperx[283].text |
從90年我們護理相關領域90年報考的有16799人可是到112年就跌到8500多人幾乎跌了一半 |
| transcript.whisperx[284].start |
8206.298 |
| transcript.whisperx[284].end |
8227.745 |
| transcript.whisperx[284].text |
而且這五年我們專技高考護理師的報名人數也明顯降低那不知道這一部分我們衛福部有沒有跟教育部來研討過為什麼這個人數下降的這麼多那衛福部針對這部分有沒有提出一些方案來跟教育部來溝通首先這個數據我想師長來分析一下好了 |
| transcript.whisperx[285].start |
8229.173 |
| transcript.whisperx[285].end |
8231.515 |
| transcript.whisperx[285].text |
這個數據可能要進一步釐清我們目前大概有40多個護理學校在培育護理學生那每年大概是14500到15000之間不過這個有重複真正的新的護理人員是大概是9000每年大概是9000 |
| transcript.whisperx[286].start |
8249.89 |
| transcript.whisperx[286].end |
8252.351 |
| transcript.whisperx[286].text |
因為有的他念了這個大學畢業要念博士碩士或是專科再去念二技那這個是重複計算但是近的話是每年大概有9000個新的護理人力的這個培育這樣子 |
| transcript.whisperx[287].start |
8265.276 |
| transcript.whisperx[287].end |
8271.617 |
| transcript.whisperx[287].text |
那缺的少子化之後其實是慢慢有在下降是真的是因為少子化的關係整個結構性的那現在對於護理人力的這個投資的這個培育世界衛生組織也一直在倡議就是說自己的國家自己培育自己的護理人力那所以他們是建議說應該要增加8到10person這樣的人力的增加的補充所以目前教育部呢他們給各個學校因為 |
| transcript.whisperx[288].start |
8293.762 |
| transcript.whisperx[288].end |
8314.255 |
| transcript.whisperx[288].text |
各個學校的那個學生的員額是有核定的每個學校可以培育多少是依照學校的量能來做量的一個控制那現在他們有開放10%的這個員額所以您的意思是說其實他這個人數降低跟少子化有比較大的關係跟我們勞動環境有沒有影響 |
| transcript.whisperx[289].start |
8315.336 |
| transcript.whisperx[289].end |
8340.629 |
| transcript.whisperx[289].text |
當然也會有影響啊如果說職場環境會影響他要不要投入這一個選擇所以我覺得衛福部應該要檢討一下是不是因為這個職場勞動環境影響到他們來報考從事這個行業的意願所以你看報考人數其實是下降很多當然少子化是一個因素但是我認為他報考的意願應該實質降低很多你看差了幾乎一倍 |
| transcript.whisperx[290].start |
8341.755 |
| transcript.whisperx[290].end |
8361.924 |
| transcript.whisperx[290].text |
如何讓我們在高中畢業生或者是甚至有專科的更多的人願意來投入這個科系其實我個人覺得非常重要對啊我們現在擔心護理人員大量離職潮但是這個要整個讓提升當然提升未來護理的專業的尊重 |
| transcript.whisperx[291].start |
8364.589 |
| transcript.whisperx[291].end |
8373.275 |
| transcript.whisperx[291].text |
對他的一個待遇的提升環境的保護這個都是要做的事情所以我說這部分衛福部要去加強你衛福部加強這個勞動環境才能讓教育部去招生會有更多人來報考當然當然 |
| transcript.whisperx[292].start |
8381.92 |
| transcript.whisperx[292].end |
8406.881 |
| transcript.whisperx[292].text |
所以我們現在擔心護理人員大量離職潮是台灣醫療體系崩潰的前奏你看我們據我們了解去年11月到今年2月我相信今天也很多委員提出短短的4個月就有754個離職而且剛剛我有聽到也有很多人詢問說他們說護理師連辦離職手續都要排隊一個多小時 |
| transcript.whisperx[293].start |
8408.373 |
| transcript.whisperx[293].end |
8430.408 |
| transcript.whisperx[293].text |
那我相信剛剛部長好像針對這部分也有回覆那可能部長也說因為還有其他等等的因素但是我覺得這也是一個警訊每一個醫師或每一個護理師當他去工會辦離職的時候因為我也當過台北市醫師工會理事長只要有人去離職我一定請同仁去了解原因 |
| transcript.whisperx[294].start |
8431.469 |
| transcript.whisperx[294].end |
8444.936 |
| transcript.whisperx[294].text |
是不是對這個職業不喜歡的我想護理師也是一樣任何一個離職除了他有家庭的因素真的沒辦法不然我們都會覺得很可惜所以你有提到怎麼樣去右繼黨 |
| transcript.whisperx[295].start |
8446.457 |
| transcript.whisperx[295].end |
8471.98 |
| transcript.whisperx[295].text |
把離職的這一段時間以後又能夠再能夠讓他回來等等的所以我們現在護理師荒嘛你看薪水又短缺而且這個離職潮又這麼大你看短短四個月就700多人離職那而且剛剛我也聽我們委員講其實針對這部分我們次長真的也要檢討一下因為 |
| transcript.whisperx[296].start |
8472.941 |
| transcript.whisperx[296].end |
8491.606 |
| transcript.whisperx[296].text |
我們第一線的醫療人員就已經很辛苦那在接受訪問在講的時候又用這種冷言冷語我覺得對這個從業人員真的是一個很大的傷害所以這部分部長真的還是要多關切一下我們順勢檢討要求所有的同仁請人順行 |
| transcript.whisperx[297].start |
8492.677 |
| transcript.whisperx[297].end |
8511.934 |
| transcript.whisperx[297].text |
對啊我覺得這還是要多加改進喔那我們針對衛福部喔我們自己部立醫院我們了解到好像部立醫院他本身這個本薪啊你看台北台中苗栗算起來他這個本薪一個小時像台北大概只有250塊 |
| transcript.whisperx[298].start |
8513.275 |
| transcript.whisperx[298].end |
8530.441 |
| transcript.whisperx[298].text |
台中244塊苗栗大概238塊而且事實上據我們了解他的時數還是低估正常他這個時數應該每天是超過8個小時所以看起來他這個本薪真的是非常非常的低耶 部長 |
| transcript.whisperx[299].start |
8532.188 |
| transcript.whisperx[299].end |
8555.945 |
| transcript.whisperx[299].text |
這個 因為是有關不利 我請執行長回答跟你回報一下那當然我們公立醫院 它心思結構就是有本縫 專業家子加上獎勵金那我們調查26家不利醫院當然有分成公職跟非公職那公職的部分 我們用中位數調查所有的8000多名的護理人員我們的公職是 中位數是72000那非公職的是52000 |
| transcript.whisperx[300].start |
8560.528 |
| transcript.whisperx[300].end |
8581.781 |
| transcript.whisperx[300].text |
公尺對就是含獎勵金因為我現在講的是本金啦本心嘛我講是本心我當然知道你說其他的什麼家籍什麼等等的部分那我是認為說這個本心的部分應該也是要檢討一下因為現在就大家就認為說護理師啊又累工作又雜那造成會缺就是因為 |
| transcript.whisperx[301].start |
8582.501 |
| transcript.whisperx[301].end |
8604.874 |
| transcript.whisperx[301].text |
他所付出的得不到相當的代價啊那連我們自己部立醫院都帶頭這麼低薪你如何去帶動其他醫院診所的這些護理師的薪水委員你報告這個薪資的裡面的架構其實都是按照行政院裡面的它裡面的包含它的點包含它的級數都是按照這個部分那當然如果說有這個值得再檢討的我們會在這個部分再來評估檢討 |
| transcript.whisperx[302].start |
8606.435 |
| transcript.whisperx[302].end |
8627.797 |
| transcript.whisperx[302].text |
最主要還是在於說我們的整個薪資結構是剛剛提到其實還有他的一個獎勵金跟所有的專業佳績就是再加起來這個他的薪資佳橋剛已經報告過所以包含這個公職跟非公職的部分其實我們都努力能夠達到這個一定的這個所謂的合理待遇好你現在看一下你看我們這有ABC你看A |
| transcript.whisperx[303].start |
8628.598 |
| transcript.whisperx[303].end |
8643.086 |
| transcript.whisperx[303].text |
他每天固定上班8小時好B他每天上班8個小時輪班C是白班小夜大夜三班輪子而且要輪班工時需要10到12個小時你看他整個 |
| transcript.whisperx[304].start |
8643.746 |
| transcript.whisperx[304].end |
8664.034 |
| transcript.whisperx[304].text |
再加上他的休假方式A跟B都是固定週休二日C要排休而且沒有固定假日你再看他的薪資結構一個底薪三萬B是三萬二到四萬二C是三萬五到四萬五那請問部長你看看這三個薪資結構如果是你 你會挑哪一個工作 |
| transcript.whisperx[305].start |
8664.929 |
| transcript.whisperx[305].end |
8685.266 |
| transcript.whisperx[305].text |
我首先當然要跟他談有沒有福利條件如果是第一個譬如說C的話這個是你每個月給我的還是未來有沒有包括年終獎金三節有沒有獎金所以這個要才知道說我雖然可以拿到四萬五其實也不高 |
| transcript.whisperx[306].start |
8686.327 |
| transcript.whisperx[306].end |
8701.224 |
| transcript.whisperx[306].text |
對啊 這個就是我們現在醫院跟診所還有醫美它的薪資結構你就在苗栗新竹那個地方好了的診所你喊五萬塊也請不到人 |
| transcript.whisperx[307].start |
8702.085 |
| transcript.whisperx[307].end |
8725.337 |
| transcript.whisperx[307].text |
所以這部分我希望部長我們今天真的是希望針對護理師他們待遇的部分要好好去檢討你看為什麼他不要在醫院都跑到診所都跑到醫美去為什麼這個上班的工作的內容還有工時還有所有的福利根本就不成比例如果我們不去深切針對這些問題檢討 |
| transcript.whisperx[308].start |
8728.139 |
| transcript.whisperx[308].end |
8732.464 |
| transcript.whisperx[308].text |
這個問題只會繼續惡化下去你看我們從106年醫院職場人數從66.5%下降到63%就減少了3.5%它的降幅是5%而診所的 |
| transcript.whisperx[309].start |
8745.938 |
| transcript.whisperx[309].end |
8767.527 |
| transcript.whisperx[309].text |
職場人數從13.7成長到16.8就明顯上升所以基本上醫院急診室這些護理師都跑到醫美都跑到診所去那你看他的整個福利的條件工時內容這個我覺得就是很大的問題希望我們衛福部部長針對這部分好好的檢討不然這個問題喔 |
| transcript.whisperx[310].start |
8769.188 |
| transcript.whisperx[310].end |
8792.334 |
| transcript.whisperx[310].text |
只會更嚴重我們不只徹底檢討已經在落實我們感謝我們中央健保署的實施長最近非常努力在加重這個是我們主席一直要求的集中症的一個給付幾乎把我們其他今年的其他總額其他以外的其他費用都挪在集中症的補充好希望衛福部的部長這個加緊腳步趕快 |
| transcript.whisperx[311].start |
8796.015 |
| transcript.whisperx[311].end |
8817.08 |
| transcript.whisperx[311].text |
訂定一些良善的制度讓我們基層從業人員有感不然這個問題有更加嚴重到時候這急診室這擁捨的情形我們怕會越來越嚴重到時候這部長真的難以收拾我們全力以赴我們也會跟各醫院團隊大家一起來努力部長跟我們同仁大家加油謝謝謝謝副委員謝謝部長休息10分鐘 |
| transcript.whisperx[312].start |
8830.342 |
| transcript.whisperx[312].end |
8830.962 |
| transcript.whisperx[312].text |
謝謝大家 |
| transcript.whisperx[313].start |
9453.674 |
| transcript.whisperx[313].end |
9458.197 |
| transcript.whisperx[313].text |
時間到了好我們現在繼續開會請我們黃秀芳委員發言謝謝主席已經開始了好謝謝請部長 |
| transcript.whisperx[314].start |
9483.481 |
| transcript.whisperx[314].end |
9507.22 |
| transcript.whisperx[314].text |
好請我們邱部長委員好 部長好 部長在前一陣子可能在二月那時候其實我也接到很多基層醫療就是民眾到醫院然後在急診那邊等非常的久或者是這個在急診然後要進到病房那也等非常久 等了很多天 |
| transcript.whisperx[315].start |
9509.242 |
| transcript.whisperx[315].end |
9531.982 |
| transcript.whisperx[315].text |
這個時候我們就會覺得說其實我們台灣就是一直會覺得說台灣的這個醫療做得很好那為什麼在這一兩年當中大家會覺得好像整個有一些狀況那我們也看到就是說在去年的時候我們去年7月我們也有一個就是護理人力的政策準備中長程的計畫 |
| transcript.whisperx[316].start |
9533.183 |
| transcript.whisperx[316].end |
9546.992 |
| transcript.whisperx[316].text |
那這個計畫下來之後其實有一些護理人員覺得蠻開心那有的人會有一些抱怨也有一些反彈那我們也看到就是說原本你們今年又編列了這個47億 |
| transcript.whisperx[317].start |
9549.313 |
| transcript.whisperx[317].end |
9576.329 |
| transcript.whisperx[317].text |
就不分醫院層級然後病房類別擴大給負啦那這個部分我原本一直認為就是說應該是從1月份應該是從1月份就會開始可是好像到現在這些護理人員好像也也還沒有收到這樣的一個給付那我想請教部長這個到底是怎麼回事報告委員我想預算程序如果完成 |
| transcript.whisperx[318].start |
9578.206 |
| transcript.whisperx[318].end |
9590.019 |
| transcript.whisperx[318].text |
我們就要趕快立即發來現在已經是三月份了因為現在整個預算程序要立好那你們什麼時候提出解凍整個會計程 |
| transcript.whisperx[319].start |
9598.815 |
| transcript.whisperx[319].end |
9613.76 |
| transcript.whisperx[319].text |
現在呼籲嘛可能要看整個settle down 看預算 預算有多少當然要解凍的就盡量來解凍 請大家幫忙那有些可能被刪的各方面 |
| transcript.whisperx[320].start |
9614.46 |
| transcript.whisperx[320].end |
9637.68 |
| transcript.whisperx[320].text |
我們做整體,一旦確定以後,我們追溯到1月馬上來發所以大家放心啦當然啊,當然你從1月份,原本這個從1月份到現在3月了這個會讓很多護理人員會覺得說那我們衛福部就嘴巴說說而已啊,實際上也沒有拿到啊 |
| transcript.whisperx[321].start |
9638.22 |
| transcript.whisperx[321].end |
9653.915 |
| transcript.whisperx[321].text |
那我是認為就是說部長針對這一部分如果說需要委員會這邊來協助或者是你們還需要提出這個譬如說可以有一部分可以解凍的話那是不是趕快來進行這樣的一個程序 |
| transcript.whisperx[322].start |
9655.521 |
| transcript.whisperx[322].end |
9667.681 |
| transcript.whisperx[322].text |
是 節奏是一回事 感謝委員會幫忙那這是整個會計程序 我剛剛有報告過嘛你整個國家總預算的確定以後才會動啊 |
| transcript.whisperx[323].start |
9669.947 |
| transcript.whisperx[323].end |
9698.393 |
| transcript.whisperx[323].text |
所以我們也希望能夠趕快有確定那昨天也才做一個預算呼籲的處理而已所以部長就是說我們現在為什麼基層醫療院所會有這樣的一個問題其實有很多會覺得說可能護理人力的不足然後有的是關床就是說關床那這個是最大的原因嗎就是說護理人力不足然後關床 |
| transcript.whisperx[324].start |
9699.033 |
| transcript.whisperx[324].end |
9724.479 |
| transcript.whisperx[324].text |
然後造成可能急診要進到病房就是大塞車這個是最主要的原因嗎當然整個醫療環境都有影響啦譬如說我們在分級分流有沒有落實那才不會增加急診不必要的壓力人力那所以這個的確是未來長期要去要去努力的啦那那個 |
| transcript.whisperx[325].start |
9727.521 |
| transcript.whisperx[325].end |
9736.074 |
| transcript.whisperx[325].text |
那護理人力的一個職場的環境跟護理人力的不足就是我們大家都知道的事情而且一直在努力 |
| transcript.whisperx[326].start |
9738.382 |
| transcript.whisperx[326].end |
9764.8 |
| transcript.whisperx[326].text |
需要的人更多但是我們在12項的一個策略努力之下的確在去年的12頁到去年的1頁其實我們也增加了3000多位的婦女同仁雖然最近看起來聽說好像有比較多離子因為最近過年後一般都是離子的一個巔峰等開學以後就是說畢業以後又是一個進來的一個 |
| transcript.whisperx[327].start |
9767.679 |
| transcript.whisperx[327].end |
9791.874 |
| transcript.whisperx[327].text |
加減起來總是去年也多了3800個但是真的還不夠不但人數我們要加強人數加強我們在護病比的達標會更快我們的工作同仁的壓力也會工作的負荷也會比較輕所以怎麼樣去加強護理人類的留任或者行進是非常重要的課題 |
| transcript.whisperx[328].start |
9792.657 |
| transcript.whisperx[328].end |
9814.867 |
| transcript.whisperx[328].text |
沒錯那部長我想請教就是說我們一直在提到除了讓所有的這個護理人員可能有這個津貼之外那怎麼樣讓這個分級醫療的這個部分那我想請教部長就目前你認為我們的這個分級醫療做得如何 |
| transcript.whisperx[329].start |
9817.195 |
| transcript.whisperx[329].end |
9833.311 |
| transcript.whisperx[329].text |
分級醫療其實從民國76年開始我們在做醫療網的時候就是分級醫療那後來當然因為醫院一直蓋所以醫院的立場會覺得分級醫療他們比較不那麼努力在推行 |
| transcript.whisperx[330].start |
9834.232 |
| transcript.whisperx[330].end |
9854.616 |
| transcript.whisperx[330].text |
那加上我們的民眾還是比較以傾向使用大醫院好像比較安心部長你們要怎麼去讓民眾更了解就是說要有分級醫療的這樣的一個觀念重病或者是有時候也不能用強迫因為一定要讓民眾說我去看基層醫療電腦比較安心電腦適當很好的照顧 |
| transcript.whisperx[331].start |
9861.377 |
| transcript.whisperx[331].end |
9867.791 |
| transcript.whisperx[331].text |
我不是我去台大我是醫水中心等很久很難掛號等很久看一看就說啊你這個齁 |
| transcript.whisperx[332].start |
9869.076 |
| transcript.whisperx[332].end |
9893.111 |
| transcript.whisperx[332].text |
可能不是我的科要掛另外一科你又要等兩個禮拜像真的這樣都會比較對病人是情何以堪可是如果你在你的社區就有熟悉的診所或最好是有建立關係的一個家庭醫師製作那你隨時任何問題包括打電話都可以我們現在有社區醫療群社區醫療群就是有一群家庭醫師24小時 |
| transcript.whisperx[333].start |
9896.229 |
| transcript.whisperx[333].end |
9918.025 |
| transcript.whisperx[333].text |
你有什麼事情只要打個電話一定幫你做處理大家要善用所以你覺得目前分級醫療做得如何一定要大大的加強所以是不滿意從我的角度我是不滿意那如果不滿意的話要怎麼如何加強 |
| transcript.whisperx[334].start |
9920.044 |
| transcript.whisperx[334].end |
9947.823 |
| transcript.whisperx[334].text |
你一方面宣導另外一方面我也知道就是說我們這個衛福部期望就是醫學中心下轉可能就是說病情穩定的這個慢性病人到基層診所可是我們也看到就是說今年的這個基層的這個總額就是已經確定這個總額這個總預算了那如果說要診所收治更多的這個病人那勢必應該會稀釋掉這個點子 |
| transcript.whisperx[335].start |
9950.925 |
| transcript.whisperx[335].end |
9971.138 |
| transcript.whisperx[335].text |
這個點子如果更多病人進來嘛基層診所更多病人進來那可能這個點子就會被稀釋掉那這樣子的話你又要如何去確保就是說這個基層診所是能夠接住病人的啦所以我覺得就是說部長可能針對這一部分我們又要希望就是說醫學中心 |
| transcript.whisperx[336].start |
9972.759 |
| transcript.whisperx[336].end |
9991.807 |
| transcript.whisperx[336].text |
這個可能就是做急重難含症的這些病患那希望這個比較輕症可能就到基層醫療院所去那怎麼樣去讓這個分級做得更徹底分級醫療做得更徹底我覺得這個應該也是我們目前要去做的一個課題 |
| transcript.whisperx[337].start |
9993.493 |
| transcript.whisperx[337].end |
10008.995 |
| transcript.whisperx[337].text |
感謝委員這個非常宏觀的來分析我們整個未來應該要走的走向那我們所有的政策都盡量讓民眾很自然的就變成分析的醫療第一個我們讓民眾有他信心的家庭醫師 |
| transcript.whisperx[338].start |
10010.137 |
| transcript.whisperx[338].end |
10031.922 |
| transcript.whisperx[338].text |
第二個我們也提高在集中症大醫院裡面集中症的給護我想這個部分在那個實施上的努力之下也都有很好的成果那今年是一個非常好的機會來實行分級醫療因為今年在政府的幫忙之下以及大家努力之下我們今年的總額是 |
| transcript.whisperx[339].start |
10033.697 |
| transcript.whisperx[339].end |
10056.502 |
| transcript.whisperx[339].text |
提升很多 單單健保的總額就提升500多億當然這裡面也有蠻多部分會在基層所以基層的醫療密集度這個部分的經費會比較多也就是說不怕接病人其實今年是一個很好的機會所以今年如果能夠利用這個錢比較就是說經費比較多的情況之下總共用在健保的700多億包括我們 |
| transcript.whisperx[340].start |
10058.083 |
| transcript.whisperx[340].end |
10067.593 |
| transcript.whisperx[340].text |
讓基層醫療能夠多做一些預防保健的工作病人下來給他前人的一個照顧然後應該幾戶的譬如說我們政府也讓城縣 |
| transcript.whisperx[341].start |
10071.601 |
| transcript.whisperx[341].end |
10091.742 |
| transcript.whisperx[341].text |
可能二十年來沒有增加大家都陪在地上做的這次要加倍幾乎所以你所講的如果說今年預算那如果說今年是預算比往年還多的話我覺得有一些政策我覺得應該要趕快去做而且是要積極的去推動 |
| transcript.whisperx[342].start |
10092.502 |
| transcript.whisperx[342].end |
10111.32 |
| transcript.whisperx[342].text |
比如說分級醫療的這個部分如果往年做的不是那麼好的話那是不是你覺得說預算有增加那如何鼓勵基層醫療院所或者是這個醫學中心下轉這個可能慢性病的這個患者或是比較輕症的患者下轉我覺得應該也要有一些誘因啦 |
| transcript.whisperx[343].start |
10112.321 |
| transcript.whisperx[343].end |
10137.726 |
| transcript.whisperx[343].text |
一方面也要讓所有的這個民眾知道就是我大病可能我這個急症或這個大病可能就到這個醫學中心那其他感冒一般的這個不是那麼嚴重的話可能就到診所或者到地區醫院區醫院就可以了我覺得這個應該也要再再去落實啦要不然我覺得每一年尤其是在過年前後每一次看到可能就 |
| transcript.whisperx[344].start |
10139.167 |
| transcript.whisperx[344].end |
10156.668 |
| transcript.whisperx[344].text |
就是醫院可能擠爆一方面可能也當時可能這個時候就是流感或者是像今年的話也許是流感或者是諾蘿病毒那也會造成整個這個醫院可能人力不足那怎樣好讓這個大醫院的部分醫學中心這個 |
| transcript.whisperx[345].start |
10158.59 |
| transcript.whisperx[345].end |
10176.278 |
| transcript.whisperx[345].text |
能夠專心在他們的這個急重難喊症那其他比較輕症或者是比較慢性病的話可能就下轉到其他醫院我覺得這個應該也是我們衛福部如果說今年你覺得預算有比較餘裕的話我覺得應該要有一些誘因然後趕快把這個分級醫療趕快落實 |
| transcript.whisperx[346].start |
10177.891 |
| transcript.whisperx[346].end |
10191.81 |
| transcript.whisperx[346].text |
非常感謝真的很敬佩我們的委員對這整個醫療體系的瞭解跟卓越的見解這就是我們今年會努力去做的方向那我們也一定努力讓我們明年不要再發生 |
| transcript.whisperx[347].start |
10192.811 |
| transcript.whisperx[347].end |
10212.772 |
| transcript.whisperx[347].text |
那個急診太辛苦的一個情況分級醫療今天是一個大好的時機部長最後一個問題就是說之前卓院長有在這個這個巡打的時候有特別提到就是說三班互併比目前還是以獎勵為主那我想請教一下部長你的意見是怎樣 |
| transcript.whisperx[348].start |
10215.26 |
| transcript.whisperx[348].end |
10239.974 |
| transcript.whisperx[348].text |
我想這個十二項政策是一直聯繫的政策啦那目前我如果站在醫療的立場那個當然就是希望說我護理人力能夠充足嘛充足我當然就希望讓他達到哪一個醫院長不希望達到負病比但是不能因為人力不足然後又要求到某些制度而讓床沒辦法開 |
| transcript.whisperx[349].start |
10241.475 |
| transcript.whisperx[349].end |
10260.634 |
| transcript.whisperx[349].text |
我想這個部分的中間永遠一個政策是要他利弊得失共同坐下來談我們衛福部一定跟醫院來針對這個部分那當然要跟護理界一直來溝通那我相信至少我們在三班互變筆的努力之下我們在醫學中心已經從36%的 |
| transcript.whisperx[350].start |
10262.396 |
| transcript.whisperx[350].end |
10286.767 |
| transcript.whisperx[350].text |
三班都達到的已經變成59%區議院從26%已經變成49%那在地區議院已經從83%達標三個都達到94%所以我們獎勵其實也是一個讓大家可以做得到的一個方向那將來當更成熟我們人力更多的時候我想就自然水到其層 |
| transcript.whisperx[351].start |
10287.607 |
| transcript.whisperx[351].end |
10313.441 |
| transcript.whisperx[351].text |
好 謝謝 我們希望就是說不要再看到醫療機構可能整個病患可能就全部都塞在急診室我覺得這個是我們不希望看到的啦對 我們一定從整個醫療體系的改變 區域的防守或者是分級分流這個部分也要來努力好 謝謝委員的指教 謝謝 |
| transcript.whisperx[352].start |
10316.641 |
| transcript.whisperx[352].end |
10328.184 |
| transcript.whisperx[352].text |
好謝謝黃秋帆委員那目前我們收到臨時提案共兩案那待會我們王振旭委員質詢之後我們來進行處理好那接下來請我們蘇欽前委員謝謝謝謝主席我請部長還有石署長好請我們邱部長跟石署長各位好好 |
| transcript.whisperx[353].start |
10347.743 |
| transcript.whisperx[353].end |
10368.455 |
| transcript.whisperx[353].text |
我們一年看接近的人次到底多少我看到很多data有的是說總人口數的20%有的講40%到底是我都不曉得確實的一年急診的人次是多少這個有統計嗎 |
| transcript.whisperx[354].start |
10371.317 |
| transcript.whisperx[354].end |
10395.549 |
| transcript.whisperx[354].text |
我們查一下好了那第二個這個急診的問題因為你我們署長是長很接近的嘛那市長也很接近的所以這個急診的問題事實上是從我們第八對立委的時候就一直凸顯出來所以不是現在才發生那為什麼今年會特別嚴重為什麼 署長 |
| transcript.whisperx[355].start |
10402.267 |
| transcript.whisperx[355].end |
10405.733 |
| transcript.whisperx[355].text |
當然有很多的原因我們過去認為當然是不是 |
| transcript.whisperx[356].start |
10410.482 |
| transcript.whisperx[356].end |
10437.632 |
| transcript.whisperx[356].text |
免疫負載以後的感染病比較多這當然是一部分那天氣的一個變化所以集中症的就是說中風心臟病或者慢性病的一個惡化這個也是其中之一那當然我們也了解到如果上上面的床數沒有足沒有夠的話當然上就上不去嘛那這個部分也會變成在急診後床方面的一個 |
| transcript.whisperx[357].start |
10439.11 |
| transcript.whisperx[357].end |
10443.961 |
| transcript.whisperx[357].text |
一個問題會呈現出來我想都是原因我們都慢慢在預防、在檢討 |
| transcript.whisperx[358].start |
10447.478 |
| transcript.whisperx[358].end |
10476.187 |
| transcript.whisperx[358].text |
那急診要做分級醫療要做什麼我覺得一直推都推不成功的有原因最主要是我們來看急診的病人我們分一二三四五級嘛是一級二級的最嚴重三級的沒通四級五級的可以等待那現在的問題是我們人口老化那小孩子又都在都會區那老人家都在鄉下比較多 |
| transcript.whisperx[359].start |
10477.148 |
| transcript.whisperx[359].end |
10504.277 |
| transcript.whisperx[359].text |
那所以這些老人到急診他可能三幾個來但是他會好轉的稍微半但是會惡化的也一半所以連醫生也沒辦法掌握這個病人是會好轉還是惡化尤其像現在呼吸道感染如果又病在細菌感染又是病毒一個晚上就白掉了整個肺部我們在急診看到就是這樣 |
| transcript.whisperx[360].start |
10505.237 |
| transcript.whisperx[360].end |
10524.39 |
| transcript.whisperx[360].text |
所以,你也不敢強制說哇,你剛才,你剛才急診,你剛才,你剛才問診,看,看,接受,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看,看, |
| transcript.whisperx[361].start |
10533.786 |
| transcript.whisperx[361].end |
10552.905 |
| transcript.whisperx[361].text |
台灣會做這個分級醫療會做不成功很難成功這個就是最大的問題啦普頓你覺得怎麼樣我覺得稍微改變會很得意但是我們這個可以改善啦譬如說我們如果能夠 |
| transcript.whisperx[362].start |
10554.806 |
| transcript.whisperx[362].end |
10571.771 |
| transcript.whisperx[362].text |
不要生小病,小病能夠馬上得到診斷就不會每次都已經到很嚴重才到急診所以我們現在的努力整個說實在的,健康台灣現在很重視從營養、運動、生活型態的一個改變大家比較健康 |
| transcript.whisperx[363].start |
10572.551 |
| transcript.whisperx[363].end |
10575.734 |
| transcript.whisperx[363].text |
第二你第三要有一個全民的健康健全 各種服務 基層醫療大家來做要讓百合民眾來信任我們的基層診所 我想這個我們早期歷史公會歷史庭文審也對基層醫療非常的重視 |
| transcript.whisperx[364].start |
10591.011 |
| transcript.whisperx[364].end |
10615.576 |
| transcript.whisperx[364].text |
跟加強這是一直大家在努力的民眾可以有信心我也不能強迫說民眾要有信心而是我們要提出我們可以做哪些事情讓民眾有信心他自然就不會跑去我比較心想也不要用硬性的讓民眾能夠有信心這不會是最重要的我們的家屬跟病人自己會選擇 |
| transcript.whisperx[365].start |
10617.296 |
| transcript.whisperx[365].end |
10630.004 |
| transcript.whisperx[365].text |
自己會虛擬的分類他會怎麼樣他不敢去哪裡他會趕快跑大醫院跑大醫院是他最大的安心嘛所以去那邊擠去那邊塞你也安心 |
| transcript.whisperx[366].start |
10631.107 |
| transcript.whisperx[366].end |
10646.775 |
| transcript.whisperx[366].text |
所以現在這撒不走,這也是公派處,也是好處啊你看日本做分子醫療,做得很好,做得下癮好,那就是出事了一個救護車撒的,一直撞,一直撞,沒人要收日本就是這樣,真的這樣啊所以,是不是日本這樣很好,我也不知道 |
| transcript.whisperx[367].start |
10652.145 |
| transcript.whisperx[367].end |
10663.043 |
| transcript.whisperx[367].text |
所以藝人在那裡出事我講去就去就去那種case在民東就不會出事了不要說對去到我那裡我一口沒了就整起來了 |
| transcript.whisperx[368].start |
10664.127 |
| transcript.whisperx[368].end |
10687.649 |
| transcript.whisperx[368].text |
真的生氣了急診室就在生啊所以跟大家報告我們台灣這個醫療的可敬性跟高水平又廣覆蓋當然問題一大堆大家從早上罵到現在但是我覺得我們就是那麼棒嘛我們就這麼好啊保定你這麼好啊署長你也這麼好啊大家拚到要死啊有限的資源做那麼多事我是覺得我要跟你們肯定啦 |
| transcript.whisperx[369].start |
10689.191 |
| transcript.whisperx[369].end |
10705.545 |
| transcript.whisperx[369].text |
事實上真的大家都盡心盡力講一些情緒話有什麼了不起呢大家有沒有情緒所以我覺得這個都可以理解大家要同理心這個問題也從馬英九時代到蔡英文時代到現在 |
| transcript.whisperx[370].start |
10706.946 |
| transcript.whisperx[370].end |
10724.318 |
| transcript.whisperx[370].text |
都一樣啊但是現在如果可以更改善當然是更好啦所以我們大家不要講意識形態啦這個醫療跟意識形態一點關係都沒有啦所以普通你會看得出來再來就是那個福利的大家現在站一腳就三十幾萬人在線上的才十幾萬人 |
| transcript.whisperx[371].start |
10728.598 |
| transcript.whisperx[371].end |
10743.45 |
| transcript.whisperx[371].text |
有一大堆是回家帶小孩照顧公婆他是可以出來做part-time的耶那這一塊剛剛你有講到說可以把它recall回來這在美國就很多啦美國就很多就是 |
| transcript.whisperx[372].start |
10744.531 |
| transcript.whisperx[372].end |
10767.813 |
| transcript.whisperx[372].text |
他你這樣做全職他沒辦法但是這些人他們就組一個公司也好啦一個是合作社也好啊你就apply他就來給他part-time來做三點鐘四點鐘這在美國很平常的啊我們這可以這塊這一塊真的要好好的來應用啦不然這些人就是人力浪費啊柏中你覺得怎麼樣 |
| transcript.whisperx[373].start |
10769.413 |
| transcript.whisperx[373].end |
10787.42 |
| transcript.whisperx[373].text |
我們在12項的婦理人力裡面第10項就是多元化彈性婦理制止職業那國防會也對這一點也要做一點幫助這真的像我們太太過去後都很高興現在孩子比較不想參與他就開始恢復去樂團拉琴並不參與就對了 |
| transcript.whisperx[374].start |
10794.482 |
| transcript.whisperx[374].end |
10814.357 |
| transcript.whisperx[374].text |
所以但是他能夠這些回流到護理在化為他過去的護理的專業我覺得是一個很珍貴我跟部長報告我們屏東縣的衛生所的護理人員退休我們都趁回來做什麼做長照、做照覆 |
| transcript.whisperx[375].start |
10815.958 |
| transcript.whisperx[375].end |
10842.609 |
| transcript.whisperx[375].text |
他65歲,我60歲拿下來身強體壯,你讓他去拉琴他也沒有婦理啦,他也沒有婦理啦這就沒意義啦所以,這些人就回來了衛生所的主任65歲退休,我就把他請回來當公衛做什麼幾乎只要來,我就拼所以我要拼到我們的衛生所主任退休下來我現在已經解決了,很好啊 |
| transcript.whisperx[376].start |
10844.91 |
| transcript.whisperx[376].end |
10863.235 |
| transcript.whisperx[376].text |
有的到七八十歲還很強啊所以現在的人沒有退休年齡嘛所以這個都是人力的運用啦這個我們會努力的這個你們都沒有看到好那最後一分鐘給我我要講一下我們自己的事情 |
| transcript.whisperx[377].start |
10864.575 |
| transcript.whisperx[377].end |
10888.135 |
| transcript.whisperx[377].text |
這個要感謝 因為我們從去年我們安排法人會休署還在往後抬頭頭頭傷亡慘重那我們從去年10月3號到現在我今天是第二次發生我從來不講話的那都默默的在做該怎麼樣 |
| transcript.whisperx[378].start |
10890.287 |
| transcript.whisperx[378].end |
10912.452 |
| transcript.whisperx[378].text |
民事的補償、賠償都在完善那所有的轉出去的病人回來只要跟我們要求我全部都給他給我我沒說過話從來沒有在媒體上講過任何一句負面的話我們都一直在做我們10月3號輝學署訪台10月4號我們就在做緊急診療館 |
| transcript.whisperx[379].start |
10917.933 |
| transcript.whisperx[379].end |
10928.47 |
| transcript.whisperx[379].text |
我們是醫護人員這麼拼然後我們的護理人員從辦這六個多月來離職的不到四個 |
| transcript.whisperx[380].start |
10929.707 |
| transcript.whisperx[380].end |
10951.937 |
| transcript.whisperx[380].text |
不到10個我沒有給他輔導到法人其他的長照什麼其他或潮州安泰等等我們是盡心盡現在有好戶價的那這些偏鄉的醫護人員當然是我們要保護啊我們是袋子袋心請他休假等等或者是平常沒有休假的全部給他補休 |
| transcript.whisperx[381].start |
10952.937 |
| transcript.whisperx[381].end |
10970.005 |
| transcript.whisperx[381].text |
做到非常非常完善那我們也很認真在做很感謝我們衛福部我們醫事師我們健保署還有我們屏東縣政府都給我們一直的幫忙輔導所以我在這邊要跟大家致謝那我們希望 |
| transcript.whisperx[382].start |
10971.326 |
| transcript.whisperx[382].end |
10985.531 |
| transcript.whisperx[382].text |
我們的員工能夠呵護他們鼓勵他們讓他們那邊繼續來替我們的屏南地區重度責任醫院我們的角色我們是努力在扮演那昨天 |
| transcript.whisperx[383].start |
10986.972 |
| transcript.whisperx[383].end |
11012.462 |
| transcript.whisperx[383].text |
我們在這邊投票醫事師 醫策會還是做重症的考核我也很感謝所以在這裡補充再次的致謝希望大家一起來跟我們的員工跟我們的醫護人員大家一起呵護 一起鼓勵不要不要沒有意義啦我從來不講過一句負面的話所以我在這裡要跟 |
| transcript.whisperx[384].start |
11013.382 |
| transcript.whisperx[384].end |
11041.312 |
| transcript.whisperx[384].text |
部長在一次的報告那我們你看我們這個這個上一張這個排碼排案榜我不曉得要怎麼排的啦這個是newsweek他們排的我們屏東縣還是我們安泰的員工的努力我們是台灣排32名的耶這不是我白說的啦 屏東我只有這間而已所以不要亂說啦也不要亂說啦我是覺得大家一起來啦感謝各位 謝謝 |
| transcript.whisperx[385].start |
11042.92 |
| transcript.whisperx[385].end |
11049.664 |
| transcript.whisperx[385].text |
好 謝謝委員 謝謝趙委好 謝謝我們蘇青前委員我們請我們下一位 我們王振旭委員好 非常感謝主席我們就請邱部長好 請邱部長 |
| transcript.whisperx[386].start |
11072.523 |
| transcript.whisperx[386].end |
11093.164 |
| transcript.whisperx[386].text |
委員好部長好剛剛聽了我們召委一席話把你驚喜啦因為的確得到這個榮譽是不容易而且經過一次這麼大的一個事件能夠趕快站起來持續服務當地的民眾應該是當務之急啦別再怕命 |
| transcript.whisperx[387].start |
11093.891 |
| transcript.whisperx[387].end |
11107.507 |
| transcript.whisperx[387].text |
那今天的主題其實是真的很重要因為這是目前讓所有民眾感受到他在這個接近醫療面面要改革自己這個身體健康疾病照顧的問題那 |
| transcript.whisperx[388].start |
11109.81 |
| transcript.whisperx[388].end |
11129.364 |
| transcript.whisperx[388].text |
所以還是能夠透過這個機會請部長再來多一些說明包括在3月3號部長也針對於這個醫院造成這個庸篩還有護理同仁離職的一些部分做相關的說明包括就有 |
| transcript.whisperx[389].start |
11132.106 |
| transcript.whisperx[389].end |
11159.945 |
| transcript.whisperx[389].text |
這個三短兩長的措施跟計畫來應應這樣的急診就診人次就開始慢慢趨緩後來才是三短兩長不是三長兩短所以能夠把事情做得更順利一點那這個部分我們也了解這個你的三短裡面是包括三項這個大家已經都討論過很多次了很多內容今天都已經很了解 |
| transcript.whisperx[390].start |
11160.385 |
| transcript.whisperx[390].end |
11177.482 |
| transcript.whisperx[390].text |
那中長期的部分剛剛也有很多委員就叫了這個部長有關護理人力還有這個健保支付標準等等不過還是要請部長或者是相關同仁再度的確認一下 |
| transcript.whisperx[391].start |
11178.363 |
| transcript.whisperx[391].end |
11205.032 |
| transcript.whisperx[391].text |
這些原因到底哪一個是最重要的哪一個是次要的哪一些是相關的因為我們知道做研究的話透過很多因素或者是一些數據的分析才有辦法去找出最重要跟其他相關的因子你這樣未來在做改善的時候才能夠真的有辦法針對一些因素做改善 |
| transcript.whisperx[392].start |
11205.712 |
| transcript.whisperx[392].end |
11234.285 |
| transcript.whisperx[392].text |
所以 嗯 部長這訪問 你看 要怎麼分析早有機會找出這個最重要的相關因子或者是最重要的因素來做未來改善的一個基礎好 是的 呃 我想它的原因應該是剛剛委員所列出來的這些都有可能是有相關的因素那是不是在當然啦 我們如果在研究當然有設定的可能 |
| transcript.whisperx[393].start |
11237.32 |
| transcript.whisperx[393].end |
11251.338 |
| transcript.whisperx[393].text |
有意義的影響因子或者是有影響因子但是他不到達統計書記當然是在研究的領域但是只要有可能影響的我們都會抓出來來分析來處理包括這裡應該要多一個 |
| transcript.whisperx[394].start |
11252.68 |
| transcript.whisperx[394].end |
11275.718 |
| transcript.whisperx[394].text |
那個分級醫療是不是沒有落實這樣子那護理人力不足當然是我想是大家公認的啦因為如果能夠床數開得更多一點的話是不是可以減緩那當然門診一約住院床位的分配失衡 |
| transcript.whisperx[395].start |
11276.587 |
| transcript.whisperx[395].end |
11295.696 |
| transcript.whisperx[395].text |
這個就要看醫院的屬性了啦像我譬如說我去跟台大醫院的大家高層朋友談的時候他說他們的內科主任說我的門診也都很嚴重啊我不是說趁差就給他去斷癮啊 |
| transcript.whisperx[396].start |
11296.756 |
| transcript.whisperx[396].end |
11299.56 |
| transcript.whisperx[396].text |
這也是要讓你做參考啦我意思是說 但是這個有在打扮這個有在處理 可利用的床位不足這個部分 |
| transcript.whisperx[397].start |
11309.977 |
| transcript.whisperx[397].end |
11337.062 |
| transcript.whisperx[397].text |
當然包括說我們是不是好好的應用那我們原來是希望院長去處理那昨天我們跟醫療工會我們敬佩他們提出從護理基層的角度來提出一個指引我覺得站在專業的角度上我們非常重視也跟他們取得共識要研究把這個指引就是說你怎麼讓病人的床可以更加靈活我們要聽護理界的指引 |
| transcript.whisperx[398].start |
11339.042 |
| transcript.whisperx[398].end |
11355.696 |
| transcript.whisperx[398].text |
另外當然是Infection這個感染這個部分我想在這個孤單期間都會比較有啦所以這些都是原因而且都是要去改善能預防的就預防能解決的就一步一步來解決 |
| transcript.whisperx[399].start |
11356.513 |
| transcript.whisperx[399].end |
11367.183 |
| transcript.whisperx[399].text |
好因為我們也知道在短期有時候沒有辦法抓到那麼多的數據的話這個我們應該來分析數據啦我覺得有幾種的他們來的一個型態我們再來分析一下對所以其實我們是很建議啦針對於 |
| transcript.whisperx[400].start |
11378.052 |
| transcript.whisperx[400].end |
11392.422 |
| transcript.whisperx[400].text |
剛剛的那些問題然後特別去分析我們所列舉出來的不管是造成這個擁塞的疾病類型醫院的層級還有在聽您早上的報告裡面也有備案嘛這備案是怎樣這一次 |
| transcript.whisperx[401].start |
11394.823 |
| transcript.whisperx[401].end |
11415.184 |
| transcript.whisperx[401].text |
發揮不了它的作用以前好像都可以透過備案ABC來解決在過年期間這個狀況今年是發生什麼問題沒有辦法讓備案發生那個效果這個就麻煩到說在一個月左右一個月內可不可以讓我們知道我們徹底來分析再跟委員報告 |
| transcript.whisperx[402].start |
11417.446 |
| transcript.whisperx[402].end |
11439.105 |
| transcript.whisperx[402].text |
OK好拜託一下因為這個是對於未來的這個改善應該是我們一定要徹底改善是那另外針對於這個護理人力跟薪資跟流財的部分剛剛也討論了非常多那不知道蔡市長有沒有注意到有這一則公會提供給會員們 |
| transcript.whisperx[403].start |
11441.167 |
| transcript.whisperx[403].end |
11467.377 |
| transcript.whisperx[403].text |
他們如何在目前的離職草裡面早上剛剛有很多委員說要擺這一點點以上才能夠有機會去跟主管討論離職的部分那這個我們也相信工會是為了他的會員希望能夠針對於一些做法提供一些參考包括說怎麼樣禁書離職的一些好方法或者是適當的方式等等 |
| transcript.whisperx[404].start |
11467.797 |
| transcript.whisperx[404].end |
11489.404 |
| transcript.whisperx[404].text |
他也提醒在這個過程裡面要注意哪一些的事情包括說如果是想要免排隊就要離職的話是可以怎麼做不過這個是基本上是根據這個勞動基準法第14條的一些處理模式因為他有規定勞工的不經過預告終止契約因為我們知道 |
| transcript.whisperx[405].start |
11490.564 |
| transcript.whisperx[405].end |
11517.929 |
| transcript.whisperx[405].text |
在這個勞動企業裡面都會宰明說如果要離職的話應該要經過什麼樣的程序嗎博文市長有沒有掌握到相關的信息有有有這個就是工會的這個網頁或是說現在各個工會因為他們要護理人員要異動都要到工會裡面去辦理這個這個不管是進來或是離開或是異動都要辦理那我們跟 |
| transcript.whisperx[406].start |
11519.245 |
| transcript.whisperx[406].end |
11546.715 |
| transcript.whisperx[406].text |
這個都同步在這個資訊的取得資訊的了解掌握上我們都知道委員剛才提的這個我們也知道有有這樣的一個訊息不過目前如果說有一些同仁是透過這個方式離職的話其實他必須要透過掌握這個固執違法事證才能夠達到這個做法的一個基本要求 |
| transcript.whisperx[407].start |
11547.475 |
| transcript.whisperx[407].end |
11563.614 |
| transcript.whisperx[407].text |
所以假設真的是這樣做而且人數越來越明顯的話可能也要提醒大家有關於勞工的院方的應變還有在這個造成的一些影響這個都要麻煩市長或者是部長這邊要多多留意 |
| transcript.whisperx[408].start |
11564.531 |
| transcript.whisperx[408].end |
11587.901 |
| transcript.whisperx[408].text |
我們一定不斷的改善護理的跟醫院來合作啦不斷改善我們醫護的待遇跟醫療的環境那當然那個只要他們在勞基法之下我們都尊重嘛但是我們努力的是能夠留任把那種環境待遇能夠盡量的做好 |
| transcript.whisperx[409].start |
11589.021 |
| transcript.whisperx[409].end |
11617.5 |
| transcript.whisperx[409].text |
能夠來留任留任更多的護理人力能夠在職場我們共同來照顧病人這是我們的最重要的努力目標因為如果透過這個方法造成離職的話其實對於這位護理同仁來講他很難再回到職場因為這個是一個不愉快過程的話造成影響其實是會蠻影響力會蠻強的所以針對這個改善計畫裡面我們提了一些建議提供給市長跟部長這邊參考 |
| transcript.whisperx[410].start |
11618.781 |
| transcript.whisperx[410].end |
11644.528 |
| transcript.whisperx[410].text |
就是真的要督導各個醫院要遵守勞動法令跟勞動契約那這個過程必須要真的要去重視他的心聲啦要有好的協商平台跟管道那當然很多資訊需要持續的公開透明才能夠讓他們瞭解也避免誤解跟正義這部分也麻煩所以非常好的建議我們一定要醫院來落實是好 再來 |
| transcript.whisperx[411].start |
11648.477 |
| transcript.whisperx[411].end |
11665.165 |
| transcript.whisperx[411].text |
來往下還有一個小議題那麻煩我們這個食藥署江署長因為最近也在討論這個事後必應藥到底要不要從處方用藥轉到指示用藥 |
| transcript.whisperx[412].start |
11667.446 |
| transcript.whisperx[412].end |
11687.017 |
| transcript.whisperx[412].text |
可能可以跟其他國家有一些使用上的符合不過也有很多的團體很擔心這樣的調整會造成哪些的影響所以不知道最近所開會裡面有沒有去掌握到目前這個藥物的使用狀況還有有沒有相關的健康風險的評估 |
| transcript.whisperx[413].start |
11688.698 |
| transcript.whisperx[413].end |
11713.149 |
| transcript.whisperx[413].text |
那當然現在還很難馬上就做了確定或決定不過如果真的開放以後那造成影響可能需要去面臨的衝擊那有沒有辦法去做好健康最終或者是實名制的可能性那這部分不知道署長有沒有一些現在的一些想法或者是未來的做法提供給大家做參考是的 |
| transcript.whisperx[414].start |
11715.117 |
| transcript.whisperx[414].end |
11738.87 |
| transcript.whisperx[414].text |
謝謝委員的提問這都非常關鍵的問題我們在上個禮拜四我們召集了111號人民團體其實有兩位學生以及相關的法規的提到了一個很重要的關鍵那目前我們看到所有的所謂指示用藥的轉類這個過程當中我們有一定的標準那陳委員在現場也非常非常關心 |
| transcript.whisperx[415].start |
11739.89 |
| transcript.whisperx[415].end |
11762.983 |
| transcript.whisperx[415].text |
我們針對這個議題之後藥界藥師公會裡面也提出他們的想法也覺得說很多的承諾我們覺得非常非常的有準備醫界的部分也有提到他們有一點擔心家長團體裡面特別有一位家長團體他本身對於所謂子宮內膜癌跟乳癌在臨床上面看到的一些些擔心 |
| transcript.whisperx[416].start |
11764.164 |
| transcript.whisperx[416].end |
11785.537 |
| transcript.whisperx[416].text |
加上學生團體裡面他特別針對他受到的教育跟配套他也覺得說希望我們能夠精進那此外呢各個國家裡面我們鄰近的日本其實也進入了所謂研議這個階段所以我們調處整個的一個過程當中我們覺得很重要的調和蠻重要的我們的經驗是需要去確認的 |
| transcript.whisperx[417].start |
11786.678 |
| transcript.whisperx[417].end |
11812.954 |
| transcript.whisperx[417].text |
那大家擔心的這一塊我覺得是可以有一個很重要的區域聯防的概念所以我們馬上有責成我們我們藥品組這邊思考如何去做台灣特殊的經驗跟調處各方能夠得到一個最適切的一個方案那目前持續在積極在研擬當中所以我想在不久的將來我想我們的經驗是會讓大家看到我們的處理是最圓滿的以上 |
| transcript.whisperx[418].start |
11814.215 |
| transcript.whisperx[418].end |
11830.666 |
| transcript.whisperx[418].text |
好 非常謝謝署長的說明因為我們看最後一張發動片知道說的確用藥安全還有身體自主權如何達到是需要大家共同來努力好 謝謝署長也謝謝署長 謝謝謝謝王偉 謝謝部長 署長好 我們接續處理臨時提案總共有兩案好 現在宣讀 |
| transcript.whisperx[419].start |
11842.162 |
| transcript.whisperx[419].end |
11865.911 |
| transcript.whisperx[419].text |
第一案要求衛生福利部針對此次醫院評鑑向立法院社會福利及衛生環境委員會提出專案報告內容包括但不限於一本次醫學中心評鑑標準及新增醫學中心的具體理由以及該醫院升格後對高頻地區醫療資源分配的影響評估二本次評定程序中各醫院的成績排序 |
| transcript.whisperx[420].start |
11866.391 |
| transcript.whisperx[420].end |
11886.949 |
| transcript.whisperx[420].text |
及核定結果三 內部簽核制部長之相關決策文件包含各單位會簽意見四 本次評定結果與既定評鑒標準不符之原因以及後續如何確保評鑒機制符合既定行政規則提案人委員 陳昭芝 王育敏 邱振軍第二案 |
| transcript.whisperx[421].start |
11888.07 |
| transcript.whisperx[421].end |
11906.78 |
| transcript.whisperx[421].text |
衛福部因限期於三個月內已將CIDP納入罕見疾病或列入重大傷病之前提完成檢討與規劃作業事後並向立法院社會福利及衛生環境委員會提交書面報告提案人委員陳金輝蘇清泉邱振軍宣讀完畢好現在第一案請問行政單位有沒有意見 |
| transcript.whisperx[422].start |
11917.12 |
| transcript.whisperx[422].end |
11917.742 |
| transcript.whisperx[422].text |
第2位 |
| transcript.whisperx[423].start |
11928.507 |
| transcript.whisperx[423].end |
11948.942 |
| transcript.whisperx[423].text |
這個提案就是關於醫院評鑑因為最近我們遇到很多問題其實都是原始於這個你要落實分流就會談到分級醫療談到分級醫療就會回到醫院評鑑那醫院評鑑部分就是說今年以及113年度有一個醫院評鑑及教學醫院評鑑作業程序有規定高評區的醫學中心評定上限是三家 |
| transcript.whisperx[424].start |
11950.023 |
| transcript.whisperx[424].end |
11971.158 |
| transcript.whisperx[424].text |
但是你的評鑑結果是跑出4家啦所以是不然你就是違反你自己的規定門檻這也不是我規定的結果你就違反但是我們都只看到每一次都只看到結果那當然你們有一些作業程序就是評定加數超過的時候當然會根據幾個指標包括醫院評鑑教學結果啦或是醫學中心任務等等有一個百分比 |
| transcript.whisperx[425].start |
11971.778 |
| transcript.whisperx[425].end |
11996.653 |
| transcript.whisperx[425].text |
然後把根據這個成績的高低去排序擇優但是我們一直都沒有看到這個一個整個決策的這個過程或是相當的一個合理的透明度我們只看到不斷的增加去年一口氣增加三家醫學中心你現在才剛剛寫清楚說上限三家現在變四家那我必須說醫學中心涉及大量的公共 |
| transcript.whisperx[426].start |
11997.313 |
| transcript.whisperx[426].end |
12026.873 |
| transcript.whisperx[426].text |
投資資源的投資應該符合確保這個區域的醫療規劃跟醫療的公平性不要造成說資源過度集中或是其他地區的醫院他們的競爭力壓力是非常大因為涉及這個重大公共利益所以監察院有提出糾正函但是好像你們都沒有去重視這件事情是為了確保這個行政透明決策合理性我們才要求說是不是要針對醫院平靜再次出現違規啦跟你們自己的規定不符 |
| transcript.whisperx[427].start |
12027.674 |
| transcript.whisperx[427].end |
12036.984 |
| transcript.whisperx[427].text |
我先不要談我的見解跟你們自己的規定不符的一個結果所以我希望能夠做一個專案報告包括準次醫學中心的評鑑標準新增這個具體理由以及該院升格後對高頻地區醫療資源分配的影響 |
| transcript.whisperx[428].start |
12043.311 |
| transcript.whisperx[428].end |
12061.637 |
| transcript.whisperx[428].text |
那剛剛我們有跟各位溝通啦第二個就是說本次評定當中成績的排選核算結果我們同意不要有這個identity就是我們並不需要是哪一家醫院我們希望知道就是說到底你們面對的原始的評分結果你們是怎麼去要去處理的那當然我們是希望看到說這個最後的決策那剛剛是有溝通說 |
| transcript.whisperx[429].start |
12065.998 |
| transcript.whisperx[429].end |
12084.042 |
| transcript.whisperx[429].text |
那如果這個第三項不要的話 部長你自己要承擔喔就是你做冠軍 大家都送你到陸地 讓你去做冠軍這次本次評定結果與既定標準不符合的原因 為什麼不符合你才自己規定三家為上限 現在又跑出一家了那以後後續如何確保這個能夠符合這個行政規則 |
| transcript.whisperx[430].start |
12088.143 |
| transcript.whisperx[430].end |
12090.744 |
| transcript.whisperx[430].text |
我的重點是現在醫療在喊緊急護理人員不夠然後人擁塞你一方面喊分級醫療一方面這個醫學中心又在網上說我看不下去好像兩手策略一方面還鼓勵大醫院一直出要蓋醫院還有1萬1千床等著增加那個擴建 |
| transcript.whisperx[431].start |
12108.451 |
| transcript.whisperx[431].end |
12119.74 |
| transcript.whisperx[431].text |
一方面又說分級醫療所以這是一個很矛盾的所以我就我的專業理解就是才提出這樣的臨時提案請大家支持也請衛福部能夠做一個回應好嗎謝謝好我想所有的努力都是要讓人民得到最好的照顧我們都知道南北醫療資源的 |
| transcript.whisperx[432].start |
12139.042 |
| transcript.whisperx[432].end |
12159.189 |
| transcript.whisperx[432].text |
的不平衡那剛剛蘇昭偉提出他們那邊的混鬥所以這個是很艱難的一個課題那我也了解到昭之委員我們長期幾十年來的混鬥共同對分級醫療我也知道你長期對醫學中心的增設 |
| transcript.whisperx[433].start |
12160.639 |
| transcript.whisperx[433].end |
12182.929 |
| transcript.whisperx[433].text |
如果沒有處理好是對醫療體系不好的我完全了解所以我們現在也在做醫院評鑑的改革目前一直在改革改革的部分當然第一個會把說第一個醫學中心有升有降好的留下來 不好的 |
| transcript.whisperx[434].start |
12183.849 |
| transcript.whisperx[434].end |
12213.138 |
| transcript.whisperx[434].text |
就是降級這個在醫院平線改革裡面的第一重點是在這個地方第二個可能要考慮到地區的遼闊性如果你都集中在一個地方可能真的不適合那時候你這樣在那邊嘛但是你如果說土地遼闊有些人口他就永遠不可能兩百萬可是他就需要有一個 |
| transcript.whisperx[435].start |
12214.144 |
| transcript.whisperx[435].end |
12241.994 |
| transcript.whisperx[435].text |
更堅強的一個堡壘來保衛我們人民的健康所以這個部分在兩百萬這個部分可能也會在改革裡面做處理那至於說我同樣一樣跟周志瑋一樣在北部如果太多醫學中心真的會變成南北不平衡那要讓他南北不平衡以及說未來的醫學中心有升有降當中 |
| transcript.whisperx[436].start |
12243.444 |
| transcript.whisperx[436].end |
12267.525 |
| transcript.whisperx[436].text |
我們必須要做一件事情先讓他南北平衡那這是一個概念第二個概念就是說所以我完全知道這個我必須要面對陳昭之委員我的幾十年來的老戰友的挑戰所以但是這個就是很痛苦也是很天人交戰但是又必須要為人民來努力的一個努力 |
| transcript.whisperx[437].start |
12271.346 |
| transcript.whisperx[437].end |
12298.107 |
| transcript.whisperx[437].text |
當然所有的決策我必須要負全部的責任我想我先講清楚我願意承擔所有的責任但是我是給我機會來講這整個決策的一個過程甚至我們的努力可以改變未來整個台灣的醫療體系那有關於南部當然永遠都是那三家嘛各位要知道今天醫學中心要再保持醫學中心是比較容易 |
| transcript.whisperx[438].start |
12299.662 |
| transcript.whisperx[438].end |
12317.074 |
| transcript.whisperx[438].text |
準醫學中心或區醫院要晉升到醫學中心他是很辛苦的為什麼 他要付出醫學中心的人力跟設備而且要達到評鑑而且可能剛開始你只得到準醫學中心 |
| transcript.whisperx[439].start |
12318.137 |
| transcript.whisperx[439].end |
12329.136 |
| transcript.whisperx[439].text |
那我們知道南部這一家有一家準理解中心他七年的準理解中心他的服務包括了屏東包括了高雄的山區 |
| transcript.whisperx[440].start |
12330.755 |
| transcript.whisperx[440].end |
12354.107 |
| transcript.whisperx[440].text |
如果你要送人口去算永遠永遠不可能讓他已經投入那麼多的而且就是為什麼要投入那麼多就是人民的需要所以他必須要用到醫水中心的標準來服務民眾他也願意到偏鄉主席我可以跟他對話嗎沒關係我可以就是說我可以直接對話嗎沒有問題 |
| transcript.whisperx[441].start |
12356.958 |
| transcript.whisperx[441].end |
12373.766 |
| transcript.whisperx[441].text |
你如果覺得說你們在做這個院作業程序的時候你認為人們高可能還需要在一家中心的話那你為什麼在作業程序113年度的你還要訂上限是三家我現在是針對你這樣規定,你自己沒有違規,你是違規嘛你的需求我聽得懂啊我們那個醫學中心四檔再放一邊 |
| transcript.whisperx[442].start |
12382.547 |
| transcript.whisperx[442].end |
12390.091 |
| transcript.whisperx[442].text |
你馬上就犯規啊那是說規定我們要站在人民的需求還有南部幾乎所有的立委站在人民的立場有一個呼籲 強烈的呼籲也在我們這裡執行 我們不能不回應 |
| transcript.whisperx[443].start |
12405.157 |
| transcript.whisperx[443].end |
12427.575 |
| transcript.whisperx[443].text |
所以這是規定,你只要鼓勵不是你意思是說你這個規定聽聽看參考用啦因為我今天沒有談大方向人民的需求勝過我們一般可以行政的規定如果這個有違反規定我願意負全責但是我必須要說明我必須要考慮到如果你今天要讓 |
| transcript.whisperx[444].start |
12428.656 |
| transcript.whisperx[444].end |
12444.763 |
| transcript.whisperx[444].text |
在四年後再去評估一次那我覺得對於南北的平衡是不平衡的減緩北部增加幾家的最好的方式就是讓南部加強 |
| transcript.whisperx[445].start |
12446.358 |
| transcript.whisperx[445].end |
12471.055 |
| transcript.whisperx[445].text |
按照人口需求這個大家都知道非常合理然後你說醫學中醫要付出代價我們同意可是你沒有講另外一面醫學東西也是很好的他的給付成績越高他的給付越多他可以買更多的他有溢價能力更強買醫材買藥品民眾也都要去因為大家在鼓勵你們都一直鼓勵蓋大醫院你都讓他們覺得醫中好棒棒就是很棒 |
| transcript.whisperx[446].start |
12473.677 |
| transcript.whisperx[446].end |
12496.393 |
| transcript.whisperx[446].text |
如果今天發生在別人的身上我不敢講今天發生在我邱某人的立上各位你也知道我是最強調分級醫療我最強調基層醫療我不可能去要去加強醫學中心的一個量數但是因為問題是民眾的需要那他到底 我們都評估喔他到底對於財務的衝擊 |
| transcript.whisperx[447].start |
12499.975 |
| transcript.whisperx[447].end |
12524.555 |
| transcript.whisperx[447].text |
在當地的高評區是只有到達0.01%那你要檢討的是醫療網的原始計畫如果你覺得兩百萬不行不要讓它擱在那裡健保法有多少條法擱在那邊然後都不動那你這樣永遠讓我們再給你法委員你會了解也一直在我希望委員能夠諒解到說這個南北平衡的如果你不在現在出生我四年後再去做 |
| transcript.whisperx[448].start |
12525.746 |
| transcript.whisperx[448].end |
12544.351 |
| transcript.whisperx[448].text |
人民的健康不能等死耶南部的民眾要照顧但是你北北已經破了嘛他七百多萬七百多萬人已經有十家但是我們現在有一個規定我們現在就是說下一次的評審真的嗎就是有升有降這是堅定的原則上一次說要降的都沒降啊一下子升三家 |
| transcript.whisperx[449].start |
12545.305 |
| transcript.whisperx[449].end |
12562.056 |
| transcript.whisperx[449].text |
沒有啊 上次是聲浪那個 老實講我跟這個南部任何醫學中心我都沒有任何關係我希望能夠做個報告因為醫院評鑑關係現在的整個氛圍嘛整個醫療的氛圍大家都回到分級醫療那分級醫療就是怎麼來的就是當初有評鑑嘛有評鑑 |
| transcript.whisperx[450].start |
12573.963 |
| transcript.whisperx[450].end |
12590.154 |
| transcript.whisperx[450].text |
準醫學中心切單給他做醫學中心有一個好處啦真的就是他真的就是看集中症了因為他的過後會比較多他會減少一些一些可能輕重病的病人那可以 會幫忙我們給他給他開區域 |
| transcript.whisperx[451].start |
12594.156 |
| transcript.whisperx[451].end |
12598.12 |
| transcript.whisperx[451].text |
好好把你這個強要做的檢討我們可以把這些報告跟你報告沒關係啊我非常願意做報告因為這個是我們共同的理念因為它不是單純業力它造成的影響的after effect後面的作用影響 |
| transcript.whisperx[452].start |
12609.411 |
| transcript.whisperx[452].end |
12627.684 |
| transcript.whisperx[452].text |
是非常大的我們沒有因為只要南北平衡那只要分級醫療你現在讓民眾覺得只有大醫院能夠照顧我像中部中部的幾個醫院也真的非常的努力喔台大營養訓練也是品質非常高大林慈濟醫院還有佳積這幾個都是非常的努力但是問題是說它因為不一樣的是說 |
| transcript.whisperx[453].start |
12634.31 |
| transcript.whisperx[453].end |
12649.787 |
| transcript.whisperx[453].text |
因為南部那一家也有7年的準你也要建保的問題我們都還在爐你知道上次那個多因為一家這樣準那就沒有讓他降了變成就三家那等於額外增加兩家那個建保署當時評估就多1億多點 |
| transcript.whisperx[454].start |
12651.289 |
| transcript.whisperx[454].end |
12675.284 |
| transcript.whisperx[454].text |
就是說這個財務評估其實還是在的喔那個可以請時事長來報告一下這樣的一個南部高評這樣多加的影響財務評估我是覺得那個是一個更大的議題啦我們在討論預算的部分可以討論但是今天是不是說我是沒有麻煩到時事長是因為今天您實際上就是說就針對今年嘛你剛剛才公佈的東西你馬上就沒有遵守 |
| transcript.whisperx[455].start |
12676.961 |
| transcript.whisperx[455].end |
12696.688 |
| transcript.whisperx[455].text |
我們不知道發生什麼事情我們每天在這邊努力就是希望譬如說護理人力不足我們就馬上想盡辦法去調整法利用調整獎勵措施我們為什麼不能對人民的健康對南北的資源的努力隨時來努力隨時來調整難道我要等四年嗎 |
| transcript.whisperx[456].start |
12698.448 |
| transcript.whisperx[456].end |
12711.754 |
| transcript.whisperx[456].text |
我就是因為這次的急者擁塞反映了單期醫療的問題嘛這個我們大家每一天每一天在爭取人民的權益是不能等的如果我再等四年啊這個這個這個他這樣閒閒在那裡 |
| transcript.whisperx[457].start |
12718.551 |
| transcript.whisperx[457].end |
12737.273 |
| transcript.whisperx[457].text |
閒在那一邊對不對閒在那一邊他上上不下也不好讓他好好的去發揮他現在有的角色那也可以平衡藍北我瞭解啦我們的討論因為林存文他們也是要評鑑啦所以說基本上那我這個臨時提案的部分就是說我在跟 |
| transcript.whisperx[458].start |
12738.929 |
| transcript.whisperx[458].end |
12766.385 |
| transcript.whisperx[458].text |
在這邊做一個確認除了第三項之外其他我都希望給予保留就是在專案的報告裡面有包含這些內容第一個我還是拜託那個委員不要在裡面提到違法或者是怎麼樣那個太傷感情了我已經被你在立法院的議事錄裡面違規啦違規啦 留下很多違規違規啦你們自己規定我拜託你給我修改好像沒有給我改 |
| transcript.whisperx[459].start |
12767.546 |
| transcript.whisperx[459].end |
12776.396 |
| transcript.whisperx[459].text |
我過去在立法院8年,得了多少次的優良立委,結果你的資訊稿都把我寫得我不是違法,違什麼樣,情何以堪?因為我真的是站在人們的立場,所以這個部分我看你今天也讓你支持著,也要湊頭 |
| transcript.whisperx[460].start |
12788.19 |
| transcript.whisperx[460].end |
12792.552 |
| transcript.whisperx[460].text |
我的法案啊,還有綠營的朋友啊,是啊我這麼認真,都專業所以你剛才講什麼,不要說違法不違法啦因為不要耽誤別的立委的時間 |
| transcript.whisperx[461].start |
12806.429 |
| transcript.whisperx[461].end |
12826.923 |
| transcript.whisperx[461].text |
為什麼的一個增加的理由我可以具體來寫沒問題好不好那以及說深合回修對高頻DC資源的影響這個OK然後評定程序的我們不要耽誤別的委員的執行時間就那個大原則是往這個方向走 |
| transcript.whisperx[462].start |
12828.726 |
| transcript.whisperx[462].end |
12851.112 |
| transcript.whisperx[462].text |
不過因為你如果要通過按我變成就是要按照這樣來剛剛有跟市長有開始做溝通的啦因為我們召委已經站起來,我們想說要把時間還是要留給其他委員要處理啦,就是要處理這件事,但是文字我們覺得可以做修正啦,我們可以再討論再討論一下,我不會馬上離開我再跟委員討論一下好了 |
| transcript.whisperx[463].start |
12864.575 |
| transcript.whisperx[463].end |
12875.283 |
| transcript.whisperx[463].text |
第一案先保留由劉市長再去跟他溝通一下那第一案我們趕快處理第一案行政單位有沒有意見這個跟 |
| transcript.whisperx[464].start |
12881.044 |
| transcript.whisperx[464].end |
12898.314 |
| transcript.whisperx[464].text |
已經跟委員溝通完畢會協助提出沒有意見會申請列入那罕病審議三個月內就辦理情況提交書面報告又照這個修訂這個好像有改文字要不要唸一下要唸一下 |
| transcript.whisperx[465].start |
12905.16 |
| transcript.whisperx[465].end |
12928.073 |
| transcript.whisperx[465].text |
有關文字修改的部分有盡於衛生福利部本應積極發揮我國罹患慢性炎症拖隨竅性多發性神經病變CIDP近500人患者於加強照顧與醫治和協助取得適用藥物等應盡之職責是以考量當前對CIDP尚未列入罕見疾病 |
| transcript.whisperx[466].start |
12929.656 |
| transcript.whisperx[466].end |
12948.328 |
| transcript.whisperx[466].text |
原決議衛生福利部應協助提供收治病人醫療機構或病友團體有關列入罕見疾病之申請審查程序事後並於三個月內向本委員會提交書面報告以上陳委員有沒有意見 |
| transcript.whisperx[467].start |
12953.247 |
| transcript.whisperx[467].end |
12975.003 |
| transcript.whisperx[467].text |
那第二案就照修正後通過那第一案先保留我們現在請林淑溫委員質詢8加4分鐘謝謝主席我們是不是請邱部長 |
| transcript.whisperx[468].start |
12981.26 |
| transcript.whisperx[468].end |
13008.397 |
| transcript.whisperx[468].text |
委員好部長好今天大家談了很多這個急診泳塞和護理人力的問題但我今天還是要繼續講這個大家都在談說這個病房護病比的限制護理人力的不足導致醫院這個關病房然後急診的住院帶床病人滯留狀況加劇那上次我也就教你就是說光是減傷第一級的 |
| transcript.whisperx[469].start |
13008.897 |
| transcript.whisperx[469].end |
13035.04 |
| transcript.whisperx[469].text |
他的平均的流治的時間都超過標準時間8小時的還要到雙倍以上那我現在就請你看一個圖到底我們這個護理人力你對於平均媒體報導這個護理人力平均年齡39歲資深護理師留任建校你們自己是這樣講留任建校你是怎麼看待這個資訊的 |
| transcript.whisperx[470].start |
13038.615 |
| transcript.whisperx[470].end |
13055.188 |
| transcript.whisperx[470].text |
我是請那個市長先回答一下我是叫你看安安就是這樣講你自己發布的新聞你們自己的這個你自己都沒看過嗎就是說這個2024因為這個時候我還沒上任所以我要仔細看一下這樣子 |
| transcript.whisperx[471].start |
13056.872 |
| transcript.whisperx[471].end |
13074.079 |
| transcript.whisperx[471].text |
不是啊這是前幾天5月去年5月13號的新聞你還沒上任好那你知道這個議題也應該要了解一下吧因為我當然是希望護理師生能夠留任不是啦現在從一路早上大家問你都覺得說 |
| transcript.whisperx[472].start |
13076.12 |
| transcript.whisperx[472].end |
13092.994 |
| transcript.whisperx[472].text |
離職的雖然很多但你們12項政策要求穩定而且已經有見效增加的人力其實都是增加的雖然有離職的但你們剛才司長一直在講說人力普遍上還是增加的從你們的職登統計都看得出來那你們現在看出來數據我告訴你2021年護理師職業的這個平均年齡是36.95歲2024年是39.25歲 |
| transcript.whisperx[473].start |
13104.824 |
| transcript.whisperx[473].end |
13126.378 |
| transcript.whisperx[473].text |
那我就這樣子問你就好了 就這件事情啦職業的平均年齡越來越增加 你怎麼看待這一件事情平均職業年齡提高啊你怎麼看啊這可能要從兩個角度嘛 |
| transcript.whisperx[474].start |
13128.993 |
| transcript.whisperx[474].end |
13147.861 |
| transcript.whisperx[474].text |
因為當初去年你們認為這個是肯定把資深的留下來從這個角度來看也許是好事情那是不是說年輕的留不住也是一件事情這個可能要來看評但我們也很好奇為什麼年輕的因為我們開設多元的人才人力的培養 |
| transcript.whisperx[475].start |
13148.681 |
| transcript.whisperx[475].end |
13171.647 |
| transcript.whisperx[475].text |
包括學士後的護理系有持續的開設而且包括護理師的考試從一年兩次變成一年三次但我們的平均職業年齡卻節節攀升那你講的你也講了就是說啊這個留不住年輕的專業的護理人力那你知道部長你知道2012年台灣護理人員平均職業年齡是幾歲嗎2012年 |
| transcript.whisperx[476].start |
13178.909 |
| transcript.whisperx[476].end |
13185.121 |
| transcript.whisperx[476].text |
2012年啦 你猜猜看 你用猜的啦你們沒數據啦 你用猜的 你猜猜看好 那多少歲 |
| transcript.whisperx[477].start |
13186.533 |
| transcript.whisperx[477].end |
13190.474 |
| transcript.whisperx[477].text |
被你偷看到了2012年29.6歲2024年39.25歲當時2012年2012年離現在並沒有很久你們專案報告是說平均年齡29歲而且21到30歲族群最多佔了43.6% |
| transcript.whisperx[478].start |
13213.982 |
| transcript.whisperx[478].end |
13235.53 |
| transcript.whisperx[478].text |
43.6%都是30歲以下的護理人力而現在30歲以下護理人力可能是低得不像樣那你對這個數字其實你都沒有掌握我剛剛問你 你也搞不清楚到底我們要肯定平均年齡39歲是留任成功還是說我們要擔心 |
| transcript.whisperx[479].start |
13236.77 |
| transcript.whisperx[479].end |
13247.313 |
| transcript.whisperx[479].text |
如果2012年平均年齡29歲2024年平均39歲如果照這個邏輯到2036年平均職業年齡會不會變成49歲有沒有可能是這樣子39歲留任都還留任成功我們很感謝這些資深的護理師扛起了這個責任可是呢我擔心的當然是年輕的職群沒有進來 |
| transcript.whisperx[480].start |
13262.065 |
| transcript.whisperx[480].end |
13283.96 |
| transcript.whisperx[480].text |
年輕的族群沒進來可是我們的養成班開很多啊我們現在要問的是說剛剛已經有委員講了到澳洲年薪170萬到美國300萬起跳但都還要扣掉生活費那如果在這裡的待遇和工時能夠改善的話大家都知道說大家如果可以留在自己的家鄉誰願意遠離故鄉呢 |
| transcript.whisperx[481].start |
13287.802 |
| transcript.whisperx[481].end |
13309.811 |
| transcript.whisperx[481].text |
不是了解而已你們的開源人數理論上是增加的取得證照的人數也越來越多可是我們平均職業年齡卻越來越高這是不合理的這種狀況裡面畢業生不來心血留不住資深扛起來然後病房關床急診永設一環扣一環 |
| transcript.whisperx[482].start |
13312.124 |
| transcript.whisperx[482].end |
13318.586 |
| transcript.whisperx[482].text |
這些畢業生留到外國去難道台灣是要幫變成一個國際護理師的執訓中心嗎台灣護理人才的養成是要幫國際的護理人員變成後備養成中心嗎 |
| transcript.whisperx[483].start |
13329.298 |
| transcript.whisperx[483].end |
13354.71 |
| transcript.whisperx[483].text |
我們很希望我們培養出來的都能夠留在國內因為國內還是需要這些人才我們想盡辦法把它留在國內所以我們現在是政策規劃是有問題還是政策規劃不利還是執行面有問題所以在這種狀況裡面不要動不動就覺得說你們市長剛剛講說我們人數是增加的人數增加都資深的年輕的優秀的沒有心血進來 |
| transcript.whisperx[484].start |
13356.011 |
| transcript.whisperx[484].end |
13366.669 |
| transcript.whisperx[484].text |
所以你的KPI應該是護理人員回流多少病床開床率是多少而不是在這裡說你有增加可是結果病床關的越多急診越湧射 |
| transcript.whisperx[485].start |
13368.311 |
| transcript.whisperx[485].end |
13378.12 |
| transcript.whisperx[485].text |
現在護理人員講啊 如果是醫生或醫院跟你們反映問題 你們都馬上回應有所回應 護理人力跟你們反映問題 護理工會跟你們反映問題你們毫無感覺 只好護理人員用集體離職來跟你們做無聲的抗議 |
| transcript.whisperx[486].start |
13389.267 |
| transcript.whisperx[486].end |
13417.448 |
| transcript.whisperx[486].text |
現在是人家反映了你們對於護理人員跟對於醫師跟對醫院他們講話的份量不一樣啊份量不一樣只好用離職來告訴你他抗議這是大問題捏對不對要怎麼走要怎麼走你的12項政策政策工具現在好像也是留住資深的而已資深的而已 |
| transcript.whisperx[487].start |
13418.581 |
| transcript.whisperx[487].end |
13439.133 |
| transcript.whisperx[487].text |
我們很希望因為一進來他工作是不是滿意新手啦 新手其實是非常重要的所以我們有這個護理新手的臨床導師我希望半年後你還告訴我你十二項政策讓年輕的護理師願意留下來為台灣的病患服務 |
| transcript.whisperx[488].start |
13442.578 |
| transcript.whisperx[488].end |
13456.376 |
| transcript.whisperx[488].text |
半年後我會再問你喔就不要再講半年前我問你的這個醫院有公安危機的你還沒告訴我還沒回答我喔當然我今天還有更重要的要問你就是因為有這個問題以外還有 |
| transcript.whisperx[489].start |
13459.019 |
| transcript.whisperx[489].end |
13486.746 |
| transcript.whisperx[489].text |
今年實施的醫院個別總額制的問題在第二季要上路了醫院個別總額制的問題啊你們有一個很有效的打擊醫療人球的策略和方案那你有很有效的羅伯漢棒子你知道總額健保總額增加了700多億醫院增加了300多億吧至少醫院拿走了一半以上吧 |
| transcript.whisperx[490].start |
13488.287 |
| transcript.whisperx[490].end |
13488.347 |
| transcript.whisperx[490].text |
那 醫院 |
| transcript.whisperx[491].start |
13490.481 |
| transcript.whisperx[491].end |
13514.86 |
| transcript.whisperx[491].text |
拿多了幾百億的錢出來可是醫院卻這樣子急診永設然後現在關病床這已經是夠荒謬 夠好笑了我今年要給你三四百億結果關了病床更多結果急診更永設然後你說你有一個醫療人球的這個應對的這個策略這樣子那我現在問你就是說啊你有沒有盤點到 |
| transcript.whisperx[492].start |
13521.339 |
| transcript.whisperx[492].end |
13523.805 |
| transcript.whisperx[492].text |
這個未來醫院個別總額制醫療現場會面臨哪一些衝擊 |
| transcript.whisperx[493].start |
13530.011 |
| transcript.whisperx[493].end |
13551.148 |
| transcript.whisperx[493].text |
阿你又有什麼因應的策略我可不可以分兩段來報告一下因為我們所有今年的預算都還沒有set down所以還沒有開始來來能夠去落實各種不管是醫院基層相關包括這個年負病比的獎金現在都還沒有開始來發我想希望能夠 |
| transcript.whisperx[494].start |
13552.61 |
| transcript.whisperx[494].end |
13557.473 |
| transcript.whisperx[494].text |
預算會計都能夠趕快做完你現在是在說個別醫院總額我們當然知道個別醫院總額是這樣子在台北區也是第二劑才會開始台北區現在所發生的醫院用色的問題 |
| transcript.whisperx[495].start |
13574.352 |
| transcript.whisperx[495].end |
13579.455 |
| transcript.whisperx[495].text |
當然應該是還沒有我沒有在問你這個我現在問你是說那個別醫院總額的話我們當然你這樣子實施這個醫院個別總額制實行下去以後醫療現場會發生什麼樣的變化那看病的民眾會受到什麼衝擊我現在是在問這個啊了解 |
| transcript.whisperx[496].start |
13594.162 |
| transcript.whisperx[496].end |
13600.544 |
| transcript.whisperx[496].text |
我是站在病人和人民的立場在問這個我想這個也不是說突然要去做不是啦會有什麼衝擊你怎麼講不出來沒關係我沒有管你我沒有突然而且我也不見得說認為這樣子是錯的我不認為這樣子就一定是不行的 |
| transcript.whisperx[497].start |
13613.467 |
| transcript.whisperx[497].end |
13632.981 |
| transcript.whisperx[497].text |
但我現在問你是說有可能面臨到看病的人會受到的衝擊是什麼你來告訴我因為你告訴我了所以你才有想說你的因應策略是什麼那證明你每一個政策新的政策的施行都是有評估有步驟而且到最後的衝擊你們也有因應的策略的我是要看到這個過程啊所以我現在問你 |
| transcript.whisperx[498].start |
13640.545 |
| transcript.whisperx[498].end |
13642.868 |
| transcript.whisperx[498].text |
這樣子新的制度上路你有沒有盤點過醫療現場會面臨什麼衝擊 |
| transcript.whisperx[499].start |
13648.072 |
| transcript.whisperx[499].end |
13668.818 |
| transcript.whisperx[499].text |
我想醫院在財務的自我管理會更加的一個謹慎那如果說他的管理他對病人就會用最有效益的方式來解決你可不可以講具體一點啊不然我講給你聽你補正耶不然我講給你聽啦我再舉個例子他長大的日子就會說 |
| transcript.whisperx[500].start |
13671.459 |
| transcript.whisperx[500].end |
13680.646 |
| transcript.whisperx[500].text |
聽你講這個我認為你不使人間煙火因為很多醫院都跳出來反映了很多醫院的發言人都出來講話了第一個根據媒體的報導台大 |
| transcript.whisperx[501].start |
13686.81 |
| transcript.whisperx[501].end |
13714.803 |
| transcript.whisperx[501].text |
民眾最擔心的就是醫學中心掛號費會不會調漲然後呢台大醫院目前掛號費100健保部分負擔420然後呢發言人就表示各種醫療支出要價不斷攀升去年點值不到0.9仍然遠遠的趕不上高漲的電費人事費為了因應可能的財務衝擊他們已經商量很多了然後他們不排除最後一個就是調漲掛號費 |
| transcript.whisperx[502].start |
13716.704 |
| transcript.whisperx[502].end |
13736.114 |
| transcript.whisperx[502].text |
然後新光醫院的副院長大家都知道醫務管理學會的理事長洪子仁也表示不過他們講的更多他們盤點醫院量能他們能做的調控措施包括調高掛費以外減少週六及夜間門診控制掛號人數延後非緊急手術等等 |
| transcript.whisperx[503].start |
13743.26 |
| transcript.whisperx[503].end |
13744.483 |
| transcript.whisperx[503].text |
現在這事情有嚴重嗎 我現在講這個可能的衝擊在這裡 生病的人會受到的衝擊 |
| transcript.whisperx[504].start |
13751.772 |
| transcript.whisperx[504].end |
13773.73 |
| transcript.whisperx[504].text |
那錢會更高的還算是最小的 調高掛號費再來開集也不會更高的週末假日還有夜間門診減少了開集要去掛號就掛不到了控制掛號人數你要去看也掛不到了半夜的週末的集中症的 |
| transcript.whisperx[505].start |
13775.332 |
| transcript.whisperx[505].end |
13787.07 |
| transcript.whisperx[505].text |
延後非緊急手術那意思是說都要碰瓶子那瓶子不上不下集中症當然排除在那個外面啦但是呢還有一種是減傷 |
| transcript.whisperx[506].start |
13789.865 |
| transcript.whisperx[506].end |
13795.15 |
| transcript.whisperx[506].text |
輕的報重的 這也不可能啊當然這種狀況 調整掛號費還掛不到號 這民怨四起啊對民眾來講 可能衝擊到醫療品質 掛號看診困難自費項目變多 手術被延後然後消基會的董事吳榮達他擔憂啊 |
| transcript.whisperx[507].start |
13810.542 |
| transcript.whisperx[507].end |
13831.872 |
| transcript.whisperx[507].text |
這一個新制上路醫療品質會下降醫院如果縮門診量民眾括號看診更困難影響就醫的可敬性當然我們希望分級醫療所以這個縮門診量是對是錯我們暫姑且不論但是這個消基會董事會講就檢驗檢查手術時間的遞延也會影響病情的發現導致病情惡化 |
| transcript.whisperx[508].start |
13838.695 |
| transcript.whisperx[508].end |
13851.78 |
| transcript.whisperx[508].text |
如果醫院若自行限縮醫療服務的申報門診檢查檢驗手術住院減少可能會影響這個事情再來喔醫療人員的收入加劇人力的出走這你們有想過嗎 |
| transcript.whisperx[509].start |
13855.666 |
| transcript.whisperx[509].end |
13869.724 |
| transcript.whisperx[509].text |
你知不知道 不是我們不支持分級醫療有時候到小診所然後醫生檢查不出問題都會叫我們說 你為了慎重起見到醫學中心去做檢查有沒有這種狀況 |
| transcript.whisperx[510].start |
13871.113 |
| transcript.whisperx[510].end |
13878.219 |
| transcript.whisperx[510].text |
有啊很多啊還有一個根據媒體報導56歲的楊女士服用高血壓的藥6年照都在台中榮總心臟內科定期回診拿單然後呢她也不懂什麼是腫瘀然後為了要掛號她覺得掛號費漲她會吞下去但是她曾經因為服用醫院給的藥不要忘了你們還有缺藥的問題喔 |
| transcript.whisperx[511].start |
13896.533 |
| transcript.whisperx[511].end |
13910.6 |
| transcript.whisperx[511].text |
你們缺藥的問題尤其是一些特殊的藥只有供給給醫院沒有供給給地區醫院也沒有供給給地方診所也沒有供給給地區的這個藥房結果那他說他的經驗是他病情穩定了醫院將他下轉到診所 |
| transcript.whisperx[512].start |
13914.141 |
| transcript.whisperx[512].end |
13929.706 |
| transcript.whisperx[512].text |
從診所要從原廠藥變學名藥還需要在醫學中心回診經每半年都抽血檢驗看這個一下在診所檢驗又要回到醫學中心就算了但是呢後來檢查好有時候又要到發現變嚴重了又要到中榮去就診 |
| transcript.whisperx[513].start |
13936.756 |
| transcript.whisperx[513].end |
13951.671 |
| transcript.whisperx[513].text |
這個我們要講的是說分級是對的但是有很多狀況並不是民眾迷信醫學醫院或教學中心而是事情的原本就是這樣對這裡治療好控制好你叫我去診所就控制不好我就要回來 |
| transcript.whisperx[514].start |
13953.413 |
| transcript.whisperx[514].end |
13973.073 |
| transcript.whisperx[514].text |
這個教學中心所以這個很複雜的不一定大家都喜歡逛醫院也不一定大家都認為到醫學中心好可是他的經驗就是如此所以他覺得說這個狀況怎麼處理呢你不可以僅憑政策的調整或是你們從上面講說就是這樣子沒問題可以改變了 |
| transcript.whisperx[515].start |
13974.514 |
| transcript.whisperx[515].end |
13979.378 |
| transcript.whisperx[515].text |
你要去掌握民眾的就醫習慣和決策的行為這是很複雜的你單純調高掛號費也不代表能夠有效的降低民眾因輕症前往醫學中心的就診的狀況這個我也諮詢過你調整了部分負擔結果呢結果呢 到醫學中心裡面看病的 看門診的量增加 增加 |
| transcript.whisperx[516].start |
14004.017 |
| transcript.whisperx[516].end |
14010.925 |
| transcript.whisperx[516].text |
現在只有改變什麼從人民的荷包掏出更多錢這一件事情而已你想要做的分級醫療沒有改變你當初漲部分負擔就說是為了要落實分級醫療結果沒有辦法控制啊 |
| transcript.whisperx[517].start |
14019.033 |
| transcript.whisperx[517].end |
14021.235 |
| transcript.whisperx[517].text |
無效啊無效的政策啊那現在呢醫改會也擔心啦門診減量以後醫院可能會透過健保轉資費減少賣信簽的處方簽的釋出調漲掛號費來增加收入導致病人看病變貴 |
| transcript.whisperx[518].start |
14037.506 |
| transcript.whisperx[518].end |
14054.852 |
| transcript.whisperx[518].text |
那為了讓治療項目得到保障甚至可能會將輕症報為重症那為了避免過度申報而斷頭給付他也可能會發展什麼我報太多被斷頭給付那他要怎麼因應如果你是醫院接應者你要怎麼因應部長 |
| transcript.whisperx[519].start |
14056.787 |
| transcript.whisperx[519].end |
14072.476 |
| transcript.whisperx[519].text |
真的很敬佩委員你覺得他們上有政策下有對策你覺得醫院會怎麼因應啊他是非常複雜的因素但是我必須要跟大家講說今天我們生活在台灣這個國度是非常幸福的 |
| transcript.whisperx[520].start |
14072.756 |
| transcript.whisperx[520].end |
14082.16 |
| transcript.whisperx[520].text |
我現在要跟你說你的政策有問題沒有啦我投資你政策可能的問題在哪裡沒有啦你講不出來我就告訴你啦醫院你一直去看一直去看他沒有辦法負責別人我們一定要改革讓他練保養所以讓永遠得到好的照顧我不算喔 |
| transcript.whisperx[521].start |
14098.886 |
| transcript.whisperx[521].end |
14127.243 |
| transcript.whisperx[521].text |
我不叫你回答你一直跟我相親 我要跟你講 北醫要面對這麼多人來看診 他怎麼因應 上有政策下有對策道高於尺 魔高於杖啦北醫要透過門前診所啦 將輕症帶出醫院治療啦而門前診所已經很多啦 很普遍啦這個就是我們在集合的重點之一集合的重點之一有改變嗎 |
| transcript.whisperx[522].start |
14128.533 |
| transcript.whisperx[522].end |
14157.403 |
| transcript.whisperx[522].text |
有解決嗎我們各區的管理在這個部分沒有啦將輕症帶出醫院假裝不是醫院去看的門前診所然後再去瓜分西醫的基層診所的總額從醫院的總額再來瓜分診所的總額而重症的病人如果沒有人要收通通給他送到公立醫院讓護理人力更慌公立醫院的 |
| transcript.whisperx[523].start |
14158.383 |
| transcript.whisperx[523].end |
14170.968 |
| transcript.whisperx[523].text |
所以如果避免醫院選病人你衝擊的配套在哪裡如果讓人家剛提出來的可能的問題你們是有能力因應的嗎你來告訴我 |
| transcript.whisperx[524].start |
14172.588 |
| transcript.whisperx[524].end |
14189.772 |
| transcript.whisperx[524].text |
透過健保轉資費你要怎麼處理減少慢性遷的事數你要怎麼處理調漲掛號費但是沒有改善醫療分級的問題你怎麼處理門前診所你說你要列為評鑑的項目但是你沒有效你要怎麼處理我們委員所擔心所提出的請你放心 |
| transcript.whisperx[525].start |
14196.261 |
| transcript.whisperx[525].end |
14214.014 |
| transcript.whisperx[525].text |
我們一定一個一個去把它監測保障保障人民身體最佳的健康限縮門診你知道台大你們台大健康政策管理研究所門診的數量真的不用太重一個門診一個診斷大規模我還沒請你說你怎麼這麼說的黃正熙教授有要拿來看其實大家都看了沒有啦我現在沒有在聽你抬槓主席我要問問題他這樣子一直抬槓我怎麼問 |
| transcript.whisperx[526].start |
14223.601 |
| transcript.whisperx[526].end |
14237.444 |
| transcript.whisperx[526].text |
沒有啦我是回答我是說台大健康政策管理研究所副教授郭年珍他最近也撰文指出個別醫院總額上路會遇到的四個問題第一個限縮門診手術是否會影響就醫的限縮門診和手術會不會影響到就醫的可進性 |
| transcript.whisperx[527].start |
14244.986 |
| transcript.whisperx[527].end |
14264.92 |
| transcript.whisperx[527].text |
那第二個就是說啊如何避免醫療醫院選擇輕症病患啊如何避免啊今年醫院的總額比去年增加了370億欸那預期的點值穩定性會提升啊可是關鍵問題在如果避免影響民眾就醫的可進性和醫療品質很低啊但是有可能 |
| transcript.whisperx[528].start |
14270.726 |
| transcript.whisperx[528].end |
14290.84 |
| transcript.whisperx[528].text |
醫院我們健保多給了370億然後你們漲部分負擔也增加了醫院的收入然後呢如果再增加掛號費收入又要增加可是未來掛號掛不到然後檢查檢查不到然後未來看病的可敬性會受影響 |
| transcript.whisperx[529].start |
14291.801 |
| transcript.whisperx[529].end |
14320.37 |
| transcript.whisperx[529].text |
你有沒有可能面臨導致高醫療需求的病患不符但是不符合重症的範圍面臨更大的困難或者是變成全民搶掛號大賽大家都要搶掛號都拜託你去搶掛號或是促使醫院策略性的選擇輕症病患平轉或上轉醫療資源耗用多的病患給其他公立的醫院進一步的加劇醫療資源分配不均 |
| transcript.whisperx[530].start |
14322.315 |
| transcript.whisperx[530].end |
14347.388 |
| transcript.whisperx[530].text |
然後再來第三點 郭年增教授講的醫院內部資源分配和管理衝突這不是醫病的問題 也不是醫院跟病人的問題而已光是醫院內部各分科的內部資源分配和管理就會產生衝突所以在某些科別好看的 成本低的 然後服務量增加 |
| transcript.whisperx[531].start |
14348.408 |
| transcript.whisperx[531].end |
14361.111 |
| transcript.whisperx[531].text |
然後薪資裡面呢 如果這種像成本高的 不賺錢的科別然後人數下降 這邊看這個吃力不討好的 醫生會收入減成本高的 成本低的 然後好看的 人看越多越賺錢的 醫生薪水越來越高 |
| transcript.whisperx[532].start |
14369.173 |
| transcript.whisperx[532].end |
14397.35 |
| transcript.whisperx[532].text |
光是在這種狀況裡面醫師現有的薪酬制度除了兼行政主管或擔任研究醫師以外仍然都是以不拖你服務的量能為基礎鼓勵多做來分配酬勞和所得可是你當總額受到嚴格的控制然後醫院如果沒有有效的調整薪資激勵這個這個激勵的鼓勵的機制的話你如果反向的鼓勵不要充量然後你沒有鼓勵 |
| transcript.whisperx[533].start |
14398.351 |
| transcript.whisperx[533].end |
14399.232 |
| transcript.whisperx[533].text |
你這個管理食物上還有一種問題是論人計酬的狀況那你減少醫療你要讓這個醫生和部門之間真的啦這問題很嚴重的譬如說 |
| transcript.whisperx[534].start |
14417.421 |
| transcript.whisperx[534].end |
14441.181 |
| transcript.whisperx[534].text |
本醫來得住院 住院的我們都知道門診轉住院的病患病情比較穩定住院的天數容易管理比較有機會接受自費治療可是急重症的急診他轉住院的病患病情是相對嚴重的住院的時間也不確定了也可能比較容易被排擠 |
| transcript.whisperx[535].start |
14441.781 |
| transcript.whisperx[535].end |
14447.965 |
| transcript.whisperx[535].text |
有沒有可能在醫院的管理上他們在各部門的住院收留上寧可優先選擇收留門診轉上來的而策略性的將急重症的急診部門的要轉病房的讓他留在急診室導致急診有壓力進一步升高 |
| transcript.whisperx[536].start |
14467.156 |
| transcript.whisperx[536].end |
14467.919 |
| transcript.whisperx[536].text |
因為這部門和部門之間 我也要選定他要選勤課 他也要選朝廷的 |
| transcript.whisperx[537].start |
14474.116 |
| transcript.whisperx[537].end |
14502.983 |
| transcript.whisperx[537].text |
所以在這種狀況裡面這一類的急診和非急診專科的衝突在醫院裡面會不會被進一步的放大畢竟多收一個急診的患者即使能夠健保的加成或是排除個別的總額之外相較於門診排成的住院病患哪一個比較符合他們那個部門的利益這個是很現實的因為那個部門也有護理人力缺護理師也考量到我寧可照顧 |
| transcript.whisperx[538].start |
14503.763 |
| transcript.whisperx[538].end |
14507.585 |
| transcript.whisperx[538].text |
門診轉上來誰要照顧那個急診 急重症轉上來的所以為了在這種狀況裡面這個問題都是內部管理會衝突的而犧牲的是病人啦在這種狀況裡面還有一種病床控管的方式並不是由科部統一管理有一些醫院的病床的管理是根據個別醫師資歷去分配的 |
| transcript.whisperx[539].start |
14530.66 |
| transcript.whisperx[539].end |
14546.749 |
| transcript.whisperx[539].text |
而個別醫師的資歷的分配狀他導致有空床仍然無法有效收治急診的病患所以在這裡我並不是說我們反對你分級醫療並不是說你反對你個別醫院的總額管制而是 |
| transcript.whisperx[540].start |
14548.223 |
| transcript.whisperx[540].end |
14563.251 |
| transcript.whisperx[540].text |
你要做的你要監測的更細緻你的配套機制要更完善而是你要預期到可能的衝擊對病人的衝擊是什麼而你的因應知道是什麼請問我剛剛講到一些問題你們的配套是什麼 |
| transcript.whisperx[541].start |
14568.493 |
| transcript.whisperx[541].end |
14582.182 |
| transcript.whisperx[541].text |
病人受到這麼大的衝擊 你的配套是什麼所以在醫界 在學界 人家已經跟你講你的政府要細緻的進行相關的監測和配套機制你說什麼呢你們現在有什麼細緻的監測和配套機制你們監測的項目有哪些監測的頻率會如何設定監測後的檢討設定多久時間 |
| transcript.whisperx[542].start |
14594.949 |
| transcript.whisperx[542].end |
14611.085 |
| transcript.whisperx[542].text |
包園,你剛剛提的,不管是郭教授,或者是你提的寶貴的見解其實我們都知道我雖然問你,你也在這裡,不是問你知不知道我問你啊,你現在監測的配套機制是什麼你若不能說,叫你書長來說啦我看你是不會說啦,叫你書長來說你,就下機會,讓書長我問一下 |
| transcript.whisperx[543].start |
14623.908 |
| transcript.whisperx[543].end |
14633.437 |
| transcript.whisperx[543].text |
跟委員報告這個個別醫院總額除了台北區之外全部都在今年1月1號都實施了台北區當然是最困難的 |
| transcript.whisperx[544].start |
14635.319 |
| transcript.whisperx[544].end |
14640.44 |
| transcript.whisperx[544].text |
南區高屏區東區都已經早已實施多年所以這個不是一個新的制度因為這些問題在過去實施之前也都有這樣的疑慮但是實施下去之後我們各區的你不要這樣子好不好中南部的醫療現場的問題跟我們北區會一樣嗎 |
| transcript.whisperx[545].start |
14659.705 |
| transcript.whisperx[545].end |
14671.875 |
| transcript.whisperx[545].text |
一個大台北地區多少人你知道嗎大台北就好了北北區就好了多少人你告訴我700萬人啊對啊但是大台北區啊700萬占全台灣三分之一耶北北區的醫療資源很豐豐盛啊 |
| transcript.whisperx[546].start |
14676.872 |
| transcript.whisperx[546].end |
14704.688 |
| transcript.whisperx[546].text |
你知道2004年就以醫院卓越計畫之名推行過了類似個別總額的制度了啦這個概念在2004年就做過了那因為部分醫院減少開立藥品種類和數量而且限制門診量導致民眾申訴掛不上號醫院減少開藥種類或數量甚至有醫學中心因為頻繁遭投訴而被中區健保業務組終止合約但是因為當時是自願參與的 |
| transcript.whisperx[547].start |
14706.829 |
| transcript.whisperx[547].end |
14733.088 |
| transcript.whisperx[547].text |
而未參加的醫院這個點子會讓他下降然後影響了整體醫療生態最後這一個計畫被監察院糾正欸那我不認為現在的計畫跟當時是一模一樣但是你們面對這個的態度你們認為台北的模式跟中南部會一樣都不會有問題學者專家叫你們監測什麼你們要監測了嗎 |
| transcript.whisperx[548].start |
14736.058 |
| transcript.whisperx[548].end |
14752.187 |
| transcript.whisperx[548].text |
有監測嗎 都會參考啦他們叫你監測什麼 你先回答我你先回答我沒有實施的台北居庸社 其他區實施的沒有你先回答我 他們要求的監測合不合理他們要求監測什麼東西 你回答得出來嗎 |
| transcript.whisperx[549].start |
14753.24 |
| transcript.whisperx[549].end |
14781.599 |
| transcript.whisperx[549].text |
我們有很多的指標在監測他在說你們都不聽就不想聽啦還在說你們都知道知道你連聽都不想聽人家建議監測實施前後的實施前後的門診和住院病患的屬性變化監測病人就醫流向是不是出現不合理的平轉或下轉引導醫院建立更合理的薪酬和資源分配機制 |
| transcript.whisperx[550].start |
14783.325 |
| transcript.whisperx[550].end |
14791.892 |
| transcript.whisperx[550].text |
引導醫院建立更合理的薪酬和資源分配機制你們的對策是什麼你們的手段 蘿蔔和棒子是什麼 |
| transcript.whisperx[551].start |
14796.738 |
| transcript.whisperx[551].end |
14815.957 |
| transcript.whisperx[551].text |
大家都轉到台大和北龍然後像那個人酬的話不收的話是要轉出那邊處分還是還是台大和北龍要負責我真的要語重心長的跟委員報告啦您的資料我們都會我們都了解也會解決但是我不是要來了解我現在問你說人家拋出來的問題 |
| transcript.whisperx[552].start |
14818.88 |
| transcript.whisperx[552].end |
14839.312 |
| transcript.whisperx[552].text |
他們絕對都是...我是幫醫院拋出來的問題拿來問你我不是在問醫院院長我擔心的是衛福部部長你要怎麼解決而你講不出來所以我擔心啦有蘿蔔有棍子但是不是一個學者所講的就代表全部 |
| transcript.whisperx[553].start |
14839.992 |
| transcript.whisperx[553].end |
14844.836 |
| transcript.whisperx[553].text |
我現在最好說一句啦現在我最好說一句啦因為我說很久了啦你為大家不是靠上身就可以解決問題你不是大家叫你為上身就可以解決問題今天在這裡是說人家提出問題了你有什麼看法你有什麼解方你面對病人受到這麼大的衝擊你的配套是什麼我有提出的問題我們一定會收起 |
| transcript.whisperx[554].start |
14868.673 |
| transcript.whisperx[554].end |
14890.503 |
| transcript.whisperx[554].text |
而今天整個衛福部包括部長包括署長都對我們提出來的病人受到衝擊回答不出來不願意回答然後轉移焦點 答非所問這才是大問題啦我們要解決所有人擔心的問題大家都宣誓性的 唯獨一再的宣誓而已 |
| transcript.whisperx[555].start |
14892.172 |
| transcript.whisperx[555].end |
14898.497 |
| transcript.whisperx[555].text |
主席有請部長部長好請問衛福部今年通過預算是多少那跟去年相比增加多少 |
| transcript.whisperx[556].start |
14925.272 |
| transcript.whisperx[556].end |
14926.035 |
| transcript.whisperx[556].text |
呃增加了大概 |
| transcript.whisperx[557].start |
14929.648 |
| transcript.whisperx[557].end |
14954.035 |
| transcript.whisperx[557].text |
三百多億今年通過將近三千七百億因為被核酸了十一億今年差不多三千七百億左右所以總共增加就算被刪了十一億也增加了三百多億對不對是我現在請教部長我們真的是增加很多服務的量我肯定衛福部啦所以一個一個來肯定你好不好 |
| transcript.whisperx[558].start |
14954.935 |
| transcript.whisperx[558].end |
14978.744 |
| transcript.whisperx[558].text |
來 我想請教部長護理人員夜班津貼這筆預算是編在哪裡我告訴你好不好是編在護理人力政策準備中長程計畫而這個計畫是列在護理及健康照護業務向下沒錯嘛 對不對好 那我想請問你護理及健康照護業務今年預算是多少79.87億嘛 對不對 |
| transcript.whisperx[559].start |
14986.045 |
| transcript.whisperx[559].end |
15002.739 |
| transcript.whisperx[559].text |
沒錯啦 如果我講錯你再更正我 後來補給我啦這是預算上面的啦去年編列多少4.78億啦對不對沒錯吧那我想請問今年護理及健康照護業務預算被刪了多少預算被刪了多少護理及健康照護業務27002700嗎一毛都沒刪啦 |
| transcript.whisperx[560].start |
15017.33 |
| transcript.whisperx[560].end |
15044.966 |
| transcript.whisperx[560].text |
你講是統三嘛 我講是這個項目三多少統三是你們要去調整的啦一毛都沒三嘛 沒錯吧然後凍結了多少 凍結了多少550萬啦 我告訴你啦 沒錯吧550萬啦 而且喔是國民黨 民進黨 民眾黨都有提案凍結喔不是只有在野黨提案凍結喔提案凍結的部分連民進黨也有喔 |
| transcript.whisperx[561].start |
15045.868 |
| transcript.whisperx[561].end |
15066.098 |
| transcript.whisperx[561].text |
那我就要請教您 部長請教我剛剛講的都沒錯吧 部長事事不管是捅山捅洞應該就是這個數目好啊 謝謝您 謝謝您告訴我然後我們部長上次在衛福部官員開記者會當時趙律師司長 蔡淑鳳司長你怎麼講的 |
| transcript.whisperx[562].start |
15070.066 |
| transcript.whisperx[562].end |
15093.451 |
| transcript.whisperx[562].text |
除護理人力政策準備中長程計畫今年編號47億不分醫院層級及病房類別所有護理人員均可以拿到一樣的獎勵預算到位就可以罰房並回溯至今年1月沒錯吧沒錯吧 對不對那我想請問部長急診優設是藍白3預算造成的嗎是不是 |
| transcript.whisperx[563].start |
15095 |
| transcript.whisperx[563].end |
15109.065 |
| transcript.whisperx[563].text |
前陣子發生急診擁捨的問題是藍白三預算造成的嗎是不是急診擁捨應該是長久以來各種因素的問題我真的非常非常謝謝也敬佩部長謝謝你啊謝謝你打臉你的次長呂健德 |
| transcript.whisperx[564].start |
15111.647 |
| transcript.whisperx[564].end |
15130.053 |
| transcript.whisperx[564].text |
我跟你講 這好好管管你的次長次長怎麼講 他在上節目說啊這個急診優設行政院編了50億的護理業班津貼但是預算已經編了 送到立法院被砍 被刪 被動所以他推給藍白衫預算耶部長我今天真正的肯定也謝謝你啊 |
| transcript.whisperx[565].start |
15135.711 |
| transcript.whisperx[565].end |
15164.3 |
| transcript.whisperx[565].text |
你知道這個謠言到處放還是政府官員去放以及所有側翼引用這個謠言到處去攻擊別人啊實際上已經講過了從最大的項目最大的項目衛福部的預算就是增加了300億啊對不對那從第二個護理人力政策整備中長城計畫實際上護理健康照顧業務 |
| transcript.whisperx[566].start |
15167.625 |
| transcript.whisperx[566].end |
15180.614 |
| transcript.whisperx[566].text |
79.87億比去年4.78億 增加75億而且一毛未三 凍結550萬結果你的次長竟然可以說這個急診用色是因為藍白 篩預算 砍預算 凍預算 |
| transcript.whisperx[567].start |
15183.672 |
| transcript.whisperx[567].end |
15203.631 |
| transcript.whisperx[567].text |
所以我謝謝部長當然我們也期待齁那個因為統山統棟還是在部長很講統山統棟難道你今天要告訴統山統棟你打算把統山統棟的項目拿去動護理人員的夜班津貼嗎那個因為必須要它穩定不是啦部長我就問你啦以後我們才敢 |
| transcript.whisperx[568].start |
15204.677 |
| transcript.whisperx[568].end |
15232.538 |
| transcript.whisperx[568].text |
第一個嘛 統三統鬥 你打算去拿去動護理人員的夜班津貼嗎沒有嘛 我直接幫你講嘛 對不對所以我回頭要跟部長說沒關係啦 部長我跟你講 我今天到現在為止是肯定你啦 為什麼我也拜託那一次而已 我直接講你再說藍白三預算 羅志強三護理人員津貼預算 醫護預算你講一次我告一次 你相不相信 |
| transcript.whisperx[569].start |
15234.892 |
| transcript.whisperx[569].end |
15260.171 |
| transcript.whisperx[569].text |
我跟他說真的可惡至極無良到一個程度我也最後跟部長做一個總結我就結束今天急診擁捨的問題很嚴重剛剛我看前面幾個委員都有質詢啊我也希望部長能夠好好去做我在大安區是一步一步的挨家挨戶的拜訪這段時間我就遇到一個離職的護理師告訴我部長你就聽聽他的心聲 |
| transcript.whisperx[570].start |
15262.23 |
| transcript.whisperx[570].end |
15287.806 |
| transcript.whisperx[570].text |
他說啊他在當護理師的時候流產三次啊流產三次其中一次是值班的時候大出血差點連命都沒有他告訴我他說我熱愛護理師工作啊可是我為什麼要離開他說不只是工作跟收入這個不合理更重要的是 |
| transcript.whisperx[571].start |
15288.564 |
| transcript.whisperx[571].end |
15312.601 |
| transcript.whisperx[571].text |
他的工作的壓力不合理幾乎壓垮了很多的護理師像他這樣資深的護理師最後選擇離開就會開始形成惡性循環不是嗎離開以後結果護理人手短缺壓力更大壓垮更多護理人員然後更多護理人員移開壓力更大再壓垮更多護理人員 |
| transcript.whisperx[572].start |
15314.032 |
| transcript.whisperx[572].end |
15334.26 |
| transcript.whisperx[572].text |
這個惡性循環才是剛剛我們部長講的急診優設長期很多的問題有待我們衛福部跟所有各院所解決嘛對不對是所以謝謝認真解決問題然後也請這個呂次長不要造謠謝謝謝謝也拜託委員齁盡量的全力來支持我們相關好謝謝羅委員謝謝部長這個還要處理呢 |
| transcript.whisperx[573].start |
15345.236 |
| transcript.whisperx[573].end |
15347.717 |
| transcript.whisperx[573].text |
主席可以嗎?好像耽誤時間的不是我吧 |
| transcript.whisperx[574].start |
15372.048 |
| transcript.whisperx[574].end |
15392.958 |
| transcript.whisperx[574].text |
前面主席在主持議事的時候,我們都尊重委員諮詢了快半個小時,你沒制止我們靜靜的在等,一句話都沒有非常尊重主席、議事的處理希望這個基本的文明跟秩序,在日晚委員會可以繼續貫徹好,來請部長 |
| transcript.whisperx[575].start |
15401.468 |
| transcript.whisperx[575].end |
15422.801 |
| transcript.whisperx[575].text |
委員好部長我想基層護理同仁的福利跟他的新生向來是我長期關注的事情上個會期針對這件事情也有跟部長當基層的護理師請命部長也有做一些承諾這個我們等一下再來講 |
| transcript.whisperx[576].start |
15424.298 |
| transcript.whisperx[576].end |
15451.325 |
| transcript.whisperx[576].text |
但是現在大家更關心的事情是說護理人員近10年離職離居空缺率不斷的升高那部長看起來好像也蠻認真的有打電話去問各個醫院說護理師現在的待遇如何那顯然部長應該也是肯認整個基本上面的勞動環境是護理師是不是繼續願意留在工作崗位上面 |
| transcript.whisperx[577].start |
15452.225 |
| transcript.whisperx[577].end |
15477.97 |
| transcript.whisperx[577].text |
的一個最重要的原因,我這樣說沒有錯吧?是對嗎?非常重要的原因好,非常重要的原因,那我們就來看賴清德總統選總統的時候,說那個護病筆要入法他那個時候講的稍微抽象一點,說兩年或者是他任內賴清德總統的這個政治承諾,部長會不會跳票? |
| transcript.whisperx[578].start |
15480.81 |
| transcript.whisperx[578].end |
15499.516 |
| transcript.whisperx[578].text |
跟委員報告因為我們一定努力所以我們先用獎勵那獎勵的比例現在奇怪怎麼部長現在講的跟賴清德當初提出來的競選政見差這麼多那個部長不好意思就是你如果要做其他的政治宣言你去開記者會 |
| transcript.whisperx[579].start |
15502.417 |
| transcript.whisperx[579].end |
15528.529 |
| transcript.whisperx[579].text |
這裡,尋答就針對問題回答,我的問題非常明確我想我們會一直溝通,特別是跟醫院,因為要充實護理人員請你聽我的問題回答好嗎好賴清德講的這個話,兩年後任內護病比錄法,這個政治承諾會不會跳票?我想在他特別後面有一個兩年內跟任內的這個我想我們會盡量來完成會盡量來完成,跳票誰要負責? |
| transcript.whisperx[580].start |
15530.14 |
| transcript.whisperx[580].end |
15553.532 |
| transcript.whisperx[580].text |
是你的責任還是賴清德的責任?那就是我工作不力對,就是你工作不力你很有肩膀,自己把他扛起來但我也幫你講一句話開這個支票的是賴清德當初這個支票開出來了以後,站在你旁邊的這位市長非常會打折水棍上 |
| transcript.whisperx[581].start |
15555.005 |
| transcript.whisperx[581].end |
15570.614 |
| transcript.whisperx[581].text |
配合當初副總統要選總統的政見趕快出來表示這是2023年11月20號的表示竹子是這樣講的最快今年年底行政程序決定出最終的版本 |
| transcript.whisperx[582].start |
15571.534 |
| transcript.whisperx[582].end |
15586.587 |
| transcript.whisperx[582].text |
他發話的時間是2023年11月20號最快今年年底就會最終版本最快有望明年上路就2024年上路那顯然到現在是沒有上路是不是飄飄我補充一下這個是應該是三班戶並比的標準 |
| transcript.whisperx[583].start |
15592.364 |
| transcript.whisperx[583].end |
15597.072 |
| transcript.whisperx[583].text |
三班戶邊筆的標準不是入法那現在如果沒有符合這個標準的話現在沒有符合這個標準有什麼狀況 |
| transcript.whisperx[584].start |
15603.166 |
| transcript.whisperx[584].end |
15631.386 |
| transcript.whisperx[584].text |
不是 這個就是說標準定案是 如果沒有符合標準會造成什麼狀況我們是在2024年的奇怪 我這麼簡單的問題你都可以繞來繞去現在我的問題很明確我們現在是用獎勵所以你還是沒有回答我的問題嗎是有效果的你現在定一個標準嘛你現在就定一個標準嘛我的問題是沒有符合這個標準的法律效果是什麼 |
| transcript.whisperx[585].start |
15632.844 |
| transcript.whisperx[585].end |
15639.267 |
| transcript.whisperx[585].text |
那你就直接回答沒有法律效果就好了嘛這麼簡單的問題寫來寫去這麼簡單的問題繞來繞去就是沒有法律效果嘛如果用獎勵的方式會有用的話現在的情況會這樣嗎當初賴清德是說用獎勵的方式嗎 |
| transcript.whisperx[586].start |
15659.329 |
| transcript.whisperx[586].end |
15685.789 |
| transcript.whisperx[586].text |
這樣對嗎?選前騙票?選後票票?這樣對嗎?這個就是基層護理同仁他們的心聲這個就是基層護理同仁的心聲這個我們一定努力但是這個要跟醫院來配合就是也要聽聽醫院看看他能不能做得到做不到所以嘛這就是等到2024年等到票投完了以後薛瑞元才講大實話嘛 |
| transcript.whisperx[587].start |
15687.625 |
| transcript.whisperx[587].end |
15711.731 |
| transcript.whisperx[587].text |
沒有辦法入法沒有時程選前一套選後一套對比的這麼清楚莫此為勝這為什麼大家不滿理由就是這個嗎去年的時候五一勞動節集成的醫護就出來喊沒有達標也沒有罰則這是為什麼去年在問法委員會問這題 |
| transcript.whisperx[588].start |
15713.94 |
| transcript.whisperx[588].end |
15738.568 |
| transcript.whisperx[588].text |
在問完委員會問這題問完了以後然後呢然後就沒有然後了嘛繼續賴皮啊就像卓榮泰講的啊我們是用獎勵的方式啊看了令人瞠目結舌啊我很希望2023年的時候賴清德總統啊是誠實的告訴全國人民啊我打算用獎勵的方式啊來處理三班互併比的問題啊 |
| transcript.whisperx[589].start |
15739.727 |
| transcript.whisperx[589].end |
15765.123 |
| transcript.whisperx[589].text |
而不是在選前的時候講一套選後的時候跳票跳票完了 推一個行政院院長出來厚著臉皮講我是用獎勵的方式報告委員 因為時間還沒到 我們會盡量來努力OK好 沒關係 有一件事情是時間到了我去年質詢就跟你講說專科護理師沒有拿到 |
| transcript.whisperx[590].start |
15766.223 |
| transcript.whisperx[590].end |
15787.839 |
| transcript.whisperx[590].text |
然後你說你一定會按照衛福部的規定去發放有嗎今年一月開始會發沒有啦今年一月是今年一月的事情啊去年該給人家的到現在都沒給啊我去年就是在問去年該給沒給的啊該給沒給的啊藉著清腸期還不履行限於幾副職員然後你跟我說今年會給 |
| transcript.whisperx[591].start |
15790.171 |
| transcript.whisperx[591].end |
15812.621 |
| transcript.whisperx[591].text |
去年有啊 去年我們271是給一般急性病房的沒有 所以我就要你先停一下好不好我如果今天沒有得到護理師的陳情我今天會傻傻的站在這邊質詢喔你們跟我說會做 那我就一定會去追蹤嘛我追蹤出來的結果就沒有嘛所以才會陳情到我這邊來嘛現實上是什麼 現實上就沒領到啊 |
| transcript.whisperx[592].start |
15818.186 |
| transcript.whisperx[592].end |
15836.012 |
| transcript.whisperx[592].text |
這每一家醫院的護理師我全部都去check過啦部長 質詢的時間到了這涉及到你的承諾這也到齊啦 這不是還沒到齊的事情啊回去清查 一個禮拜以後給我書面回覆好不好好的 可以齁好 謝謝委員 |
| transcript.whisperx[593].start |
15841.089 |
| transcript.whisperx[593].end |
15847.436 |
| transcript.whisperx[593].text |
謝謝黃委員 標準接續楊瓊英委員質詢謝謝主席 陽瓊發言 邀請部長 |
| transcript.whisperx[594].start |
15870.99 |
| transcript.whisperx[594].end |
15878.694 |
| transcript.whisperx[594].text |
部長好現在我們說醫護血汗這一個崩潰兩個字來形容那這個崩潰 |
| transcript.whisperx[595].start |
15880.049 |
| transcript.whisperx[595].end |
15901.615 |
| transcript.whisperx[595].text |
也已經很久到底我們改善的口號還要很多久我們看到現在目前為止醫護現場的崩潰無論是急診室的庸塞重症病患難以排入ICU尤其我們還看到我們的醫護人員真的太辛苦了 |
| transcript.whisperx[596].start |
15902.435 |
| transcript.whisperx[596].end |
15927.453 |
| transcript.whisperx[596].text |
他必須要上了十幾個小時急診一個人要顧十幾個人救護車送病患來 甚至全部滿床重症者沒有床不能那怎麼辦 救護車的床啊下來做暫時床做暫時床在這樣的情況之下 我只能夠用血汗崩潰來形容 |
| transcript.whisperx[597].start |
15929.281 |
| transcript.whisperx[597].end |
15940.093 |
| transcript.whisperx[597].text |
我要請教因為你也是來自醫界你也當過民意代表真正的原因是什麼會導致現在的現狀真正的原因是什麼請做說明 |
| transcript.whisperx[598].start |
15943.703 |
| transcript.whisperx[598].end |
15955.747 |
| transcript.whisperx[598].text |
這個有分長期跟短期啦那短期這次發生的比較嚴重我們不可諱言就是護理人力方面需要加強護理缺人力不足醫療體系缺人在近期當然是比較明顯那長期來講就是我們在推分級 |
| transcript.whisperx[599].start |
15964.935 |
| transcript.whisperx[599].end |
15985.711 |
| transcript.whisperx[599].text |
醫療這個部分也沒有落實那民眾還是相信大醫院其實有些病其實是可以找他社區的一個診所醫師部長你剛剛所說的原因主要你講出三點第一個也就是整個醫療體系缺人 |
| transcript.whisperx[600].start |
15986.929 |
| transcript.whisperx[600].end |
15997.539 |
| transcript.whisperx[600].text |
接下來缺衣物接下來護理人員不足那這個原因這麼危急他面臨到下一個環節問題是什麼請問下一個環節問題是什麼導致這樣的原因條件下一個環節是什麼 |
| transcript.whisperx[601].start |
16008.277 |
| transcript.whisperx[601].end |
16010.619 |
| transcript.whisperx[601].text |
下一個環節就是醫院要關病房急診待診停治的時間會越多 |
| transcript.whisperx[602].start |
16030.14 |
| transcript.whisperx[602].end |
16052.102 |
| transcript.whisperx[602].text |
再來就是門診床位調度會失衡是不是所以它是連環問題一直產生你是醫界出身你告訴我是這不是一朝一夕耶也不是現在才發生因為在疫情之後我們已經提出出現了護病比是一比十 |
| transcript.whisperx[603].start |
16053.655 |
| transcript.whisperx[603].end |
16072.72 |
| transcript.whisperx[603].text |
是不是所以你們在評鑑裡頭你提出的1比6 1比7 1比9作為評鑑的原因之內所以因此我要跟你討論1比12的地區醫院也因為如此你剛剛講到一個關鍵醫務人員不夠所以只好關病房對不對所以這樣的情況我們要怎麼解決我回顧在2003年的時候 |
| transcript.whisperx[604].start |
16083.379 |
| transcript.whisperx[604].end |
16101.785 |
| transcript.whisperx[604].text |
我們為了也就是病房費在我們健保體系我們把它拉出來護理人員單獨體系對不對護理會拉出來目的要做什麼我們希望護理人員很辛苦他可以願意要留下來而且我們專款專用第一梯是20億 |
| transcript.whisperx[605].start |
16106.84 |
| transcript.whisperx[605].end |
16128.835 |
| transcript.whisperx[605].text |
就如此解決了當時稍微的緊張可以緩和一點但是到目前為止我們要怎麼辦我們要怎麼辦離職潮這麼多衍生的問題因為人力不足導致醫院的方式關病房也好再急診請大家不要再到急診了媒體這麼罷你看到吧那你要怎麼解決 |
| transcript.whisperx[606].start |
16135.9 |
| transcript.whisperx[606].end |
16161.536 |
| transcript.whisperx[606].text |
當然必須要到急診還是到急診那如果說一些未婚化的症狀那我們希望說能夠有分流的機制那這樣能舒緩急診的壓力這個部分當然從預防性的措施我們要做那至於說人力方面我們不停的在努力提高醫護同仁的待遇還有改善公司醫護同仁的待遇我們問兩種總統說 |
| transcript.whisperx[607].start |
16165.419 |
| transcript.whisperx[607].end |
16186.451 |
| transcript.whisperx[607].text |
總統說我們的這個三班互併筆要入法什麼時候要入法已經過了一年了他說兩年或者在任內你是他的部長你會完成他的承諾嗎我一定會完成他的承諾你會完成他的承諾也就是說我們的三班互併筆一定會入法你現在進程怎麼樣 |
| transcript.whisperx[608].start |
16190.509 |
| transcript.whisperx[608].end |
16216.67 |
| transcript.whisperx[608].text |
跟委員報告進程如何你們現在討論到哪裡其實這個有很多政策請針對議題提問因為你已經說你會完成總統的政治承諾那請問但是因為要達到的時候也是要努力嘛所以我們現在你現在進度怎麼樣沒關係本市只要了解進度我們首相的努力之下我們從去年的3月醫學中心36%達到 |
| transcript.whisperx[609].start |
16218.471 |
| transcript.whisperx[609].end |
16223.774 |
| transcript.whisperx[609].text |
三班護病比 三班喔 都達到的36% 現在已經59%了所以你現在不是在錄法嘛 你現在只是自助嘛現在是獎勵的情況之下那區議院已經到達50%那地區議院已經到達94%我相信獎勵的如果落實對於護病比應該是會達到更好的目標獎勵的經費在你編列在今年度 |
| transcript.whisperx[610].start |
16246.377 |
| transcript.whisperx[610].end |
16262.288 |
| transcript.whisperx[610].text |
是你編的嘛大家全力支持嘛對不對感謝感謝感謝齁還好你說一句感謝不能再造謠一定要好好想好好的支持我們的醫護所以本期在這裡討論我們現在對不起還沒一頁還沒辦法發啦等整個預算確認以後我們就趕快來發從一頁就要趕快來發這個項目是79.87億嘛對不對大家全力的在支持啊 |
| transcript.whisperx[611].start |
16276.781 |
| transcript.whisperx[611].end |
16294.698 |
| transcript.whisperx[611].text |
所以接下來本席要請問您剛才承諾的你會完成總統他所說的互併三班這個字的路法對不對三班互併筆你會完成他的 |
| transcript.whisperx[612].start |
16295.526 |
| transcript.whisperx[612].end |
16321.285 |
| transcript.whisperx[612].text |
路法全力以赴完成任務全力以赴完成任務好請你繼續加油接下來我要請問面對到這樣的問題你要怎麼做本席具體給你建議在短期之內你必須要增加因為民眾需求你剛才說的醫院在喊不要到急診來了我們已經超額很多好幾倍了你說該去還是要去不是你一句該去還是要去你要解決他們的問題啊 |
| transcript.whisperx[613].start |
16323.226 |
| transcript.whisperx[613].end |
16349.14 |
| transcript.whisperx[613].text |
所以急診住院的配床是不是應該要增加第二個 用設施所需的醫護人力是不是要增加第三個 要建立ICU的調配制度在短期內是不是應該這三項要好好的趕快去協助他們有 這個都在努力都在努力 方案請給本席好 沒問題接下來中長期 |
| transcript.whisperx[614].start |
16350.24 |
| transcript.whisperx[614].end |
16376.457 |
| transcript.whisperx[614].text |
護理人員我說我從2003年就開始護理人員的待遇跟工作狀態都應該列為你重要的改革政策真正的來支持我們的醫護包括我們的護理會你的預算這個向下要怎麼樣專款專用不能再挪用對不對是不是該給護理的我們一定要求醫院要公開透明 |
| transcript.whisperx[615].start |
16377.378 |
| transcript.whisperx[615].end |
16396.924 |
| transcript.whisperx[615].text |
不能扣東扣西公開透明不能扣東扣西立法院大家全力的支持你這79億多將近80億我希望你好好善用真正讓我們的護理人員醫護可以好好放心的來照顧這是我們非常希望要努力的目標請你把方案給本席謝謝 |
| transcript.whisperx[616].start |
16401.055 |
| transcript.whisperx[616].end |
16411.294 |
| transcript.whisperx[616].text |
那繼續我們請陳穎委員質詢我們全部答詢完再休息啦客人再動一下就好了有便當的人先吃啦都發了吧 |
| transcript.whisperx[617].start |
16425.762 |
| transcript.whisperx[617].end |
16444.276 |
| transcript.whisperx[617].text |
那個主席可以一分鐘會議詢問我很快速講一下今天有看到我們那個委員會有裝了這個監測器那特別這個有趣的是有這個分貝的部分那我剛剛查的資料就是50分貝以下會讓人家感覺這個寧靜舒適心情愉悅 |
| transcript.whisperx[618].start |
16447.818 |
| transcript.whisperx[618].end |
16467.87 |
| transcript.whisperx[618].text |
那再來就是說70分貝這個以上呢就會造成大家心情煩躁神經緊張然後無法專心影響學習所以我們這個可能也要注意一下官員在這個70分貝以上能不能專心聽委員的垂詢這個也是很重要的那當然 |
| transcript.whisperx[619].start |
16469.231 |
| transcript.whisperx[619].end |
16483.588 |
| transcript.whisperx[619].text |
這個長期處於70分貝以上也會造成大家這個情緒的焦躁所以久而久之可能大家也是需要去看心理醫師或者去做 如果你不會紓壓的話沒有來我那邊吧台喝咖啡的話可能也會造成一些影響 |
| transcript.whisperx[620].start |
16484.389 |
| transcript.whisperx[620].end |
16502.557 |
| transcript.whisperx[620].text |
那再來重要的是你要80分貝 85分貝這些真的會造成聽力的傷害所以我剛剛很注意在看這個分貝問題因為很多的時間是超過80分貝所以我在這邊特別提醒這個所有的這個不管是委員會還是立法院 |
| transcript.whisperx[621].start |
16504.838 |
| transcript.whisperx[621].end |
16518.726 |
| transcript.whisperx[621].text |
這個職業安全衛生設施規則三百條之一這個勞工超過平均85分貝故主要採取聽力保護措施那當然我們已經有做這個監測的這個系統但是我們並沒有做這個監測危害的控管都沒有防護 |
| transcript.whisperx[622].start |
16519.986 |
| transcript.whisperx[622].end |
16547.265 |
| transcript.whisperx[622].text |
這個防音防護的這個配備也沒有譬如說耳塞啦或者是有人在控管那個麥克風我們如果太近聲音太大的時候你就可以稍微調整一下那當然漸減OK那成效評估改善這個可能後續要做我想以上做這個提醒非常感謝昭瑋給我這個時間把這個問題點出來好那我現在接下來要來進等一下喔 不好意思 |
| transcript.whisperx[623].start |
16554.64 |
| transcript.whisperx[623].end |
16571.225 |
| transcript.whisperx[623].text |
我接下來要來質詢首先我有三 今天有三個問題那我先講一下這個加熱菸的部分當然那個部長跟那個健保署署長部長我想先因為對部長跟國健署 |
| transcript.whisperx[624].start |
16573.586 |
| transcript.whisperx[624].end |
16597.525 |
| transcript.whisperx[624].text |
國建署是因為裝傻還是不夠專業因為他們說他們沒有做這個菸捐年度統計的資料所以呢我們辦公室呢就只好自己找資料然後我們自己幫國建署製作了這個非常清楚的表格那我們來看一下這幾年菸捐的收入99年的菸捐 |
| transcript.whisperx[625].start |
16597.845 |
| transcript.whisperx[625].end |
16625.455 |
| transcript.whisperx[625].text |
菸捐將近348億到了去年只剩下264億那我們這個兩個年度來比較一下就是少了84億之多但是民國99年的菸價跟113年來相比這個價格其實是低了很多那菸捐的比例卻大幅的增加但是收入卻大減到原因何在部長其實可以想一想 |
| transcript.whisperx[626].start |
16626.274 |
| transcript.whisperx[626].end |
16653.441 |
| transcript.whisperx[626].text |
因為這個吸菸比例並沒有減少但抽脂菸的人口很多都轉為去抽這個加熱菸了那加熱菸的部分就是基於一些很奇妙的人還有很奇妙的原因所以很奇妙的現在抽加熱菸是不用繳菸捐的所以衛福部的政策不僅 |
| transcript.whisperx[627].start |
16655.561 |
| transcript.whisperx[627].end |
16677.913 |
| transcript.whisperx[627].text |
不是在意志吸這個加熱菸喔反而是在鼓勵大家去吸加熱菸那這個因為齁這個錢啊都進了這個加熱菸這個走私販的口袋了所以呢唯一損失的是健保的挹注所以我們石崇良署長他就要哭哭了 |
| transcript.whisperx[628].start |
16678.894 |
| transcript.whisperx[628].end |
16694.826 |
| transcript.whisperx[628].text |
那按照這個國建署的觀念用健康風險來抑制吸煙吸加熱煙的人口如果這個推論他是真的那麼未來我們國人因為吸這個吸煙的健康風險反而會增加 |
| transcript.whisperx[629].start |
16695.586 |
| transcript.whisperx[629].end |
16710.551 |
| transcript.whisperx[629].text |
因為健保支出會增加嘛那未來這個健保也會被拖垮那醫療品質會下降所以這個到底是不是你們衛福部的德政這個我們就是一直都打問號啦所以我今天特別製作這個表格給大家提醒 |
| transcript.whisperx[630].start |
16711.604 |
| transcript.whisperx[630].end |
16738.382 |
| transcript.whisperx[630].text |
注意這個問題是 謝謝好 那再來部長你沒有要發表一下意見嗎那個當然 謝謝當然我們努力之下那個車淹的比例是有降低啦那剛剛您所重視的我們也通過淹害防治法那在加熱淹的部分也一直在審查那這個部分我想我們一定按照 |
| transcript.whisperx[631].start |
16739.898 |
| transcript.whisperx[631].end |
16753.067 |
| transcript.whisperx[631].text |
加緊時程來做 重點是那個菸捐的收入不要讓他滿天亂飛我們那個我們按照一切按照規定來處理那希望當然 |
| transcript.whisperx[632].start |
16755.009 |
| transcript.whisperx[632].end |
16765.081 |
| transcript.whisperx[632].text |
眼尖增加這也是兩難的事情反正我就覺得H&M是不是比較多不是一些奇妙的人不應該是落到走私的走私的業者這個是最重要的我們這個錢要收回來 |
| transcript.whisperx[633].start |
16771.028 |
| transcript.whisperx[633].end |
16792.824 |
| transcript.whisperx[633].text |
好 那接下來一個重要的問題 我們討論一下就是有關於這個台東醫療資源缺乏 當然是我們台東長久的痛那如果說民眾遇到這種急性腦中風 急性冠心症 心導管的問題那台東有七家醫院 那到底就是可以必須要送到哪裡 |
| transcript.whisperx[634].start |
16793.724 |
| transcript.whisperx[634].end |
16811.321 |
| transcript.whisperx[634].text |
那看來看去呢我們也就是只有就是說送到這個台東馬街因為台東沒有中度急診的醫院只有一家台東馬街是急重症醫院那其他六家都是一般的這個急診那依照這個緊急醫療能力的分級的規定 |
| transcript.whisperx[635].start |
16812.542 |
| transcript.whisperx[635].end |
16836.757 |
| transcript.whisperx[635].text |
急重症的醫院必須要在24小時提供外科、內科、骨科、耳科、麻醉科、神經科、神經外科、婦產科等等的這些專科醫師的緊急的照會服務所以我們台東馬街醫院它就等於我們整個重症醫療的核心我想這個大家都知道的 |
| transcript.whisperx[636].start |
16838.177 |
| transcript.whisperx[636].end |
16862.706 |
| transcript.whisperx[636].text |
台東馬街呢 希望就是說他們希望把這個院內老舊的這個醫護宿舍改建那因為現在我們目前的宿舍我有去看過這個屋齡已經40年了大家可以想像40年的屋齡馬上就會知道他的這個防火防震都不符合現在的標準而且我去看了還四個人擠在一間 |
| transcript.whisperx[637].start |
16864.625 |
| transcript.whisperx[637].end |
16888.719 |
| transcript.whisperx[637].text |
那如果說原地那馬街他們有自備有準備經費那如果說原地打掉重建那重建期間的這個銜接過程會有很多在這個台東我們馬街醫院就是說醫護發生這個他們會發生這個住宿的問題那再加上就是說台東馬街呢因為要充實這個醫療設備所以今年他們還要蓋這個癌醫的大樓 |
| transcript.whisperx[638].start |
16893.121 |
| transcript.whisperx[638].end |
16909.236 |
| transcript.whisperx[638].text |
那在這個整個建樓的過程當中預期會發生就是說可能民眾要去就醫停車的問題就會嚴重不足那再來就是說病患跟家屬當然就是說他這樣就會很不方便啦 |
| transcript.whisperx[639].start |
16909.716 |
| transcript.whisperx[639].end |
16933.909 |
| transcript.whisperx[639].text |
那最近我跟這個莊瑞雄委員呢我們都非常關心台東馬街宿舍改建還有這個停車場用地的問題喔莊瑞雄委員他已經在上個禮拜呢院會質詢的時候有提到這件事情那台東馬街尋找的用地雖然是國產署的可是畢竟衛福部是主管機關所以我今天要在這裡特別提醒喔 |
| transcript.whisperx[640].start |
16934.209 |
| transcript.whisperx[640].end |
16961.774 |
| transcript.whisperx[640].text |
因為台東馬街對於這個台東醫療服務量的那麼重要那麼這件事情我和莊惠雄委員我們一定絕對會大力的支持還有促成那在2月9號的時候我和莊委員呢我們在台東馬街就是說有現場會看了這個去看了宿舍跟停車場等等的這些的現況那 |
| transcript.whisperx[641].start |
16963.254 |
| transcript.whisperx[641].end |
16972.34 |
| transcript.whisperx[641].text |
就是說昨天我們服務處也陪同了這個馬街醫院跟國產署針對這個用地的問題來做這個協商那我想協商的結果其實還蠻正面的所以 |
| transcript.whisperx[642].start |
16978.624 |
| transcript.whisperx[642].end |
17000.839 |
| transcript.whisperx[642].text |
如果這個馬街如果可以找到合適用地的時候是非常需要衛福部針對醫院改建宿舍跟停車場這件事情在公共性、政策性還有必要性這三個方面給予這個肯定跟支持的評價那我想了解一下部長你對這件事情的支持的立場應該沒有問題吧 |
| transcript.whisperx[643].start |
17004.231 |
| transcript.whisperx[643].end |
17027.241 |
| transcript.whisperx[643].text |
報告委員,真的非常感謝委員關心我們台東醫療的水準過去也協助了很多醫療的提升的計畫所以我們藝界都很感謝台東馬街的確是我們重中之重也感謝馬街醫院有宗教的精神 |
| transcript.whisperx[644].start |
17028.081 |
| transcript.whisperx[644].end |
17053.231 |
| transcript.whisperx[644].text |
很多很多的優秀的人才都到那邊服務那也受到台東當地大家的居民的一個支持特別在那個村委員也給予很大的支持那在護理醫護的宿舍的確是非常的老舊他們台東馬街不是沒有錢是沒有地所以我們如果能夠政府來改善 |
| transcript.whisperx[645].start |
17054.071 |
| transcript.whisperx[645].end |
17076.788 |
| transcript.whisperx[645].text |
那個醫護的試射當然是我是求之不得昨天的協調其實已經狀況還不錯怎麼樣拜託我們都可以去拜託能夠讓他趕快讓醫護的試射完成所以就是確定的時候你們趕快對於這個剛剛講的只要我們衛護部能夠做的我們一定全力以赴當然停車的空間也非常重要因為有時候在看病真的 |
| transcript.whisperx[646].start |
17077.489 |
| transcript.whisperx[646].end |
17098.427 |
| transcript.whisperx[646].text |
不要停車停到掛號的輪到你都過了我想那個就是說謝謝部長那後面這個三個方面的這個肯定評價就拜託你了那之後就是說接下來的這個跟台東縣政府的一些募領回饋的這個機制我們我也會協助去協調 |
| transcript.whisperx[647].start |
17103.211 |
| transcript.whisperx[647].end |
17120.771 |
| transcript.whisperx[647].text |
那就最後一個問題我很快也很重要就是說剛剛大家關心的這個偏鄉醫護人力短缺的問題當然這工作環境待遇還有這個三病互併比的這個落實都是改善護理工作環境的這個很關鍵的一個問題 |
| transcript.whisperx[648].start |
17121.832 |
| transcript.whisperx[648].end |
17142.028 |
| transcript.whisperx[648].text |
那其實之前部長有講過說護理師的薪水7萬元這句話 抱歉我從來沒有講過護理師的薪水7萬元那是媒體以及記者會所承認我們今天出來的是網站那自己去看網站各醫院的一個內容他其實也會看到最低 |
| transcript.whisperx[649].start |
17142.708 |
| transcript.whisperx[649].end |
17163.741 |
| transcript.whisperx[649].text |
也比較高的這樣的好那沒有關係我修正一下齁那或許媒體我從來沒有講過這句話那我們從媒體上我從來沒認得多少錢它是夠的齁但是那是媒體看的這樣部長今天給你大大的澄清因為我永遠覺得醫護的薪水必須要再提高那就接下來請給我機會因為我沒有時間了我趕快講齁 |
| transcript.whisperx[650].start |
17167.183 |
| transcript.whisperx[650].end |
17186.41 |
| transcript.whisperx[650].text |
當然這個媒體這樣寫7萬元這個數據當然部長也講嚴重失真那但是我講一下我們台東護理師工作經驗1到5年的薪資只有台東馬街超過6萬塊而已其他都沒有那其他這個公立醫院大概都5萬多 |
| transcript.whisperx[651].start |
17187.31 |
| transcript.whisperx[651].end |
17201.795 |
| transcript.whisperx[651].text |
那這個數據包括公職護理的薪資也相對比較高可是其他私立醫院的部分只有4萬元甚至我們台東在某家的醫院的護理師他職業一年的護理師薪水只有3萬多內 |
| transcript.whisperx[652].start |
17203.888 |
| transcript.whisperx[652].end |
17217.854 |
| transcript.whisperx[652].text |
你們有知道這個訊息嗎只有三萬多這就是我們城鄉落差的一個差異所以我理解每一家的醫院它的複雜度是不一樣但是職業的護理師薪資只有三萬多 |
| transcript.whisperx[653].start |
17219.955 |
| transcript.whisperx[653].end |
17239.766 |
| transcript.whisperx[653].text |
有合理嗎你說這個台東這一家嗎對那個是一個宗教型的醫院那它的loading也許真的是沒有那麼大就好像你診所診所來講它的薪資可能也沒有辦法像醫院那麼高 |
| transcript.whisperx[654].start |
17240.086 |
| transcript.whisperx[654].end |
17265.948 |
| transcript.whisperx[654].text |
因為大家都留不住嘛所以自然而然那個loading就是變成這樣子所以我想講的是我知道你們會有一些理由但是我只是講我是覺得就是說我們一直在強調就是說要留住這個偏鄉人才的情況我覺得衛福部其實這個時候你們就應該要干預這個市場第一其實像這種燈塔型的醫院我們都會健保都會特別的補助而且希望能夠提高 |
| transcript.whisperx[655].start |
17266.849 |
| transcript.whisperx[655].end |
17290.07 |
| transcript.whisperx[655].text |
護理的待遇 這個我們會去多 會去協助那到底要怎麼留住偏鄉的護理人才就是說當然大家都知道就是說住院護理費的偏鄉加成的機制好那我要再提一下這個加成在106年的時候比例從3%提高到15%那這個但是我們都 |
| transcript.whisperx[656].start |
17290.791 |
| transcript.whisperx[656].end |
17316.395 |
| transcript.whisperx[656].text |
之前也有講過啦 說到底這些加成的點數有多少是真正實際反映到這個護理師的薪水待遇上因為我們都知道護理這個護理費用當然有包括到一些儀器設備還有其他等等的不一定只是護理的這個薪資但是我想就是說這一項加成的名稱對偏鄉護理師是很不公平甚至講嚴重一點說這樣的名稱對偏鄉護理師他是一個不正義的名稱 |
| transcript.whisperx[657].start |
17320.336 |
| transcript.whisperx[657].end |
17340.596 |
| transcript.whisperx[657].text |
因為偏鄉住院護理費加成15%的感覺好像是增加經費但是實質到偏鄉護理師的口袋裡其實根本就不是這樣所以這個加成我希望可以有一定比例反映到偏鄉護理師的薪資上面 |
| transcript.whisperx[658].start |
17342.078 |
| transcript.whisperx[658].end |
17367.436 |
| transcript.whisperx[658].text |
這個一定比例 我想今天重點你們一定框一個比例到裡面那在這個15%當中一定提撥一定的比例作為這個護理師的這個額外加急的部分那去年我在去年那個預算審查的時候我們也有提案所以這個部分可能請會後是不是那個健保署再跟我們說明一下辦理的情況大概我想這邊 |
| transcript.whisperx[659].start |
17368.797 |
| transcript.whisperx[659].end |
17389.151 |
| transcript.whisperx[659].text |
提的就是說怎麼樣提高這個誘因還有框那個比例請你們好好回應我們該給護理師的就一毛錢也不用少那他的護理會怎麼樣去分配有一定的比例這個要清清楚楚公開透明要取得大家的一個共識這樣子好再麻煩你們兩週內好沒問題謝謝謝謝謝謝陳委員謝謝部長接下來我們請洪孟楷委員質詢 |
| transcript.whisperx[660].start |
17402.639 |
| transcript.whisperx[660].end |
17406.529 |
| transcript.whisperx[660].text |
來邱部長抱歉沒讓你坐下來這樣麻煩你好不好 |
| transcript.whisperx[661].start |
17408.919 |
| transcript.whisperx[661].end |
17434.879 |
| transcript.whisperx[661].text |
委員好好直接切入重點大家都關心我們全國的急重症醫療量能是但是昨天爆發新聞我看到說昨天有個新聞是邱太元拍板護理跨科資源指引定案要研議要出來馬上今天又講說護理人員認為根本是跨科資源指引是犧牲權益啊部長 |
| transcript.whisperx[662].start |
17436.246 |
| transcript.whisperx[662].end |
17449.932 |
| transcript.whisperx[662].text |
怎麼會有那麼大的落差現在我們會提出跨科資源指引嗎好 感謝委員的推行那這個是這樣子我們定期跟台灣醫療工會我想那個有醫師有護理師 |
| transcript.whisperx[663].start |
17451.613 |
| transcript.whisperx[663].end |
17455.457 |
| transcript.whisperx[663].text |
可能理解這不用講背景說明啦我們現在在承認問題來回答問題好不好提議說有一個護理有護理的角度提出一個所以你昨天有沒有拍板我確定當然拍板要研議啊要把他的版本拿來他們也很客氣說希望提兩個版本來給我們來參考這樣子 |
| transcript.whisperx[664].start |
17470.586 |
| transcript.whisperx[664].end |
17497.041 |
| transcript.whisperx[664].text |
所以那個我們因為相對這個在醫療公會其實也很代表基層的一個護理的心聲啦所以我們一定要去悉心的來也感謝他們願意提出版本這個他們也花了很多的精神所以我們正在為了部長所以版本也還沒有看到方向是什麼他版本昨天應該還沒有提出來是不是那個有沒有 |
| transcript.whisperx[665].start |
17499.901 |
| transcript.whisperx[665].end |
17513.572 |
| transcript.whisperx[665].text |
要不要看一下昨天的新聞是怎麼跑馬以及今天早上護理師是怎麼樣的強烈的抗議他強烈譴責衛福部侵害護理的權益要求撤回跨科指引跟颱風天出勤指引 |
| transcript.whisperx[666].start |
17514.639 |
| transcript.whisperx[666].end |
17541.221 |
| transcript.whisperx[666].text |
沒關係 這個我們齁 就到現在還搞不清楚不是 護理這幾個團體有護理師公會 護理醫學會 護理公會還有昨天我們定期見面的台灣醫療公會那台灣醫療公會提出來的一個他們不希望用院方的角度來做床的分配因為這樣有一點會影響到護理那護理輪流念力提出這樣一個我們當然要研議啊 那當然我也知道 |
| transcript.whisperx[667].start |
17541.881 |
| transcript.whisperx[667].end |
17546.383 |
| transcript.whisperx[667].text |
他們裡面的代表講說在工會本席剛剛已經講了工會是反對這個的啦工會是反對嘛工會反對所以我也可以找工會來和我溝通一下啦總是要解決問題嘛 |
| transcript.whisperx[668].start |
17557.126 |
| transcript.whisperx[668].end |
17571.198 |
| transcript.whisperx[668].text |
工會代表什麼工會代表就是護理人員嘛最基層的地線的護理人員那你們今天在做這樣子的一個指引的時候沒有找護理人員來討論那你昨天一直推說所謂的定期會但定期會 |
| transcript.whisperx[669].start |
17572.119 |
| transcript.whisperx[669].end |
17593.355 |
| transcript.whisperx[669].text |
那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔那個就是護理人員喔 |
| transcript.whisperx[670].start |
17601.707 |
| transcript.whisperx[670].end |
17623.304 |
| transcript.whisperx[670].text |
有沒有轉彎的方向是不是又轉彎了哪一方面轉彎有沒有要推出所謂的跨科資源指引如果有人適當而且是護理界都有共識的我們當然樂觀其成因為總比院方來院方來調床所以後續會不會找相關公會大家來討論沒問題啊 |
| transcript.whisperx[671].start |
17625.973 |
| transcript.whisperx[671].end |
17646.842 |
| transcript.whisperx[671].text |
我們把所有相關的附議環節通通找來討論啊好 部長你的承諾找所有的相關環節來討論來 另外喔我們一直講說三班互併比啊其實前兩天的這個總諮詢的時候那個總預算的附議的時候我也特別跟您請教是 |
| transcript.whisperx[672].start |
17647.742 |
| transcript.whisperx[672].end |
17674.058 |
| transcript.whisperx[672].text |
其中三份互併比你現在都一直講是說要獎勵先行對不對回答很多的委員是我說實在話給醫院時間來補足人力習慣互併比的政策我想這個也不要說一步到位然後好像馬上就要開罰但重點是現在大家的獎勵到底有沒有在一個公平公允的標準我覺得這是很重要的事情我們先問 |
| transcript.whisperx[673].start |
17676.427 |
| transcript.whisperx[673].end |
17691.017 |
| transcript.whisperx[673].text |
幾個問題第一三班戶病比現在是以醫院來做單位還是以病床來做單位是各個病房還是整個整體醫院嘛 |
| transcript.whisperx[674].start |
17694.399 |
| transcript.whisperx[674].end |
17719.7 |
| transcript.whisperx[674].text |
過去很多的護理人員一直在跟你強調一直在討論是說一家醫院裡面它有各個不同的狀況你如果說用整個醫院的人力跟整個醫院病床數據來做平均的話你那個數據沒有辦法如實的呈現時段也好這個醫院也好它都會有一個落差那醫護人員有沒有 |
| transcript.whisperx[675].start |
17720.424 |
| transcript.whisperx[675].end |
17749.387 |
| transcript.whisperx[675].text |
您想要 您是司長嗎好蔡司長蔡司長有沒有之前有接受過護理人員一直跟你反應是說其實高低護病比互相稀釋可能會造成不公允的情況所以希望是能夠用病床為基礎單位來公告三班護病比這個三班護病比我們這個住院有兩大病床一個叫做一般急性病床一個是特殊病床那我們現在的三班護病比指的是急性一般 |
| transcript.whisperx[676].start |
17750.906 |
| transcript.whisperx[676].end |
17753.308 |
| transcript.whisperx[676].text |
急性一般病床那這個全國大概有10萬床那這個病床其實有不同科別不同的科別但是在討論裡面可行跟理想當然可行跟理想總是有一個距離但是這個是經過了七個版本 |
| transcript.whisperx[677].start |
17767.639 |
| transcript.whisperx[677].end |
17779.645 |
| transcript.whisperx[677].text |
半年的填報六次的系列的協商那當然大家沒有完全大家都滿意但是沒有辦法達成對但是有共識啊共識就是說先上路就是還是醫院的共識還是你會服務的共識有護理有醫院很實在話講來部長是 |
| transcript.whisperx[678].start |
17789.656 |
| transcript.whisperx[678].end |
17818.009 |
| transcript.whisperx[678].text |
剛剛司長也特別另外提到另外一個部分也是我想請教的就是所謂的病床其實有分一般急性的一般病房以及隔離病房 特殊病房那你這個三班護病筆其實是沒有把特殊病房給放進去的沒有放進計算那代表什麼代表說有一些護理人員他有可能他也要負責到這個部分但是他是沒有加入計算那某種程度上他也是增加護理人員的負擔啊 |
| transcript.whisperx[679].start |
17819.774 |
| transcript.whisperx[679].end |
17839.837 |
| transcript.whisperx[679].text |
三班戶病比最大的目的就是整個醫院在一個復循環裡面那我們怎麼讓復循環變成正那當然問題的優先次序嘛因為現在醫院裡面最留不住的其實是一般級性病床而且是他也是護理院最大宗的因為一般級性病房大概是10萬床特殊病房是4萬床那他這個人力的配備設備人力的那個標準都不一樣市長來 部長 |
| transcript.whisperx[680].start |
17849.591 |
| transcript.whisperx[680].end |
17870.777 |
| transcript.whisperx[680].text |
我其實今天點出來這個問題我們還是要一起面對就說現在我們看到的是希望護理人員能夠有更多護理人員投入大家都有熱情有想法是南丁格爾但是不是一而再再而三去壓榨或是說是讓他們負擔更重的沉重他們是南丁格爾但是不要把他們當成是塑膠麻糬 |
| transcript.whisperx[681].start |
17871.858 |
| transcript.whisperx[681].end |
17890.417 |
| transcript.whisperx[681].text |
要持續的濃捏持續的壓榨那護理人員尤其是像今天我們看到台灣護士醫療產業工會他們也發出強烈的新聞稿來要求的時候是不是真的也應該聽聽護理人員的心情我們會請他來溝通最後 |
| transcript.whisperx[682].start |
17893.629 |
| transcript.whisperx[682].end |
17917.338 |
| transcript.whisperx[682].text |
部長一分鐘的時間喔馬街醫院有受到這個駭客入侵是不是現在有一千多萬筆的病患個資說被外洩我一直強調是說源頭管理非常重要因為如果說這則個資被詐騙集團掌握的話詐騙集團非常好騙他可能就直接打電話給某某某譬如說打電話給邱先生嗎 |
| transcript.whisperx[683].start |
17918.382 |
| transcript.whisperx[683].end |
17934.682 |
| transcript.whisperx[683].text |
你的身份證字號幾號你的出生年日日幾號我都已經先跟你講完之後我再來去取信於你之後要詐騙就相對容易了解那我想請教2023年速發部成立的時候也說要打造資安國家隊 |
| transcript.whisperx[684].start |
17935.888 |
| transcript.whisperx[684].end |
17956.381 |
| transcript.whisperx[684].text |
就到現在2025年了我們發生的這個馬街醫院說這個病患各自外洩有沒有掌握到情況他到底是馬街醫院他的醫療他的這個防火牆或是說相關的這個治安不夠完整還是說這是普遍各醫院的狀況是這樣子 我們衛福部一聽到這個消息那當然爆發脹機啦 就馬上 |
| transcript.whisperx[685].start |
17958.422 |
| transcript.whisperx[685].end |
17977.634 |
| transcript.whisperx[685].text |
跟司法部去做最好的一個處理所以後來就沒有那個後來就沒有再有延伸那之前的內容因為馬届醫院說他們已經進入司法程序所以也不變說明好那我們掌握的情況因為衛福部是主管機關各單位你現在各下面的醫院 |
| transcript.whisperx[686].start |
17978.835 |
| transcript.whisperx[686].end |
18002.108 |
| transcript.whisperx[686].text |
因為我覺得醫院的病患個資其實是非常詳細的是不是所以說我們有沒有去現在來了解譬如說儲發部然後了解一下說我們現在各醫院大家到底有資安的狀況我們的衛福部的資金是非常強的那跟事發部合作已經跟各個關鍵找了60家的 |
| transcript.whisperx[687].start |
18003.329 |
| transcript.whisperx[687].end |
18014.815 |
| transcript.whisperx[687].text |
重要的醫院 已經開過了很早就開過大概兩個禮拜前就開過會跟他們講要怎麼防護而且有一套防護的機制這醫院被害是什麼時候被害的應該是二月 |
| transcript.whisperx[688].start |
18019.016 |
| transcript.whisperx[688].end |
18044.276 |
| transcript.whisperx[688].text |
之前就應該是被害了啊但是發現的時候我們就開始進行一連串的補救措施以及緩緩未來更多影響好那是不是可以請給本席相關的資料沒問題好不好你們做了因應馬街醫院被害之後做了什麼樣的一個加強管制的措施開會的後續的一個結論已經要求各醫院增加這個治安的一個防範沒問題這個我們都有加強謝謝沒問題謝謝謝謝孟海委員 |
| transcript.whisperx[689].start |
18047.839 |
| transcript.whisperx[689].end |
18049.099 |
| transcript.whisperx[689].text |
謝謝部長 來請張祺凱委員質詢委員好來來 重新開始 |
| transcript.whisperx[690].start |
18078.436 |
| transcript.whisperx[690].end |
18104.552 |
| transcript.whisperx[690].text |
是 謝謝委員長我今天要談一件很讓人家心疼也是捨不得的事情我們希望一起來補破網不要讓失去親人的人傷口一直被掀開不要有造成二度傷害跟三度的傷害最近有一位傷心的媽媽一個貼文 |
| transcript.whisperx[691].start |
18106.949 |
| transcript.whisperx[691].end |
18119.879 |
| transcript.whisperx[691].text |
引起非常大的一個迴響他講他的處境下面很多留言說我碰到的狀況跟你非常的類似那我們看一下這個媽媽的貼文是這樣講的他講說剛剛衛生索來電 |
| transcript.whisperx[692].start |
18128.322 |
| transcript.whisperx[692].end |
18155.137 |
| transcript.whisperx[692].text |
請問說是我嗎 他說對然後再提說恭喜你們家小朋友滿六個月了媽媽說不好意思之前已經告訴你們了寶寶已經離開了他的小孩不幸離開他了可是衛生所的人又打了電話來衛生所的人也說抱歉抱歉急忙掛了這個電話媽媽說 |
| transcript.whisperx[693].start |
18158.339 |
| transcript.whisperx[693].end |
18186.449 |
| transcript.whisperx[693].text |
他講完之後他開始裂崩開始掉眼淚了他實在不明白衛生所為什麼一直打電話來呢前幾個月衛生所打電話說要打疫苗就已經跟他講過一次了而且之前去衛生所申請這個醫療補助的時候已經附了死亡的證明跟出戶的這個證明為什麼衛生所還一直打電話來傷我的心呢他問了一個很重要的問題 |
| transcript.whisperx[694].start |
18189.079 |
| transcript.whisperx[694].end |
18216.63 |
| transcript.whisperx[694].text |
為什麼 副政事務所或者其他單位這個系統是不會連線嗎不只是這位傷心的媽媽他這個貼文 貼出來之後啊下面非常非常多的留言有一個人就講了說我也有過同樣的這個經歷他說他的小朋友啊小兒子滿月前就過世了 |
| transcript.whisperx[695].start |
18218.103 |
| transcript.whisperx[695].end |
18243.014 |
| transcript.whisperx[695].text |
那沒有滿一歲以前 幾乎每個月都打預防針所以衛生所是幾乎每個月都打來每次都要跟他回說我小孩已經過世了但是下一次 衛生所還是打電話來每次他都必須哭著一次說你們有必要每個月提醒我嗎我的小孩已經走了這不只是二次傷害 這傷口要先幾次 |
| transcript.whisperx[696].start |
18248.058 |
| transcript.whisperx[696].end |
18268.513 |
| transcript.whisperx[696].text |
左下角這個 你看這個也是健保 這個剛剛講是衛生所的問題健保局一個民眾說他接到了追繳健保費用的這個帳單可是我妹妹都已經離開兩年了當下他很激動 花瘋一樣去問最後一次就診是三個月內嗎另外這個 右上角這個 |
| transcript.whisperx[697].start |
18275.346 |
| transcript.whisperx[697].end |
18304.202 |
| transcript.whisperx[697].text |
這是一位曾經在衛生所實習的一個員工他講說他有一次打架去關心關懷這個社區的老人打架過去是一位男生接的他說你是某某伯伯嗎那男生跟他講說找他有什麼事情我們這裡衛生所是定期電話去關心伯伯那個男生說他已經過世了他說他掛完電話之後他接他自己像一個罪人 |
| transcript.whisperx[698].start |
18305.643 |
| transcript.whisperx[698].end |
18327.108 |
| transcript.whisperx[698].text |
他聽到阿伯伯伯過世的消息他也很難過可是有時候為什麼這個員工就問啊為什麼沒有同步去更新資料呢讓這種事情發生呢下面有衛生所還有好幾個例子那個留言好多好多喔伯弟是你們衛生所跟戶政事務所沒有連線嗎還是衛生所這邊的作業橫向的聯繫有問題為什麼這麼多人碰到這樣一個問題 |
| transcript.whisperx[699].start |
18333.759 |
| transcript.whisperx[699].end |
18339.949 |
| transcript.whisperx[699].text |
這個可能各縣市的縣市政府的一個互動真的是需要來加強 |
| transcript.whisperx[700].start |
18342.674 |
| transcript.whisperx[700].end |
18366.47 |
| transcript.whisperx[700].text |
我們可以來瞭解狀況來瞭解狀況現在連線的狀況是怎麼樣所以部長你現在回去今天就做好不好好沒問題不要讓這個事情再老實講這真的很心疼的事情小孩離開了已經很捨不得了那你又打電話去提醒他你傷口要再掀一次好不好老實講這個事情對政府來講很容易做到我們是一個數位的政府 |
| transcript.whisperx[701].start |
18367.659 |
| transcript.whisperx[701].end |
18370.727 |
| transcript.whisperx[701].text |
到現在我們的戶政事務所跟我們的衛生局衛生單位這個連線都還連不起來嗎 |
| transcript.whisperx[702].start |
18374.489 |
| transcript.whisperx[702].end |
18402.362 |
| transcript.whisperx[702].text |
所以第一個事情 柏定你現在阿波東的委員你先去問一下我馬上來瞭解先瞭解一下 到底你們衛生所跟副政事務所之間那個連接到底是怎麼樣因為衛生所是縣市政府在管的對 你也主管機關嘛 對不對你也是主管機關這是全國的問題啦是是是那個 柏定這兩件事情這健保局這個稍微我們來瞭解一下去瞭解一下 到底這連接是什麼當然他有可能碰到 例如說可能是個資的 |
| transcript.whisperx[703].start |
18404.349 |
| transcript.whisperx[703].end |
18412.203 |
| transcript.whisperx[703].text |
保護問題可是這顯然就是很多人都碰到問題你知道嗎這個推文有多少人上去知道嗎超過一百萬的人 |
| transcript.whisperx[704].start |
18414.901 |
| transcript.whisperx[704].end |
18437.955 |
| transcript.whisperx[704].text |
留學人非常多 都是很多人碰到類似謝謝委員提醒剛講的小孩或是妹妹家裡面的長輩也一樣啊不要再去做惡毒的這個傷害對政府來講 只要保證你回去把它問清楚第一個護生室我跟你們連線到底目前是怎麼樣那如果真的是有個資保護的問題要怎麼去解決是的那第二個還有一個問題喔你們衛生所 |
| transcript.whisperx[705].start |
18438.995 |
| transcript.whisperx[705].end |
18452.072 |
| transcript.whisperx[705].text |
內部健保局裡面內部自己的這個橫向的聯繫為什麼衛生所裡面第一個人打去他如果說知道已經是有一個家裡人家小朋友離開了你應該註記啊怎麼會有第二個人又打去呢 |
| transcript.whisperx[706].start |
18453.527 |
| transcript.whisperx[706].end |
18474.039 |
| transcript.whisperx[706].text |
所以不是只有跟護送事務所就是衛生局裡面這個單位這個好不好橫向聯繫要能夠改進好不好我們來瞭解馬上來瞭解好那這件事情要慢慢補充我們共同來做希望這個事情不要再發生瞭解瞭解你今天很清楚那你一個禮拜你好好不好一個禮拜等會員報告通電話不要通電話你給我一個 |
| transcript.whisperx[707].start |
18477.481 |
| transcript.whisperx[707].end |
18505.277 |
| transcript.whisperx[707].text |
一個禮拜內給我一份報告就是你查的這個狀況到底是什麼地方出了問題當然也有可能我覺得可能很有可能是個資啦可是我跟你講全世界比較進步的國家沒有說家裡面有一個人離開了然後用一個個資所以其他相關的單位相關的單位你說你還要發你是打疫防針之外一個小孩或一個人他有很多都是跟其他部位都有關係嘛對不對所以說橫向這個一定是要解決要不然台灣就變成一個很落後很落後的一個我們是數位強國耶 |
| transcript.whisperx[708].start |
18507.418 |
| transcript.whisperx[708].end |
18515.985 |
| transcript.whisperx[708].text |
是好不好好謝謝這事情要趕快走一個禮拜你跟我講好沒問題到底這個問題在什麼地方來準備怎麼解決好不好謝謝好謝謝謝謝委員好謝謝詹委員謝謝部長繼續請劉建國召委諮詢好謝謝主席好謝謝主席沒關係你慢慢說 |
| transcript.whisperx[709].start |
18537.663 |
| transcript.whisperx[709].end |
18540.505 |
| transcript.whisperx[709].text |
我想今年的一月起的流感還有洛羅等疾病的流行 |
| transcript.whisperx[710].start |
18555.168 |
| transcript.whisperx[710].end |
18583.384 |
| transcript.whisperx[710].text |
那全國急診室大爆滿二月更達到這個高峰然後急診醫學會也發文警告急診用篩情況他是講說急診用篩情況已達前所未有的嚴重程度部長當急診醫學會發出這個聲明我是挺感到汗顏也難過因為在你的任內遇到前所未有的急診用篩 |
| transcript.whisperx[711].start |
18584.81 |
| transcript.whisperx[711].end |
18611.084 |
| transcript.whisperx[711].text |
那部長也貴為醫師雖然是加醫科但也來自台大總統也是醫師我們召委也是醫師蘇召委也是醫師我不是聽到要拖下去所以在你的任內發生這個前所未有的急診用篩的嚴重程度急診醫學會跳出來來訴諸媒體反而不是訴諸我們衛福部相關的單位 |
| transcript.whisperx[712].start |
18612.56 |
| transcript.whisperx[712].end |
18617.011 |
| transcript.whisperx[712].text |
看如何來做最快的有效的應驗的作為來減短這樣的用篩 |
| transcript.whisperx[713].start |
18620.959 |
| transcript.whisperx[713].end |
18642.125 |
| transcript.whisperx[713].text |
我覺得這是坦白講這是很大的諷刺啦對不對你要用另外一個高度去思考是在台灣的醫療尤其是急診的部分已經很嚴重的問題在發生而且會越來越惡劣啦然後我們都很清楚嘛齁這個廉價的時間過年啊這個過年時間什麼地方人通常關公地窟嘛總告地窟嘛還有一窟你知道嗎便宜啦 |
| transcript.whisperx[714].start |
18651.997 |
| transcript.whisperx[714].end |
18665.065 |
| transcript.whisperx[714].text |
便衣是絕對是過的時間是可以說當中是八成、八成的對不對到急診流關的他或許不一定要上到便床但是他可能要在那邊待了三個鐘頭、四個鐘頭、五個鐘頭 |
| transcript.whisperx[715].start |
18667.335 |
| transcript.whisperx[715].end |
18691.585 |
| transcript.whisperx[715].text |
他會覺得懦弱上吐下瀉他總是要有一個觀察床讓他可以平躺好好休息一下但是基本上是不可能的現在連急診室的那個流光的觀察床都不足甚至是坐在椅子上在等待處置這台灣的急診的狀態部長應該很清楚 |
| transcript.whisperx[716].start |
18695.166 |
| transcript.whisperx[716].end |
18703.492 |
| transcript.whisperx[716].text |
部長不清楚醫師師也應該很清楚相關的單位也會很清楚怎麼會變成這個樣子然後讓急診醫學會是透過媒體來發聲我覺得在連結上是出了什麼問題 |
| transcript.whisperx[717].start |
18712.672 |
| transcript.whisperx[717].end |
18730.455 |
| transcript.whisperx[717].text |
今天如果部長是壓抑還是部長是攝護的我倒不會特別去提醒這個事情就是我用另外一個角度去思考去討論畢竟部長就是我剛剛特別提到你來自台大嘛然後又是加一科的專職這樣的一個專業的醫師總統也是醫師啊那我們怎麼會在這個當下發生這麼嚴重的讓急診醫學會沒有辦法跟你們 |
| transcript.whisperx[718].start |
18740.817 |
| transcript.whisperx[718].end |
18765.157 |
| transcript.whisperx[718].text |
來做反應 來看如何應應來讓這樣的急診 庸篩不會破紀錄的 前所未有的來得到舒緩我記得這件事情部長要講清楚我也覺得這件事情部長要非常慎重因為等一下會再討論分級醫療分級醫療八年了為什麼做不好你們衛務部連分級的管理都出問題 |
| transcript.whisperx[719].start |
18767.236 |
| transcript.whisperx[719].end |
18773.982 |
| transcript.whisperx[719].text |
你們衛福部連分級怎麼做都一直出問題啊所以會累死不長今天這件事情如果沒有很慎重的很嚴肅的然後去面對然後而且那個積極的應變的方式趕快出來我覺得我覺得我覺得不要說醫療體系會崩壞基準會崩壞連衛福部你都會崩壞 |
| transcript.whisperx[720].start |
18797.028 |
| transcript.whisperx[720].end |
18804.504 |
| transcript.whisperx[720].text |
不過你說這個你不知道可以接受嗎我現在是肺腑之炎啦這怎麼可以在你的臉上發生這種事情 |
| transcript.whisperx[721].start |
18807.018 |
| transcript.whisperx[721].end |
18826.072 |
| transcript.whisperx[721].text |
而且流感、A流、懦弱三種這種很惡劣的這種情況一直在發生你應該都會清楚的醫院會遇到什麼狀況診所會遇到什麼狀況而且又適逢到農曆的過年這其實如果有保護住一段時間或是在病院住一段時間的人就都很清楚了 |
| transcript.whisperx[722].start |
18830.646 |
| transcript.whisperx[722].end |
18838.528 |
| transcript.whisperx[722].text |
一定有問題要怎麼應變要怎麼處理你要怎麼想一套應變的方式不要讓這個北方不要讓這個北方加速不要讓這個醫生不要讓這個護士三星這麼大這麼大這麼大萬年了所以這個萬年都沒有辦法對你們就要透過媒體來跟你們說這真的是這真的是我們要很大的很大的檢討的地方 |
| transcript.whisperx[723].start |
18860.691 |
| transcript.whisperx[723].end |
18879.995 |
| transcript.whisperx[723].text |
這個不用談到什麼專業了啦 我坦白講啦這種常態的 然後會發生的事情你們連這種常態會發生的事情你們都沒有辦法應變然後今天還有勞蘇昭偉排一個歷史專案報告來這邊做討論的情況之下這幾個人是要怎麼舉的好這家屬是要怎麼奉心喪意去進行 |
| transcript.whisperx[724].start |
18885.706 |
| transcript.whisperx[724].end |
18896.357 |
| transcript.whisperx[724].text |
這個基金社 藝生社要怎麼給我 給我去救人這個護士是要做到什麼程度 要抄到什麼程度這能不能遞到你政府 還是便宜更多的這個 這是重視前所未有 |
| transcript.whisperx[725].start |
18904.915 |
| transcript.whisperx[725].end |
18923.705 |
| transcript.whisperx[725].text |
急診用篩情況已達前所未有的嚴重程度你們不敢否認嘛事實就如此嘛為什麼會這樣呢你們真的真的真的面對到問題然後了解到問題怎麼去處理這個問題是不是請部長能用最簡單最快的然後最重點式的方式來做個回應好不好 |
| transcript.whisperx[726].start |
18924.212 |
| transcript.whisperx[726].end |
18950.202 |
| transcript.whisperx[726].text |
好的我想我們在在每年過春節的時候我們都很擔心所以就有預備包括政府也幫忙所以我們買了10萬支的一個疫苗希望控制流感然後我們也開健保署也加重了那個各個 尤其是診所給他30%的一個給付那機關署也在那個各個急診 |
| transcript.whisperx[727].start |
18953.663 |
| transcript.whisperx[727].end |
18975.351 |
| transcript.whisperx[727].text |
補助來成立了傳染病的一個門診來分散急診的力量的一個人力的量能的承擔所以這樣的一個情況那當然我們的確這次的就診人數比較多就診人數比較多後闖的就比較多那其實這個部分我們都完全的有訴訟的掌控那自己急診醫學會其實我跟 |
| transcript.whisperx[728].start |
18977.012 |
| transcript.whisperx[728].end |
18995.892 |
| transcript.whisperx[728].text |
集子醫學院的理事長是非常熟悉所以我們一直在討論那他們可能集子醫學院本身也覺得必須要呼籲當然他要發布這個我是尊重而且我們悉心因為總是要面對問題嘛那問題出來就是來解決啊所以那個 |
| transcript.whisperx[729].start |
18997.153 |
| transcript.whisperx[729].end |
19012.991 |
| transcript.whisperx[729].text |
我們來探討NEC是一回事解決困難才是重要的所以我們就馬上發動NEC的一個調配的機制第二個我們也發動區域的聯防第三個我們更是希望民眾如果有任何問題是不是優先先到你的 |
| transcript.whisperx[730].start |
19014.313 |
| transcript.whisperx[730].end |
19030.146 |
| transcript.whisperx[730].text |
各地的一個社區診所先做一個screen因為可能很多流感那種病毒在那邊處理就好了這是一個短暫那我們持續努力的就是我們護理的工作環境待遇跟一個環境另外也 |
| transcript.whisperx[731].start |
19030.786 |
| transcript.whisperx[731].end |
19047.482 |
| transcript.whisperx[731].text |
健保署馬上在處理集中症方面的一個給付這個部分也馬上會來5月會來落實我們緊急希望來改善未來我們會更聆聽各方的聲音看看怎麼樣來共同來面對這個醫療界的一個很重要的問題 |
| transcript.whisperx[732].start |
19048.563 |
| transcript.whisperx[732].end |
19071.422 |
| transcript.whisperx[732].text |
部長我想不用聆聽了你直接要到現場到戰場去實地的了解這個我想很多面相要討論也有面相要處理對不對但是我們簡單講一下基層醫學會特別有做這樣的呼籲我在波文也特別提到我不曉得你們到現在為何不可以去掌控 |
| transcript.whisperx[733].start |
19072.122 |
| transcript.whisperx[733].end |
19100.468 |
| transcript.whisperx[733].text |
掌握了全國像遇到這種兩三類型的流感在交互的時候在盛行的時候那你必須要去掌握全國這些急診室的觀察床還是一般的病床還是這個ICU的使用率還是空床率都有掌握而且15分鐘就會換心理次你們怎麼掌握我們有那個平台哪一個平台可以跟我說清楚哪一個平台嗎 |
| transcript.whisperx[734].start |
19102.346 |
| transcript.whisperx[734].end |
19128.738 |
| transcript.whisperx[734].text |
對於急診的及時就醫人數的話其實我們是自動間接醫院的掛號系統所以是說每15分鐘登記一次所以就醫的來診量跟住院的在ICU特別是加護病房因為現況的部分其實塞車的都是那幾家大醫院然後以這樣子的來說的話其實我們在部裡面的政策其實就是重症不漏接然後那個系統基本上面就是連從我們的 |
| transcript.whisperx[735].start |
19131.019 |
| transcript.whisperx[735].end |
19154.908 |
| transcript.whisperx[735].text |
衛福部的緊急藥管理系統裡面去接醫院的掛號的一個系統以上就是就是到醫院的一個掛號系統你們去透過那個系統去掌握掌握病床數ICU急診的觀察床急診的待床人數急診的待床人數然後跟所謂的那個我們加護病房的空床數使用率 |
| transcript.whisperx[736].start |
19156.167 |
| transcript.whisperx[736].end |
19167.247 |
| transcript.whisperx[736].text |
那個系統可以那個系統是在給你做這樣的功能還是只有在統計那個後程的功能 |
| transcript.whisperx[737].start |
19169.317 |
| transcript.whisperx[737].end |
19197.955 |
| transcript.whisperx[737].text |
給民眾的其實很重要的其實民眾需要知道就是哪邊現在有等候很多的後床的人數所以公開給民眾的即時資訊其實是後床的人數每一家醫院的後床人數這是公開給民眾的這是公開給民眾嘛對不對那你衛部你要去掌握嘛對不對那你衛部掌握是透過什麼掌握你是透過這個掌握跟一般民眾去看這個地方的待床數後診數還有我們還要掌握江戶病房的 |
| transcript.whisperx[738].start |
19199.096 |
| transcript.whisperx[738].end |
19220.367 |
| transcript.whisperx[738].text |
你怎麼掌握嘛哪一個系統掌握我們的緊急醫療管理系統緊急醫療管理系統可以去掌握全國現在遇到這樣的疫情情況之下哪一家醫院還有多少的空床宿江戶病房ICU其他沒有嘛急診沒有嘛一般病床沒有嘛或診病人有啊 |
| transcript.whisperx[739].start |
19221.067 |
| transcript.whisperx[739].end |
19242.201 |
| transcript.whisperx[739].text |
後診病人是後診病人的人數嗎還有等候病後床的就是說我們掌握的除了等候的人數就是還沒被看的嘛然後第二個其實是已經看完以後在流管的人數還有就是說流管確定要住院大概這幾個是我們會持續掌握的人數 |
| transcript.whisperx[740].start |
19242.921 |
| transcript.whisperx[740].end |
19270.932 |
| transcript.whisperx[740].text |
沒有 這蘇昭薇來行的 你要讓她說她會聽下去喔妳說我不會聽到 有沒有聽到沒有我再請到一邊就對了Common Lighting 你是怎麼掌握你們有什麼系統去掌握Common Lighting 就是你衛護部成立一個指揮中心我知道對一邊有ICU 我知道對一邊還有多少的控窮力我知道對一邊可以怎麼做讓我去做調配嘛 對不對那你是用哪一個系統也是緊急醫療管理系統緊急醫療管理系統 |
| transcript.whisperx[741].start |
19272.065 |
| transcript.whisperx[741].end |
19293.511 |
| transcript.whisperx[741].text |
不對吧你COVID-19爆發的時候衛生部不是有建設一個叫做全國負壓病房的管理系統當時是為了掌握負壓病房的空床疫嘛請139家隔離醫院每日至結合並追蹤管理系統通報負壓病房隔離病床的收治情形嘛對不對讓指揮中心能夠掌握全國負壓病房的即時動態嘛是不是這樣 |
| transcript.whisperx[742].start |
19295.572 |
| transcript.whisperx[742].end |
19321.345 |
| transcript.whisperx[742].text |
那個是不是啦是不是啦我要講的是這邊在講的是負壓隔離病房對嘛這負壓隔離病房是用這樣處理嘛對不對對然後他要人工通報可是我們這邊是直接接醫院的住院管理系統所以是直接自動通報直接接受醫院的住院的系統對好所以你就可以即時去掌握這家醫院的ICU對的空窗率空窗數對朝偉你朝偉已經在嘆氣了 |
| transcript.whisperx[743].start |
19326.719 |
| transcript.whisperx[743].end |
19349.686 |
| transcript.whisperx[743].text |
你說對嗎?你肯定他說對?有這個系統有這個系統,這個系統可以用嗎?有,可以我覺得有問題吧?柏堆你要了解清楚嗎?他現在跟我講喔,我等一下就TEST喔每天不管是長官或我們自己內部都有都掌握到,譬如說11點跟下午3點的一個狀況 |
| transcript.whisperx[744].start |
19351.286 |
| transcript.whisperx[744].end |
19361.057 |
| transcript.whisperx[744].text |
不過你要看喔你要看COVID-19爆發的時候你們是用什麼呢你們是用這個全國負壓病房的管理系統好然後這個是什麼請139家隔離醫院 |
| transcript.whisperx[745].start |
19366.448 |
| transcript.whisperx[745].end |
19395.268 |
| transcript.whisperx[745].text |
每日是結合並追蹤管理系統通報的這個是人工的我們現在目前這個是我們在講的是傳染病防治所以他是139家醫院我們全國的急救責任醫院是205家所以我們的急救責任醫院的數目遠比隔離醫院來的多然後因為大家人工通報這個增加人工的負荷所以我們這邊的緊急藥管系統是直接借劫然後反而可以減少人力以上 |
| transcript.whisperx[746].start |
19397.369 |
| transcript.whisperx[746].end |
19415.819 |
| transcript.whisperx[746].text |
真的我們的系統是可以確認你現在可以跟部長講說全國現在哪一家就是205家嘛對不對這家醫院哪邊有空床ICU 監護病房還有後床後床的人後床的人數 |
| transcript.whisperx[747].start |
19417.44 |
| transcript.whisperx[747].end |
19437.336 |
| transcript.whisperx[747].text |
後診的人數後診跟後診的人數不一樣後診不一定要去後床啊對 後診就是說還沒看到的啦是嘛是嘛 要看到就不一定要去變床啊等要斷的啦 是啊等要斷的 另外就是ICU 那也很重要嘛ICU的空床現在狀況啊你如果有辦法去斷 等要斷的人沒有代表你如果有辦法去斷 你會扛不住啊 |
| transcript.whisperx[748].start |
19439.6 |
| transcript.whisperx[748].end |
19455.595 |
| transcript.whisperx[748].text |
你說頂環有六個北方 那就另外一個體系沒關係啦 我覺得現在已經是AI時代嘛AI行動創新內閣 如果連這樣的系統都建置得很奇怪如果說今天community的時候還要去借CDC的所謂的結核病追蹤管理系統 |
| transcript.whisperx[749].start |
19456.576 |
| transcript.whisperx[749].end |
19481.853 |
| transcript.whisperx[749].text |
那我就覺得到現在沒有把這個東西建設起來這個衛護部有愧對國人這第一件事情啦第二件事情分級醫療我跟部長講啊部長特別重視分級醫療但分級醫療不處理妥當的話我們下次的開會還是會再討論到分級醫療嘛話說起來很簡單的授意就好了這個我都有特別提供出來數字應該也跟你們一樣你自己可以看醫學中心看診率106年看診率是10.65%嘛113年是再往上 |
| transcript.whisperx[750].start |
19486.976 |
| transcript.whisperx[750].end |
19493.362 |
| transcript.whisperx[750].text |
然後這個113的全國轉整數上轉的數額高達99萬222件下轉的只有10萬08千多件等於是1比9啦如果要說那麼嚴重是1比10啦因為是99萬多嘛 |
| transcript.whisperx[751].start |
19505.851 |
| transcript.whisperx[751].end |
19517.596 |
| transcript.whisperx[751].text |
若是說對的額度要轉上去的上轉的這個數跟下轉數就是不符合比例所以1比10嘛這個情況一直沒有改善過啊所以我才說你們分級醫療在這個地方就連衛福部都沒有再分級了啦你如果去交代這些大醫院小醫院跟你再做分級醫療 |
| transcript.whisperx[752].start |
19531.874 |
| transcript.whisperx[752].end |
19547.942 |
| transcript.whisperx[752].text |
包委員這個病人如果已經到譬如說到台大醫院你要他到中興醫院去住院那是要揮盡多少我們是揮盡多少苦心跟他說你到中興醫院也可以得到很好的一個照顧還有那邊的總醫師都會來看所以這樣的 |
| transcript.whisperx[753].start |
19549.782 |
| transcript.whisperx[753].end |
19573.655 |
| transcript.whisperx[753].text |
所以第一個應該是先讓民眾知道他的問題到哪一邊看是最適合的我剛剛有報告如果他的身體有任何不舒服我們希望他旁邊有社區診所有家庭醫師先跟他過濾他自然就會說你這個我直接去中心醫院斷他就好了不用去台台台你可能要等很久的那裡也沒有床等等這些我相信 |
| transcript.whisperx[754].start |
19575.836 |
| transcript.whisperx[754].end |
19598.623 |
| transcript.whisperx[754].text |
這樣這個才是真的分歧醫療啦不然你講的是一個樣態啦有些樣態這是屬性嘛對不對尤其你跟便衣你要再叫他去買啦這我們知道啦這很清楚但是我現在是要跟你說你一般接受你要上傳去大型便衣就對了其實像轉整當中開到人家的衣繩也會說得很清楚嘛接受衣繩會告訴你代替找什麼人你去代替找衣繩嘛很簡單就這樣改觀嘛但是 |
| transcript.whisperx[755].start |
19600.684 |
| transcript.whisperx[755].end |
19624.524 |
| transcript.whisperx[755].text |
他要大便宜的 其實他想要大便宜的 救地的 遺地的他可以一般接受嘛對啊 啊這要怎麼處理這要怎麼存 這要怎麼存上轉的這樣處理有高的測試啊 如果他轉下去每一個也給他幾百塊的一個下轉的費用啊所以那個 所以這個也 這幾天來一直在鼓勵啊 |
| transcript.whisperx[756].start |
19625.445 |
| transcript.whisperx[756].end |
19639.374 |
| transcript.whisperx[756].text |
這個我是確定知道的啦因為我們很鼓勵攤辦性病就盡量轉回社區去去看就好了在大型的醫院的醫師有感想說你去哪家診所嗎轉到哪家診所去嗎 |
| transcript.whisperx[757].start |
19640.461 |
| transcript.whisperx[757].end |
19657.789 |
| transcript.whisperx[757].text |
其實現在都有社區醫療群的制度是沒有錯啦所以那個都大概我台大醫院我們上轉藥到的醫院會很明確啦我們下轉藥到其他診所下轉的醫院有很多有很多它的轄下可能有一百家診所對譬如台大醫院的社區醫療群有五個每一個大概有十個 |
| transcript.whisperx[758].start |
19659.33 |
| transcript.whisperx[758].end |
19687.939 |
| transcript.whisperx[758].text |
也診所沒關係啦 不用時間管理啦我不要讓教育為難我自己做主席我想你能夠去掃去我們參考嗎下轉的情況為什麼會這麼低嘛你們的檢討是在什麼地方我們怎麼樣來改善一個星期可以給我們吧好 先保持先保持謝謝 感謝謝謝劉建國委員 謝謝部長王宏威委員王宏威委員不在 |
| transcript.whisperx[759].start |
19689.882 |
| transcript.whisperx[759].end |
19710.123 |
| transcript.whisperx[759].text |
羅賓才 羅賓才 羅賓才委員不在陳培宇委員 咨詢好 謝謝主席謝謝劉建國學長好 那主席我請部長 謝謝 |
| transcript.whisperx[760].start |
19717.068 |
| transcript.whisperx[760].end |
19738.262 |
| transcript.whisperx[760].text |
委員好部長辛苦了今天的議題我們當然關心啦不過因為還有另外一個兒少全法修法在即兒少全法的部分有一個部分我認為是目前我們在幾次公聽會當中或者是目前衛福部給我們的資料裡面我們已經都做了研究也跟你們所知跟你們討論過我們覺得有匱乏的地方我這裡就直接跟部長討論好來下一頁 |
| transcript.whisperx[761].start |
19743.758 |
| transcript.whisperx[761].end |
19760.824 |
| transcript.whisperx[761].text |
主要就是因為目前安置在安置機構裡面的兒少在2024年的數字有5000多位將近6000位而這些孩子們他不管年紀多大他都是因為原生家庭的有一些問題沒有辦法照顧這些小孩 |
| transcript.whisperx[762].start |
19761.324 |
| transcript.whisperx[762].end |
19779.966 |
| transcript.whisperx[762].text |
所以這些小孩都必須要被安置在安置機構裡頭那部長應該可以想像像這樣子原生家庭有一些創傷導致這些孩子必須被放在安置機構裡頭我們可以想像他們在心理健康的資源所需要的服務量應該比一般家庭的小孩來得多對不對 普遍上是的 |
| transcript.whisperx[763].start |
19781.428 |
| transcript.whisperx[763].end |
19809.502 |
| transcript.whisperx[763].text |
那部長如果你也認同那我要跟部長反映喔目前很多安置機構我知道相關的法規都有規定不管是兒少福利機構或是團體家庭所謂的團家都有規定有相關的標準也有說要給心理輔導機制那我知道你們衛福部也說有非常多機制都已經在進行了可是實務上的狀況就是可能這些機構彼此的服務品質有一些落差或者是有一些機構的所在地理位置很偏鄉很多人不要去 |
| transcript.whisperx[764].start |
19810.282 |
| transcript.whisperx[764].end |
19831.637 |
| transcript.whisperx[764].text |
那他們能不能真的找到夠好的心理師也好社工師也好相關的心理健康資源進到現場服務小孩我們其實是很多擔心因為很多現場的聲音告訴我們是不足的那在很多公聽會之後呢我們在2月6號我們辦公室在2月6號發函要求衛福部在未來的兒少法修法會議專家團體諮詢會當中 |
| transcript.whisperx[765].start |
19834.839 |
| transcript.whisperx[765].end |
19852.575 |
| transcript.whisperx[765].text |
應該要找心理學精神醫學的專家學者來開會討論兒少法修法的時候只要談論到安置兒少心理機構的時候我們應該要更專業的心理健康支持我們希望你們三週內給我們相關的會議規劃好 沒問題不是 部長你說沒問題 |
| transcript.whisperx[766].start |
19854.296 |
| transcript.whisperx[766].end |
19869.025 |
| transcript.whisperx[766].text |
你的同仁現在要哭了 來部長來看下一張結果三個禮拜後你們給我的回應是這樣你們衛福部說不用他說已經有相關資源了 都已經Ready了不需要為了這些安置機構的小孩再有什麼方案 再有什麼專家會議 他說不用不一定有他說不用 要怎麼樣 |
| transcript.whisperx[767].start |
19873.808 |
| transcript.whisperx[767].end |
19897.829 |
| transcript.whisperx[767].text |
因為那個委員是專家啦我回去了解一下我覺得應該您講的有道理我們再來重新檢討因為不是只有心理醫生告訴我們也不是只有心理師告訴我們是很多安置機構的社工老師還有在裡面服務的心理師他們真的就告訴我們這幾年我們社會越來越困難越來越複雜很多被送到安置機構的小孩他們的心理創傷的問題越來越複雜 |
| transcript.whisperx[768].start |
19900.131 |
| transcript.whisperx[768].end |
19926.559 |
| transcript.whisperx[768].text |
那如果有夠多專業的人進來幫忙我覺得對孩子是好事對機構裡面這些在照顧小孩的大人也是好事保重對不對對所以我很謝謝你們同仁給我們這些回應我也知道衛福部在很多心理健康真的已經非常非常非常認真我也知道我們花了很多錢很多資源希望協助國人整體的身心健康所以我今天沒有要質疑這個我只是要拜託部長我們在安置機構的部分是 |
| transcript.whisperx[769].start |
19927.179 |
| transcript.whisperx[769].end |
19949.528 |
| transcript.whisperx[769].text |
未來兒少全法修法嗎我們把這個部分先聽聽專家的聲音不管是邀請安置機構的社工老師心理老師或是這些安置機構主持人來是加上心理學精神醫學的相關專家好不好好我想這個部分是我非常重視的我本身也是台大心理系的和平教授所以我對心理的一個重要性那你要為你的專業同僚那個來所以您的 |
| transcript.whisperx[770].start |
19954.89 |
| transcript.whisperx[770].end |
19973.06 |
| transcript.whisperx[770].text |
您的指導我個人非常的認同部長我不敢說指導啦就拜託啦我們為孩子爭取權益其實就是在為大人更好的工作環境爭取權益好最後一題來很快很快那另外一個比較困難的我先說我自己承認這題比較難但是我們花一些時間長一點時間來討論 |
| transcript.whisperx[771].start |
19975.001 |
| transcript.whisperx[771].end |
20003.78 |
| transcript.whisperx[771].text |
我們後續在很願意跟衛福部直接召開討論會議就是這個安置機構的離開安置機構的小孩呢在兒少全法原來的條文59跟62條要求政府要追蹤輔導至少一年事實上現在也有這樣做那衛福部你們修法說要改成以後要提供家庭支持還有自立生活服務這個正向完全給予肯定也很謝謝衛福部願意陪孩子一起面對這個現實可是有一個比較大的困境就是目前我們政府提供支持服務到21歲 |
| transcript.whisperx[772].start |
20005.181 |
| transcript.whisperx[772].end |
20026.942 |
| transcript.whisperx[772].text |
可是在國外他們有發現很多21歲就算已經年滿21歲的小孩但是我剛剛說他來自有創傷的原生家庭他來自複雜的社區環境他可能甚至在學校的學習都沒有那麼有把握的情況下我們很難想像他一離開安置機構他就要自己立刻獨立自主生活其實也有很多兒少有跟我們來反映這個現況 |
| transcript.whisperx[773].start |
20028.183 |
| transcript.whisperx[773].end |
20039.071 |
| transcript.whisperx[773].text |
但我知道我們把21歲延伸到23或25有資源分配的問題有資源分配的困境但我們有沒有機會往這裡去想部長你覺得呢 |
| transcript.whisperx[774].start |
20040.752 |
| transcript.whisperx[774].end |
20059.467 |
| transcript.whisperx[774].text |
我覺得如果專家覺得這樣子是必要的我們絕對仔細的來研議啊是是那至少我們開啟研議的討論好不好好好那這個部分我們辦公室也會持續來追蹤好今天非常謝謝部長兩個議題知恥而哨都給予正面的回應我們一起努力謝謝部長謝謝主席謝謝謝謝陳委員謝謝部長葉研資葉研資葉研資委員不在楊耀委員你沒質詢嗎 |
| transcript.whisperx[775].start |
20080.529 |
| transcript.whisperx[775].end |
20081.811 |
| transcript.whisperx[775].text |
謝謝主席 主席我請一下邱部長 |
| transcript.whisperx[776].start |
20088.174 |
| transcript.whisperx[776].end |
20108.865 |
| transcript.whisperx[776].text |
委員好 部長好 剛好就有幸聽到劉建國委員的質詢您在答覆的時候有關分級醫療的轉整的部分由上級往下級轉 |
| transcript.whisperx[777].start |
20111.207 |
| transcript.whisperx[777].end |
20117.777 |
| transcript.whisperx[777].text |
你剛好舉到了台大轉中心那本席剛好在 |
| transcript.whisperx[778].start |
20119.082 |
| transcript.whisperx[778].end |
20143.218 |
| transcript.whisperx[778].text |
前兩個禮拜有一個服務案件就是很典型就是台大轉中心那我現在就直接跟部長探討一下病患家屬的感受我大概不止一次在這個執行台上講過就是要落實分級醫療必須要每一個每一層的層級 |
| transcript.whisperx[779].start |
20146.027 |
| transcript.whisperx[779].end |
20169.017 |
| transcript.whisperx[779].text |
負擔有他應該要有的醫療責任對不對配置人力跟種種是這樣子就是去台大急診那必須要住院還蠻急還蠻嚴重的可是台大就是沒有病床後來就說服了 |
| transcript.whisperx[780].start |
20170.592 |
| transcript.whisperx[780].end |
20194.404 |
| transcript.whisperx[780].text |
病患家屬就轉到中心轉到中心以後當然就有病床有病床是可以安心治療的第一步我想應該是這樣子對病患也好對病患家屬也好就是安心治療的第一步可是他大概在住院的第三天就有跟我講他覺得 |
| transcript.whisperx[781].start |
20196.291 |
| transcript.whisperx[781].end |
20211.736 |
| transcript.whisperx[781].text |
我不敢評斷,這個是家屬的感受,他覺得在中心的各項檢查好像不如台大那麼嚴謹 |
| transcript.whisperx[782].start |
20217.918 |
| transcript.whisperx[782].end |
20234.09 |
| transcript.whisperx[782].text |
我講是病患家屬的感受並不是指控中興醫院這個我必須要很明確的講中興醫院的醫療品質也非常高所以我才說這是家屬的感受家屬為什麼會有這個感受 |
| transcript.whisperx[783].start |
20235.888 |
| transcript.whisperx[783].end |
20258.098 |
| transcript.whisperx[783].text |
其實從這裡就可以看出來,由上轉下有多困難因為台灣一般的民眾,我人已經到醫學中心了,我就不願意到區域醫院到區域醫院了,你說要轉第七醫院,他也會有抗拒 |
| transcript.whisperx[784].start |
20260.203 |
| transcript.whisperx[784].end |
20264.49 |
| transcript.whisperx[784].text |
這個是一件很困難的事情所以劉建國委員剛剛的數據10比1我個人是覺得其實已經算 |
| transcript.whisperx[785].start |
20272.87 |
| transcript.whisperx[785].end |
20299.76 |
| transcript.whisperx[785].text |
也接受上轉下的通常出於無奈的比較多啦應該這麼講,要不然應該很難啦,對不對所以分級醫療的部分我還是這樣子講那另外還有一個問題就是上轉下現在我的看法,我的觀察連澎湖兩家醫院都有降載的情形 |
| transcript.whisperx[786].start |
20301.687 |
| transcript.whisperx[786].end |
20323.223 |
| transcript.whisperx[786].text |
就是病床降載的情形所以也不見得上要轉下就有得轉因為病床降載也好 關床也好是一個全面性的問題並不限於哪一層級的醫院院長我這樣子講 對不對 |
| transcript.whisperx[787].start |
20330.12 |
| transcript.whisperx[787].end |
20347.616 |
| transcript.whisperx[787].text |
所以人力才是問題我們今天講集中症我還是要講一下二月底的時候台灣急診醫學會就已經有警示今年的急診的用篩大概前所未有的嚴重 |
| transcript.whisperx[788].start |
20351.28 |
| transcript.whisperx[788].end |
20377.736 |
| transcript.whisperx[788].text |
其實這個問題產生其實會引發很多後續的問題所以衛福部的新聞稿曾經指出說衛福部在春節的年後就已經發現醫院有擁塞的問題也開了四次會可是二月底 |
| transcript.whisperx[789].start |
20378.666 |
| transcript.whisperx[789].end |
20389.481 |
| transcript.whisperx[789].text |
台灣醫學會還發出警訊,到底為什麼?你們開會在前嘛,那他們警示在後,問題也一直存在嘛 |
| transcript.whisperx[790].start |
20390.601 |
| transcript.whisperx[790].end |
20413.591 |
| transcript.whisperx[790].text |
部長回答或市長回答就可以因為我先瞭解順序一下啦那個第一次開會是2月3號那急診醫學會是幾月份第一次會議是2月8號2月8號對不對2月8號對然後第二次是2月13那急診是是2月底發出的警示2月底發出的警示2月底台花對那其實這中間我跟急診醫學會的理事長 |
| transcript.whisperx[791].start |
20415.834 |
| transcript.whisperx[791].end |
20442.392 |
| transcript.whisperx[791].text |
不曉得互動多少次了啦那急診醫學會站在關心國家的整個體制畫出的我們真的我完全他畫了以後我們隔天還是還是在一起啊所以我會尊重說每一個專業團體站在國家的立場沒有我覺得急診醫學會呢我們就是來解決問題這樣子也是出於善意對我覺得他們是出自於善意想要幫 |
| transcript.whisperx[792].start |
20444.353 |
| transcript.whisperx[792].end |
20464.32 |
| transcript.whisperx[792].text |
看看呼籲大家共同來關心這個問題那大家來解決這樣子我現在問的就是說為什麼我們的作為會慢半拍啦我現在問的是真的因為你們開會其實開很早嘛就表示你們有問題意識嘛部長你懂我的意思嗎 |
| transcript.whisperx[793].start |
20472.004 |
| transcript.whisperx[793].end |
20478.57 |
| transcript.whisperx[793].text |
對 因為前三次當然是有請林靜儀次長主持那他可能要收集 |
| transcript.whisperx[794].start |
20479.54 |
| transcript.whisperx[794].end |
20504.113 |
| transcript.whisperx[794].text |
第一次的意見他提出看怎麼做第二次可能在領悉共識可能那個劉市長都有參與他解釋一下我補充一下其實急診醫學會會提出這個他的重點在於大家都一直在講急診優篩其實是月優篩所以我們前面開幾次會的部分的話其實是第一個院內先處理 |
| transcript.whisperx[795].start |
20504.813 |
| transcript.whisperx[795].end |
20525.529 |
| transcript.whisperx[795].text |
然後那個急診醫學會覺得是說這必須要TOP DOWN下來再來呼籲所以他們決定是說用這樣的方式的話其實應該是全院一起來協助因為不是只有急診的問題包括了人力這些其實才是產生這次在因應這一塊的時候他們覺得長期來的消化這個急診 |
| transcript.whisperx[796].start |
20526.329 |
| transcript.whisperx[796].end |
20552.866 |
| transcript.whisperx[796].text |
這一次事件由春節這樣子延伸過來再加上那個傳染病的這一塊的人數然後之後又可能會因為春節之後恢復正常了門診的病人又要門診的病人又要進來了那原本給急診的這條綠色通道就會被關他們擔心這個所以才會在2月22號的時候提出這樣的聲明以上對啦我其實其實 |
| transcript.whisperx[797].start |
20554.686 |
| transcript.whisperx[797].end |
20573.372 |
| transcript.whisperx[797].text |
並不是要跟你們討論台灣急診協會為什麼發啦我直接跟部長和市長說明好了啦我覺得假如人力不做增補隨時會用篩啦 |
| transcript.whisperx[798].start |
20576.69 |
| transcript.whisperx[798].end |
20604.707 |
| transcript.whisperx[798].text |
因為台灣的健保這麼可貴就醫的可親性這麼高造成了很多後續的問題啦柏君你有沒有聽到我的意思我就是覺得這個不只是今年啦我相信而且根據我這裡的資料是是急診專科住院醫生的招生率是 |
| transcript.whisperx[799].start |
20606.488 |
| transcript.whisperx[799].end |
20621.595 |
| transcript.whisperx[799].text |
是低到讓我們覺得有點恐怖因為急診專科它本身就是一個必須要長期生活在高度壓力緊張的環境的一個工作 |
| transcript.whisperx[800].start |
20622.795 |
| transcript.whisperx[800].end |
20642.208 |
| transcript.whisperx[800].text |
就在醫生的範圍裡面他算是比起其他的醫生他可能生活的壓力更大工作的壓力更大那我們假如說沒有辦法招足一定的人力我也知道健保署很 |
| transcript.whisperx[801].start |
20644.5 |
| transcript.whisperx[801].end |
20670.745 |
| transcript.whisperx[801].text |
很有心要解決問題啦所以我們好像又撥了42億要來增加集中症的給付然後提高急診護理師的待遇不過我還是要講就是說有一些事情確實可以用錢解決有一些事情沒有辦法啦這個是比較長久的問題就藉由今天這個機會跟部長 |
| transcript.whisperx[802].start |
20675.607 |
| transcript.whisperx[802].end |
20694.858 |
| transcript.whisperx[802].text |
我們真的是必須要增加人力人力不增加永遠都會堵塞因為我想健保制度已經走到這裡也不可能就醫的可親信把它降低不可能啦 |
| transcript.whisperx[803].start |
20696.059 |
| transcript.whisperx[803].end |
20720.516 |
| transcript.whisperx[803].text |
假如不可能的話就只能增加人力設備的投資是比較快而且比較小事人力的培育比較困難不管是醫生護理師我覺得有很多不是待遇的問題的好不好我們有一些其他的問題我們就下一次有機會再做探討 |
| transcript.whisperx[804].start |
20728.341 |
| transcript.whisperx[804].end |
20748.137 |
| transcript.whisperx[804].text |
何欣淳 何欣淳委員不在許新穎 許新穎委員不在鄭振前 鄭振前 鄭振前委員不在林楚英 林楚英 林楚英委員不在王逸川 王逸川 王逸川委員不在本日會議詢問全部結束 |
| transcript.whisperx[805].start |
20753.436 |
| transcript.whisperx[805].end |
20773.792 |
| transcript.whisperx[805].text |
那個臨時提案因為提案委員不在我們就不處理下次再提不要管他下次要再提了委員王一川所提書面質詢列入記錄刊登公報現在做以下決定報告與尋討完畢 |
| transcript.whisperx[806].start |
20775.373 |
| transcript.whisperx[806].end |
20791.688 |
| transcript.whisperx[806].text |
委員質詢未及答覆或請補充資料者相關機關以兩週內書面答覆委員另行要求期限者從期所定本日會議到此結束現在散會 |
| transcript.whisperx[807].start |
20831.869 |
| transcript.whisperx[807].end |
20850.443 |
| transcript.whisperx[807].text |
谢谢大家 |