| IVOD_ID |
17276 |
| IVOD_URL |
https://ivod.ly.gov.tw/Play/Full/1M/17276 |
| 日期 |
2026-03-18 |
| 會議資料.會議代碼 |
委員會-11-5-26-2 |
| 會議資料.會議代碼:str |
第11屆第5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 |
5 |
| 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5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 |
2026-03-18T08:37:35+08:00 |
| 結束時間 |
2026-03-18T14:27:00+08:00 |
| 影片長度 |
05:49:25 |
| 支援功能[0] |
ai-transcript |
| video_url |
https://h264media01.ly.gov.tw:443/vod_1/_definst_/mp4:1M/bfaf9b39ac01a6858c1e201b3fb6835a4b18c695ae313e55157d0edf07c12ea68c2c79d6c991843e5ea18f28b6918d91.mp4/playlist.m3u8 |
| 會議時間 |
2026-03-18T09:00:00+08:00 |
| 會議名稱 |
立法院第11屆第5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、勞動部、原住民族委員會、內政部、教育部、行政院人事行政總處、銓敘部及國家衛生研究院，就「如何精進偏鄉醫療與長照資源落差及落實《原住民族健康法》之困境，並對提升原住民族健康權益及強化原鄉照護量能（含提升機關位階與人力配置）」進行專題報告，並備質詢。
【3月18日及3月19日，二天一次會】） |
| 委員名稱 |
完整會議 |
| 委員發言時間 |
08:37:35 - 14:27:00 |
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請準備報告出席人數報告委員會出席委員人數12人已足法定人數現在開會請議事人員宣讀上次會議事錄 |
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1372.315 |
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立法院第十一屆第五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115年3月11日9點43分至10點9分地點群憲樓801會議室初期委員蘇清泉等15人主席廖委員韋祥選舉事項選舉第十一屆第五會期本會召集委員主席宣告推選盧委員現一及林委員約請為本會期本會召集委員宣讀完畢請問委員會上次議事錄有錯誤或遺漏之處 |
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1404.464 |
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沒的話一速率確定 |
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1406.823 |
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1432.494 |
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百日會議一層為邀請衛生福利部部長勞動部原住民主委員會內政部教育部行政院人士行政總署全序部及國家衛生研究院就如何進行偏鄉醫療與長照支援及落實原住民主健康法制困境並對提升原住民主健康權益及強化照護量能含提升機關衛接與人力配置進行專題報告並備質詢 |
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介紹在場委員及列席官員我們歡迎我們林玥琴召委王振旭委員衛生福利部部長石崇良護理及照護健康室市長蔡淑鳳長期照護室市長祝健芳文明健康署署長沈敬芬中央健保署署長陳亮宇 |
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1466.553 |
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1477.118 |
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社家署署長周道軍醫事司副市長劉玉京勞動發展署署長黃玲瑜園民會處長劉赫駿科長李佩軒國土署科長許嘉玲 |
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1494.537 |
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1522.019 |
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消防災害管理署副組長周泰利科長郭芳明災務部中規師專門委員王佩珊高教師專門委員郭嘉英行政院人事組邊人力處專門委員廖政文科長呂威毅 |
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1524.932 |
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1540.568 |
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情緒部法規司專委蕭立榮國衛院院長司徒惠康歡迎接下來請衛生福利部部長做報告 |
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1548.989 |
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1571.266 |
| transcript.whisperx[8].text |
主席還有各位委員各位女士先生今天是立法院第十一屆第五會期這個社會福利及衛生環境委員會召開委員會議那麼我們本部呈邀列席就如何精進偏鄉醫療與長照資源的落差與落實原住民族健康法是困境 |
| transcript.whisperx[9].start |
1571.926 |
| transcript.whisperx[9].end |
1595.967 |
| transcript.whisperx[9].text |
那麼提升援助民族的健康權益及強化原鄉照護量能來提出專案報告那再請各位委員不吝指教那麼為了提升偏鄉的醫療資源及服務品質那麼本部呢那麼持續以下的這個六個策略方向來推進那麼第一個呢就是先提升這個醫療照護的可進性那麼 |
| transcript.whisperx[10].start |
1597.388 |
| transcript.whisperx[10].end |
1624.793 |
| transcript.whisperx[10].text |
我們在這個健保裡面有山地離島地區的醫療給付提升計畫也就是俗稱的IDS來提供夜間還有立假日的門診專科診療跟巡迴醫療的服務那麼同時我們也在111年開始那麼決定在花蓮縣的秀林鄉開辦全人的照護執行計畫來提升全人的整合服務量能那麼同時在114年擴大 |
| transcript.whisperx[11].start |
1627.333 |
| transcript.whisperx[11].end |
1644.034 |
| transcript.whisperx[11].text |
辦理到全國六區的這個偏鄉地區那麼另外呢也在針對這個在離島或山地鄉醫療資源不足地區的醫院也提供了這個點子保障的相關的這個措施來提升那麼 |
| transcript.whisperx[12].start |
1645.416 |
| transcript.whisperx[12].end |
1668.662 |
| transcript.whisperx[12].text |
民眾的這個醫療的照護可敬信那麼第二呢是充實在地的醫師人力那麼我們有推動重點科別的培育公費醫師制度那麼也有原鄉離島醫師人員養成公費生的計畫那麼同時在這個公費生的空窗期間呢也有辦理偏鄉醫師的留任獎勵計畫那麼來充實 |
| transcript.whisperx[13].start |
1671.023 |
| transcript.whisperx[13].end |
1697.922 |
| transcript.whisperx[13].text |
這個在地的這個醫事人力那第三呢是強化這個公立醫療的設備那麼在離島偏鄉地區呢那麼多數主要的醫院呢都是公立醫院那因此呢我們在公立醫院的服務方面不斷的在精進那麼包括呢強化新血管新導管式的設立包含癌症化學治療的在地化還有緊急醫療服務量能的提升 |
| transcript.whisperx[14].start |
1699.623 |
| transcript.whisperx[14].end |
1723.324 |
| transcript.whisperx[14].text |
也持續的在投入一些重大的醫療設備像核磁共振、電腦斷層等等至於在原鄉或者是離島的衛生所、衛生室的資訊化服務也是一個重點提升它的整個基礎的網路設備的更新跟傳輸的速度來提升醫療服務的效能跟品質 |
| transcript.whisperx[15].start |
1724.905 |
| transcript.whisperx[15].end |
1750.638 |
| transcript.whisperx[15].text |
第四是強化在地的醫療量能除了前面的人力的在地補充之外也透過醫學中心的資源獎勵計畫導入醫學中心或重度急急救醫院的專科人力進入到偏鄉補給不足來提升在地的緊急救護量能跟醫療的能力 |
| transcript.whisperx[16].start |
1751.198 |
| transcript.whisperx[16].end |
1775.797 |
| transcript.whisperx[16].text |
那麼這是第四個那麼再不足的部分呢那麼再第五個就是遠距醫療的照護那為了持續的提升這個專科服務的資源進入到偏鄉那麼強化這個分散式的照護那我們是在109年開始就在原鄉的離島衛生所推動這五官科耳鼻喉科眼科皮膚科等等專科的遠距醫療照護服務到110年的時候呢擴大 |
| transcript.whisperx[17].start |
1779.079 |
| transcript.whisperx[17].end |
1799.074 |
| transcript.whisperx[17].text |
然後在去年的8月則全面的放寬適用遠距醫療服務給付的區域到135個鄉鎮可服務的人口超過180萬那麼也不限任何的科別均可執行了 |
| transcript.whisperx[18].start |
1799.674 |
| transcript.whisperx[18].end |
1824.193 |
| transcript.whisperx[18].text |
那麼第六就是強化緊急醫療的後送機制那麼為了強化這個偏鄉的緊急後送跟轉診我們有成立了14個這個急重症的轉軸網絡那各設置有一處的這個遠距醫療合作那麼中心那麼另外在空中救護轉診跟後送品質的部分分別在三個離島設立的駐地的這個 |
| transcript.whisperx[19].start |
1828.197 |
| transcript.whisperx[19].end |
1836.79 |
| transcript.whisperx[19].text |
緊急後送機制另外也設立空中轉診審核中心24小時提供即時的緊急醫療資源跟轉診評估跟協調 |
| transcript.whisperx[20].start |
1839.744 |
| transcript.whisperx[20].end |
1868.773 |
| transcript.whisperx[20].text |
那麼此外呢在提升這個偏鄉地區的長照資源部件的部分呢那麼我們則是定有這個給支付的加成制度那麼針對長照機構的部件那麼也有開辦會的鼓勵那麼另外也為了鼓勵這個居服員投入這個原鄉服務那麼我們有持續的加碼跟各項的這個事辦計畫另外也透過長照基金的挹注那麼 |
| transcript.whisperx[21].start |
1870.753 |
| transcript.whisperx[21].end |
1897.503 |
| transcript.whisperx[21].text |
讓這個以這個原民會為主的這個文化這個健康站的部件那麼同時結合這個長照10年計畫3.0中核定的這個原住民族專章跟指定指標輔導這個文件會那麼成立這個喘息服務或者是這個居家式的長照服務的結合最後呢再落實 |
| transcript.whisperx[22].start |
1898.905 |
| transcript.whisperx[22].end |
1913.875 |
| transcript.whisperx[22].text |
原住民族健康法提升原鄉照護量能的部分那麼為了促進原住民族的健康平等那麼建構以原民為中心的健康政策那麼本部呢則是補助了國會院成立的 |
| transcript.whisperx[23].start |
1914.795 |
| transcript.whisperx[23].end |
1938.253 |
| transcript.whisperx[23].text |
這個原住民族健康研究中心來強化原住民族的健康資料庫的建立同時依法也成立了原住民族健康政策會來擴大原住民族代表跟跨部會機關代表的參與並寬列了這個原住民族健康的相關預算那麼強化對原住民族健康的重視 |
| transcript.whisperx[24].start |
1940.034 |
| transcript.whisperx[24].end |
1949.714 |
| transcript.whisperx[24].text |
那麼以上都是為了落實健康台灣的願景那本部將持續的精進各項的政策再請各位委員不吝指教 謝謝 |
| transcript.whisperx[25].start |
1952.356 |
| transcript.whisperx[25].end |
1979.082 |
| transcript.whisperx[25].text |
謝謝部長有關本次會議各項書面資料進入記錄刊登公報現在開始審打 作以下宣告本會委員審打時間6加2分鐘 略協委員4分鐘4點半截止發言登記委員如果書面質詢前 散會前提出預期不受理暫定10點半休息10分鐘原則上11點半處理臨時提案11點截止收案現在請登記第一位委員 禮略請召委發言 |
| transcript.whisperx[26].start |
1987.231 |
| transcript.whisperx[26].end |
1989.673 |
| transcript.whisperx[26].text |
主席麻煩我們的市部長好 委員長部長早 在長照3.0要上路的原因我有很多問題要來請教部長我最近趁著空檔時間 從2月1號到現在我大概走訪不同縣市的長照機構那非都會地區需要長照機構而設立長照機構最大的問題不外乎就是評鑑 |
| transcript.whisperx[27].start |
2015.06 |
| transcript.whisperx[27].end |
2028.491 |
| transcript.whisperx[27].text |
所以我想先來請教部長有關評鑑的問題台灣已經邁入了我們的超高齡社會長照的制度也是進入到而今年正式進入到長照3.0目前全台最 |
| transcript.whisperx[28].start |
2029.13 |
| transcript.whisperx[28].end |
2049.255 |
| transcript.whisperx[28].text |
需要長照服務的人口已經超過了100萬人因此長照服務的品質跟我們的監督機制非常的重要可是我們自己看到就是說最近就有報導指出現行的長照機構評鑑制度出現了文件導向的一個現象甚至延伸出協助機構來撰寫評鑑資料的一個評鑑顧問 |
| transcript.whisperx[29].start |
2054.209 |
| transcript.whisperx[29].end |
2078.451 |
| transcript.whisperx[29].text |
不然你自己有沒有看這樣子的一篇蠻冗長報的那收費呢從10到50萬不等所以部長你知道這件事嗎這樣子的一個評鑑制度到底是要在提升照顧品質還是在檢查文件品質這事實上是由來一直以來的問題我想不是只有長照過去托嬰中心幼兒園也都是這樣就是有寫手來幫忙幫你 |
| transcript.whisperx[30].start |
2080.242 |
| transcript.whisperx[30].end |
2100.072 |
| transcript.whisperx[30].text |
整套的東西都整理好可是到底真實的事實上是機構的品質嗎可是如果評鑑事實上是如果做文件的話一定會拿到優好如果一旦發生問題的時候很常政府就會被批評說啊你已經他都是優啊那他為什麼會這樣為什麼發生不幸的事件呢好所以不知道你知道這樣的狀況嗎 |
| transcript.whisperx[31].start |
2101.532 |
| transcript.whisperx[31].end |
2121.663 |
| transcript.whisperx[31].text |
我想跟委員說明,那麼為了提升這些照護的品質,我們經常都是採用兩個手段,一個就是督導考核,那一個就是用這個評鑑的方式。那當然評鑑是比較軟性啦,那但是呢,它的標準上呢,就可以可能會朝向這個一直在優化。 |
| transcript.whisperx[32].start |
2123.464 |
| transcript.whisperx[32].end |
2144.393 |
| transcript.whisperx[32].text |
確實在過去從醫院評鑑可能做了比較久大家也可以看得到這個後來也是出現有這個文件paperwork太多反而造成臨床上的壓力所以我想這個長照的評鑑我們也一樣會跟目前在做醫院評鑑改革的精神是一樣的盡量去降低 |
| transcript.whisperx[33].start |
2145.794 |
| transcript.whisperx[33].end |
2164.217 |
| transcript.whisperx[33].text |
這個文件這個paperwork盡量能夠降低但是也導入一些智慧化因為我們也不想只是因為一日的評鑑當天的評鑑那很多就是一日表現很好但是平常不好所以還是要建議過去用文件就是說可能當天 |
| transcript.whisperx[34].start |
2164.817 |
| transcript.whisperx[34].end |
2179.174 |
| transcript.whisperx[34].text |
一天的評鑑怕失準所以才會準備一堆長期的文件那如果我們能夠建立起自廠的監測機制那麼我想這個文件的要求就可以下降當然在 |
| transcript.whisperx[35].start |
2179.694 |
| transcript.whisperx[35].end |
2192.15 |
| transcript.whisperx[35].text |
我們的長照機構跟醫院不同是說它的小規模的很多所以它本身的資訊能力也比較有落差所以我們會盡量來協助改善 |
| transcript.whisperx[36].start |
2194.633 |
| transcript.whisperx[36].end |
2208.263 |
| transcript.whisperx[36].text |
所以我最擔心的就是說第一線公眾員反映說有些機構就是文書人員很多幾乎都在做文書可是照顧人力很少照顧員必須花很大量的時間將近大概要花35%時間來處理重複的一些記錄 |
| transcript.whisperx[37].start |
2210.604 |
| transcript.whisperx[37].end |
2219.652 |
| transcript.whisperx[37].text |
反而壓縮了照顧長者的時間更可能找所謂的我們的評鑑顧問來代寫我覺得先個案紀錄找評鑑顧問來代寫實在是坦白講有點離譜就是說我從A機構評鑑的時候看到的跟B機構寫的個案紀錄完全一模一樣這真的事實上讓我們覺得說那這樣子的 |
| transcript.whisperx[38].start |
2229.861 |
| transcript.whisperx[38].end |
2253.661 |
| transcript.whisperx[38].text |
品質何在呢所以想問部長說目前評鑑指標當中我們的文書記錄跟實際照顧品質的比重各自是多少為什麼因為有時候評鑑幾乎委員都在看黨本資料很少去看到現場現場也有些樣板的給你看甚至記錄都有樣板的給你看所以政府是否評估過這種過度化的反而是讓增加第一線的一些負擔 |
| transcript.whisperx[39].start |
2255.065 |
| transcript.whisperx[39].end |
2256.892 |
| transcript.whisperx[39].text |
詳細的評鑑的過程我是不是請長照司的副市長來補充 |
| transcript.whisperx[40].start |
2262.02 |
| transcript.whisperx[40].end |
2290.106 |
| transcript.whisperx[40].text |
謝謝 謝謝委員這邊的垂詢關心那我們其實非常看這種評鑑的實質到底評到了什麼所以你們只有60項可是那指標真的都是在文書因為有分專業組跟經營管理組那委員剛剛說只看文件不看現場那個是經營管理組因為他確實要看他整個機構的管理的部分去抽那些相關人員排班的一些狀況那另外三個全部是看現場市長說這些也是可以做出來的嗎 |
| transcript.whisperx[41].start |
2291.246 |
| transcript.whisperx[41].end |
2319.127 |
| transcript.whisperx[41].text |
看現場的部分其實是當場抽個案然後當場這個要求這個照顧的人那一個行為動作讓他當場做出來所以其實這樣子其實是可以看到所有的現場的照顧的人力有沒有能力去處理這些相關的市長我想這個評鑑應該講不是只有長照連我覺得很多的機構評鑑都落入到這問題所以我只是希望你們 |
| transcript.whisperx[42].start |
2320.308 |
| transcript.whisperx[42].end |
2338.593 |
| transcript.whisperx[42].text |
不管照顧小的照顧老的齁真的機構在照代為照顧的時候真的要去把關了齁那另外衛福部也透過我們的住宿型機構的照顧品質獎勵計畫來鼓勵提機構提升品質這很好啊齁報導也指出說有些機構在申請補助時只有針對 |
| transcript.whisperx[43].start |
2339.853 |
| transcript.whisperx[43].end |
2360.735 |
| transcript.whisperx[43].text |
少數的樣板個案來展示他的照顧成果所以要問的是會不會如何確保這些補助真正能夠反映到整體的照顧品質是不是有事後的追蹤跟我們的隨機抽查像剛剛部長也講了 不能一天好 其他天事實上都沒辦法事實上是滿足 |
| transcript.whisperx[44].start |
2361.455 |
| transcript.whisperx[44].end |
2372.403 |
| transcript.whisperx[44].text |
照顧品質所以我不知道說你們事後有沒有做一些追蹤或者是抽查因為報導裡面反映的是說當天大家都表現得很好可是後邊呢並不是這樣子做 |
| transcript.whisperx[45].start |
2375.209 |
| transcript.whisperx[45].end |
2390.957 |
| transcript.whisperx[45].text |
對 就像我剛剛提到的我們大概有三個機制嘛一個就是這個年度的督導考核嘛那一個就是評鑑這個是定期的那還有一種就是不定期的抽查制度啦那我想剛剛委員所提到的 |
| transcript.whisperx[46].start |
2393.158 |
| transcript.whisperx[46].end |
2414.711 |
| transcript.whisperx[46].text |
這個為了避免只是在當天的樣板個案那可能要去強化這種外部專家的這個審視的能力第二個就是抽查所以部長我還是認為未來真的長照3.0應該從文件治理走向品質治理減少文書型的一個指標強化實地訪查來讓我們的 |
| transcript.whisperx[47].start |
2417.132 |
| transcript.whisperx[47].end |
2433.357 |
| transcript.whisperx[47].text |
住民跟家屬有回饋機制讓長照真的是去能夠提升品質再要問的是就是說我們的長照3.0到底誰在使用為什麼這樣講因為我常常說政策制定一定要回到真正的使用者的一個經驗首先 |
| transcript.whisperx[48].start |
2433.877 |
| transcript.whisperx[48].end |
2449.089 |
| transcript.whisperx[48].text |
依據衛福部資料顯示大概112年的長照服務使用者當中失能的人照顧的大概將近八成可是50到64歲的身心障礙大概兩成是最低的所以現在超過七成的長照服務使用者都是 |
| transcript.whisperx[49].start |
2450.571 |
| transcript.whisperx[49].end |
2470.169 |
| transcript.whisperx[49].text |
輕中度的失能者不然這是代表我們現在的長照服務的主要對象其實都是輕中度失能者問題就在這裡真正照顧壓力最大的其實是重度的失能家庭而這些家庭往往不是靠長照制度而是靠家人自己在乘或者是聘僱外籍看護工 |
| transcript.whisperx[50].start |
2471.169 |
| transcript.whisperx[50].end |
2491.424 |
| transcript.whisperx[50].text |
來做照顧所以看統計目前台灣就是全台大約有21.4萬名的一個失能者的一個聘僱外籍家庭的看護移工可是其中大約有4成同時使用長照服務可是更值得注意這4成當中因為去年開始外聘我們的 |
| transcript.whisperx[51].start |
2492.905 |
| transcript.whisperx[51].end |
2508.005 |
| transcript.whisperx[51].text |
看護移工的時候還是可以用你的長照服務可是值得注意這四層裡面只有三分之一其實只有用一項服務不然這代表什麼這是不是代表我們的長照制度的一個設計可能沒有真正貼近重度家庭的需求 |
| transcript.whisperx[52].start |
2508.665 |
| transcript.whisperx[52].end |
2523.67 |
| transcript.whisperx[52].text |
政府現在公布的長照服務涵蓋率其實是不是高就是你高估了制度真正要滿足需求的程度為什麼現在滿意度很高可是滿意度是不是有用的人可是有很多人事實上是沒有在使用你的需求的評估 |
| transcript.whisperx[53].start |
2524.89 |
| transcript.whisperx[53].end |
2546.077 |
| transcript.whisperx[53].text |
的狀況是什麼否則的話你現在的滿意度事實上是有用的人嘛所以好像沒辦法真正的事實上知道說到底那個需求到底是什麼那這會造成什麼問題當長照服務滿意度越來越高時這些需要長照資源的重度家庭可能因為沒有被知道沒有在使用你的資源而且 |
| transcript.whisperx[54].start |
2546.677 |
| transcript.whisperx[54].end |
2565.587 |
| transcript.whisperx[54].text |
部長當長照服務滿遇度越高不是應該會減少照顧者的照顧壓力嗎那為什麼我們還是依然發生了照顧殺人的悲劇依然持續在發生所以要問是如何提升從那個重度失能者使用長照的比例讓政府接住照顧者 |
| transcript.whisperx[55].start |
2566.527 |
| transcript.whisperx[55].end |
2582.774 |
| transcript.whisperx[55].text |
也跟委員說明一下按照我們的統計在幾支付的使用比例裡面大概重度的是佔20%然後中度的40%那當然還有40%是屬於輕度的大概是這樣的分佈那麼比較tricky的就是這個重度的 |
| transcript.whisperx[56].start |
2583.674 |
| transcript.whisperx[56].end |
2606.509 |
| transcript.whisperx[56].text |
有一部分其實是到這個住宿式機構去的這個大概差不多12萬人那還有一些是在家裡的所以我們在居家的部分怎麼去強化這個支持就是剛剛回應到最後這個長照悲劇的部分其實就是那個重度在居家的部分怎麼去強化這個support對 部長上次我有諮詢也講過這個對 包含喘息的還有這個社區裡面的照顧者的資源 |
| transcript.whisperx[57].start |
2613.253 |
| transcript.whisperx[57].end |
2640.545 |
| transcript.whisperx[57].text |
這些我們在長照3.0裡面會特別來談話所以希望部長我這以下有三個建議請你大概一個月內給我這個報告也就是政府應該建立我們重度失能優先支持的一個服務設計然後降低申請門檻像可不可以增加我們的夜間或者是喘息服務而且要簡化我們的申請流程第二個就是政府應該思考整合移工跟長照制度不要讓家庭自己有外聘 |
| transcript.whisperx[58].start |
2641.141 |
| transcript.whisperx[58].end |
2667.193 |
| transcript.whisperx[58].text |
移工的時候自己呢獨自要去照顧的時候以為反正他有移工可是實際上基本上他的負擔還是大的可能去思考到這個兩者是不是可以怎麼協作那政府也需要建立真正反應需求的政策指標所以你現在用的長照的服務的涵蓋率來說明你的政策成果可是真正要被服務的人可能重度的事實上是沒被你納入 |
| transcript.whisperx[59].start |
2669.121 |
| transcript.whisperx[59].end |
2691.193 |
| transcript.whisperx[59].text |
跟委員再補充其實我們長照3.0已經把那個有移工我剛也講過他們用的比例事實上非常的低你還是要去瞭解為什麼用的比例這麼低再來瞭解一下使用率低的所以部長是不是可以一個月月提供這些評估報告這三項可以啦好謝謝部長謝謝謝謝委員謝謝林玉琴委員再來請陳清輝委員 |
| transcript.whisperx[60].start |
2703.123 |
| transcript.whisperx[60].end |
2707.125 |
| transcript.whisperx[60].text |
主席好 各位委員還有官員好 我們請時部長請時部長部長好部長因為我知道您在衛福部已經服務非常非常久所以對於所有的菸害防治這些相關的法規您應該是非常非常熟悉啦那我們來看一下這個數據經歷菸害防治法的修法還有我們把菸捐調漲我們會看到說 |
| transcript.whisperx[61].start |
2730.154 |
| transcript.whisperx[61].end |
2744.491 |
| transcript.whisperx[61].text |
男性女性整體的吸菸人數是節節下滑這個成效是卓越的不過到某一個時間點他就有一點停滯了那你會知道說女性吸菸的比例還在近年來提高的原因是什麼嗎女性吸菸率上升的問題 |
| transcript.whisperx[62].start |
2753.032 |
| transcript.whisperx[62].end |
2767.225 |
| transcript.whisperx[62].text |
您說我們也特別注意到了有注意到就是說這個女性的吸菸率好像這個這兩年有一些爬升的現象我們再來細部的分析看看有什麼特別的原因 |
| transcript.whisperx[63].start |
2767.945 |
| transcript.whisperx[63].end |
2796.184 |
| transcript.whisperx[63].text |
所以現在回答不出來沒關係我先跟您說到最後整體持平這個也許是一個沒有辦法改變的樣態因為吸菸的人口就是有一個固定但是我們現在想要您注意的地方是這個女性吸菸的比例升高還有兒少您的報告已經延遲了一陣子了這個你們每兩年會做一次調查所以112到114應該要有但現在115年3月了 |
| transcript.whisperx[64].start |
2796.684 |
| transcript.whisperx[64].end |
2812.88 |
| transcript.whisperx[64].text |
第一我想請問你的報告什麼時候會出來跟委員說明我們內部的報告大概已經完成大概下個禮拜會對外公佈那你要不要先稍微講一下數據看起來這個數字是有在往下有在往上嘛因為110下降 |
| transcript.whisperx[65].start |
2814.065 |
| transcript.whisperx[65].end |
2840.774 |
| transcript.whisperx[65].text |
如果你說下降那我會覺得跟大眾你隨便到你隨便問一個校園的老師跟大眾的認知實在是太脫節了這個多月委員質詢耶裡面牽涉內建部牽涉治安包括電子菸的購買網路上現在好簡單甚至他到便利商店只要包一包他根本也不知道裡面是菸然後48種口味都可以買得到他 |
| transcript.whisperx[66].start |
2841.934 |
| transcript.whisperx[66].end |
2869.845 |
| transcript.whisperx[66].text |
關係到青少年的健康嘛兒少健康 校園的煙害防治還關係到這個毒品治安甚至是行車等等因為上次煙案新聞常常都會發現所以你的意思是說110到112下降大眾已經覺得跟他們在路上看起來不太一樣現在112到114又下降了你現在要告訴我們這個嗎112到114又下降了電子煙的青少年使用又下降了 |
| transcript.whisperx[67].start |
2871.552 |
| transcript.whisperx[67].end |
2893.754 |
| transcript.whisperx[67].text |
我請那個國健署省署長說明一下這個目前的調查報告是報告委員從我們的監測調查抽樣的調查的數據來看確實是在下降在國中高中電子菸加熱菸跟止菸的吸菸率當然下降不是那麼明顯就是可能從3.7下降到3.5左右你們是怎麼抽樣調查的我好奇問一下 |
| transcript.whisperx[68].start |
2895.136 |
| transcript.whisperx[68].end |
2908.295 |
| transcript.whisperx[68].text |
我們的監測調查有一定的程序那那個抽樣的話就會隨機的去抽樣你們是抽兒少這個族群還是你們有去問老師高中生你們沒有去問老師我們其實是針對學生抽樣 |
| transcript.whisperx[69].start |
2910.802 |
| transcript.whisperx[69].end |
2931.82 |
| transcript.whisperx[69].text |
我問你小的時候你如果被發一張問卷問你有沒有偷抽菸你會寫有嗎在整個抽菸過程當中都會保護個人的隱私你要不要考慮換一個方法因為這個跟大眾的認知真的差太多了我們建議你如果你要去調查要不要把這個師長的數據跟學生的數據對起來看看謝謝委員的建議我們會納入參採 |
| transcript.whisperx[70].start |
2939.824 |
| transcript.whisperx[70].end |
2962.378 |
| transcript.whisperx[70].text |
好那再來我們再回來請教部長部長因為現在呢台北市有率先提出說他們想要效法日本可以在室外推這個戶外負壓吸菸室大概有兩個優點第一個是二手菸嘛你有時候走在路上沒有明確的規範哪邊是禁菸的地方那可能就會吸到別人的二手菸甚至是三手菸 |
| transcript.whisperx[71].start |
2963.359 |
| transcript.whisperx[71].end |
2983.139 |
| transcript.whisperx[71].text |
再來呢我們可以把菸蒂集中管理不會讓清潔人員東掃西掃這樣子那前幾天你是在媒體上說台北市這樣做與法可行我們是想問您是對這個政策正面看待還是覺得說菸漢防治法您很熟法規沒有很明確寫不行所以你們可以自己來做做看 |
| transcript.whisperx[72].start |
2984.219 |
| transcript.whisperx[72].end |
2999.833 |
| transcript.whisperx[72].text |
沒有我講的法規非常清楚這個是在菸害防治法第19條第一項第4款就是可以由各級主管機關去公告哪個地方是一個吸菸禁菸的場所然後在這個禁菸場所 |
| transcript.whisperx[73].start |
3001.694 |
| transcript.whisperx[73].end |
3030.443 |
| transcript.whisperx[73].text |
指定的這個區域裡面再去指定可吸菸區啦那所以按照這樣的話就譬如說你現在是在行人這個什麼步道區你就給他宣布他不是明定我們在院內防治法18條是針對室內主要空間去做明定這個禁菸那但是部分的室內空間可以設室內吸菸室19條的話多數是針對戶外明定但是保留了第4款由各級 |
| transcript.whisperx[74].start |
3031.603 |
| transcript.whisperx[74].end |
3058.684 |
| transcript.whisperx[74].text |
這個主管機關再去宣布一個禁煙場所然後再配合這個吸煙區的設施我幫你調出來這邊是第18條你剛講的如果我們要在室內設一個吸煙室其實你規定的是蠻清楚的你寫說負壓要多少換氣要幾倍滑門要怎麼做排煙口距離多遠這個你是有一個SOP的所以我們偶爾也會在一些百貨公司看到有這樣子的室內吸煙室但是室外這個是您剛提的第19條嘛 |
| transcript.whisperx[75].start |
3061.286 |
| transcript.whisperx[75].end |
3084.163 |
| transcript.whisperx[75].text |
它現在是講吸菸區所以我剛剛問你的是說室外吸菸室是不是用你的19條這是第一啊因為你講到說每一個地方它可以有明確的標示說這邊是吸菸區另外面積不得大於室外面積的二分之一嘛那其實它沒有一個統一的標準我們現在要問出來的就是說 |
| transcript.whisperx[76].start |
3088.206 |
| transcript.whisperx[76].end |
3105.836 |
| transcript.whisperx[76].text |
之後台北市真的開始做或者是有人覺得台北市做得不錯但是它的設置的樣貌不太一樣你是不是這邊你要說我都正面看待各縣市怎麼做都可以取決於他們的預算或是他們的規劃或者是你要統一給一個指引 |
| transcript.whisperx[77].start |
3106.596 |
| transcript.whisperx[77].end |
3125.977 |
| transcript.whisperx[77].text |
因為你剛剛說你會依照法規第19條但很簡單你看18、19差多少18訂得很細耶19只有講說你要放一個標示跟不可以超過二分之一就這樣耶對當時候在立法的時候這個都是在法規上把它區分出來因為室內的空間有限 |
| transcript.whisperx[78].start |
3126.658 |
| transcript.whisperx[78].end |
3141.762 |
| transcript.whisperx[78].text |
所以你要設置一個室內CNC的時候呢會有比較高規格的設置所以才會有授權執法去訂定這個這個室內CNC的設置標準但是戶外的樣態很多它空間也比較大 |
| transcript.whisperx[79].start |
3142.362 |
| transcript.whisperx[79].end |
3163.912 |
| transcript.whisperx[79].text |
所以他只是指定一個CN區但是這個CN區必須要有管理分別在這個這個陰害防治法的第22條跟23條他都有規範你的管理設備上你怎麼維護那避免呢這個保護我們受保護的像是孕婦啦還兒童呢青少年的不要進入到CN區明顯標準所以你的意思是說 |
| transcript.whisperx[80].start |
3165.092 |
| transcript.whisperx[80].end |
3181.771 |
| transcript.whisperx[80].text |
我只是要問一個結論您的意思是說現行的法規已經足夠了你未來不會再另外出一個指引假使特縣市實施的室外吸菸區或是室外吸菸室它看起來的規格不同你不會再另外設指引了 |
| transcript.whisperx[81].start |
3181.971 |
| transcript.whisperx[81].end |
3198.787 |
| transcript.whisperx[81].text |
我們會看未來各縣市執行的情形如何譬如說它現在我那天提的很簡單的概念就是你這個CN區戶外這個CN區你可以比照這個去設置這個市內CN市的設置標準去設置當然沒有問題 |
| transcript.whisperx[82].start |
3199.808 |
| transcript.whisperx[82].end |
3220.695 |
| transcript.whisperx[82].text |
你是規定還是說你可以可以是大家都要叫室內這樣做那麼你現在來講呢這個戶外的這個指定的吸菸區與法是可行就是說你必須先指定一個區域是禁菸然後再去指定那個吸菸區吸菸區不能夠應該是這樣講啦其實我們只是很簡單的想要 |
| transcript.whisperx[83].start |
3223.936 |
| transcript.whisperx[83].end |
3249.294 |
| transcript.whisperx[83].text |
請教你如果未來各縣市不同大家已經花了預算去做了嘛你會不會跑出來說不行這樣子不行你可能要依照我們第18條的規定市內的那些規定來做我們現在其實就是問你一個很簡單的問題你會出職員還是不會目前這個法律上沒有授權但是如果說各縣市政府有這個需要我們可以召集大家來共事一下 |
| transcript.whisperx[84].start |
3250.815 |
| transcript.whisperx[84].end |
3271.855 |
| transcript.whisperx[84].text |
就是專家跟各縣市大家來共識一下說大家都要朝這個方向想要這樣做的話有一個您說的指引也好或者是一個那現在有一個縣市想要這樣子做了你要找嗎如果是台北市已經有一些做法他可以提供給我們我們來幫他協助看一下 |
| transcript.whisperx[85].start |
3272.776 |
| transcript.whisperx[85].end |
3286.325 |
| transcript.whisperx[85].text |
不是啦現在就是要問你說你會不會主動去找他們說你要怎麼做我跟你商量一下那看你做出來不要做出來中央要說不行要依照第18條其實我們就是問你這麼簡單的問題我們希望齁這個 |
| transcript.whisperx[86].start |
3290.948 |
| transcript.whisperx[86].end |
3305.647 |
| transcript.whisperx[86].text |
這個禁煙這個煙害防治都是我們共通的目標啦所以如果是縣市政府有這個需要的時候都可以請我們我們會來協助另外我們這個國建署也會找這個專家大家來討論一下 |
| transcript.whisperx[87].start |
3307.709 |
| transcript.whisperx[87].end |
3331.061 |
| transcript.whisperx[87].text |
所以你最近有這個規劃會請這個台北市想要做的這個資料先送來那我們也可以幫他列為我們在討論的一個這個材料所以在這邊請教您一個進度就您多久以內會完成這個會議您預計這個月底之前就會召開這個月底 對下一個署長您可以回座 |
| transcript.whisperx[88].start |
3332.602 |
| transcript.whisperx[88].end |
3343.85 |
| transcript.whisperx[88].text |
好下一個呢是最近很多護理師在網路上討論的這個影片啊他們看著看著就哭了我們現在沒有聲音在辛苦的時候你要想到有一個人就算已經當到總統了還是很羨慕你的工作 |
| transcript.whisperx[89].start |
3355.698 |
| transcript.whisperx[89].end |
3379.268 |
| transcript.whisperx[89].text |
這個是賴清德總統他1月24號出席健康台灣深耕論壇的時候講出來的話但當然後來根據審計部他有去調查他說實際上月投保薪資是3.8萬但在賴總統的眼中他覺得5萬很高他很羨慕他們可是護理師說這是他們不眠不休犧牲了很多生活品質家庭生活才換來的 |
| transcript.whisperx[90].start |
3381.51 |
| transcript.whisperx[90].end |
3405.95 |
| transcript.whisperx[90].text |
這邊簡單的數據不過相信部長你也知道嚴重性近期內有個調查針對五千多名的護理人員他發現說未來一年內離職大概有45%那年資在五年以下離職意向最高他們高達52%那現在這個新的世代的他不一定是因為薪水他可能還要兼顧工作環境有不友善還有他的工時高壓醫療糾紛等等 |
| transcript.whisperx[91].start |
3409.012 |
| transcript.whisperx[91].end |
3422.899 |
| transcript.whisperx[91].text |
這邊只是很簡短想要問石部長兩個問題您最近接受媒體的採訪你有提出好幾個解方包括調高住院的護理費啊或者是集中生護理費要再提升但是我針對其中兩個 |
| transcript.whisperx[92].start |
3424.8 |
| transcript.whisperx[92].end |
3430.823 |
| transcript.whisperx[92].text |
覺得非常的疑惑也是網路上很多人在討論的一個叫做住院整合照護計畫擴大你一口氣從五千要加到三萬三萬請問你現在的規劃人第一個人哪裡找第二你床哪裡來你的空間在哪裡你盤點過了嗎你可以告訴我們你初步盤點的狀況嗎 |
| transcript.whisperx[93].start |
3447.009 |
| transcript.whisperx[93].end |
3474.854 |
| transcript.whisperx[93].text |
我想要先替賴總統澄清那天的談話我在現場他主要是針對醫師的發言他不是說護理人員的薪水他很羨慕不是這樣他提的意思是說因為他一開始的志向是要從醫但是因為走入了政治之後那麼就放棄了從醫這一條路所以他是針對底下的這些醫師大家的同僚 |
| transcript.whisperx[94].start |
3477.975 |
| transcript.whisperx[94].end |
3497.423 |
| transcript.whisperx[94].text |
這個抒發 他很羨慕大家能夠繼續的統一的這個職責沒有 大家都歡迎他回來做臨床工作所以他不需要羨慕 他完全不需要羨慕你先回答這個住院整合照護計畫你一口氣從五千喊到三萬你到底盤點過嗎 你這個三萬是什麼根據來的嗎 |
| transcript.whisperx[95].start |
3501.178 |
| transcript.whisperx[95].end |
3528.419 |
| transcript.whisperx[95].text |
我想這個住院整合照護計畫是對於這個減輕護理人員的負荷是很有幫忙那麼因為現在的高齡化的關係住院的很多都是老人家那麼他需要一些生活的服務照護那麼如果沒有這些服務的話呢那通常這些工作就會轉嫁到護理人員的身上所以在過去呢我們已經推動了兩年效果很不錯 |
| transcript.whisperx[96].start |
3529.059 |
| transcript.whisperx[96].end |
3558.316 |
| transcript.whisperx[96].text |
那只不過又與預算的關係呢只能夠推動到5000床那現在呢5000床以去年我們編的5.6億來講已經用超過了所以我們才會在去年的這個預算裡編列的時候希望今年能夠擴大因為有很多醫院提出需求我們是根據提出的需求但是我們的預算只有那麼多才核定5000床事實上需求已經超過這是醫院提出來的所以我們是根據醫院所提出來 |
| transcript.whisperx[97].start |
3559.156 |
| transcript.whisperx[97].end |
3585.151 |
| transcript.whisperx[97].text |
希望開辦的那麼去規劃這樣加一加有三萬就對了但是你的造福源現在還有一個很大缺口根據不同的統計第一我先更新一下你一三年開始你是希望可以減少護理人員的流失可是護理師提供給我們的數據還是在流失這第一所以我不知道這個效果很好可能是局部有幫到忙還是怎麼樣再來呢當然是因為他的規模不夠嘛 |
| transcript.whisperx[98].start |
3586.031 |
| transcript.whisperx[98].end |
3596.935 |
| transcript.whisperx[98].text |
因為只有五千五千床而已規模不大我們現在一共的床數急性病床就七萬床教服員這個兩萬到六萬的缺口你如果沒有解決請問你這個三萬床要怎麼開出來我想因為我們這個三萬床剛剛提到這個是醫院提出說他可以 |
| transcript.whisperx[99].start |
3603.519 |
| transcript.whisperx[99].end |
3618.653 |
| transcript.whisperx[99].text |
他可以開辦的床數只是我們的預算不足以給他所以我們才會編列預算希望說那醫院既然他願意來開辦那我們就來提供預算所以只是這樣的一個好沒關係我們會每年再看一下您這個護理師的數據但是因為這個預算沒有審查 |
| transcript.whisperx[100].start |
3620.595 |
| transcript.whisperx[100].end |
3642.191 |
| transcript.whisperx[100].text |
所以沒有辦法執行我跟你說我們先看你還有一個叫做放寬護理師實習年限很多護理師在網路上討論說你要怎麼放寬護理師實習年限這件事情你有沒有初步的一個想法你是要怎麼放寬從本來是怎麼樣放寬到如何 |
| transcript.whisperx[101].start |
3643.12 |
| transcript.whisperx[101].end |
3666.064 |
| transcript.whisperx[101].text |
就是我們過去這個護理系畢業之後那麼他要考照所以我們給他一年多的時間那你要改成什麼樣在這個之前就是他如果願意繼續實習那他就可以繼續留下來然後在這個多久以內完成你說放寬嘛多久以內我們當然希望他考上嘛所以就是繼續這個時間的話我們要跟護理界討論 |
| transcript.whisperx[102].start |
3669.025 |
| transcript.whisperx[102].end |
3685.16 |
| transcript.whisperx[102].text |
所以你講出放寬護理師實習年限你還沒跟護理師討論喔我是說要放寬到多久還沒有定案但是這個方向上已經確定你什麼時候跟護理師團體開過會我一直都在開過會我知道我知道我是說什麼時候討論過放寬護理師實習年限上次就已經討論過了討論過了就朝這個方向 |
| transcript.whisperx[103].start |
3691.391 |
| transcript.whisperx[103].end |
3700.637 |
| transcript.whisperx[103].text |
但是你們總該有一個討論是幾到幾吧年限上還沒有確認但是你在會議上提的意見是多久我沒有提哪多久啊我只是說要放寬那對方提的呢因為現在跟護理師聽到的聲音好像不太一樣 |
| transcript.whisperx[104].start |
3713.322 |
| transcript.whisperx[104].end |
3730.414 |
| transcript.whisperx[104].text |
那哪裡不一樣我是說他們是反對有一些護理師團體他們覺得沒有被徵詢到意見另外他們也沒有很贊成放寬因為你應該是要提高留任的比例開源也很重要可是現在很多人是有護理師執照可是不願意執業嘛 |
| transcript.whisperx[105].start |
3732.249 |
| transcript.whisperx[105].end |
3751.797 |
| transcript.whisperx[105].text |
我想這個職業的考量因素很多啦那我們只是讓願意留在這個護理職場的包含這些實習生也是啊也給他機會啊我們可以跟你要一下這個會議記錄嗎你上次跟護理師團體討論然後裡面有包括方寬護理師我們一直有這個招募師也有在跟 |
| transcript.whisperx[106].start |
3752.711 |
| transcript.whisperx[106].end |
3755.852 |
| transcript.whisperx[106].text |
就很多在討論所以他們的意見是什麼就一句話就好了我們請我們這個關於護理的輔助能力這一塊其實是一個比較整體性的討論那有分一些層級那譬如說有護理師的是擔任護理師的工作那護理師我們現在有討論一個叫護理師助理那護理師助理就很像現行的有一個實習護士那這個實習護士就是沒有拿到證照的 |
| transcript.whisperx[107].start |
3780.277 |
| transcript.whisperx[107].end |
3783.759 |
| transcript.whisperx[107].text |
在護理師的督導之下那他現在可以有15個月那這兩個制度要怎麼做一個整合就是說他沒有考上的但是他不用就是說沒有工作但是他做的不是護理工作是護理的輔助工作謝謝最後只問一句話因為這個是之前跟 |
| transcript.whisperx[108].start |
3798.268 |
| transcript.whisperx[108].end |
3820.602 |
| transcript.whisperx[108].text |
邱太仁部長曾經討論過的,白班今天從我們這一屆立委上任陳建仁院長就答應了但當去年年初就已經陳建仁院長就答應了白班今天今年應該就是可以發出來了吧我們現在跟物理界的一個長期的討論是說我們在那個三班戶面筆的獎勵你一定要去顧及到要去白班,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員 |
| transcript.whisperx[109].start |
3822.977 |
| transcript.whisperx[109].end |
3846.952 |
| transcript.whisperx[109].text |
當時我問百般津貼但他回答是三班戶並比給獎勵所以最後我們到底會不會發百般津貼就這樣而已我們現在的規劃就是已經以這個達標獎勵那多數醫院都已經發給百般津貼了因為夜班已經有津貼了所以他們的達標獎勵款那多數就是發在這個百般的所以你的意思是說你們會改成用這個對達標獎勵 |
| transcript.whisperx[110].start |
3851.634 |
| transcript.whisperx[110].end |
3861.844 |
| transcript.whisperx[110].text |
達標獎勵來取代白斑津貼就我們不去明訂白斑津貼啦就是用護病筆的達標獎勵由醫院去發放他現在都是發放到白斑的身上好謝謝主席謝謝部長好謝謝謝謝陳清輝委員接下來我們請邱輝祿委員 |
| transcript.whisperx[111].start |
3883.939 |
| transcript.whisperx[111].end |
3905.9 |
| transcript.whisperx[111].text |
主席各位委員還有各位這個政府官員大家好那我其實想要針對石部長就是陳金輝委員諮詢那個石部長的部分做一個想法的分享第一件事情就是新進護士薪水真的沒有五萬有的話也只是極端值 |
| transcript.whisperx[112].start |
3907.621 |
| transcript.whisperx[112].end |
3925.229 |
| transcript.whisperx[112].text |
我想如果講新進護士薪水5萬我覺得完全是睜眼說瞎話這是第一點基層護理人員的心聲那第二個呢就是住院整合照護計畫當然我們要納入照服員但是請注意我們在112年的時候我們已經有密戶罪了 |
| transcript.whisperx[113].start |
3925.649 |
| transcript.whisperx[113].end |
3945.321 |
| transcript.whisperx[113].text |
那如果沒有取得護理人員資格的人來執行護理業務就會有密戶罪但是實際的臨床實務上造福源跟護理人員的業務範圍有一些模糊的空間那是誰創造這個模糊空間就是衛福部的函式衛福部的函式針對有些醫療輔助行為有些函式是 |
| transcript.whisperx[114].start |
3946.641 |
| transcript.whisperx[114].end |
3966.668 |
| transcript.whisperx[114].text |
指出要護理人員依據醫師的指示執行但是有些韓式又說照服員可以做這裡有一個模糊空間那我也希望住院整合照護計畫在執行的時候在推動的時候也能夠考慮到照服員跟護理人員之間的職業界限不是單純人力的問題我覺得法規完備也需要去處理這樣子 |
| transcript.whisperx[115].start |
3967.728 |
| transcript.whisperx[115].end |
3975.559 |
| transcript.whisperx[115].text |
好那現在呢第三點呢就是當然就回到我們的主題我們的主題今天我要有請那個衛福部部長 |
| transcript.whisperx[116].start |
3979.971 |
| transcript.whisperx[116].end |
4004.623 |
| transcript.whisperx[116].text |
今天我想要針對部長來就教一個問題就是偏遠地區家庭專科護理師執行醫療輔助行為的釋法性那我想我們都知道偏遠地區其實醫師的人力非常的缺乏所以為了照顧當地的居民去尋找醫師的輔助人力就顯得非常的重要也有這個必要性好那我們也看到衛福部這幾年非常積極的在推動 |
| transcript.whisperx[117].start |
4005.303 |
| transcript.whisperx[117].end |
4024.623 |
| transcript.whisperx[117].text |
家庭專科護理師制度那我想這個制度就是作為偏遠地區醫師輔助人力的一個來源的來源那我想這個方向當然我沒有反對但是有一些家庭專科護理師執行醫療輔助司法性問題值得探究那我想我這邊第一個問題就是 |
| transcript.whisperx[118].start |
4027.126 |
| transcript.whisperx[118].end |
4037.534 |
| transcript.whisperx[118].text |
請問一下家庭專科護理師根據預歷醫療流程來執行醫療輔助行為請問這個釋法性為何就是有沒有違法的疑慮 |
| transcript.whisperx[119].start |
4039.474 |
| transcript.whisperx[119].end |
4065.101 |
| transcript.whisperx[119].text |
我認為是沒有我們都有這個育立醫療流程的那個相關的規範的那個公告都有所以部長覺得家庭專科護理師依據育立醫療流程來執行醫療輔助行為沒有違法性的問題沒有問題好那我在想就是我們的中央主管機關的大家長就是衛福部然後就是部長你如果您都覺得這個問題沒有司法性的問題 |
| transcript.whisperx[120].start |
4066.021 |
| transcript.whisperx[120].end |
4083.488 |
| transcript.whisperx[120].text |
那我覺得醫療機構有可能無所適從而跟著一起違法了而不自知那為什麼因為部長你根本不覺得一個有違法性的一個情境他充滿違法的一個模糊地帶他充滿違法的一個空間 |
| transcript.whisperx[121].start |
4084.788 |
| transcript.whisperx[121].end |
4107.592 |
| transcript.whisperx[121].text |
我就現在一一的來跟部長說明為什麼家庭專科護理師依據預定醫療流程來執行醫療輔助行為其實是有違法的疑慮的那我們先從第一個階段開始說起我們專科護理師在執行醫療輔助行為要有法源那法源是什麼就是專科護理師你要執行醫療輔助行為的前提你要有醫師的指示 |
| transcript.whisperx[122].start |
4108.112 |
| transcript.whisperx[122].end |
4125.343 |
| transcript.whisperx[122].text |
沒有醫師的指示你執行的醫療輔助行為你就會觸犯民醫罪法源依據在護理人員法24條那這邊就提到說醫療輔助行為應該在醫師的指示之下行之好那接著呢我們來看一下為什麼醫師要指示專科護理師去執行醫療輔助行為舉例傷口的換藥為什麼醫師要這麼做 |
| transcript.whisperx[123].start |
4129.045 |
| transcript.whisperx[123].end |
4144.091 |
| transcript.whisperx[123].text |
情境是醫師他會評估病人的需求如果病人有傷口換藥的一個需要的話醫師就會指示專師去執行醫療輔助行為所以醫師他診察完病人之後他指示護理師 |
| transcript.whisperx[124].start |
4144.851 |
| transcript.whisperx[124].end |
4159.864 |
| transcript.whisperx[124].text |
去做醫療輔助行為這段的法源是來自於醫師法第11條的本文讓我們來讀一下本文醫師非親自檢查不得實行治療開給房企所以這段的法源依據在醫師法第11條那我們把這兩個階段合併起來組成一個專科護理師執行醫療輔助行為的三部曲第一部曲醫師會評估病人的需求病人有換藥的需求他 |
| transcript.whisperx[125].start |
4169.572 |
| transcript.whisperx[125].end |
4191.559 |
| transcript.whisperx[125].text |
醫師就會進行第二部曲的動作醫師會指示專科護理師去執行醫療輔助行為專科護理師會進行第三部曲的動作就是在醫師的指示之下會去執行醫療輔助行為那這是一般通常的情形但是我們來講情境B情境B就是有些偏遠地區因為在山之巔海之邊完全沒有醫師的醫療資源 |
| transcript.whisperx[126].start |
4193.2 |
| transcript.whisperx[126].end |
4211.833 |
| transcript.whisperx[126].text |
那如果專科護理師要去執行醫療輔助行為例如說傷口的換藥你要死守著我們剛講的專科護理師執行醫療輔助行為的三部曲的話你沒有醫師何來醫師的親自診查何來醫師的指示那專科護理師如何去執行醫療輔助行為所以這時候呢就給了一個解套的一個空間 |
| transcript.whisperx[127].start |
4212.734 |
| transcript.whisperx[127].end |
4228.033 |
| transcript.whisperx[127].text |
解到的空間就是醫師法第11條的但書這邊提到說如果是偏遠地區那醫師沒辦法親自診察沒有關係那可以用通訊的方式去取代醫師的親自診察那親自診察之後醫師還是要下指示還是要下遺囑給專科護理師去執行醫療輔助行為這是 |
| transcript.whisperx[128].start |
4230.976 |
| transcript.whisperx[128].end |
4257.665 |
| transcript.whisperx[128].text |
情境B那我們現在來看就是本席想請教部長的情境C請問一下專科護理師依據預歷醫療流程執行醫療輔助行為在這個情境當中到底有沒有法源因為我們情境A講的法源就護理人員法24條醫師法第11條情境B講的法源就是護理人員法24條還有那個醫師法第11條的單書那請問一下情境C法源在哪裡 |
| transcript.whisperx[129].start |
4259.326 |
| transcript.whisperx[129].end |
4273.497 |
| transcript.whisperx[129].text |
跟委員說明很佩服您對法規上的熟悉程度不過在護理人員即使不是專科護理師他在醫師的指示之下都可以執行醫療輔助行為 |
| transcript.whisperx[130].start |
4275.731 |
| transcript.whisperx[130].end |
4291.393 |
| transcript.whisperx[130].text |
那麼過去的指示包含了預歷我們在過去臨床上就有這個叫做臨床路徑那麼臨床路徑的就是一種預歷醫療流程的概念所以就是按照 |
| transcript.whisperx[131].start |
4291.893 |
| transcript.whisperx[131].end |
4304.736 |
| transcript.whisperx[131].text |
有一些的這個標準化的照顧模式下那麼醫師先下了這些這個預歷醫療流程或者是臨床入境由醫院所設計請問一下在那個處理的情境處理人員依照這樣的預歷醫療流程或臨床入境去執行並沒有違法之理但是你在打B你沒有掌握我的問題其實真的沒有掌握 |
| transcript.whisperx[132].start |
4316.858 |
| transcript.whisperx[132].end |
4329.273 |
| transcript.whisperx[132].text |
我們來看一下蔡淑鳳師長她怎麼來介紹專科護理師的一個職業範圍她說根據醫院的預立醫療流程醫師不在場的時候專科護理師可以執行低危險的醫療行為這當中你根據預立醫療流程在這個病床 |
| transcript.whisperx[133].start |
4332.977 |
| transcript.whisperx[133].end |
4361.416 |
| transcript.whisperx[133].text |
當下的這個情境其實醫師並沒有對病人去進行進行親自診察也沒有辦法指示專科護理師去執行所謂的預立醫療流程就是早在早在病人的情境發生之前你先把病人的一個情境先預立起來預立起來之後讓專科護理師根據預立醫療流程去執行但是你把這個流程拿到事發的當下去其實根本沒有醫師的診察來介入啊那沒有醫師的診察來介入那這樣不是違反醫師法第11條的規定嗎 |
| transcript.whisperx[134].start |
4362.937 |
| transcript.whisperx[134].end |
4377.421 |
| transcript.whisperx[134].text |
那我們來看一下家庭專科護理師的日常家庭專科護理師的日常這邊提到說他們就是按照預歷醫療流程來問診來做生品來執行超音波來執行心電圖這邊心電圖的執行超音波的執行這裡就充滿滿滿的醫療輔助行為的概念所以我還是要請問一下部長請問一下專科護理師依據預歷醫療流程來執行醫療輔助行為到底有沒有法權 |
| transcript.whisperx[135].start |
4390.384 |
| transcript.whisperx[135].end |
4408.051 |
| transcript.whisperx[135].text |
那你告訴我有法源是哪一條 你就告訴我有法源是哪一條醫療流程同樣的建築在緊急醫療救護法裡面的高級救護技術員緊急醫療救護法就是一個緊急醫療救護法是法律 立法院三途通過的法律但是護理人員所依據的醫療流程並沒有三途通過的法律真的不要硬拗了部長我告訴你這個問題全台灣沒有一個人比我更了解 |
| transcript.whisperx[136].start |
4415.094 |
| transcript.whisperx[136].end |
4437.188 |
| transcript.whisperx[136].text |
因為我研究這個問題已經研究十幾年了我真的可以告訴你專科護理師的職業範圍我一路跟著他們走到現在這件事就是沒有法源你講的緊急醫療救護法有法源就是規範在緊急醫療救護法但是專科護理師根據預歷醫療流程來執行這些醫療輔助業務就是沒有法源不要睜眼說瞎話就是沒有法源我很重要哪裡你指出來啊 |
| transcript.whisperx[137].start |
4440.089 |
| transcript.whisperx[137].end |
4462.18 |
| transcript.whisperx[137].text |
我都可以告訴你秦慶A的法源是醫師法第十一條護理人員法二十四條秦慶B的法源是十一條的單數護理人員法二十四條你告訴我秦慶西的法源在哪裡你告訴我啊你講不出來你現在就當著全國人民的面前告訴我們秦慶西的法源在哪裡就沒有為什麼我會這麼激動因為就沒有我研究了十幾年就沒有 |
| transcript.whisperx[138].start |
4463.66 |
| transcript.whisperx[138].end |
4488.553 |
| transcript.whisperx[138].text |
這個沒有真的就沒有請你告訴我法源在哪裡中華民國的法典六法全書打開請問是哪一條真的沒有法源不要睜眼說瞎話我希望針對這個沒有法源的問題這個法律漏洞的問題你們去填補家庭專科物理師有他推動的必要性我認同但是法源要完備因為法源如果不完備會有什麼問題會有命運罪的問題如果今天專科物理師也好護理人員也好 |
| transcript.whisperx[139].start |
4488.953 |
| transcript.whisperx[139].end |
4508.745 |
| transcript.whisperx[139].text |
他沒有在醫師的指示之下執行醫療輔助行為他會有密護罪你們如果要另辟蹊徑讓他們能夠根據預理醫療流程去執行醫療輔助行為請修法把這個法院的漏洞填補起來更何況你們今年今年積極推動了家庭專科護理師的育成居家護理所的示範計畫法院的依據好嗎 |
| transcript.whisperx[140].start |
4511.767 |
| transcript.whisperx[140].end |
4514.028 |
| transcript.whisperx[140].text |
而我們這個法案的依據是24條護理人員法的24條那第20條裡面就講專科護理師及第7條之一接受專科護理師訓練之後的這個專科護理師呢他可以在這個 |
| transcript.whisperx[141].start |
4527.355 |
| transcript.whisperx[141].end |
4533.836 |
| transcript.whisperx[141].text |
醫療監督下執行的醫療型業務我們有定這個辦法所以你覺得監督兩個字就是法源嗎那我們這個有一個辦法那辦法已經把專科護理師可以執行那個項目已經匡列出來好我告訴你第一你覺得監督兩個字不是你覺得監督兩個字就是等一下你覺得你讓我講你覺得監督兩個字就是法源請問監督的定義是什麼醫師所為的指示指導跟督促 |
| transcript.whisperx[142].start |
4557.02 |
| transcript.whisperx[142].end |
4573.113 |
| transcript.whisperx[142].text |
所謂的監督就是醫師所謂的指示指導跟督促請問一下這六個字當中有育立醫療流程的概念嗎好第二第二第二就算就算專科護理師與醫師監督下執行醫療業務辦法是一個法源好了是一個法源我們勉強認為他是一個法源他是一個法規命令 |
| transcript.whisperx[143].start |
4575.615 |
| transcript.whisperx[143].end |
4592.843 |
| transcript.whisperx[143].text |
法規命令如果抵觸一司法第十一條規定就會違法這是基本的common sense法律的ABC你抵觸的不是一司法第十一條的規定而已你還抵觸了一司法二十八條密罪的規定一司法二十八條密罪規定白紙黑字在這邊請詳讀那我接著講家庭專科護理師你們近年積極的這個推動那你們在事辦計畫裡頭呢 |
| transcript.whisperx[144].start |
4600.547 |
| transcript.whisperx[144].end |
4624.527 |
| transcript.whisperx[144].text |
要求呢居家護理所必須添設這些設備我覺得是應該的我覺得是必要的但是這些設備的添置就曝露出說居家護理所的專科護理師去居家勤進執行業務他其實就是滿滿醫療輔助行為的執行但是卻沒有法源你說的法源預立醫療流程根本沒有法源你講的那一條根本不是法源兩個辦法有魔法授權下的兩個辦法來來來一個來來來來來來來 |
| transcript.whisperx[145].start |
4628.15 |
| transcript.whisperx[145].end |
4639.101 |
| transcript.whisperx[145].text |
這個嘛 這個嘛 請問一下 這個哪裡 哪裡說 你告訴我哪裡說專科護理師依據預歷醫療流程可以執業 你告訴我 5678956789 我已經羅列出來了 五哪一條說專科護理師依據預歷醫療流程可以執業 五哪裡有 六 哪裡有 七 哪裡有 |
| transcript.whisperx[146].start |
4652.762 |
| transcript.whisperx[146].end |
4672.756 |
| transcript.whisperx[146].text |
哪裡有 有啦 第六條說根據育立醫療流程可以開立表單只有說根據育立醫療流程可以開立表單有說根據育立醫療流程可以執行醫療輔助行為嗎請不要睜眼說瞎話了 沒有法源 沒有法源就是沒有法源 你再硬繞一千次 還是沒有法源 |
| transcript.whisperx[147].start |
4675.798 |
| transcript.whisperx[147].end |
4692.388 |
| transcript.whisperx[147].text |
好請問何時能夠把這個法源填補起來法規不完備法律有漏洞請問何時能夠把這個法源其實就是修法補法源而已有這麼困難嗎有一些認知上的落差啦沒有認知上的落差沒有完備完全沒有完備 |
| transcript.whisperx[148].start |
4693.328 |
| transcript.whisperx[148].end |
4715.853 |
| transcript.whisperx[148].text |
我們過去執行這麼長的時間從來沒有發生過違規或者是法院的這些判決的事因為衛福部長就是完全欠缺法律的認知啊所以在你的眼裡看起來就是沒有違法的情勢啊但事實上就是欠缺法源你們完全指不出來法源我已經努力出來啊你說有兩部執法好來這部執法我已經努力出來56789請問哪裡告訴你專科護理師依據預理醫療流程可以執行醫療輔助行為 |
| transcript.whisperx[149].start |
4722.415 |
| transcript.whisperx[149].end |
4723.596 |
| transcript.whisperx[149].text |
請告訴我比如說這個你們就修法就好了嘛檢查檢驗這個本來就是醫師要開的已經授權了授權什麼這個第一條啊比如說非親入性的這些本來是醫師的範圍 |
| transcript.whisperx[150].start |
4742.625 |
| transcript.whisperx[150].end |
4763.283 |
| transcript.whisperx[150].text |
是低風險 受選之下是專科護理師的職業範圍根據副表一跟副表二可以執行40樣的醫療輔助行為問題是前提要有醫師的指示啊沒有醫師的指示你要按照醫療流程你就要有法源啊就是找不到法源 師長真的找不到法源專科護理師他有當然一個國際上跟 |
| transcript.whisperx[151].start |
4763.783 |
| transcript.whisperx[151].end |
4771.512 |
| transcript.whisperx[151].text |
大家在醫療照顧需求的講話是公平的所以這個我們法規已經完備了說起法院我講最後一件事情那個護士的實習要點其實也是行政規則如果你們要透過護士的 |
| transcript.whisperx[152].start |
4780.643 |
| transcript.whisperx[152].end |
4790.569 |
| transcript.whisperx[152].text |
的實習要點去擴展非具護理人員資格的人來臨床上執行業務的話那你們把這個法源放在行政規則裡頭我個人認為用行政規則的位階來處理這個事也抵觸了護理人員法的規定因為護理人員法說要取得證書的人才可以充護理人員但是你們現在讓不具護理人員資格的人就用你們的行政規則就可以在臨床上執業我就問一句嘛請問一下 |
| transcript.whisperx[153].start |
4809.68 |
| transcript.whisperx[153].end |
4826.389 |
| transcript.whisperx[153].text |
病人的安全你置於何地病人的安全沒有取得護理人員資格的人你讓他去執業請問病人安全置於何地你就只是因為人力荒你找不到人力你沒有辦法用這些留任的獎金的方式或者是用一些人力改善的方式你就用這種 |
| transcript.whisperx[154].start |
4827.529 |
| transcript.whisperx[154].end |
4845.584 |
| transcript.whisperx[154].text |
奇奇怪怪的方式去讓護理人員回流回流的不是合格的護理人員我相信這個基層護理人員是沒有人可以接受的你一來維持一定程的健康你二來貶低護理人員專業的價值沒有具備護理人員的資格就可以投入職場請問一下我們辛苦去考國考到底是為了什麼 |
| transcript.whisperx[155].start |
4850.008 |
| transcript.whisperx[155].end |
4875.644 |
| transcript.whisperx[155].text |
你如果用行政規則的方式去放寬非具護理人員資格人投入職場行政部本身衛福部本身就是帶頭違法其實衛福部帶頭違法的地方比比皆是我今天只是揭露一樣到兩樣而已好那再請這個衛福部呢能夠去這個填補漏洞給我們專科護理師一個完備的一個法律制度避免他們在命運罪的邊緣遊走好那 |
| transcript.whisperx[156].start |
4876.55 |
| transcript.whisperx[156].end |
4883.092 |
| transcript.whisperx[156].text |
以上說明謝謝好謝謝謝謝協和律委員謝謝部長接下來請黃秀芳委員謝謝主席我們請部長有請部長 |
| transcript.whisperx[157].start |
4902.377 |
| transcript.whisperx[157].end |
4917.129 |
| transcript.whisperx[157].text |
部長辛苦了我昨天跟呂次 呂次長有參加我們彰化縣長照這個社福大樓長照多功能的這個社福大樓的這個啟用那當然很多長輩對於我們的這個潛在基礎建設 |
| transcript.whisperx[158].start |
4920.471 |
| transcript.whisperx[158].end |
4931.275 |
| transcript.whisperx[158].text |
補助的長照大樓社福大樓都非常的滿意唯一不滿意的就是說它的空間還是有限可以容納的民眾還是有限想要進去的民眾他們後面 |
| transcript.whisperx[159].start |
4935.856 |
| transcript.whisperx[159].end |
4958.135 |
| transcript.whisperx[159].text |
就是要還要在後面排隊所以這個不論是在我們的這個多功能的這個大樓裡面或者是在社區這個關懷據點或者是長昭溪據點都有這樣的一個問題就是很多長輩他想要到這個社區就近的這個關懷據點或長昭據點那因為礙於空間的關係所以也都要排隊 |
| transcript.whisperx[160].start |
4958.955 |
| transcript.whisperx[160].end |
4965.8 |
| transcript.whisperx[160].text |
所以我不知道說未來部長針對這一部分可以怎麼樣再去做一些改善 |
| transcript.whisperx[161].start |
4968.458 |
| transcript.whisperx[161].end |
4995.628 |
| transcript.whisperx[161].text |
所以委員是說那個空間不夠是不是就是還有很多長輩想要進去嗎對啊而且現在的社區社區的那個社區自己經營的關懷據點也好或者是長照西據點那空間真的都非常的小有的就是就近有一些公共的這個場域那這個場域可能只能容納二三十個人那也許這個社區還有很多長輩 |
| transcript.whisperx[162].start |
4996.528 |
| transcript.whisperx[162].end |
5011.701 |
| transcript.whisperx[162].text |
他想要進來可是礙於空間的關係就是沒辦法所以我覺得說未來是不是有可能每個社區可以再多增加一個點不知道可不可以朝這個方向去努力就是我們再來 |
| transcript.whisperx[163].start |
5013.042 |
| transcript.whisperx[163].end |
5034.54 |
| transcript.whisperx[163].text |
這個了解一下 如果是這個需求上還不夠這個容量還不夠的話 那也許我們也可以來研究看看現在有一些閒置的公共空間 看如何來這個轉型讓這個長輩呢 他希望的活動的空間能夠有我覺得這個委員的建議我們來調查一下 |
| transcript.whisperx[164].start |
5037.582 |
| transcript.whisperx[164].end |
5063.308 |
| transcript.whisperx[164].text |
確實有這樣的一個需求我們一開始是以一鄉鎮一個長照開始做設計然後開始再進步到說以一個學區所以我們也是一步一步在一直在長資源那如果現在到每一個學區都有了但是這個空間不夠太小那要多設一個我們來研究看看調查一下看哪些地方有這樣的需求 |
| transcript.whisperx[165].start |
5064.909 |
| transcript.whisperx[165].end |
5090.911 |
| transcript.whisperx[165].text |
謝謝謝謝部長接下來我想請教就是在2024年監委那個王又嶺監委有針對衛福部的這個長照2.0有做一些調查報告那當時有特別提到就是說我們的這個縣市的住宿市機構還有失智的這個照護資源供應供給不足那接下來就是說我們也看到這個長照的服務的目標 |
| transcript.whisperx[166].start |
5091.731 |
| transcript.whisperx[166].end |
5115.635 |
| transcript.whisperx[166].text |
群體推估參數衛福實況那我們看到就是說在長照2.0可能我們比較著重在輕度跟中度的這個族群那反而是重度的這個族群長輩可能這個資源比較不夠那我們也期待就是說2026年的這個長照3.0針對這個重度的這些群組是不是可以再加強 |
| transcript.whisperx[167].start |
5116.815 |
| transcript.whisperx[167].end |
5134.366 |
| transcript.whisperx[167].text |
給更多的一個資源而且我覺得說這些重度的這個民眾這個家庭更需要政府的資源因為有一些他可能也許需要我們的這個這個造福的這個資源可是他可能 |
| transcript.whisperx[168].start |
5135.507 |
| transcript.whisperx[168].end |
5152.333 |
| transcript.whisperx[168].text |
有一些這個資源不是可以這麼到位所以我希望就是說針對這個長照3.0已經開始那這些針對重度的這些長輩或者有需求的這些重度的民眾那是不是政府的資源能夠更加的投入 |
| transcript.whisperx[169].start |
5153.493 |
| transcript.whisperx[169].end |
5171.82 |
| transcript.whisperx[169].text |
跟委員大概說明一下確實我們剛剛有提到我們現在長照使用對象裡面大概只有兩層是重度者所以對於這個重度的他的這個長照因為大概就兩個地方一個是素素是機構那另外一個就是居家他只能大概是這兩個 |
| transcript.whisperx[170].start |
5173.18 |
| transcript.whisperx[170].end |
5196.552 |
| transcript.whisperx[170].text |
重度這個住宿室的話我們現在看起來是這樣整體的量是夠但是有區域不平衡的問題像有些區域上的就比較難長出這個住宿室機構所以這個我們會繼續來努力另外也去這個我們可能接下來會朝向去提高這個住宿型機構的補助然後也減輕民眾的負擔也鼓勵有這樣的機構可以長出 |
| transcript.whisperx[171].start |
5198.473 |
| transcript.whisperx[171].end |
5226.427 |
| transcript.whisperx[171].text |
那第二個就是去強化那個重度居家的長照服務希望看能不能夠優先讓這些長照重度的家庭能夠用到比較多的居家重度的通常跟醫療的需求也會有所以強化居家的醫療跟長照的結合這也是另外在長照3.0裡面特別需要去強化包含夜間跟假日期間的這些重度 |
| transcript.whisperx[172].start |
5227.367 |
| transcript.whisperx[172].end |
5249.251 |
| transcript.whisperx[172].text |
我希望未來我們長照3.0應該是針對重度的這個部分應該要再加強另外部長我想請教就是說我最近接到一個個案就是一個96歲的一個阿嬤她原本身體狀況都非常的好頭腦也很清楚四肢也都很靈活可能長輩其實96歲其實身體狀況急轉直下她原本是獨居 |
| transcript.whisperx[173].start |
5255.872 |
| transcript.whisperx[173].end |
5273.862 |
| transcript.whisperx[173].text |
家裡面的人原本他的小孩就沒有住在一起這個長輩他自己生活自己都還OK那現在身體狀況可能有一些就是有一點點狀況那他的小孩想說要幫他申請這個長照幫他煮一個中餐 |
| transcript.whisperx[174].start |
5275.44 |
| transcript.whisperx[174].end |
5296.316 |
| transcript.whisperx[174].text |
那我們的照管人員是不是會去家裡面去評估通常是這樣子嘛 對不對就是會去家裡面去做評估那評估是不會過 但是沒過啦評估之後是沒有過因為這個照管人員說這個阿嬤頭腦清楚 四肢靈活她自己還可以煮飯那所以這個有一個狀況 |
| transcript.whisperx[175].start |
5301.451 |
| transcript.whisperx[175].end |
5322.479 |
| transcript.whisperx[175].text |
後來他們就說可是這個阿嬤身體狀況是一天一天就是不是那麼好所以他們還是希望希望能夠請到這個幫他這個我們的服務然後幫他煮個中餐這樣子那就有人就教他就是說如果照管人員來這個跟你做訪問的時候要記一下啦 |
| transcript.whisperx[176].start |
5325.899 |
| transcript.whisperx[176].end |
5355.619 |
| transcript.whisperx[176].text |
要記一下 保證你會知道嗎如果他原本可能四肢很靈活可以走路的你就記一下 記說你沒辦法走路他問你 他問A你就答B所以我會覺得說有必要這樣子嗎就是說如果這個阿嬤96歲那身體狀況確實就是不如以前那有必要叫阿嬤就是說你記一下這個照管人員來訪問的時候你就假裝一下我覺得沒必要這樣子吧 |
| transcript.whisperx[177].start |
5356.019 |
| transcript.whisperx[177].end |
5376.573 |
| transcript.whisperx[177].text |
部長針對這個個案你會如果是你的話你會怎麼處理這個跟委員在確認您說的這個是一個那個獨居的長者是不是他的小孩沒有跟他住一起沒有住一起嘛所以這個現在是符合我們那個獨老我們現在有兩塊一個是這個長照針對主要是失能者的照顧 |
| transcript.whisperx[178].start |
5377.373 |
| transcript.whisperx[178].end |
5395.554 |
| transcript.whisperx[178].text |
另外在長者的社區服務的部分我們現在有一個獨老計畫在推動也就是今年開始會做送餐會有送餐的服務如果他不到私能沒有落入到長照服務對象但是他又獨居 |
| transcript.whisperx[179].start |
5396.575 |
| transcript.whisperx[179].end |
5415.929 |
| transcript.whisperx[179].text |
小孩沒有住一起這個就落入我們的獨老定義那過去我們的獨老服務是先針對中低收入戶而已就是比較弱勢的但是今年開始因為我們有特別預算預注了62億所以我們會專門發展所有的65歲以上的獨老者我們都希望納入到我們的服務範圍 |
| transcript.whisperx[180].start |
5417.41 |
| transcript.whisperx[180].end |
5435.912 |
| transcript.whisperx[180].text |
那優先會從75歲以上開始所以剛剛這90幾歲的阿嬤這個應該很快就會得到我們的照顧好我希望是如此不需要去假裝沒有假裝說他身體可能有非常嚴重或者是他答不出來我覺得有時候 |
| transcript.whisperx[181].start |
5436.713 |
| transcript.whisperx[181].end |
5455.143 |
| transcript.whisperx[181].text |
可能有這個需求那如果都已經九十幾歲了其實我覺得確實可以應該可以得到我們政府一個比較好的一個照顧啦所以部長把這個最基層的這個問題跟你講就是說在基層會碰到這樣的一個狀況也讓你知道因為我們現在優先是針對75歲以上的長者先去關懷房事 |
| transcript.whisperx[182].start |
5463.448 |
| transcript.whisperx[182].end |
5477.486 |
| transcript.whisperx[182].text |
然後關懷訪視之後就會去做評估看看他的需求是什麼然後再去連接後續看看是送餐服務啦還是關懷啦還是需要緊急救援裝置啦對這些獨居的長者這是我們的重點 |
| transcript.whisperx[183].start |
5478.447 |
| transcript.whisperx[183].end |
5496.504 |
| transcript.whisperx[183].text |
那接下來我想請教就是說部長你知道賴總統在上個月有特色一位也是阿嬤了90幾歲那他也照顧他的小孩50幾年所以我們就可以看到就是說長照這個部分針對重度 |
| transcript.whisperx[184].start |
5498.005 |
| transcript.whisperx[184].end |
5523.118 |
| transcript.whisperx[184].text |
針對重度的這個家庭確實需要政府更多的一個資源來協助那避免會有這樣的一個長照杯葛所以我想請教部長針對這部分那未來你們怎麼再去做一個篩檢剛剛有特別提到重度的這個家庭他可能進到這個長照可能就只有兩成左右那其他的部分你們要怎麼再去做一個篩檢就是說這些 |
| transcript.whisperx[185].start |
5525.499 |
| transcript.whisperx[185].end |
5540.688 |
| transcript.whisperx[185].text |
主動篩檢那高負荷的這個家庭是不是要優先趕快來協助對 這個個案真的是很遺憾那所以我們也檢討強化了我們在這個社安網裡面的出篩啦 |
| transcript.whisperx[186].start |
5541.548 |
| transcript.whisperx[186].end |
5558.702 |
| transcript.whisperx[186].text |
這些社安網裡面的服務人員網絡人員我們去強化他們的這個教育訓練去能夠極少的去辨識這個高負荷高風險的這些家庭照顧者然後導入資源因為我們現在在長照3.0裡面也是要在更多元的 |
| transcript.whisperx[187].start |
5559.302 |
| transcript.whisperx[187].end |
5585.332 |
| transcript.whisperx[187].text |
這個家庭照顧者的支持方案包含這個據點還有這個服務的內容包含喘息或專業服務的教導等等這一些那麼特別是那個喘息服務那個導入進去我想會朝這幾個方向來做最重要就是我們會從那個初篩裡面去強化能夠早一點察覺到這一些個案我希望就是說主動篩檢 |
| transcript.whisperx[188].start |
5587.193 |
| transcript.whisperx[188].end |
5603.248 |
| transcript.whisperx[188].text |
不是市衛福部或地方政府大家就是主動篩檢那找出這個高負荷的這個家庭因為確實如果長期這樣照顧確實真的壓力還蠻大的而且經濟應該我覺得都會出問題對啊好麻煩謝謝謝謝黃委員謝謝黃學光委員接下來請邱振軍委員 |
| transcript.whisperx[189].start |
5618.325 |
| transcript.whisperx[189].end |
5619.976 |
| transcript.whisperx[189].text |
主席好啊我們請石部長請石部長 |
| transcript.whisperx[190].start |
5624.625 |
| transcript.whisperx[190].end |
5647.154 |
| transcript.whisperx[190].text |
主委好部長好我看你們今天這個報告講了很多那有做什麼但我看完只有一個感覺你們現在是在講投入不是在講結果那我想今天招委特別安排這個案子就是希望我們要誠實面對偏鄉跟原鄉醫療的這個還有我們長照的結構性問題那今天談偏鄉醫療我就用苗栗的現況來說 |
| transcript.whisperx[191].start |
5648.755 |
| transcript.whisperx[191].end |
5673.44 |
| transcript.whisperx[191].text |
南莊、三灣、斯坦、泰安是四個鄉鎮有三個共同的問題就是偏遠、高齡、醫療可進性不足泰安鄉更是我們原住民鄉鎮也是你們原住民健康法應該最優先照顧的地方我先講幾個事實泰安鄉是僅僅醫療資源不足的地區醫療高度依賴這個IDS的計畫來支撐 |
| transcript.whisperx[192].start |
5676.241 |
| transcript.whisperx[192].end |
5698.41 |
| transcript.whisperx[192].text |
目前多數居民就醫需要跨鄉鎮到頭份或苗栗市甚至跑到台中去那你們的報告裡面說IDS一年服務幾十萬人次那我請教部長這幾十萬人次裡面有多少比例是夜間急診有多少是成功及時處理還是絕大部分都只是拿這個慢性病的這個門診 |
| transcript.whisperx[193].start |
5701.377 |
| transcript.whisperx[193].end |
5715.83 |
| transcript.whisperx[193].text |
在IDS還有這個醫事室也有一些這個醫療站的補助或者是那個急救責任醫院的補助裡面他就包含了夜間跟假日的緊急醫療服務詳細的數字我們在提供給委員 |
| transcript.whisperx[194].start |
5718.972 |
| transcript.whisperx[194].end |
5736.736 |
| transcript.whisperx[194].text |
在泰安這個地方我們這個也是用公務預算去補助應該是大千醫院去承接的那個我不希望看到這個是很好的一個數字我們需要了解是說我們這個計畫到底有救了多少人這個才是重點對不對 |
| transcript.whisperx[195].start |
5738.937 |
| transcript.whisperx[195].end |
5762.133 |
| transcript.whisperx[195].text |
那另外我們醫療這個偏鄉醫療的主要問題就是距離嘛那再來看南江山灣跟斯坦那他到頭份我們要意識大概車程大概至少要45分鐘到一個小時以上那對高齡者來說這不是距離是門檻那你們有沒有統計過平均就醫這個的交通時間偏鄉居民每年自費的交通成本是多少 |
| transcript.whisperx[196].start |
5763.314 |
| transcript.whisperx[196].end |
5791.584 |
| transcript.whisperx[196].text |
有沒有去了解過這個好像我們就沒有這個方面的數字好那你說我們有培養醫師嘛有補助那我再問一個最直接的就是這四個鄉鎮有多少是常駐專科醫師心臟內科有幾位急診醫師有幾位這個我們查一下之後再提供給委員對不對所以我覺得這個應該是我覺得數字應該是不好看那這代表你們政策只是培養人不是留下人 |
| transcript.whisperx[197].start |
5792.56 |
| transcript.whisperx[197].end |
5814.072 |
| transcript.whisperx[197].text |
你培養了人之後他們可能過來有一些的誘因那他達到目的之後他就走了啊對不對所以我們就整個這個你們就一直要去循環這個甚至沒有人來那原住民這個民族的健康法是要縮短這個醫療的落差健康的落差那但現在我們看到的現實是 |
| transcript.whisperx[198].start |
5815.353 |
| transcript.whisperx[198].end |
5838.94 |
| transcript.whisperx[198].text |
集中症要外送醫療靠巡迴體系是沒有建立的那這樣的醫療條件有縮短我覺得這只是一個口號而已嘛那原住民第二這個健康法的第二條明文規定中央主管機關應指定專責單位辦理那原住民的民族健康事務是遊衛福部這個專責單位到底是誰 |
| transcript.whisperx[199].start |
5841.781 |
| transcript.whisperx[199].end |
5863.573 |
| transcript.whisperx[199].text |
有嗎有是誰跟委員說明一下就是說我們在推動這個這個原鄉的這個醫療確實在苗栗來講就這個每10萬人口的醫師數也好或者病常數也好當然是相對那真正負責任的是誰所以我們要把它再提高那原住民族的這個健康 |
| transcript.whisperx[200].start |
5864.714 |
| transcript.whisperx[200].end |
5885.934 |
| transcript.whisperx[200].text |
這個餘命的落差其實有在縮短啦103年的時候大概落差10歲啦那現在113年的統計是落差大概7歲所以這個有在縮短中有在努力縮短中那至於這個專責單位啊我們現在在我們這個部內呢就是這個護理及健康照護師裡面有特別的這個3D理導課在負責 |
| transcript.whisperx[201].start |
5888.737 |
| transcript.whisperx[201].end |
5904.138 |
| transcript.whisperx[201].text |
那醫事是管這個IDS計畫嘛對不對IDS是健保的計畫對健保的嘛那護理及健康照護是這個長照3.0的嘛國際醫術是管這個原住民健康促進計畫 |
| transcript.whisperx[202].start |
5905.279 |
| transcript.whisperx[202].end |
5924.799 |
| transcript.whisperx[202].text |
那部長你本人雖是這個原住民族健康政策會的召集人他只是一個諮詢單位不是執行單位嘛那現在我在看有沒有一個人一個專責的人在負責這個我有專責的他現在就是在這個叫做這個照務這個護理及健康照務室裡面 |
| transcript.whisperx[203].start |
5925.58 |
| transcript.whisperx[203].end |
5943.505 |
| transcript.whisperx[203].text |
那我們會希望讓這個師能夠扮演更多這個原住民族健康的這個政策的這個任務當然執行面的話需要跨師署的合作政策的部分我們有智庫在設置在這個國衛院裡面的原住民族健康的研究 |
| transcript.whisperx[204].start |
5944.525 |
| transcript.whisperx[204].end |
5947.451 |
| transcript.whisperx[204].text |
那什麼時候 有沒有一個具體時間我們現在在進行這個主改 那麼這個組織法也已經在這個他不是已經有法律了嗎 |
| transcript.whisperx[205].start |
5957.588 |
| transcript.whisperx[205].end |
5981.535 |
| transcript.whisperx[205].text |
不是有這條法案有有有 那像我們在調整在組織法調整的過程當中去強化應該在這個配合這個立法院的這個我們組織法的修訂的你送了嗎已經送了 已經在那個司法法制這個聯席會議上已經審完出了委員會那這個後續就是等這個協商我希望這個盡快啦 好不好 盡快落實 |
| transcript.whisperx[206].start |
5982.595 |
| transcript.whisperx[206].end |
5998.911 |
| transcript.whisperx[206].text |
那接下來部長我再請問你食藥署蔡淑珍副署長在關稅協定簽訂之後公開表示針對美牛絞肉內臟跟降低這個萊劑標準的重新評估那重啟評估是因為為了應驗台美關稅協定這個證明就是說這項作業的出發點是經貿補償而不是國人飲食習慣改變我說的沒錯吧我們在調整這個是這個嗎 |
| transcript.whisperx[207].start |
6007.689 |
| transcript.whisperx[207].end |
6026.968 |
| transcript.whisperx[207].text |
應該是說在我們這一次重新再調整這個相關的規範主要是跟國際接軌那麼參考了這個國際的標準然後再重新計算我們過去的計算公式上不同的有沒有因應是不是因為這個關稅的問題來調整 |
| transcript.whisperx[208].start |
6030.353 |
| transcript.whisperx[208].end |
6036.695 |
| transcript.whisperx[208].text |
這個本來就在我們的這個期程裡頭在進行所以這個到底國際的結果是怎樣那依照食安法我們衛福部有責任這個台灣人愛吃內臟的習慣嘛別的國家是沒有不太吃這個所以我們是不是應該進行獨立評估既然風險存在那這個 |
| transcript.whisperx[209].start |
6052.739 |
| transcript.whisperx[209].end |
6078.174 |
| transcript.whisperx[209].text |
你現在說不是因為這個關稅的問題那你為什麼不選擇對國人最安全的現行標準那跟委員說明確實如您提到的這個內臟的部分我們有獨立的評估就是說按照這個CODES的這個殘留標準然後在國人的飲食習慣上去做推估來驗證它是不是安全所以你不會去照國際標準就對了你會甚至比國際標準更嚴格嗎 |
| transcript.whisperx[210].start |
6081.079 |
| transcript.whisperx[210].end |
6103.774 |
| transcript.whisperx[210].text |
我們現在是按照國際標準來做驗證那看看國人的習慣上會不會超出這個標準那看起來是OK所以我們就可以對齊國際標準所以你認為是我們台灣國人的飲食習慣喜歡吃內臟所以內臟的部分它是符合國際標準的對那我們之前限定的標準為什麼要限這麼低 |
| transcript.whisperx[211].start |
6105.295 |
| transcript.whisperx[211].end |
6121.528 |
| transcript.whisperx[211].text |
當時候的計算方式假設的不同假設條件不同那現在假設是什麼現在假設的條件調整之後就是說你不太可能這個比如說以這個腎跟肝來講你不會同時一天都到同樣的最高劑量 |
| transcript.whisperx[212].start |
6122.662 |
| transcript.whisperx[212].end |
6143.191 |
| transcript.whisperx[212].text |
那個是會有互相取代性的你不會同時吃這麼多所以我覺得那個設置那個設定的條件不一樣就是說既然是你不想你這樣講我認為為了國人的健康我希望你把嚴格這個標準從嚴來認定你不要用這個國際的最低標準來認定是的好不好一定是國人的健康優先 |
| transcript.whisperx[213].start |
6143.951 |
| transcript.whisperx[213].end |
6172.501 |
| transcript.whisperx[213].text |
那再來我再問就是我們部立苗栗醫院跟這個我們台中榮總在去年11月4號這個簽署這個醫療NOU當時的這個色目標很清楚是要補足苗栗專科人力與急重症的這個量能嘛那目前請問一下目前中榮實際派駐部苗的醫師人數是多少實際上的人數我要再確認一下再跟委員這個回報部長就沒有關係苗栗啊 |
| transcript.whisperx[214].start |
6173.958 |
| transcript.whisperx[214].end |
6191.779 |
| transcript.whisperx[214].text |
一直在關心那是多少人力哪些專科每週急診那是固定派駐還是支援性這個輪診對不對是部長我們來聊一下之後還是要到高梅莉再走一走好我去看看 |
| transcript.whisperx[215].start |
6192.399 |
| transcript.whisperx[215].end |
6207.706 |
| transcript.whisperx[215].text |
對啊那我跟你講啦目前據我所知他現在醫師好像還沒有開始派所以這部分啦不要說這個NOU簽了之後好像只是一個形式上那我們希望更盡快來落實這個部分 |
| transcript.whisperx[216].start |
6208.346 |
| transcript.whisperx[216].end |
6226.414 |
| transcript.whisperx[216].text |
那當然我也希望部長來做媒介啦不單單只是這個中榮其他的各大醫療院所也可以請部長來協助為我們苗栗這個醫療能夠增加一些這個量能增加一些專科的醫師這樣好嗎好那另外最後一個問題最後一個問題就是我們 |
| transcript.whisperx[217].start |
6228.955 |
| transcript.whisperx[217].end |
6245.826 |
| transcript.whisperx[217].text |
布苗嘛 我聽到我們院長前陣子有到苗栗去就是說我們這個集中跟大樓的栽標在2026年4月就要開始那6月要動工 這個有確定嗎這個已經核定了核定了 你確定要標的出去 |
| transcript.whisperx[218].start |
6248.154 |
| transcript.whisperx[218].end |
6261.225 |
| transcript.whisperx[218].text |
上次流標20次耶所以你們的金額到底有沒有有調整那萬一再標不出去你們怎麼辦再放個10年沒有沒有一定要讓他所以是不是有沒有這個我問三個問題啦照片如果流標有沒有備案 |
| transcript.whisperx[219].start |
6267.655 |
| transcript.whisperx[219].end |
6292.717 |
| transcript.whisperx[219].text |
因為我們已經重新調整這個標案的內容應該是可以那萬一預算不夠我們有提高預算的準備嗎對有嘛我們就是要讓它做成好那這個供期如果延誤我們目前有沒有什麼一個替代的醫療的這個量能的這個備案我們不希望它延誤我們希望讓它按照這個期程進行萬一勒 |
| transcript.whisperx[220].start |
6294.022 |
| transcript.whisperx[220].end |
6318.959 |
| transcript.whisperx[220].text |
不要有外遇 從2010年講到現在2010年就啟動這個案子一直到2021年重新再啟動一次所以已經你看16年了對不對 人生有幾個16年這16年有多少遺憾你知道嗎是是 我們這一次有絕對的決心要把這個事情完成好啦 部長您應該多關心一下苗栗好不好好 謝謝部長 謝謝謝謝邱委員 謝謝邱正軍委員 |
| transcript.whisperx[221].start |
6322.984 |
| transcript.whisperx[221].end |
6342.483 |
| transcript.whisperx[221].text |
在此宣告待會六個響委員質詢完畢後休息十分鐘現在請蘇慶泉委員發言好謝謝主席我請部長跟國建署署長請市部長請 |
| transcript.whisperx[222].start |
6344.72 |
| transcript.whisperx[222].end |
6364.727 |
| transcript.whisperx[222].text |
主委好,柏柳,現在新來的這個委員一個比一個還要堅持,看你要怎麼辦。要看委員拜託。我先剛剛講的那個專科副理事,我要這邊補充一下。 |
| transcript.whisperx[223].start |
6365.848 |
| transcript.whisperx[223].end |
6375.254 |
| transcript.whisperx[223].text |
那個在第八屆的時候改的就改婦理人權法本來要立一個專章或是一個專法結果不可行啦 |
| transcript.whisperx[224].start |
6376.175 |
| transcript.whisperx[224].end |
6399.313 |
| transcript.whisperx[224].text |
那現在後來就改婦理人員法就改兩三條所以那個時候就改兩三條之後就從負面表列變成正面表列那婦理 專科婦理是很高興他們就這十幾年來走得很好啊現在要做專法 |
| transcript.whisperx[225].start |
6401.877 |
| transcript.whisperx[225].end |
6426.93 |
| transcript.whisperx[225].text |
我想是不太可能,邱委員該檢視,我看他,常委員有沒有討論我是說最多是專章,用一個專章還是說處理這件法來修,修得更完善一點也是一個方法所以讀到這你的頭痛好,我們今天要講那個原住民法,原住民醫療法 |
| transcript.whisperx[226].start |
6427.97 |
| transcript.whisperx[226].end |
6437.693 |
| transcript.whisperx[226].text |
我們原住民的平靜壽命,我們盧宣毅主席一直在關心,就是說他這樣...你收起來,你也收起來,你也上來我國電室的... |
| transcript.whisperx[227].start |
6445.745 |
| transcript.whisperx[227].end |
6460.413 |
| transcript.whisperx[227].text |
他們的VC肝啊什麼的都沒有進步啊他們的原住民平均壽命比我們平地少了7歲多嘛那這7歲多到底現在第一有沒有改善啊那你們到底做什麼 |
| transcript.whisperx[228].start |
6463.047 |
| transcript.whisperx[228].end |
6476.139 |
| transcript.whisperx[228].text |
其實跟委員說明我們真的是很努力在縮短那如果比較其他的國家的落差其實我們做的不會太差啦當然這中間還有很多需要 |
| transcript.whisperx[229].start |
6478.041 |
| transcript.whisperx[229].end |
6497.038 |
| transcript.whisperx[229].text |
跟紐西蘭的原民、澳洲、美國這裡有原住民的國家來相比這個落差我們做的是還好啦但是當然還是應該要更努力的來縮短這中間當然從幾個原因嘛從它的死因分布 |
| transcript.whisperx[230].start |
6498.579 |
| transcript.whisperx[230].end |
6522.862 |
| transcript.whisperx[230].text |
我們一般國人的這個死因的這個ranking來看有幾個比較不同的地方第一個是癌症的這個分佈會不太一樣第二個是這個交通事故意外傷害這個在國人死因都是在5名以外但是在原鄉地區是比較高的所以這個事故傷害這個是比較高 |
| transcript.whisperx[231].start |
6524.202 |
| transcript.whisperx[231].end |
6546.722 |
| transcript.whisperx[231].text |
在癌症的裡面也可以看得到他的口腔癌跟肝癌的比例也是比較高所以他的確實有跟一般不一樣所以我們才需要去成立專責的研究單位我們在國衛院裡面那麼去國衛院做什麼 你老婆做什麼你們到底有做什麼事啊 |
| transcript.whisperx[232].start |
6549.98 |
| transcript.whisperx[232].end |
6574.804 |
| transcript.whisperx[232].text |
國內做很多事情那就這個援助民族健康的部分第一個最重要就是建立它的資料庫健康資料庫這個是最重要把這個援助民的相關的疾病的型態還有它的流行病學把它建立起來所以前幾年都在大概建這個資料庫我們主席主席魏延湘就公共衛生所主任都在幾十人都在拚這個 |
| transcript.whisperx[233].start |
6579.206 |
| transcript.whisperx[233].end |
6604.964 |
| transcript.whisperx[233].text |
他長期服務偏鄉啦 跟蘇爾園一樣啦平地的那些感染啊 鼻屍肝啊 酗酒的這個還有一些感染症 事實上平地已經已經比較少了 像膝肝已經排除了那原住民這邊 因為肝病的死亡還是偏高嘛國健署你到底有做什麼 我問你到底有做什麼 |
| transcript.whisperx[234].start |
6607.654 |
| transcript.whisperx[234].end |
6623.87 |
| transcript.whisperx[234].text |
報告委員其實我們原住民的BC肝篩檢的涵蓋率其實是高於全國的平均我們的涵蓋率大概是75%然後全國是61%那我們原住民的慢性肝病跟肝硬化的標準死亡率其實也從111年的每10萬人口52.1下降到112年的39.5 |
| transcript.whisperx[235].start |
6629.395 |
| transcript.whisperx[235].end |
6647.712 |
| transcript.whisperx[235].text |
所以其實在整個照顧上篩檢然後跟整個標準化死亡率其實都有在進步當中那我們也會再持續關注原住民區相關的醫療照顧服務屏東有八個原鄉 也算台灣最多的那譬如說從牡丹不要只講牡丹玩很好玩 牡丹那邊生病 |
| transcript.whisperx[236].start |
6654.724 |
| transcript.whisperx[236].end |
6670.657 |
| transcript.whisperx[236].text |
到東港安泰要96分鐘96分鐘那你們台北市的居民不舒服6分鐘就可以到達你想要就醫的地方一天一天的救這麼多 |
| transcript.whisperx[237].start |
6671.843 |
| transcript.whisperx[237].end |
6685.96 |
| transcript.whisperx[237].text |
所以那個事實上,我都解決了,它的路程就是這樣所以,這個交通跟這個時間是第一個天然的障礙這個保證你有什麼想法嗎? |
| transcript.whisperx[238].start |
6688.303 |
| transcript.whisperx[238].end |
6710.82 |
| transcript.whisperx[238].text |
你很不可以說這樣繼續下去,不是這樣,繼續沒進步啦屏東是這樣就是因為屏東很狹長,真的很長的,從南到北那資源多數集中在屏北啦,靠屏東是這樣資源多數集中在屏北,所以屏南確實是一個比較資源 |
| transcript.whisperx[239].start |
6713.021 |
| transcript.whisperx[239].end |
6735.506 |
| transcript.whisperx[239].text |
少的地方 三個主要醫院我們一直在挹注希望大家用分工合作的方式 區域聯訪主要的南門醫院 恆春基督教醫院跟我們自己的部立醫院所以南門醫院讓它主要發展在外科為主這個基督教醫院我們就主要讓它在內兒科的部分內科的部分 |
| transcript.whisperx[240].start |
6738.727 |
| transcript.whisperx[240].end |
6765.067 |
| transcript.whisperx[240].text |
這個心血管我們現在在我們的恆春醫院也要設心導管很認真 做心導管嘛 跟你合作的嘛心導管嘛另外再上來一點我們在那個訪療 也是所以我們一路希望用接力式的都是有一些責任醫院來提升這個救命的服務用接力式的方式來 |
| transcript.whisperx[241].start |
6766.488 |
| transcript.whisperx[241].end |
6784.726 |
| transcript.whisperx[241].text |
還有他的衛生所衛生所的配備還好但是如果那個什麼診療站就分的診療站那個設備就很簡陋了對那一直想說要加強那縣政府都公共的事實上我想要出來就要出一間也是要衛福部啦 |
| transcript.whisperx[242].start |
6785.507 |
| transcript.whisperx[242].end |
6798.279 |
| transcript.whisperx[242].text |
衛生部有在寬列預算嗎另外一個就是這張是長照其實我們在衛生所也在強化也把衛生所的醫療資源用醫學中心的任務 |
| transcript.whisperx[243].start |
6802.743 |
| transcript.whisperx[243].end |
6814.512 |
| transcript.whisperx[243].text |
就去前進這裡的偏鄉嘛所以像我講的牡丹現在就義大去支援嘛那高一的支援那也下來了那個地方所以我們也是用這個醫學中心來補儲支援這個衛生所 |
| transcript.whisperx[244].start |
6818.211 |
| transcript.whisperx[244].end |
6832.881 |
| transcript.whisperx[244].text |
那你現在在那個造物師裡面有設一個科在管這一塊嘛那一直有人講說那個層級太低啦是不是把它升作處啦還是什麼 |
| transcript.whisperx[245].start |
6835.609 |
| transcript.whisperx[245].end |
6863.28 |
| transcript.whisperx[245].text |
不然你會想辦法我們會一個科長怎麼去指揮其他的人誰會有師長在的有師長師長是有在做的主要是說我們未來這個在主改之後我們會讓這個師擔負更多的這個原住民主健康的政策擬定的任務會讓讓他投入更多的人力跟資源這樣所以你要說到要做到你 |
| transcript.whisperx[246].start |
6865 |
| transcript.whisperx[246].end |
6879.307 |
| transcript.whisperx[246].text |
那個原住民的平均壽命73點多嘛 我會記一下有在減到嗎 有沒有在增加就是這個落差在縮短啦 以前差10歲啦跟全國漁民差10歲啦 現在是差7歲 |
| transcript.whisperx[247].start |
6882.908 |
| transcript.whisperx[247].end |
6906.127 |
| transcript.whisperx[247].text |
所以希望能夠,因為我在巖鄉也看到一些老人家壽命也有到九十幾歲的,看了都很高興所以他不是沒有那個條件,也不用講說他們的體質應該都可以九十幾歲都可以到達的,所以應該是要 |
| transcript.whisperx[248].start |
6907.088 |
| transcript.whisperx[248].end |
6930.455 |
| transcript.whisperx[248].text |
公共衛生的部分還有我們照護的部分包括長照的部分都應該好因為像國健署就是六癌篩檢因為現在四個變六個六癌篩檢要加強啊原鄉離山地離島原鄉你的醫療上來就是你的得症啦在大都會裡面有什麼好出來的每天就衝 |
| transcript.whisperx[249].start |
6934.273 |
| transcript.whisperx[249].end |
6956.3 |
| transcript.whisperx[249].text |
每個人的門庭弱勢,每個人都搞得很漂亮,不需要你的什麼挹注嘛。這都會區的人,他的保險要多,經濟力要強。現在台北市就醫那麼方便,用的醫療每人平均每年發揮的醫療,台中市也差不多啦,都用到偏鄉的兩倍三倍嘛。 |
| transcript.whisperx[250].start |
6957.318 |
| transcript.whisperx[250].end |
6981.493 |
| transcript.whisperx[250].text |
你有算過錢嘛 你知道嗎所以你偏鄉做得好 離島做得好你就是好的伯娘啦讓你病得好 你就能出生了啦搞定婦女 你就得天下啦好不好 伯娘 加油啦好 謝謝蘇委員 繼續努力謝謝蘇信學委員 謝謝部長接下來請廖偉祥委員 |
| transcript.whisperx[251].start |
6998.155 |
| transcript.whisperx[251].end |
7018.505 |
| transcript.whisperx[251].text |
謝謝主席 請石部長請石部長部長好部長好部長我想要先請教幾個關於這個健康幣的問題首先是想要先請教一下健康幣你們預計使用的項目是用公務預算支出還是用基金預算 |
| transcript.whisperx[252].start |
7020.187 |
| transcript.whisperx[252].end |
7032.36 |
| transcript.whisperx[252].text |
我們目前的設計上就是我們的公務預算是做這個平台的維護那真正這個幣是跟這個民間的企業單位合作所以我們沒有發這個現金的這種幣 |
| transcript.whisperx[253].start |
7035.604 |
| transcript.whisperx[253].end |
7042.552 |
| transcript.whisperx[253].text |
所以也有用這個基金的部分嗎?就是一部分公務一部分基金嗎?沒有基金主要就是在建構那個資訊平台OKOK那其次我想要請教一下目前APP設計的進度跟這個兌換平台的設計已經完成了嗎? |
| transcript.whisperx[254].start |
7054.327 |
| transcript.whisperx[254].end |
7071.526 |
| transcript.whisperx[254].text |
我們現在有兩個機制一個是祭典祭典的話我們是搭載我們現行的健保的這個健康存摺以既有的健康存摺這個平台去擴充裡面就未來就會有一個健康幣專區 |
| transcript.whisperx[255].start |
7072.987 |
| transcript.whisperx[255].end |
7088.914 |
| transcript.whisperx[255].text |
把你從事的這些健康行為包含打疫苗啦這個做癌篩啦等這個我等一下會問到因為你們原本有一個APP嘛對對對就在那個APP阿另外一個是國健署的這個Health Go這是原本的國健署的APP |
| transcript.whisperx[256].start |
7089.614 |
| transcript.whisperx[256].end |
7106.6 |
| transcript.whisperx[256].text |
那現在就是健康幣會搭載它這個所以有Housego也會有健康幣然後你們的健康存摺也會有應該是這樣健康存摺上面是積分的累計因為這裡面有一些個人資料所以不拿來我們等一下再討論這個部分因為今天主要就是要跟你討論這個政策細節 |
| transcript.whisperx[257].start |
7108.661 |
| transcript.whisperx[257].end |
7126.931 |
| transcript.whisperx[257].text |
所以那你們現在目前有預計說合作的商家有多少預計每年會指引多少預算啦那財務結構有完成了嗎具體有跟哪一些商家目前有在我們跟幾大超商都有在洽接他們也都展現了相當的這個合作意願這樣 |
| transcript.whisperx[258].start |
7127.751 |
| transcript.whisperx[258].end |
7147.174 |
| transcript.whisperx[258].text |
OK所以聽起來好像還是很模糊的初步的階段是不是是嗎部長因為你們曾經是承諾說4月要如期上線啦但是現在好像還有很多細節還在洽談中會不會延期應該是這麼說就是我們原本是希望這個是獨立上線 |
| transcript.whisperx[259].start |
7148.015 |
| transcript.whisperx[259].end |
7175.13 |
| transcript.whisperx[259].text |
那但是這個之前呢也有委員 向昌清委員也在指教說這個政府有好多個幣包含這個文化幣啦 客家幣啦 健康幣希望整合所以這個行政院呢 院長也有指示希望朝這個方向所以我們現在會搭配整個這個整合方案來推動所以期程上我們可以往後延所以你確定會往後延了嗎不可能4月上限 |
| transcript.whisperx[260].start |
7176.39 |
| transcript.whisperx[260].end |
7204.926 |
| transcript.whisperx[260].text |
因為的確這裡面有很多細節到現在好像還是很初步還需要去整合的階段那在上線之前因為我目前在網路上能夠收集到的資訊也有限就想要先請教一下部長你們在推動健康幣的政策的時候是不是也有考慮到公衛的三段五級的概念對有嗎但是因為根據媒體報導你們是說透過篩檢可以換幣但是他們在公衛政策上就我們的理解的分類他是屬於第二段第三級 |
| transcript.whisperx[261].start |
7205.706 |
| transcript.whisperx[261].end |
7223.373 |
| transcript.whisperx[261].text |
就是中間那個部分所以我是想問說想要跟部長討論是你是不是應該把這個政策理念用公共把它去重新檢討有沒有可能不要把它放在第三級而是從第一級就開始健康促進的部分跟委員說明我們也有在考量跟這個 |
| transcript.whisperx[262].start |
7224.293 |
| transcript.whisperx[262].end |
7246.578 |
| transcript.whisperx[262].text |
穿戴式裝飾結合包含那個運動走路一天走多少步把它納入也是可以基點沒有錯因為其實我想你們應該也有去做一些國際偵測的研究像新加坡的健康促進局它還有一個全國步數挑戰它後面還有拓展深度旅遊的健康計畫然後像台北的這個YouSport |
| transcript.whisperx[263].start |
7246.938 |
| transcript.whisperx[263].end |
7268.706 |
| transcript.whisperx[263].text |
台北樂運動的這個計畫所以其實我們最主要就是說再跟你討論這個就是說你們應該再往前提然後把前面這一段健康促進把它放到很重要的一個比較重要的一個角色其實根本來說我們希望結合的是生活型態就是那個生活習慣的改變所以這裡面包含這個運動一定會在裡頭 |
| transcript.whisperx[264].start |
7270.867 |
| transcript.whisperx[264].end |
7291.786 |
| transcript.whisperx[264].text |
那因为我们现在的这个健康存折就是可以把跟运动表已经可以结合在一起了所以这个可以计算进来那另外还有像那个生活形态的评估我们也会把它纳入到这个健康币里面所以你这里就牵扯到运动的部分了所以我想问那 |
| transcript.whisperx[265].start |
7292.506 |
| transcript.whisperx[265].end |
7306.832 |
| transcript.whisperx[265].text |
那我想問說你這樣子跟運動幣會不會有重疊疊床架屋的部分那這部分你沒有去跟運動部對接去討論嗎因為這樣會不會有不會就是說我們是累積點數啦並不是發錢出去所以你運動就累積的點數那累積的點數之後呢再去換成 |
| transcript.whisperx[266].start |
7314.975 |
| transcript.whisperx[266].end |
7329.512 |
| transcript.whisperx[266].text |
健康幣去做其他的這個折抵比如說他未來在超商我們跟合作的超商就可以去折抵折扣買東西的時候就可以有折扣大概是這樣去折抵這樣子跟現在運動幣不會有重疊的地方嗎 |
| transcript.whisperx[267].start |
7330.112 |
| transcript.whisperx[267].end |
7356.904 |
| transcript.whisperx[267].text |
因為運動幣目前是他是他是發出來啊對對對沒錯但是他是發出來可是你去做了這件事情之後他們兩者之間那我們未來的合作是他拿了這個運動幣去做的這個運動的活動可以來累積健康幣所以就變成一個生態循環然後拿了健康幣之後呢那麼再去換運動幣可以嗎可以再換回去運動幣嗎譬如說我們再跟一些運動業者 |
| transcript.whisperx[268].start |
7359.066 |
| transcript.whisperx[268].end |
7383.423 |
| transcript.whisperx[268].text |
合作他就可以換他的這個門票入場的折扣這樣對所以其實我也想要跟部長分享就是說因為其實健康幣你們在規劃的時候不要太封閉不要說好像你只能夠做什麼事如果今天你做了就像你剛說的因為我健康幣是我先做了一個動行為我可以累積這個credit變成一個可能是健康幣那你的健康幣就應該讓他可以更廣泛的運用在 |
| transcript.whisperx[269].start |
7384.343 |
| transcript.whisperx[269].end |
7409.118 |
| transcript.whisperx[269].text |
社會的其他地方包括你要換成運動幣也好換成文化幣也好你要去超商消費也好我認為這樣子才有辦法去做到真正去推廣第一級的健康促進因為事實上也有發生大家你們去研究一下可能也有發生說之前在推廣很多的運動活動的時候說你如果來運動場所所以你就可以打折等等的 |
| transcript.whisperx[270].start |
7409.398 |
| transcript.whisperx[270].end |
7425.528 |
| transcript.whisperx[270].text |
可是最後發現說事實上真的會去運動的他本來就會去運動所以就只有他會拿到這個這個優惠那不運動的我就是不運動所以我的意思就是說想要跟部長講就是說你這個所謂的健康病你在規劃的時候你就應該讓他通用性再多一點 |
| transcript.whisperx[271].start |
7426.048 |
| transcript.whisperx[271].end |
7446.642 |
| transcript.whisperx[271].text |
因為我本席也是支持這樣的概念我們如果從第一期就開始讓大家健康促進的話所以因為目前為止可以看到的好像是說我目前網路上查到因為你剛剛講的跟我查到的資訊是有一點落差比如說是打疫苗完成篩檢定期健康檢查他可以換成所謂的無糖飲料健康蔬食那我覺得 |
| transcript.whisperx[272].start |
7448.25 |
| transcript.whisperx[272].end |
7474.081 |
| transcript.whisperx[272].text |
應該要把這個所謂的鼓勵運動以及這個幣的通用性擴大不然他你就沒有辦法促進到那些他本來沒有去參與的人你沒有給他更強的動力啊所以這部分就是想要跟你說你們應該再去多串聯其他的就像你剛剛說的是不是行政院這邊應該再去串聯不管是中央的幣也好甚至是到地方政府他們有哪一些可以大家串在一起合作的 |
| transcript.whisperx[273].start |
7474.801 |
| transcript.whisperx[273].end |
7497.297 |
| transcript.whisperx[273].text |
然後真正促進說我都不想去參與的這些人可以讓他有動力他搞不好就是想說我想要賺一點這個文化幣所以我來運動一下對不對我來健康檢查一下我覺得這樣子才會比較有這個好的正向循環是不是有嗎會嗎有有謝謝委員的指教我們朝這個方向來做最大化 |
| transcript.whisperx[274].start |
7497.717 |
| transcript.whisperx[274].end |
7523.553 |
| transcript.whisperx[274].text |
對 然後所以剛剛談完通用性其實我現在還要再講回去你剛剛說的因為你們有這個全民健保行動快易通那我們在APP上面會遇到幾個問題第一個是現在其實絕大多的功能都整合進去健保快易通那你在架構這個健康幣的平台的時候你剛剛有講到又有健習生然後又有這個裡面健康存摺 |
| transcript.whisperx[275].start |
7524.393 |
| transcript.whisperx[275].end |
7543.15 |
| transcript.whisperx[275].text |
其實我認為你這樣子民眾要下載很多的APP那你是不是應該盡量整合到現在已經有最多人的地方因為你現在這個健康實習生健習生啦健習生第一個你們下架了嘛可是他們之前只有500人下載那我有看到部長你說很不滿意嘛可是 |
| transcript.whisperx[276].start |
7544.291 |
| transcript.whisperx[276].end |
7562.148 |
| transcript.whisperx[276].text |
這個部分你們是不是應該要想辦法整合到現在健保快一通有多少人1500萬人次曾經下載過的是1300萬對那健康存摺使用的有多少730萬如果常規在使用每個月三個月內都有使用的大概是兩三百萬 |
| transcript.whisperx[277].start |
7563.289 |
| transcript.whisperx[277].end |
7585.064 |
| transcript.whisperx[277].text |
兩三百萬對啊常規使用啊但是真正有的東西應該已經下載過的有1300萬對嘛所以他其實量體已經很大了嘛是所以你應該是直接整合進去你就不用再去說用什麼見習見習生health go這越來越複雜然後好多個APP一般人怎麼用那對於長輩來講他要去學習要再去下載一個新的也很困難嗯嗯嗯 |
| transcript.whisperx[278].start |
7585.644 |
| transcript.whisperx[278].end |
7611.415 |
| transcript.whisperx[278].text |
所以你是不是應該朝向直接把它整合進去的方式而且因為你如果還要獨立的話你還要編一個特種費教育費我們當時候會把它兩個分開最主要是因為那個健康存摺上有太多的醫療資料所以在做後續的這些操作的時候怕有這些各自治安的問題所以我們希望讓健保的這個My Health Bank當存就是健康資料就好 |
| transcript.whisperx[279].start |
7611.715 |
| transcript.whisperx[279].end |
7627.136 |
| transcript.whisperx[279].text |
不要再去做其他後面的這些兌換各式各樣的活動讓他這個資安上也比較好管理所以他是累積計算積分之後要使用的時候轉到另外一個平台那這個平台我們現在是設定在 |
| transcript.whisperx[280].start |
7628.218 |
| transcript.whisperx[280].end |
7650.416 |
| transcript.whisperx[280].text |
這個用國建署的這個這個平台去去承載然後他在跟其他很多的商家合作比如說他要產生這個流水號去換的時候都在這裡就不會拿著這個健康存摺去做這些消費行為就是讓健康存摺比較單純化你可以再去思考一下其實他也應該是有機會是把它獨立出 |
| transcript.whisperx[281].start |
7650.896 |
| transcript.whisperx[281].end |
7674.693 |
| transcript.whisperx[281].text |
在這個平台在這個APP你看怎麼樣把它區隔出來好我們也比如說在互動的時候它有哪一些資料是絕對不會被拿出去的對我覺得這個部分你們應該思考一下要不然你努力一個然後就是跌床架屋之外你要去推廣它到很多人下載我看都不如你現在這個APP把它整合好所以我覺得這個部分你們應該朝向APP整合的方式 |
| transcript.whisperx[282].start |
7675.333 |
| transcript.whisperx[282].end |
7700.571 |
| transcript.whisperx[282].text |
那我也要有個 最後有個小問題要反映喔我們有接獲到很多的民眾投訴這個問題就是說在你們健保快衣桶裡面如果要登入使用健保卡的功能就需要用這個OTP的驗證碼好 但是現在驗證它產生了這個驗證碼之後它又要求你要另外登入另外用瀏覽器登入你有沒有覺得這個在操作上有點怪怪的就是 |
| transcript.whisperx[283].start |
7702.608 |
| transcript.whisperx[283].end |
7727.688 |
| transcript.whisperx[283].text |
目前市面上的APP都朝向可以直接綁定然後就是讓Google甚至是Line這個部分來做串流那你如果說資安有疑慮不做串接還可以理解但是你收了驗證碼的功能我們應該說希望在手機上操作而不是直接跨到瀏覽器所以我們在用的時候常常就是它出了這個之後我要複製這個OTP的碼之後我要再打開一個瀏覽器然後去找到這個對應的網頁然後再輸入進去 |
| transcript.whisperx[284].start |
7730.506 |
| transcript.whisperx[284].end |
7752.443 |
| transcript.whisperx[284].text |
它是不是應該可以直接用跳轉就好因為你這樣其實是很複雜像我們辦公室的同仁就遇到這樣子的問題我想那個因為部長你有沒有看過這個概念就像是什麼就像是周星馳的電影你有看過那個太陽能手電筒嗎就是你不用光照它的時候它不亮你要它亮你還要用另外一個手電筒去照它亮你等於是 |
| transcript.whisperx[285].start |
7753.263 |
| transcript.whisperx[285].end |
7777.649 |
| transcript.whisperx[285].text |
多了一層不知道在幹嘛用的一個功能委員提的這個是虛擬健保卡啦因為它就等同我們的實體健保卡在就醫的時候使用所以它需要有一個驗證的流程但是這個驗證的能不能讓它再簡單一點這個我們來研究一下謝謝您給我們指證這個是虛擬健保卡我知道我剛剛說就是要使用這個健保卡功能的時候它要有這個OTP驗證的流程 |
| transcript.whisperx[286].start |
7779.269 |
| transcript.whisperx[286].end |
7807.779 |
| transcript.whisperx[286].text |
那我們認為要驗證沒有錯但是你應該讓他的流程更順一點其實我們那個健保的APP裡面那個健康存摺的時候是很簡單他甚至可以用那個人臉辨識就可以進去每一次這個很簡單但是這個虛擬健保卡確實是比較複雜因為他會連結到你後面的那個就醫的那些憑證這樣可是你都掃臉了其實虹膜技術這應該就是已經確保就是你本人了 |
| transcript.whisperx[287].start |
7808.619 |
| transcript.whisperx[287].end |
7828.846 |
| transcript.whisperx[287].text |
所以你這個流程請回去檢討一下好不好可以本席辦公室一個報告書面報告我們再請健保署研究一下這個虛擬健保卡這個部分對 因為你既然都可以掃臉了應該就確定是這個人了嘛是對 好好 謝謝好 謝謝 謝謝委員謝謝廖偉強委員謝謝四成兩部長先來休息十分鐘 |
| transcript.whisperx[288].start |
8522.048 |
| transcript.whisperx[288].end |
8547.583 |
| transcript.whisperx[288].text |
我們繼續開會好 那我們繼續 請王玉敏委員發言謝謝主席 我們有請部長有請施部長 |
| transcript.whisperx[289].start |
8553.946 |
| transcript.whisperx[289].end |
8577.251 |
| transcript.whisperx[289].text |
部長好 部長今年2026年請問你的住宿機構你的那個入住率要達到百分之多少入住率您的意思是說因為目前是還有一些那個空間對 現在是84你今年你的報告裡面長照3.0你說2026要提高 |
| transcript.whisperx[290].start |
8581.764 |
| transcript.whisperx[290].end |
8606.72 |
| transcript.whisperx[290].text |
應該是說我們會繼續去擴充那個量能因為雖然現在看起來沒有滿但是有些區域上還是有不足啦所以我們還是會去繼續的鼓勵把那個住宿式長照機構希望要在不足的地方還是要再增加起來所以不會是用入住率因為那個會再增加那這個入住率指的就是住宿式機構啦 |
| transcript.whisperx[291].start |
8607.7 |
| transcript.whisperx[291].end |
8614.328 |
| transcript.whisperx[291].text |
那你們住宿機構的使用率你們報告提到2026短期目標87%你不是這樣寫嗎應該是嘛我們報告沒有寫這個報告沒有寫這個喔你們2026沒有目標 |
| transcript.whisperx[292].start |
8624.417 |
| transcript.whisperx[292].end |
8653.151 |
| transcript.whisperx[292].text |
沒有特別去說入住率是多少 定這種目標是不是因為我們還會再漲資源好 我今天要跟你討論的就是我們現在高齡人口越來越多 失能人口也越來越多但是我看到一個就是我們現在住宿機構你現在看到的入住率現在是84%但是這些的空缺他不是真的他想要空下來而是因為在他的這個照護筆底下呢照護 |
| transcript.whisperx[293].start |
8653.951 |
| transcript.whisperx[293].end |
8662.393 |
| transcript.whisperx[293].text |
人員不足然後所導致的這個床位被迫封床這個現象你們有掌握嗎 |
| transcript.whisperx[294].start |
8664.234 |
| transcript.whisperx[294].end |
8692.193 |
| transcript.whisperx[294].text |
我們如果是以整體啦因為這個整體跟區域是不一樣就是有些地方是有床可是有床沒有人的現象我要講的是這個這個現象你們看到了嗎那所以我們才會讓這個住宿式機構也可以開放那個這個移工移工來協助按照一定的比例上去可以聘移工來補足這個人力上不足但是這三年來 |
| transcript.whisperx[295].start |
8693.314 |
| transcript.whisperx[295].end |
8714.241 |
| transcript.whisperx[295].text |
他流失的這些造福人員在機構裡面高達3427人我要跟你討論的就是那難道我們本土的這一些長照機構人力的流失不需要去改善嗎就是只能用移工來補足然後不去探究為什麼這些人要離開機構沒有辦法長期待在機構裡面 |
| transcript.whisperx[296].start |
8718.402 |
| transcript.whisperx[296].end |
8747.019 |
| transcript.whisperx[296].text |
這個問題你們有去檢討嗎要怎麼改善在你的長照3.0裡面有沒有針對這一些照服員包括他的待遇跟勞動條件你要做什麼樣的一個調整怎麼樣留住人在現場因為如果按照這樣的一個流失的速度的話那這個是一個危機變成是有一些住宿機構有床也沒有人沒有人其實你就不能再招收新的這些受照顧者 |
| transcript.whisperx[297].start |
8748.265 |
| transcript.whisperx[297].end |
8767.014 |
| transcript.whisperx[297].text |
跟文說明這個確實這個會流動因為我們在長照體系裡面有一些會流到居家有些流到社區甚至有些流到醫院所以他會流動那但是我們還是希望能夠久任所以我們先去年開始吧有開始 |
| transcript.whisperx[298].start |
8768.315 |
| transcript.whisperx[298].end |
8783.985 |
| transcript.whisperx[298].text |
有在增加112年開始有給他們這個這個進階的就進階的造福源給他每月的津貼5000元來鼓勵他留任連續四年這樣但是2025年他還是持續下降中 |
| transcript.whisperx[299].start |
8785.046 |
| transcript.whisperx[299].end |
8803.336 |
| transcript.whisperx[299].text |
有沒有發揮效果我想整個的長照人力是增加啦整個人力是增加當然在住宿式機構有這些流失不過也有在挹注在進來那個我想我們會持續的去注意到這個人力的變動 |
| transcript.whisperx[300].start |
8804.577 |
| transcript.whisperx[300].end |
8832.57 |
| transcript.whisperx[300].text |
你可以看到下一張圖你看到的是我們現在本土的人力在下降那增加的是什麼增加的是移工的人數也就是我們現在住宿機構裡面其實是高度仰賴移工來補足人力的缺口但是在這樣子下去這是一個好的方向嗎就是說我們過去不是在講說我們本土應該要建構屬於自己本土的兆福遠的人力嗎這個才是本 |
| transcript.whisperx[301].start |
8833.951 |
| transcript.whisperx[301].end |
8844.636 |
| transcript.whisperx[301].text |
但是這一塊本我覺得都在流失當中而在當中的這個問題你們應該好好去探究因為包括你們的訓練你們趙福遠的訓練我看到的數字你們2025年的訓練人數是不是6506人 |
| transcript.whisperx[302].start |
8853.723 |
| transcript.whisperx[302].end |
8877.828 |
| transcript.whisperx[302].text |
跟委員說明 確實人力是一個很大的挑戰2024年是7259人 2025年又下降連前面的職選訓練的人數都在減少 這是個危機我們也看到這個危機 因為確實是整個台灣的工作勞力人口在下降是整個的下降 各行各業都下降 |
| transcript.whisperx[303].start |
8878.428 |
| transcript.whisperx[303].end |
8905.418 |
| transcript.whisperx[303].text |
對 但是偏偏未來長照這邊需要的人口的力是在增加對 需求是要增加的所以這個是非常大的挑戰所以除了靠這個外籍移工之外我們也在想辦法智能化的照顧要導入有嗎 你現在有跟上智能化有什麼新的方案3.0裡面就特別要補助他們去用一些更多的科技我們現在AI發展還是緩慢的 |
| transcript.whisperx[304].start |
8907.739 |
| transcript.whisperx[304].end |
8925.052 |
| transcript.whisperx[304].text |
還有其他的科技啦好像這個自動智慧化的監測啦還有這個資料的這個monitor等等這些都想辦法在還有它的管理啦等等把它導入進來就是希望去去share掉一些人力的負荷當然這個 |
| transcript.whisperx[305].start |
8927.293 |
| transcript.whisperx[305].end |
8951.706 |
| transcript.whisperx[305].text |
我要求你們應該要有一個完整的針對長照的人力你要怎麼樣去補足你要有一套完整的計畫包括你剛剛講如果要引用一些智能輔具甚至未來AI整個的運用我都贊成但是要務實你要看到這個人力缺口的現象要不然我看到你們唯一的解方就是大量進口外籍移工 |
| transcript.whisperx[306].start |
8952.199 |
| transcript.whisperx[306].end |
8968.49 |
| transcript.whisperx[306].text |
用移工來補足所有的缺口這個就是解方但是不是只有這樣子我覺得本土的如果我們希望讓這些造福源就是人數可以穩定隨著我們要照顧人口可以穩定成長的話顯然你之前提出來的這一些獎勵方案 |
| transcript.whisperx[307].start |
8969.892 |
| transcript.whisperx[307].end |
8975.138 |
| transcript.whisperx[307].text |
誘因都還不足所以我希望你們是不是可以一個月之內你們提一個檢討報告針對本土造福人力流失你要怎麼樣去提高從前端的訓練到他的福利到他的薪資到他的職場環境我覺得你們該是到了一個整個好好的去 |
| transcript.whisperx[308].start |
8990.394 |
| transcript.whisperx[308].end |
9008.84 |
| transcript.whisperx[308].text |
檢討了那該是國家資源應該要挹注的我覺得就是要強力挹注啊因為這個是未來的問題我們現在已經遇到了那你如果這一塊你不及早去因應跟補足的話你將來都仰賴外籍移工但是外籍移工萬一他沒有辦法如期的進那麼多的時候 |
| transcript.whisperx[309].start |
9009.52 |
| transcript.whisperx[309].end |
9028.249 |
| transcript.whisperx[309].text |
我們就連照顧都會出問題好不好你一個月之內提一個檢討報告出來好不好應該要怎麼做我覺得你要有一個更大的戰略來看待這件事情不是且戰且走應該好好的找專家學者來把這件事情好好的提出一個解方可不可以這個給我們長一點時間因為這個不簡單三個月三個月但是也要快了好不好好 |
| transcript.whisperx[310].start |
9034.432 |
| transcript.whisperx[310].end |
9038.536 |
| transcript.whisperx[310].text |
那另外一個今天謝謝昭偉安排這個議題這個長昭資源的失衡我覺得中央應該要看見你們在長昭3.0有提出一個構想說十分鐘的生活圈這個口號這個喊得很響亮但是我不知道你們沒有好好去真的走入偏鄉 |
| transcript.whisperx[311].start |
9057.133 |
| transcript.whisperx[311].end |
9084.865 |
| transcript.whisperx[311].text |
看到偏鄉他從一個村到那個村的距離到底有多麼的遙遠今天我們召委排這個議題我想他看到了這個原鄉有這樣的問題那我就具體指出來嘉義縣的阿里山鄉他也是原鄉地區那你看到這個地圖你們說這個涵蓋率有達到破百了百分之一百一十五聽起來都很好聽但是你看他的資源分佈 |
| transcript.whisperx[312].start |
9085.905 |
| transcript.whisperx[312].end |
9108.131 |
| transcript.whisperx[312].text |
它比較密集的地方都是在一些人口比較多的鄉鎮但是你看到右手邊這個阿里山鄉這個阿里山鄉你看起來就是稀稀落落範圍這麼的廣大但是不可能是你們喊出來的10分鐘的生活圈這是天方夜譚不可能的事那所以針對這樣子的一個地區我問兩個問題第一個就是 |
| transcript.whisperx[313].start |
9113.812 |
| transcript.whisperx[313].end |
9116.555 |
| transcript.whisperx[313].text |
你們說10分鐘開車的距離第一個問題是10分鐘開車的距離請問車子誰開老人家自己開嗎現在交通部針對高齡長者開車他們現在是很審慎的就是不鼓勵啦 |
| transcript.whisperx[314].start |
9132.009 |
| transcript.whisperx[314].end |
9157.808 |
| transcript.whisperx[314].text |
就是要加強管制那你這些對象都是高齡者我就問你要自己開嗎如果不是自己開你現在的3.0有針對交通問題有增加車輛嗎就是這種接受嗎我到ABC的據點我這些交通車我的量能你有提高嗎我在偏鄉地區看到的就是交通是一個很大的問題 |
| transcript.whisperx[315].start |
9158.849 |
| transcript.whisperx[315].end |
9172.497 |
| transcript.whisperx[315].text |
你的服務你沒辦法到家你是用定點定點又遙遠又是山路然後你要老人家自己開那麼遠的山路然後來到這個定點然後提供服務交通真的是一個很大的問題你們3.0解決了什麼好 |
| transcript.whisperx[316].start |
9175.743 |
| transcript.whisperx[316].end |
9196.248 |
| transcript.whisperx[316].text |
跟委員說明當然這個不可能我們到處都是10分鐘啦我們必須去誠實的去面對在地理上的障礙所以像這個山地鄉當然就是一個很困難的地理障礙但是如何讓他能夠在地得到服務這個是方法啦 |
| transcript.whisperx[317].start |
9197.188 |
| transcript.whisperx[317].end |
9211.244 |
| transcript.whisperx[317].text |
所以除了交通接送到某些地方之外我們也在思考那麼一直在目前這個規劃中的共生宅讓它能夠在地就是它不具有經濟規模啦這個地方的人真的少所以 |
| transcript.whisperx[318].start |
9212.085 |
| transcript.whisperx[318].end |
9238.038 |
| transcript.whisperx[318].text |
沒有辦法我們剛剛說的涵蓋率是用overall的數字去說服務的人數跟capacity這樣算出來可是這個地方就是漲不出來因為他的那個住宿司機構出不來所以才會我們現在也在希望在這些地方有一些這個社區自發性叫做共生宅我們現在在規劃中那你預計什麼時候要實施這個年底前就會開始試辦了我們現在在密集的討論預計從哪邊開始試辦 |
| transcript.whisperx[319].start |
9240.72 |
| transcript.whisperx[319].end |
9262.872 |
| transcript.whisperx[319].text |
會支援比較缺乏的地方我們考慮的兩個方向一個就是重症兒童因為重症兒童現在我們的住宿司機構比較不好收因為這個都是混不太可能專門是為了這個兒童的這個住宿司機構嘛所以轉換因為他人數又比較少所以轉換成用共生宅來試辦這是一種 |
| transcript.whisperx[320].start |
9264.833 |
| transcript.whisperx[320].end |
9286.443 |
| transcript.whisperx[320].text |
另外一種就是資源不足的地方他就長不出資源了那我們用另外一種方式來新的一種家的方式來來提供這個對你講的這是另外一個但是我剛問的交通你沒有回答你有沒有去提到這個交通我們有那個這個交通接送啊你現在的量能都不夠啊 |
| transcript.whisperx[321].start |
9288.22 |
| transcript.whisperx[321].end |
9315.548 |
| transcript.whisperx[321].text |
你現在量差很多現在其實都好像在搶門票一樣我們現在是做多元的方式嘛也有那個計程車的也有那個這個我希望你們可以好好去研議你們的這個交通的量能應該也可以提供另外一種叫做自助的就是社區自助的只要這裡面有人有駕照他的過去駕駛能力是好的然後呢他不用具備有計程車的資格就是說等於是自助系統裡面就是互助啦對 |
| transcript.whisperx[322].start |
9317.429 |
| transcript.whisperx[322].end |
9332.681 |
| transcript.whisperx[322].text |
他願意擔任志工有點像Uber對 有點像是但是他是以可以就是如果這個老人定期要去這一些長照的服務機構的話我們來研究一下就是在我們那個平台上面有一種就是像委員講的是類似像Uber一樣 |
| transcript.whisperx[323].start |
9336.344 |
| transcript.whisperx[323].end |
9356.182 |
| transcript.whisperx[323].text |
對 因為很多計程車司機也沒有辦法到那麼偏鄉的地方他要做他自己的生意但是這裡面如果有人其實是有優越的駕駛的能力他不見得拿到計程車的牌照但是用一種互助的方式他可以彼此之間就是形成一個互助系統然後他也有責任 就是他去接受 |
| transcript.whisperx[324].start |
9356.582 |
| transcript.whisperx[324].end |
9378.317 |
| transcript.whisperx[324].text |
他沒有辦法開車的老人到這一個據點來或者是來接受你ABC據點都可以這種我認為你們也要認真去考慮偏鄉沒有計程車啦那麼高的山上跟你說一台都沒有啦不可能啦在那邊沒有辦法跑就類似像我們來開個Uber一樣嘛他來登記嘛那這個平台上他可以叫這些我們來評估 |
| transcript.whisperx[325].start |
9380.558 |
| transcript.whisperx[325].end |
9396.623 |
| transcript.whisperx[325].text |
我覺得交通量能事你這種偏鄉地方不要去講什麼十分鐘啦他有車子可以出門就已經是覺得很幸福了因為沒有辦法帶他出門老人就像沒有腳一樣所以這個部分我希望你們可以跟 |
| transcript.whisperx[326].start |
9397.663 |
| transcript.whisperx[326].end |
9413.112 |
| transcript.whisperx[326].text |
我不知道你們是不是要跟交通部研議我們要找交通部對在一些特定的偏遠地方的區域在安全的原則底下不是普及性的啦就是對一些那個有缺口的地方對好不好你也通盤去檢討那這個一樣你一個月可以給一個 |
| transcript.whisperx[327].start |
9417.074 |
| transcript.whisperx[327].end |
9434.159 |
| transcript.whisperx[327].text |
提出一個這個很複雜因為這個還涉及到交通部的那你也要三個月嗎三個月三個月那就要兩個報告一個是人力的一個是交通解決的方案好不好好謝謝好謝謝謝謝委員謝謝王一鳴委員謝謝石沉仁部長接下來請我們杜鑽進委員發言好謝謝主席那請問石部長 |
| transcript.whisperx[328].start |
9445.836 |
| transcript.whisperx[328].end |
9446.097 |
| transcript.whisperx[328].text |
請施長長部長 |
| transcript.whisperx[329].start |
9450.024 |
| transcript.whisperx[329].end |
9476.882 |
| transcript.whisperx[329].text |
主委好 石部長我們賴總統有推健康台灣政策當然我們去了解它也是因應我國人口結構的改變還有我們醫療照護需求的增加我們石部長本身也醫療備檢然後也做過健保署署長我們認為一個地區它在高齡人口達到一個數量其實就應該要有長照跟醫院的醫療需求 |
| transcript.whisperx[330].start |
9477.702 |
| transcript.whisperx[330].end |
9496.717 |
| transcript.whisperx[330].text |
那现在针对之前我们在总执行也提过像我们桃园沿海我们认为这个整个医疗资源就是很匮乏那尤其那我们现在先讨论长照的部分那长照部分当然后来我们在观音大坡讲一个长照园区在2025年 |
| transcript.whisperx[331].start |
9498.078 |
| transcript.whisperx[331].end |
9514.782 |
| transcript.whisperx[331].text |
中巡有開始動工那當然他其實他從當初規劃到動工其實也花了大概8年的時間那這部分不知道部長對大坡角長照園區這部分了解嗎這個我比較陌生不好意思請我們長照師師長 |
| transcript.whisperx[332].start |
9518.247 |
| transcript.whisperx[332].end |
9534.359 |
| transcript.whisperx[332].text |
謝謝委員關心那這個案子因為是我們的部立桃園醫院提出計畫那用長照基金這邊補助他做這個200床的住宿床的一個規劃那目前其實整個案子應該 |
| transcript.whisperx[333].start |
9535.98 |
| transcript.whisperx[333].end |
9559.196 |
| transcript.whisperx[333].text |
我們經費是應該是一百一十一年核定下去的一一一一零一一一那段時間核定下去那現在都是都在都在進行因為當時也有要必須要跟地方要去取得一些共識那也曾經委員也有曾經安排一次到實地看訪所以那個地方還涉及到說還要開路就是還要規劃這個這個路線所以其實問題是比較複雜 |
| transcript.whisperx[334].start |
9565.78 |
| transcript.whisperx[334].end |
9591.268 |
| transcript.whisperx[334].text |
當初規劃到動工其實也真的花了很長的時間那所以現在當然也感謝我們已經開始動工所以我們現在不知道了解他所有的進度都正常那目前進度到底到哪裡因為現在這個部分管控是我們衣服會在管控那這部分再幫我們了解一下我們衣服會其實一直在盯因為我希望今天跟部長提就是因為我們桃園沿海這個 |
| transcript.whisperx[335].start |
9593.169 |
| transcript.whisperx[335].end |
9615.655 |
| transcript.whisperx[335].text |
我們一直講這個醫療資源匱乏那好不容易有這個長照園區希望部長能夠幫我們監督一下讓這個工程能夠順利讓它如期如子完成對對對這部分請部長幫我們多關心一下好所以那再來我們就討論醫療需求嘛那我們今天主要都是針對我們桃園沿海醫療需求的問題那 |
| transcript.whisperx[336].start |
9617.435 |
| transcript.whisperx[336].end |
9633.479 |
| transcript.whisperx[336].text |
部長也知道我們一直在談部桃新屋分院從2023年我們就知道它的量能都滿窄在總諮詢也提過那當初也拜託我們行政院卓榮泰院長院長好像有指示部長請部長檢討我們沿海醫療資源的問題那 |
| transcript.whisperx[337].start |
9638.58 |
| transcript.whisperx[337].end |
9667.377 |
| transcript.whisperx[337].text |
據我們了解部桃新屋分院他的徵件計畫我們查過從國發會一月份就已經送到行政院那不知道現在到底進步了目前已經正式核定了已經核定了我們趕快動所以因為我有看國發會的建議國發會直接寫希望行政院盡快核定表示他們也認為這個急迫性跟重要性那可是後來我們也有了解 |
| transcript.whisperx[338].start |
9668.638 |
| transcript.whisperx[338].end |
9685.218 |
| transcript.whisperx[338].text |
部桃醫院好像針對很多請他們要自籌經費這一部分他們認為好像有很大的困擾是不是這樣新屋這邊沒有問題是那個桃園醫院我們現在有兩個案子一個是新屋分院新屋分院這個已經核定了這個沒有問題經費沒有問題了 |
| transcript.whisperx[339].start |
9687.381 |
| transcript.whisperx[339].end |
9710.555 |
| transcript.whisperx[339].text |
那再來是那個我們那個桃園醫院就是那個本院的地方那個我們也要有新建那個一個大樓所以那個部分的還在審查中那個預算還在爭取所以部桃醫院新屋分院經費自籌款的部分不會有問題那個OK 那個OK那所以目前新屋分院整個計畫那個會準備要趕快來動要來開始動了 |
| transcript.whisperx[340].start |
9713.296 |
| transcript.whisperx[340].end |
9741.816 |
| transcript.whisperx[340].text |
所以那也不會有自籌款的問題嘛那個還好主要是那個桃園醫院這部分真的拜託部長因為大家都很期望啦因為我們沿海這醫療資源當初我們都講過整個桃園就是沿海跟南區這醫療資源非常匱乏所以這個目前看到最有機會就是部桃新屋分院的增建計畫所以大家很多民眾啊 |
| transcript.whisperx[341].start |
9742.296 |
| transcript.whisperx[341].end |
9757.193 |
| transcript.whisperx[341].text |
像我們陽梅觀音新屋大園整個沿海甚至平鎮農產其實對於這個南區部桃新屋分院的徵建計畫大家都引頸很久這部長這一部分希望部長我們希望我們會去這個壯大這個桃葉醫院的量能 |
| transcript.whisperx[342].start |
9762.119 |
| transcript.whisperx[342].end |
9782.066 |
| transcript.whisperx[342].text |
包含跟新屋分院這邊我們的期待是希望讓這個我們的部桃能夠成為醫學中心來發展所以他現在已經通過重度級急救責任醫院希望他也能夠讓新屋這邊也提升起來這樣好對因為這也牽扯到我們周邊有一個觀音工業區他是我們全 |
| transcript.whisperx[343].start |
9782.726 |
| transcript.whisperx[343].end |
9810.665 |
| transcript.whisperx[343].text |
全台湾北部最大的工业区这我们也提过很多次他每天去上班的人最少三万人以上而且他里面有很多的行业像金属制品制造业机械设备制造业电子零组件制造业还有一些比较特别像化学材料化学制品的制造业那我们现在一直很担心万一真的有发生什么公安方面的问题那在第一时间他要去 |
| transcript.whisperx[344].start |
9811.505 |
| transcript.whisperx[344].end |
9827.166 |
| transcript.whisperx[344].text |
周邊都沒有一些大型的醫療院所而且也沒有急診室所以我們那時候是有提是不是針對這部分緊急醫療網路的部分在工業區內或者甚至就近就應該要有 |
| transcript.whisperx[345].start |
9827.646 |
| transcript.whisperx[345].end |
9844.402 |
| transcript.whisperx[345].text |
急診室或者一些比較大型的醫療院所當然部桃新屋分院也是一個好的方法也是一個好的院所但是畢竟其他的觀音工業區過去車程要30分鐘以上所以我們針對 |
| transcript.whisperx[346].start |
9846.123 |
| transcript.whisperx[346].end |
9867.203 |
| transcript.whisperx[346].text |
這個部分是不是應該在這個大型的工業區內或者周邊短程類是不是應該要有增加這個醫療資源急診室或者一些大型的院所甚至是不是應該要針對他的產業類別應該要有一些去做一些比較相關的專責醫院我想 |
| transcript.whisperx[347].start |
9867.842 |
| transcript.whisperx[347].end |
9890.418 |
| transcript.whisperx[347].text |
因為這個工業區的關係比較擔心的就是一些公安意外的時候的緊急應變委員關切應該是屬於這一個那麼我再請醫事司跟了解一下這裡面有沒有什麼特殊需要應變比如說毒化災它需要特別的應變的那我們來提升它的這個 |
| transcript.whisperx[348].start |
9891.658 |
| transcript.whisperx[348].end |
9918.525 |
| transcript.whisperx[348].text |
應變能力當然這個也要跟主管機關大家來討論因為要設這些站也好或者是它的應變機制也好可能我們要跨機關的合作這樣所以我們說本身我們沿海南區醫療資源就很匱乏加上又有這麼大的工業區這麼多的產業類別所以我們希望衛福部是不是可以針對經濟部像依照不同的產業類別 |
| transcript.whisperx[349].start |
9919.625 |
| transcript.whisperx[349].end |
9941.116 |
| transcript.whisperx[349].text |
然後再跟勞動部針對各工業區內的職災復健照護這一部分是不是演繹在工業區內或者周邊能夠來設一些專責的相關醫院那一方面能夠提升我們醫療資源另外一方面也對我們工業區內這麼多的勞工也是一個保障是不是這一部分我們來針對這個產業園區 |
| transcript.whisperx[350].start |
9945.039 |
| transcript.whisperx[350].end |
9967.794 |
| transcript.whisperx[350].text |
去設計他的緊急醫療網絡啦就是他發生一些緊急事件的時候他應該是應變醫院是在哪裡那或者是需要有一個前進的救護站的設計還是什麼我們這個我請醫師師來規劃那師傅可以幫我們演繹一下然後再給我們一個進度大概多久可以給我們看到這個相關的報告也是三個月啦 |
| transcript.whisperx[351].start |
9968.474 |
| transcript.whisperx[351].end |
9979.166 |
| transcript.whisperx[351].text |
我們要跨單位去那拜託因為這可能要跟經濟部、勞動部幾個部會研議一下那拜託部長三個月內給我們初步研議跟我們的規劃進度這個地方的一個緊急醫療應變的網絡跟計畫這樣好謝謝感謝謝謝部長謝謝委員謝謝投選局委員發言 |
| transcript.whisperx[352].start |
10000.182 |
| transcript.whisperx[352].end |
10008.533 |
| transcript.whisperx[352].text |
好 接下來請我們盧憲一委員謝謝主席 有請我們園民會好 請園民會讓部長休息一下 |
| transcript.whisperx[353].start |
10018.397 |
| transcript.whisperx[353].end |
10040.784 |
| transcript.whisperx[353].text |
昨天大概有談過這個議題了那處長不知道昨天有沒有聽到我們的質詢關於原住民的部分有那我先問就是剛好之前我們在3月初的時候跟桃園市政府原民局一起去拜訪主委針對Pride Act的那個經費的需求目前的那個規劃進度到哪裡了 |
| transcript.whisperx[354].start |
10041.304 |
| transcript.whisperx[354].end |
10055.996 |
| transcript.whisperx[354].text |
跟委員報告現在目前研議會已經有把相關的計畫已經收到那我們正在辦理中那你可以告訴的告訴國人嗎現在在整個援助民主健康的這個議題我們人民會的角色在哪裡 |
| transcript.whisperx[355].start |
10057.203 |
| transcript.whisperx[355].end |
10076.42 |
| transcript.whisperx[355].text |
現在因為在嚴明會底下我們社會福利處那有三個科 其中一個就是衛生保健科那主要的任務大概就是我們在健保費的一個補助當中針對10歲以下 55歲以上 六列二目的部分那這塊是由嚴明會這邊來去做指引 |
| transcript.whisperx[356].start |
10079.242 |
| transcript.whisperx[356].end |
10091.771 |
| transcript.whisperx[356].text |
還有一些針對一些街頭病完治獎金那另外我們在長照方面的話我們也針對因為用長照基金也卸衛福部嘛那我們在從105年開始從121站現在 |
| transcript.whisperx[357].start |
10095.834 |
| transcript.whisperx[357].end |
10114.586 |
| transcript.whisperx[357].text |
已經增加到532站那我們服務的族人在各個部落當中總共有18000多人每天都是在量血壓那也讓我們的族人也有一個很好的一個健康管理的一個行為大概重點是這樣子關於交通補助費的部分呢 |
| transcript.whisperx[358].start |
10114.986 |
| transcript.whisperx[358].end |
10132.756 |
| transcript.whisperx[358].text |
那交通補助會現在目前是編載衛福部的衛福部嗎?對所以你最主要的部分就是看的健保費還有我們文件站的這個部分是OK好那謝謝我們羅署長的回答請回那我們有請國務院院長 |
| transcript.whisperx[359].start |
10139.656 |
| transcript.whisperx[359].end |
10160.255 |
| transcript.whisperx[359].text |
委員長好很高興您能夠親自來因為第一次見到您然後我也知道國務院擔任了非常重要的角色尤其在原子民主健康資料這個部分那我昨天有詢問我們的部長說可能每年有2500萬的經費到那我想再確認一下是每年都會有嗎還是每幾年會有還是怎麼樣 |
| transcript.whisperx[360].start |
10161.549 |
| transcript.whisperx[360].end |
10179.318 |
| transcript.whisperx[360].text |
跟委員報告從這個2023年12月29號國衛院正式成立援助民族的健康研究中心到現在每一年部裡面事實上都寬列預算給國衛院來進行這個我們研究中心的各項任務的進行 |
| transcript.whisperx[361].start |
10180.404 |
| transcript.whisperx[361].end |
10199.931 |
| transcript.whisperx[361].text |
他說從賴總統的健康台灣願景中的三高防治八八八計畫與癌症防治計畫這個希望能夠從全國的健康資料裡面來勾結我們原住民健康資料那我想知道這個部分的資料的收集有沒有完全還是說還在進行中是 根文報告那我們從這個 |
| transcript.whisperx[362].start |
10202.031 |
| transcript.whisperx[362].end |
10220.18 |
| transcript.whisperx[362].text |
研究中心成立以後我們就組織了一個研究的一個諮議委員會那目前17位委員裡面大概有八成以上都是我們原住民族的各領域的專家醫師跟學者那我們在從事一般的這一些健康資料庫的建置的時候 |
| transcript.whisperx[363].start |
10220.76 |
| transcript.whisperx[363].end |
10237.374 |
| transcript.whisperx[363].text |
我們特別強調文化的敏感度所以我們就在各面向諮詢我們的這些委員那目前我們希望成立一個可以長期追蹤而且是多面向可以做分析的一個援助民族的生命歷程的 |
| transcript.whisperx[364].start |
10237.914 |
| transcript.whisperx[364].end |
10254.965 |
| transcript.whisperx[364].text |
健康資料庫那從延續我們過去從1998年開始的健保相關的資料庫我們希望可以納入更多的包括死因包括癌症包括疫苗的接種也包括這些未來的這些相關的跟 |
| transcript.whisperx[365].start |
10255.865 |
| transcript.whisperx[365].end |
10278.811 |
| transcript.whisperx[365].text |
就學就醫相關的其他部會的資料我們可以整合在一起就說我們希望能夠整合健保醫療利用長照慢性病死因啊偏向的醫師人力跟文化照護服務的關鍵資料然後整合成一個政策是不是目前有一個政策的一個優先的順序嗎還是你們已經有產生一個政策的導引給我們的部長參考 |
| transcript.whisperx[366].start |
10280.174 |
| transcript.whisperx[366].end |
10309.621 |
| transcript.whisperx[366].text |
是 那目前我們這一年多來就是說諮詢了這些委員我們針對12個主要的議題包括這些醫療照護包括長照包括慢性病包括癌症包括口腔的衛生等等我們有12個重要的面向那目前希望可以透過更深入的這個研究所以經過兩次的計畫的徵集我們目前有六個計畫要開始執行那這個六個計畫的主持人 |
| transcript.whisperx[367].start |
10310.021 |
| transcript.whisperx[367].end |
10325.495 |
| transcript.whisperx[367].text |
或共同主持人必須要有原住民族的身份那我感謝國會的努力我相信在你們的努力之下還有我們的監督之下希望把這項工作做好那我會持續關注這個議題那謝謝院長親自到場謝謝謝謝委員好 請衛福部長請部長 |
| transcript.whisperx[368].start |
10333.817 |
| transcript.whisperx[368].end |
10345.671 |
| transcript.whisperx[368].text |
部長就講一個比較我們就開始講到比較細節的問題了那我剛看了就是說偏鄉地區的一個健保署回答一下就是我剛看醫療 |
| transcript.whisperx[369].start |
10350.02 |
| transcript.whisperx[369].end |
10378.123 |
| transcript.whisperx[369].text |
缺乏的地區的範圍裡面我看竟然沒有高雄市高雄市我看了一下我在我常常經過的地方我覺得特別偏遠的地方比如說六龜還有甲仙那為什麼這兩個區沒有在我們的醫療缺乏的地區因為它是鄰近我們納瑪下桃園最近的那個平地鄉如果說平地區那如果說我們這兩個區塊 |
| transcript.whisperx[370].start |
10379.724 |
| transcript.whisperx[370].end |
10398.324 |
| transcript.whisperx[370].text |
完全沒有醫療服務的時候其實要藉助甲仙跟六龜可是甲仙跟六龜如果他本身也是醫療缺乏地區的話這個部分要怎麼去補足委員指的是說什麼就是說他們的醫療要去看病啊急救啊其實在 |
| transcript.whisperx[371].start |
10399.571 |
| transcript.whisperx[371].end |
10428.982 |
| transcript.whisperx[371].text |
在我們納瑪下跟桃園地區可能相對不樂因為他們可能只有一個點比如說衛生所可是比如說他為了要就近他會到甲仙跟六龜可是甲仙跟六龜他明明他也是醫療缺乏的地區那如果說這個這個重點沒有被看看到的話沒有資源更多給他們的時候我們鄰近的族人要去的時候他們也是去一個醫療缺乏的地區啊我的意思是這樣是說沒有列入那個嗎對啊他沒有列入甲仙跟六龜沒有列入 |
| transcript.whisperx[372].start |
10430.772 |
| transcript.whisperx[372].end |
10448.982 |
| transcript.whisperx[372].text |
跟委員報告我們健保在列入偏鄉事實上每一季都會有提案我會盤點這個醫療資源跟當地的居民的人數我們剛委員提到這兩處我們回去再做盤點我們每一季每一季都有持續列入的那再跟委員補充事實上不是只有偏鄉是挹注偏鄉醫療資源 |
| transcript.whisperx[373].start |
10450.283 |
| transcript.whisperx[373].end |
10469.063 |
| transcript.whisperx[373].text |
醫事室那邊有以外光是健保署就有三個一個是委員知道的燈塔型醫院那另外一個就是IDS第三個是醫缺醫不足的巡迴診所以總共有三個健保署那為什麼會特別講到這個就是因為要洗腎可能就要到這兩個地區啦因為我們娜瑪夏跟桃園就是沒有洗腎的床嘛 |
| transcript.whisperx[374].start |
10469.483 |
| transcript.whisperx[374].end |
10488.853 |
| transcript.whisperx[374].text |
那我是希望能夠特別重視他鄰近的這個平地鄉的一個平地區的一個醫療的規模讓我們鄰近的族人如果要到那個地方的時候又找不到可以去洗腎或者是說進一步的治療的地方我認為是這樣第二個就是我們的養成計畫已經這麼久了可是我還是會聽到 |
| transcript.whisperx[375].start |
10489.993 |
| transcript.whisperx[375].end |
10505.8 |
| transcript.whisperx[375].text |
有些他非以色列的比如說他是藥師啦或者是護理師啊結果他找不到地方可以服務比如說呢因為他可能因為是縣市政府他把關了一些人士的一個缺口那他認為這個是在地方的人事權不過 |
| transcript.whisperx[376].start |
10506.42 |
| transcript.whisperx[376].end |
10528.807 |
| transcript.whisperx[376].text |
他已經受完訓練了他也要償還公費了他卻苦無沒有地方可以服務我覺得這個明明是我們衛福部去訓練的或者說我們公費的這些養成計劃的學生你不能讓他沒有地方可以服務啊所以我是覺得說你們應該去盤點有多少個畢業生拿到執照以後他確實找不到地方服務你們要擔下這個責任來幫他們找 |
| transcript.whisperx[377].start |
10530.487 |
| transcript.whisperx[377].end |
10553.56 |
| transcript.whisperx[377].text |
好跟委員說明我們確實也發現到有一些在地養成的因為他的第一順位是要回到他本來的原鄉但是因為如果沒有缺因為可能之前的服務的還沒有期滿或者是繼續留下來了那他就沒有缺出來那我們就會有第二順位第三順位可能會逐步的擴大到其他的這個 |
| transcript.whisperx[378].start |
10554.6 |
| transcript.whisperx[378].end |
10569.786 |
| transcript.whisperx[378].text |
偏鄉人力不足的地方然後或者是我們的部立醫院所以當然我們有一些順位啦至少讓他有地方可以去啦我們剛才講的燈塔醫院嘛對不對也可以去還有我們的我們再盤點一下因為我們大概是 |
| transcript.whisperx[379].start |
10570.686 |
| transcript.whisperx[379].end |
10592.571 |
| transcript.whisperx[379].text |
半年會盤點一次看有哪些缺不過我想說如果找不到的就直接來跟我們報導上次我有提過就是有一些公費醫師他想要去居家醫療型態的診所服務我希望他能夠也列入可以償還公費的一個選項因為之前有這樣看過我們也列在這個Priority裡頭 |
| transcript.whisperx[380].start |
10594.511 |
| transcript.whisperx[380].end |
10614.25 |
| transcript.whisperx[380].text |
那還有一個IDS值班的地點因為永遠都是在衛生所可是其實衛生所是相對醫療的那個比較豐富的地方為什麼怎麼說呢因為很多開業意會顯在人多的地方比如說像山地門的話它就會開在可能開在水門或者是開在什麼我的意思是說 |
| transcript.whisperx[381].start |
10615.071 |
| transcript.whisperx[381].end |
10644.631 |
| transcript.whisperx[381].text |
因為都沒有去檢討IDS的晚上的值班地點所以它地點永遠都一樣所以缺乏的地方永遠缺乏比如說呢我們里那裡它是一個八八風災移居的一個區塊它居住了三個鄉的一個原住民主人口在那裡結果變成是遠變成是全國最大的地區還有我們長治百合可是IDS的那個點它就不是在那裡啊所以它應該是要有一個所謂的彈性也就是說我們不能只限定說IDS的值班的地點是 |
| transcript.whisperx[382].start |
10645.812 |
| transcript.whisperx[382].end |
10663.405 |
| transcript.whisperx[382].text |
陰性規定是在哪裡應該讓衛生局所去盤點說哪一些鄉鎮或者是說區域或是部落是需要晚上夜間值班的地方而不是永遠都在那個地方stand by然後永遠都沒有病人來或者說該需要服務的人沒有服務到 |
| transcript.whisperx[383].start |
10664.545 |
| transcript.whisperx[383].end |
10691.416 |
| transcript.whisperx[383].text |
我們今年那個IDS檢討的時候我就請健保邀請那個衛生局來表示意見看他有沒有需要調整的點這樣按照那個地方上的需求來調整最後因為時間的關係我還是講到巴士量表因為我曾經因為這樣的事情召集過衛福部還有園民會到辦公室來聊因為我們的平均餘命就是差到7歲左右可是就因為這樣的一個差距我們沒有做adjustment |
| transcript.whisperx[384].start |
10691.636 |
| transcript.whisperx[384].end |
10710.282 |
| transcript.whisperx[384].text |
所以我希望至少75歲或是至少有一個降低對原住民來講當然不是每一個原住民可以請的起可是當他有這個需求的時候應該就因為他的民族的關係而得到這方面的一個你提的是說80歲以上面80兩表希望那個年齡下降對原住民好 我們來 |
| transcript.whisperx[385].start |
10712.103 |
| transcript.whisperx[385].end |
10728.509 |
| transcript.whisperx[385].text |
我們來提建議給勞動部啦因為我也問過勞動部長 勞動部長說這是衛福部的事情對啊我知道 所以我們要提建議啦所以我那時候叫跨部會的一個學者好不好發布的時候要他們發布但是我們來提建議 建議按照這個年齡的這個餘命的落差來做調整我們來發這個公文給勞動部 建議他 |
| transcript.whisperx[386].start |
10738.312 |
| transcript.whisperx[386].end |
10743.977 |
| transcript.whisperx[386].text |
對那個元敏的話他的那個免巴氏陽表的那個年齡往下修看看是不是到75這樣好 謝謝好 謝謝盧縣議委員 |
| transcript.whisperx[387].start |
10752.711 |
| transcript.whisperx[387].end |
10756.255 |
| transcript.whisperx[387].text |
目前收到臨時提案共商案 |
| transcript.whisperx[388].start |
10773.339 |
| transcript.whisperx[388].end |
10781.226 |
| transcript.whisperx[388].text |
等一下我先宣告一下 待會謝一芳委員執行完畢後休息20分鐘用餐休息過後處理臨時提案現在請林淑芳委員發言好 謝謝昭偉 是不是請我們這個部長 石部長有請石部長 |
| transcript.whisperx[389].start |
10802.123 |
| transcript.whisperx[389].end |
10827.953 |
| transcript.whisperx[389].text |
好部長我今天要跟你討論的是這個瘦瘦針瘦瘦針那因為你們食藥署在今年的這個2月7號發布了一個新聞稿把這個近期國際新聞報導裡面美國有數千名GLP-1受體促銷劑類品藥品使用者因嚴重副作用提起大規模訴訟而英國吉保健 |
| transcript.whisperx[390].start |
10828.833 |
| transcript.whisperx[390].end |
10855.575 |
| transcript.whisperx[390].text |
產品管理局亦於近期發布安全警訊提醒該類藥品可能引發嚴重的急性胰臟癌的風險包含罕見的壞死性和致死性胰臟炎的案例大家都知道我們也有許可我們最近通報的不良反應截至到去年年底為止是21件 |
| transcript.whisperx[391].start |
10857.216 |
| transcript.whisperx[391].end |
10881.688 |
| transcript.whisperx[391].text |
那都還沒有觀測到大概整體性的藥品安全的問題大概21件而已但你們食藥署發布這個新聞大概是要提醒大家說這個東西部分是可以許可用於12歲以上但大多數都能限成人使用而且要符合需符合BMI等使用條件你們是這樣子提醒 |
| transcript.whisperx[392].start |
10882.648 |
| transcript.whisperx[392].end |
10905.082 |
| transcript.whisperx[392].text |
所以你們這個新聞稿大概也有另外兩個重點第一個就是說網路販售違法第二個這個全國藥物不良反應通報兩年間21件那請問部長你覺得目前你們說網路販售違法那受受真正網路販售的猖獗的情形你覺得嚴重嗎主秘 不然你先計算好 主秘質詢你 |
| transcript.whisperx[393].start |
10910.427 |
| transcript.whisperx[393].end |
10917.317 |
| transcript.whisperx[393].text |
祖密在質詢抱歉我們暫停一下因為他干擾到我的質詢抱歉 |
| transcript.whisperx[394].start |
10920.722 |
| transcript.whisperx[394].end |
10942.623 |
| transcript.whisperx[394].text |
你們告訴大家說網路販售違法那網路販售的問題嚴不嚴重我真的跟委員說明我偶爾也會聽到有朋友在講類似像這種他並不是在我們的藥局或者是診所拿到在藥局就沒有藥局管理的問題了嗎 |
| transcript.whisperx[395].start |
10944.951 |
| transcript.whisperx[395].end |
10965.404 |
| transcript.whisperx[395].text |
藥局的部分喔就是說你說在網路上拿到的違法但在藥局就沒有藥局管理的問題了嗎也有也有這個藥是屬於醫師的處方藥所以一定要有醫師的這個處方那你覺得兩年間只有接獲21件疑似不良反應的數字你覺得有沒有黑數的可能存在 |
| transcript.whisperx[396].start |
10967.932 |
| transcript.whisperx[396].end |
10974.166 |
| transcript.whisperx[396].text |
這個所有的report都是under report啦所有的通報都是都有低估的可能啦 |
| transcript.whisperx[397].start |
10974.827 |
| transcript.whisperx[397].end |
11000.182 |
| transcript.whisperx[397].text |
那但是呢就是說我們到目前是還沒有看到那個很嚴重的像這個報章所揭露的所以我們也在提醒臨床的同仁所以你有看到這個報章的媒體的報導囉有有有媒體講得很嚴重你認為媒體講得太過嚴重了是不是不是是要提醒我們的臨床的醫療人員去注意媒體的報導是什麼內容我現在跟你講這個媒體的報導 |
| transcript.whisperx[398].start |
11004.645 |
| transcript.whisperx[398].end |
11026.207 |
| transcript.whisperx[398].text |
就是說記者分別潛入三個社群名字叫授授真的 簡重的 相關的社群記者潛入三個社群其中一個LINE的社群人數每個月成長的幅度大概增加500人截至他截稿前 那個社群是2000人的規模 |
| transcript.whisperx[399].start |
11028.269 |
| transcript.whisperx[399].end |
11032.413 |
| transcript.whisperx[399].text |
那網友大概問說大概多少錢5MG的大概多少錢有沒有推薦北部的比較便宜的診所到處在缺貨跟版主拿的話很快就會拿得到大概都是這種問題要回應 |
| transcript.whisperx[400].start |
11044.025 |
| transcript.whisperx[400].end |
11053.816 |
| transcript.whisperx[400].text |
那其實表面上好像大家在裡面詢問事實上版主也往往為了求真若可的人告訴大家說我這裡很多優惠的價格提供了購買的管道所以很多不肖業者在裡面滲入違法販售的很隱蔽的就在這個裡面 |
| transcript.whisperx[401].start |
11063.886 |
| transcript.whisperx[401].end |
11085.777 |
| transcript.whisperx[401].text |
這還是眾多地下流通管道之一一個LINE群組就兩千多人顯然就使用者或是搜尋資訊者或是提供管道給徵者兩千多人一個LINE而已這只是其中一個你說記者寫得太過嚴重有沒有太過嚴重我覺得我是持保留啦 |
| transcript.whisperx[402].start |
11087.247 |
| transcript.whisperx[402].end |
11113.532 |
| transcript.whisperx[402].text |
但是一般人你只要打開IG、FB、Trade、Dcard所有售售真的廣告都無所不在所以裡面都要詢問然後裡面的帳號真假不知道那些有人問問題有人健康諮詢、價格諮詢回答的人到底是誰也不知道身份是不是專家也不知道但是這些匿名的陌生者 |
| transcript.whisperx[403].start |
11114.572 |
| transcript.whisperx[403].end |
11128.024 |
| transcript.whisperx[403].text |
還真相當起這種醫師啦回覆他人用藥的疑問從如何減輕副作用到真劑保存的方式來源不明的這一些到底是假醫師這些醫主 |
| transcript.whisperx[404].start |
11130.125 |
| transcript.whisperx[404].end |
11145.757 |
| transcript.whisperx[404].text |
還經常錯誤擺出然後到底說我針劑已經打了我可不可以記我可以放多久打開的已經使用過的針劑可以再放一個月嗎有人就說我的醫師告訴我可以放三四個月在那裡不斷的分享 |
| transcript.whisperx[405].start |
11146.778 |
| transcript.whisperx[405].end |
11149 |
| transcript.whisperx[405].text |
這樣的方法會不會出問題 會喔 這是處方藥大家都知道處方藥 要醫師評估 詢問病史才能夠取得但是在網路社群上 賣家不去醫師資格那沒有見面 毫無門檻 直接流通成交買賣 |
| transcript.whisperx[406].start |
11170.942 |
| transcript.whisperx[406].end |
11192.614 |
| transcript.whisperx[406].text |
然後賣家的話術也不是專業性讓消費者使用的風險增加很多啊可是呢記者還報導他透過這個社群接觸到其中一名版主自稱是職業的藥師所以他有管道可以輕易拿得到這個真品藥品 |
| transcript.whisperx[407].start |
11193.875 |
| transcript.whisperx[407].end |
11211.744 |
| transcript.whisperx[407].text |
四年間他從在FB上販售瘦瘦針現在轉向LINE的社群賣猛煎了社群人數破千他說有人38公斤也想買他說我是覺得有點病態不建議他打但是我最後還是賣給他 |
| transcript.whisperx[408].start |
11213.645 |
| transcript.whisperx[408].end |
11236.371 |
| transcript.whisperx[408].text |
王先生表示現在他也知道因為他藥師嘛他知道這樣子在社群上販賣藥品是違法但他還是希望能趁這個機會趕快多賺一點錢這只是網路平台一個社群幾千人每個人都有幾千人網路平台那還有沒有其他管道還有沒有其他違法的管道在販賣就你所知部長還有嗎 |
| transcript.whisperx[409].start |
11241.425 |
| transcript.whisperx[409].end |
11244.026 |
| transcript.whisperx[409].text |
這個我就不清楚不清楚我告訴你還有去年12月有一個獨家新聞華航的空服員從日本私自夾帶大量的猛劍熱入境沒有申報的12盒回台的時候被松山機場海關查獲然後沒收了全部然後也依要事法移送法辦這個東西是日本代購回來還有一種是真的是代購網頁 |
| transcript.whisperx[410].start |
11269.479 |
| transcript.whisperx[410].end |
11288.48 |
| transcript.whisperx[410].text |
境外 我剛剛講的是除了社群在境內購買以外現在是境外回來的很多 境外回來的所以你們都沒有掌握有沒有特殊的職業或集團違法的從境外攜帶入境為什麼要去境外攜帶入境 為什麼 |
| transcript.whisperx[411].start |
11293.387 |
| transcript.whisperx[411].end |
11308.648 |
| transcript.whisperx[411].text |
比較便宜因為無獨有每一個國家定價都不一樣都不一樣而且包裝也不一樣網路上流傳日本代購售售真更便宜所以 |
| transcript.whisperx[412].start |
11309.389 |
| transcript.whisperx[412].end |
11330.598 |
| transcript.whisperx[412].text |
平行輸入水貨來了然後呢蒙建勒為例連日本是周拋型的獨立分裝的一支單次使用的台灣是一支分四次嘛所以都看得出來看包裝蒸汽多少量就知道是日本的還是台灣的都看得出來 |
| transcript.whisperx[413].start |
11331.838 |
| transcript.whisperx[413].end |
11350.107 |
| transcript.whisperx[413].text |
那我們現在看到這樣第一個境外輸入不是只有這樣子還有一個是跨境網站購買售售真日本的但是是跨境的網站代購日本的商品的網站 |
| transcript.whisperx[414].start |
11351.716 |
| transcript.whisperx[414].end |
11371.626 |
| transcript.whisperx[414].text |
所以這個裡面標榜日本進口的代購網站可以看一下嗎不僅有日本實體店鋪的資訊和公司的簡介還附有完整購買說明和注意事項這些網站試圖將代購流程包裝的好像他們是透明的正規的合法的 |
| transcript.whisperx[415].start |
11372.606 |
| transcript.whisperx[415].end |
11387.074 |
| transcript.whisperx[415].text |
還有代購的網路賣家毫不避諱地提出沒關係我還可以幫你安排在日本代看診讓日本醫師開藥再把藥寄回台灣你看這個代購網站叫什麼KUWA在這裡代購他會幫你買日本直送你看客戶評價 |
| transcript.whisperx[416].start |
11398.197 |
| transcript.whisperx[416].end |
11421.909 |
| transcript.whisperx[416].text |
下訂三天就送到台灣了啊這個只有日文以外再來就繁體製他的網頁只有兩個版本日文跟繁體製為台灣專門架設的然後點開門見樂的頁面客戶評價都是台灣消費者看一下全部都是台灣的然後呢然後呢部長他這個 |
| transcript.whisperx[417].start |
11427.959 |
| transcript.whisperx[417].end |
11449.59 |
| transcript.whisperx[417].text |
從日本就直接輸入進來了以這樣的方式購買藥品郵寄到台灣是合法的嗎這個當然違法那食藥署有沒有在處理呢這很廣泛耶普遍耶食藥署有在處理嗎不合法你說不合法當然不合法有在管理嗎你不知道這個我們要來檢討好我現在要告訴你 |
| transcript.whisperx[418].start |
11455.546 |
| transcript.whisperx[418].end |
11476.038 |
| transcript.whisperx[418].text |
你們人家記者去採訪了食藥署藥品組組長王淑芬組長表示該網站監察IP是在國外的境外公司政府沒有管轄權跟調查權難以開罰但是如果一旦接獲通報 |
| transcript.whisperx[419].start |
11477.239 |
| transcript.whisperx[419].end |
11504.761 |
| transcript.whisperx[419].text |
因為藥物可能的安全疑慮還是會有所以會把不是 它是說如果未來藥物本身有安全的疑慮你們食藥署就會把相關資訊放在食藥署的食藥碰瘋廣告專區所以會善盡提醒國人注意產品的安全和品質欸 寶丁你剛才這個網站很有名它不是那個第一次 |
| transcript.whisperx[420].start |
11506.712 |
| transcript.whisperx[420].end |
11512.256 |
| transcript.whisperx[420].text |
這個網站不是第一次,2024年在COVID-19的時候,他們販賣莫拉皮拉韋的藥品,販賣過但食藥署的管理方式就是說,好你們這是碰瘋廣告,我把你放在專區給大家知道,就沒了 |
| transcript.whisperx[421].start |
11527.125 |
| transcript.whisperx[421].end |
11529.206 |
| transcript.whisperx[421].text |
然後2025年我在這裡也質詢過這個網站他們在賣什麼史蒂諾斯然後我在這裡質詢說這個是 |
| transcript.whisperx[422].start |
11541.235 |
| transcript.whisperx[422].end |
11557.669 |
| transcript.whisperx[422].text |
是問題網路上違法販賣這麼嚴重當時石耀水是說這境外網站無法可管就蓄以為夷的立委這樣子消極怠惰的態度難怪境外網站行利做家好 |
| transcript.whisperx[423].start |
11558.67 |
| transcript.whisperx[423].end |
11570.612 |
| transcript.whisperx[423].text |
也賣得很好 鑽羊藥也賣得很好 安眠藥也賣得很好抗COVID-19的抗病毒的莫拉皮拉維當時也賣得很好現在授受針也賣得很好我們現在是沒有政府嗎你們一句話 境外網站沒有辦法管理 開發不到 |
| transcript.whisperx[424].start |
11585.563 |
| transcript.whisperx[424].end |
11601.539 |
| transcript.whisperx[424].text |
阿得雙手一攤嗎跟委員說明我們也已經關注到這個電商平台或者是這個網路上販賣的這個問題所以我們近期就會提出要事法的修法把它納入管理 |
| transcript.whisperx[425].start |
11602.139 |
| transcript.whisperx[425].end |
11607.921 |
| transcript.whisperx[425].text |
這句話我已經聽了快一年了因為我在2022年諮詢史蒂諾斯的時候2022年我諮詢史蒂諾斯的時候你們就這樣子講了而且你們本來說都沒有境外網站沒有辦法管結果我去年提了預算凍結案你們就馬上找相關單位來屏蔽了那個網站有一個假的史蒂諾斯台灣官方網站你們就馬上給它屏蔽掉了 |
| transcript.whisperx[426].start |
11629.288 |
| transcript.whisperx[426].end |
11649.571 |
| transcript.whisperx[426].text |
現在是整個其他的不只是賣這個的還有就是什麼都賣的 哭啊的你們就不敢屏蔽掉如果蝦皮你也不敢屏蔽掉所以呢 容許這樣的跨境網站我覺得政府現在是睜一隻眼閉一隻眼然後說要修法也已經講了一年了版本也沒有拿出來 |
| transcript.whisperx[427].start |
11650.612 |
| transcript.whisperx[427].end |
11668.999 |
| transcript.whisperx[427].text |
食藥署回答我本來說都沒有辦法管後來怎麼網站就屏蔽掉了只要要給他凍結預算馬上就有效率把那個網頁屏蔽掉了這樣的違法只是這樣子嗎只是這樣子嗎這樣違法的行徑延伸的醫療問題有哪些啊 |
| transcript.whisperx[428].start |
11670.699 |
| transcript.whisperx[428].end |
11695.993 |
| transcript.whisperx[428].text |
網路上亂購代購境外輸入然後我們的藥局沒有處方籤藥局直接可以買得到然後就是這樣子亂很亂啊所以這個台大醫院內分泌新陳代謝科的主治醫師李洪源質疑同樣的藥物能用更便宜的價格取得其中的原因和風險相當不可控台大醫院 |
| transcript.whisperx[429].start |
11696.573 |
| transcript.whisperx[429].end |
11717.243 |
| transcript.whisperx[429].text |
嘉義部兼任組織醫師年曉欣也強調這種藥品來源不明 無法確認真為批號 效期 成分也沒有經過食藥署檢測不知道有沒有符合台灣的衛生法規所以在這種運送的過程有沒有變質 保存是不是完整有沒有被稀釋掉 |
| transcript.whisperx[430].start |
11718.343 |
| transcript.whisperx[430].end |
11734.732 |
| transcript.whisperx[430].text |
如果這麼容易可以跨國帶來帶去世界級的藥廠為什麼還要耗費資金做冷鏈處理這風險很大我就要講這一段是說所有的很多醫生都出來講其實這樣子的跨國境外輸入風險很大風險很大 |
| transcript.whisperx[431].start |
11737.935 |
| transcript.whisperx[431].end |
11756.289 |
| transcript.whisperx[431].text |
那為什麼還是這麼大量而政府都沒有管那除跨國網路我剛剛講了藥局和診所的無處方籤販售無處方籤販售的問題真的就這一篇媒體的報導其實也是很嚴重 |
| transcript.whisperx[432].start |
11757.982 |
| transcript.whisperx[432].end |
11773.202 |
| transcript.whisperx[432].text |
三名記者主動提供自己的BMI他們的BMI是16到19分別致電到藥局的實體諮詢結果發現其中幾間藥局並沒有拒絕販售也沒有按照流程索取處方簽 |
| transcript.whisperx[433].start |
11774.523 |
| transcript.whisperx[433].end |
11787.196 |
| transcript.whisperx[433].text |
所以這樣子在民眾眼中大家認為很專業的 為健康把關的也有藥局勢 直接就賣了像賣OK棒一樣的賣了那我現在要講說保證保證這個問題真的 |
| transcript.whisperx[434].start |
11797.913 |
| transcript.whisperx[434].end |
11817.278 |
| transcript.whisperx[434].text |
所以我們從兩個方向來跟委員報告第一個我們在上半年我們就會提出修法的版本現在已經我看了差不多了所以我們接下來就會開始來做預告所以上半年我們就會提出那個關於這個網路平台的這個管理的修法網路平台以外的呢代購的呢 |
| transcript.whisperx[435].start |
11817.978 |
| transcript.whisperx[435].end |
11841.369 |
| transcript.whisperx[435].text |
日本代購的呢 日本境外輸入的呢然後沒有處方簽的藥局就販售呢我還沒有講一個 還有一個醫美診所 有醫師耶你看這醫美診所的廣告醫美診所的廣告你感覺直接就無選醫你到我這個醫美診所來我就免費送你馬上打蒙健樂體驗一次當然醫美診所 |
| transcript.whisperx[436].start |
11846.53 |
| transcript.whisperx[436].end |
11872.043 |
| transcript.whisperx[436].text |
大家都知道這個已經有違法了啦這個要請那個醫師師交代給衛生局去查處這個已經有違法違反我們醫療法的廣告了這個免費促銷這個不行了就已經這樣因為診所授受針的流通方式比我們想像中的更彈性沒有一整支的藥可以賣啊那這個體驗醫治可能是一支打四個人欸一支打四個人欸換個針頭就繼續打四個人欸 |
| transcript.whisperx[437].start |
11876.281 |
| transcript.whisperx[437].end |
11879.425 |
| transcript.whisperx[437].text |
醫美診所這個要查然後沒有處方簽就可以施打 贈送 免費體驗在這種 我就想說我們再這樣下去你會覺得要釋法就等於是擺著好看的啦 |
| transcript.whisperx[438].start |
11892.947 |
| transcript.whisperx[438].end |
11920.03 |
| transcript.whisperx[438].text |
不是只有你剛剛講的網站上販售日本的怎麼辦醫美這些怎麼辦還有另外一個就是通路就是要去掌握這個藥商供應到哪裡去所以我們會把這個流向掌握出來所以如果他的這個流向是藥商供應給藥局是正常的所以藥局就要有一定的處方簽要能夠讓我們查核不然他就是違法販賣 |
| transcript.whisperx[439].start |
11921.251 |
| transcript.whisperx[439].end |
11938.196 |
| transcript.whisperx[439].text |
你們沒有在稽查量跟處方簽對不對得起來不知道啦醫美診所更難啦但我的意思是說欸這樣大家打全台灣都沒有人出事嘛只有21件一年兩年21件看起來好像都沒出事欸 |
| transcript.whisperx[440].start |
11940.19 |
| transcript.whisperx[440].end |
11950.976 |
| transcript.whisperx[440].text |
不良反應件數只有21件然後我們大家在催上面你隨便搜尋猛健樂不舒服划一分鐘的螢幕都比21件還要多部長你們的查處只有21件我剛剛講在網路上隨便划一分鐘猛健樂不舒服搜尋都比21件還要多 |
| transcript.whisperx[441].start |
11964.574 |
| transcript.whisperx[441].end |
11967.917 |
| transcript.whisperx[441].text |
這個問題是什麼 你知道嗎這個問題是什麼我剛剛講的 代購進來的委託從日本境外輸入的醫美診所免費體驗的藥局沒有廚房間買的然後在賴群組集體購買的這些人打了出事了請問 藥害補償救濟可以去通報嗎他可以去通報不良反應嗎 可以嗎 |
| transcript.whisperx[442].start |
11993.134 |
| transcript.whisperx[442].end |
12016.571 |
| transcript.whisperx[442].text |
他們有資格這些違法管道取得的他們可以去通報不良反應嗎可以嗎不良反應的話都可以通報就是說如果你是在醫療端發現的因為我們的通報是從醫療端通報不是民眾的各自通報所以如果你是因為不舒服去就醫這個醫療端發現說是因為打這個藥感染的後面他就會通報 |
| transcript.whisperx[443].start |
12020.934 |
| transcript.whisperx[443].end |
12040.419 |
| transcript.whisperx[443].text |
通報以後那個當事人是不是有違法這個就要看後面因為通報只是處理這個通報了以未來的醫藥害救濟的話他可以試用嗎醫藥害救濟現在目前是兩種一種是按試印證使用的可以救濟第二個是off-label use |
| transcript.whisperx[444].start |
12041.479 |
| transcript.whisperx[444].end |
12048.344 |
| transcript.whisperx[444].text |
是醫師認為有使用必要的時候那個最先前提要架構合法使用吧這些都不合法的所以你現在把最前提叫要合法使用像of labor use的或者是他適應症的有符合的都可以申請你沒有講最核心第一句要合法取得合法醫師給你使用的才有 |
| transcript.whisperx[445].start |
12063.775 |
| transcript.whisperx[445].end |
12078.93 |
| transcript.whisperx[445].text |
而我剛剛講的一個菌組就兩千了每天代購不曉得幾千的違法在藥局買的一枚免費給你體驗的事實上要害就是通通都不能夠申請不能夠申請他還會給你通報嗎不會通報了搞不好還有法律責任要問責 |
| transcript.whisperx[446].start |
12087.213 |
| transcript.whisperx[446].end |
12106.88 |
| transcript.whisperx[446].text |
但是呢 這個問題你們做了什麼 我的意思是說2月食藥署的新聞講了說美國數千名嚴重副作用他連嚴重副作用是什麼都沒講耶然後講英國政府發布了安全警訊嚴重胰臟炎 壞死和致死性的胰臟炎 |
| transcript.whisperx[447].start |
12111.105 |
| transcript.whisperx[447].end |
12135.597 |
| transcript.whisperx[447].text |
這個東西我們的政府都沒有正中歧視告訴大家多嚴重那如果你打了有什麼症狀要怎麼反應那美國這個幾千人4400名的病患去提告從18歲到87歲你知道你知道多嚴重嗎我們政府都沒有告訴人家多嚴重是新聞報導而已 |
| transcript.whisperx[448].start |
12137.518 |
| transcript.whisperx[448].end |
12155.565 |
| transcript.whisperx[448].text |
你們的食藥署跟他說美國數千人使用者因嚴重副作用提起大規模訴訟你們食藥署連告訴大家警告大家這個問題有多嚴重都不願意做75%的人主張有胃麻痺表現為嚴重延緩胃排空有人被診斷為嚴重或永久性的胃麻痺或胃清癱 |
| transcript.whisperx[449].start |
12162.327 |
| transcript.whisperx[449].end |
12189.057 |
| transcript.whisperx[449].text |
然後腸組色、腸梗色有人手術有人結腸破裂嚴重嘔吐就不講還有眼睛與神經發生問題包括突發性的視力喪失心的色盲或眼部血流中斷還有其他不良反應包括腎靜脈血栓或肺栓塞有死亡案例這個是可是一般人不會覺得我肺栓塞我血栓 |
| transcript.whisperx[450].start |
12190.598 |
| transcript.whisperx[450].end |
12200.252 |
| transcript.whisperx[450].text |
是跟達蒙建勒有關啊政府也沒有對外公告啊也沒有實證啊但美國的案子是這樣子你們為什麼連這個資訊都這麼的這麼的保守不願意 |
| transcript.whisperx[451].start |
12205.539 |
| transcript.whisperx[451].end |
12233.678 |
| transcript.whisperx[451].text |
這樣子輕輕的帶過一筆帶過都不願意提醒台灣而且台灣有這麼多違法在使用違規在使用的新聞稿輕描淡寫的嚴重副作用是政府的立場還是藥廠的立場你們這麼多問題就只用一個美國這些使用者有嚴重副作用五個字帶過這是要代表政府的立場還是符合藥廠的利益 |
| transcript.whisperx[452].start |
12236.769 |
| transcript.whisperx[452].end |
12257.431 |
| transcript.whisperx[452].text |
可不可以這樣做不行啦我知道是不行啦那個有一個加醫科醫師王子允因為他媒體有報導所以我就直接就講出來了他說他這些問題讓他聯想到減重手術他這個醫生說我常常 |
| transcript.whisperx[453].start |
12258.812 |
| transcript.whisperx[453].end |
12275.257 |
| transcript.whisperx[453].text |
說應該抱著必死的覺悟去接受手術因為死亡對個人或家屬來講只是0跟1那很多人不管用藥或手術都是心存僥倖覺得手術同意書或是訪單上的副作用不會發生在自己身上所以民眾心存僥倖跟醫師淡化風險跟安全保證就是這些悲劇發生的原因 |
| transcript.whisperx[454].start |
12281.279 |
| transcript.whisperx[454].end |
12287.083 |
| transcript.whisperx[454].text |
對藥廠而言他們的工作只有砸錢研究跟研發還有用研究結果申請藥證只負責把可能的副作用寫出來已經有兩個藥廠並不負責民眾的心態跟醫生的話術所以這個王醫師講到說已經有兩個身心科醫師連有他的朋友不斷的反應他們因為身心科嘛所以會有人問求診嘛 |
| transcript.whisperx[455].start |
12308.661 |
| transcript.whisperx[455].end |
12332.612 |
| transcript.whisperx[455].text |
身心科醫生說 又遇到一位達蒙健那一個月發現沒有性慾 沒有活力 然後新發生憂鬱的患者真心建議開瘦瘦針的醫師 要積極追蹤患者的心理狀態所以不是只有生理上的憂鬱症 沒有活力 然後沒有性慾 |
| transcript.whisperx[456].start |
12334.141 |
| transcript.whisperx[456].end |
12335.702 |
| transcript.whisperx[456].text |
我今天這個問題的質詢不是反對民眾去使用也不是政府要不要反對減重治療而是一個本來應該要嚴格管理的處方藥 |
| transcript.whisperx[457].start |
12352.751 |
| transcript.whisperx[457].end |
12370.59 |
| transcript.whisperx[457].text |
正在被醫美化商品化網路化甚至地下化而主管機關卻還停留在被動的提醒零星的通報還有事後回應的層次這個才是我們憂心的廚房要這樣子在社群這樣子賣然後 |
| transcript.whisperx[458].start |
12373.07 |
| transcript.whisperx[458].end |
12397.899 |
| transcript.whisperx[458].text |
醫事管理 醫療倫理 用藥安全的防線全部全面的在鬆動更嚴重的是這樣犯難的違法的流通和錯誤的使用風險食藥署公佈的不良反應通報卻低得不成比例這到底是真的沒問題還是代表我們的整個監督監測的機制根本就沒有真正的反映出這個社會正在發生的醫療風險 |
| transcript.whisperx[459].start |
12402.541 |
| transcript.whisperx[459].end |
12411.067 |
| transcript.whisperx[459].text |
所以國外這樣的潛力 那我們政府到底要怎麼樣你有沒有盤點 這三年授受針違法販售違法輸入沒有處方給藥診所拆分施打 這些醫美診所免費施打這一些查處有沒有 開罰有沒有 我想是沒啦再來 |
| transcript.whisperx[460].start |
12424.998 |
| transcript.whisperx[460].end |
12442.207 |
| transcript.whisperx[460].text |
社群平台跨境網站地下代購以及診所藥局違規違法亂象你們到底要怎麼管理具體上我想你們也還沒有那在這種已經發生問題了真的有副作用了違法使用他真的有副作用了他要怎麼辦 |
| transcript.whisperx[461].start |
12443.459 |
| transcript.whisperx[461].end |
12468.134 |
| transcript.whisperx[461].text |
他能怎麼辦 那政府該怎麼辦我們應該要怎麼辦我今天是提醒大家啦因為授受真的商品這些藥品藥品商品化跟處方要把關失靈喔不是因為只有民眾有需求也不是因為只有社群平台助長了這個風潮其實背後很明確就是一個商業的結構 |
| transcript.whisperx[462].start |
12469.835 |
| transcript.whisperx[462].end |
12485.58 |
| transcript.whisperx[462].text |
高單價高討論度而且要持續不斷回購的自費藥品當這個收益這麼可觀的時候市場自然就會傾向擴大它的消費傾向淡化它的風險包裝它的便利性 |
| transcript.whisperx[463].start |
12486.46 |
| transcript.whisperx[463].end |
12510.176 |
| transcript.whisperx[463].text |
所以今天最需要被追究的不是業者賣得太過頭而已而是主管機關你在這個過程裡面有沒有扮演了一個消極縱容的角色如果政府沒有及時介入這些高風險的處方藥沒有主動查查 沒有清楚的揭露風險沒有對不當的行銷和灰色的流通 |
| transcript.whisperx[464].start |
12511.296 |
| transcript.whisperx[464].end |
12533.166 |
| transcript.whisperx[464].text |
設下明確的界線那麼這種行政上的消極跟怠惰本身就成為藥品商品化的推手所以換句話說售售真不是自然成為變成商品化的而是在市場強力推動下政府消極怠惰的管理這狀況下一步一步的變成暢銷商品藥品變商品 |
| transcript.whisperx[465].start |
12536.828 |
| transcript.whisperx[465].end |
12554.463 |
| transcript.whisperx[465].text |
這個顯然管理的強度都沒有了 促漲了藥品商品化我今天是要說這些 你們要怎麼做跟委員說明 我們一個月會提出整個強化的管理措施出來請您放心 措施要有行動 要管理 |
| transcript.whisperx[466].start |
12557.414 |
| transcript.whisperx[466].end |
12570.658 |
| transcript.whisperx[466].text |
藥廠賺得很爽啦可是他們對風險其實是不在乎的而我們是在乎風險的但我們政府連掌握風險的能力都沒有企圖都沒有這才是大問題啦謝謝好 謝謝委員我們一個月內會提出強化的措施 |
| transcript.whisperx[467].start |
12574.875 |
| transcript.whisperx[467].end |
12588.557 |
| transcript.whisperx[467].text |
好謝謝林子芬委員我們重新宣告待會兒王正旭委員尋答完及處理臨時提案處理完待謝一芬委員執行完畢後休息二十分鐘用餐現在請王正旭委員發言這三千塊會來嗎 |
| transcript.whisperx[468].start |
12607.339 |
| transcript.whisperx[468].end |
12629.931 |
| transcript.whisperx[468].text |
好 謝謝主席謝謝召委重新安排這個行程相關的議程我還是要麻煩石部長因為今天有兩個問題想要透過我請石部長對 召委特別安排的內容來跟部長對話包括第一個就是偏鄉離島疑似人員流財 |
| transcript.whisperx[469].start |
12631.031 |
| transcript.whisperx[469].end |
12646.403 |
| transcript.whisperx[469].text |
還有健康資料庫的整合健康資料庫的整合剛剛趙薇也有稍微跟院長提到過另外一個議題就是慢性病防治法的進度我想這兩個議題都非常非常需要 |
| transcript.whisperx[470].start |
12647.185 |
| transcript.whisperx[470].end |
12668.737 |
| transcript.whisperx[470].text |
再透過今天的方式來跟大家做討論那第一個就是有偏鄉離島疑似人員流財的措施我想這部分部長也非常清楚部長過去這麼長的一段時間擔任在這個衛福部裡面有非常多的經驗那也實務也知道幫助非常多相關的偏鄉的議題 |
| transcript.whisperx[471].start |
12670.083 |
| transcript.whisperx[471].end |
12689.919 |
| transcript.whisperx[471].text |
那如何留財應該是所有在做偏鄉處理過程當中最重要的一部分那其實透過這個離老偏鄉長期的醫療人力的不足不只是醫師而已應該是相關的人力都會受到影響 |
| transcript.whisperx[472].start |
12690.82 |
| transcript.whisperx[472].end |
12717.291 |
| transcript.whisperx[472].text |
那我們有了解很多的家籍很多的津貼都是希望讓人才能夠留在偏鄉可是也有其他的相關條件包括交通不方便或者是生活條件等等的所以留任的機制並不是那麼樣的穩定這是我們目前一直在面臨的問題所以我在最近跟陳妍委員還有莊瑞雄委員一起提了一個有關於醫療法 |
| transcript.whisperx[473].start |
12718.371 |
| transcript.whisperx[473].end |
12738.466 |
| transcript.whisperx[473].text |
第88條的修正的內容是希望能夠強化這個照顧的量能有關於人才流失的部分我們是希望在這個第88條裡面呢在第三項就是能夠針對醫事人員服務在偏鄉在離島偏鄉各級醫院及衛生所的部分收入 |
| transcript.whisperx[474].start |
12739.11 |
| transcript.whisperx[474].end |
12752.525 |
| transcript.whisperx[474].text |
能夠透過好的方案來免於紀錄年度因課稅所得的課稅的部分適用範圍當然這個還需要再進一步的處理我想這部分最重要的就是希望能夠透過這個稅制的優惠 |
| transcript.whisperx[475].start |
12755.528 |
| transcript.whisperx[475].end |
12771.201 |
| transcript.whisperx[475].text |
讓來肯定我們醫事人員在惡劣的環境裡面做非常好的貢獻那我相信這個長期在衛生地方衛生所服務的盧扎偉應該感受非常深刻因為我們知道盧扎偉在這方面真的貢獻非常非常的多 |
| transcript.whisperx[476].start |
12772.375 |
| transcript.whisperx[476].end |
12796.804 |
| transcript.whisperx[476].text |
所以衛福部這邊是不是能夠認同這個稅制優惠可以作為流採的一個補充方案那這樣的修正方向不知道部長有沒有進一步如何跟財政部啟動相關的評估跟研理跟委員說明為了增加這個流採其實我們也做了很多的措施那也有規劃中的那第一個我們就已經希望把這個已經 |
| transcript.whisperx[477].start |
12797.344 |
| transcript.whisperx[477].end |
12819.663 |
| transcript.whisperx[477].text |
做的就是把那個所有的給付都再加成所有的這個離島我們都是加30%那另外有一些偏鄉我們也都有加成的給付就是希望讓這些院所的收入會比較高那麼第二個當然希望他的這個收入高是要反映在這個人員的薪資上所以我們現在也在規劃要爭取在這個 |
| transcript.whisperx[478].start |
12820.864 |
| transcript.whisperx[478].end |
12846.704 |
| transcript.whisperx[478].text |
偏鄉有個偏鄉佳績這當然指的是公立醫院的部分公立醫療機構的部分讓他可以有一個偏鄉佳績我們現在在爭取看看能不能提增加這個項目來留產至於說這個稅制的優惠的部分我想這個還涉及到跟這個財政部的討論我們來跟他研究看看那麼這個的可能性怎麼樣 |
| transcript.whisperx[479].start |
12847.324 |
| transcript.whisperx[479].end |
12868.112 |
| transcript.whisperx[479].text |
是我們是希望雙管齊下這是除了能夠透過進貼方式來處理以外那我們也希望透過稅制的方式也一起來讓這些在偏鄉服務的醫事人員都能夠感受到政府對他們的付出另外一份的肯定那第二部分就要麻煩也要請司徒院長 |
| transcript.whisperx[480].start |
12868.963 |
| transcript.whisperx[480].end |
12895.868 |
| transcript.whisperx[480].text |
來一起來討論有關於原住民健康資料庫的整合的部分剛剛趙偉其實也有跟院長做一些討論我們了解其實透過在112年正式施行了原住民原住民主健康法以後呢國會院也在同年底就成立了原住民主健康研究中心在這個中心裡面其實有三項非常重要的核心任務就是 |
| transcript.whisperx[481].start |
12896.69 |
| transcript.whisperx[481].end |
12922.304 |
| transcript.whisperx[481].text |
第一要建構整合性的原住民主健康資料庫的平台來進行健康指標的建設與分析那第二部分就是推動以原住民主為主體的研究涵蓋了這個健康照護模式優化還有這個政策建言的提出第三個部分就是深化原住民主主題性的研究強調這個健康價值跟信念的實踐以實現健康自覺的目標 |
| transcript.whisperx[482].start |
12923.206 |
| transcript.whisperx[482].end |
12941.33 |
| transcript.whisperx[482].text |
那目前中心最重要的任務之一就是要擴展與維護原住民主的健康資料庫剛剛院長有稍微做一些說明其中我們其實非常關注的就是有關於資料的整合還有分析跟運用所以 |
| transcript.whisperx[483].start |
12941.86 |
| transcript.whisperx[483].end |
12965.279 |
| transcript.whisperx[483].text |
也麻煩再請院長確認一下目前在這個數據的串接進度上面橫向串接不曉得完成度如何第一個那第二個就是說在處理過程裡面有沒有碰到法律或者是一些技術上的瓶頸那哪一些是正在進行當中還需要持續來處理的部分那這部分可不可以請院長先做個說明謝謝 |
| transcript.whisperx[484].start |
12967.28 |
| transcript.whisperx[484].end |
12989.349 |
| transcript.whisperx[484].text |
謝謝謝謝委員那目前我們在過去一年半的時間那對資料庫的這個整理的工作事實上是背上我們過去從1998年就開始的從這個原住民族的相關的健保資料庫就醫的這些資訊還有他的包括死因跟癌症檔那我們現在試著再把 |
| transcript.whisperx[485].start |
12990.109 |
| transcript.whisperx[485].end |
13009.32 |
| transcript.whisperx[485].text |
各項的這些資料做串接的時候事先的盤點大概基本的工作我們已經開始在進行串接的工作我們那個包括在我旁邊的我們院裡面的這個莊少委員莊博士他過去幾年非常多的這個對資料庫串接的工作的這個經驗我們已經陸陸續續在做橫向的串接 |
| transcript.whisperx[486].start |
13012.864 |
| transcript.whisperx[486].end |
13033.629 |
| transcript.whisperx[486].text |
那法規的部分有些時候我們會碰到在使用上包括這個我們這個個案的這些隱私包括他這些個案的這些相關連結的部分這個是我們目前還在做有一些是要需要做克服的那技術的部分我們做橫向的連結是沒有問題 |
| transcript.whisperx[487].start |
13034.429 |
| transcript.whisperx[487].end |
13053.222 |
| transcript.whisperx[487].text |
OK我們了解因為這些資料的隱私性甚至敏感度都非常非常的高所以在處理的部分就是一定要讓國務院這邊能夠做非常好的一些保護跟處理那我們知道將來在做這個研究對策應用的部分如何能夠將這個資料分析出來的結果 |
| transcript.whisperx[488].start |
13054.224 |
| transcript.whisperx[488].end |
13068.863 |
| transcript.whisperx[488].text |
很精準的轉換到變成是偏鄉醫療資源數據的決策參考因為我們不知道我們知道這個不僅是讓這個資料庫裡面的數據放在資料庫裡面而已最重要還是後續的應用那我們以SNS篩檢數據為例 |
| transcript.whisperx[489].start |
13071.206 |
| transcript.whisperx[489].end |
13095.561 |
| transcript.whisperx[489].text |
將來如果確定了可以知道哪一些的部分可以配置上有更好的使用的話就非常非常的重要比如說將來在偏鄉還剩的是個篩檢巡迴車的配置我們不知道到底目前哪一個地方是最需要透過這樣的數據庫的分析結果來加以改善那當然如果能夠把其他的部分一起整合進來的話 |
| transcript.whisperx[490].start |
13096.602 |
| transcript.whisperx[490].end |
13111.583 |
| transcript.whisperx[490].text |
包括像兒童篩檢、成人健檢還有五大癌症的篩檢透過偏鄉一站式的服務的政策規劃那這部分可能就是需要運用到這個資料庫那這部分的應用不知道目前有沒有需要再加強哪一個部分 |
| transcript.whisperx[491].start |
13115.082 |
| transcript.whisperx[491].end |
13137.408 |
| transcript.whisperx[491].text |
跟委員報告就是說關於國民健康署的癌症篩檢跟成人健檢的部分我們有針對原名鄉的部分再進行一次分析啦那在成人預防保健的部分喔就是原名鄉的這個使用利用率喔其實比起全國來說都還是來得高的不過在癌症篩檢的部分確實會有一些狀況不太一樣的情形 |
| transcript.whisperx[492].start |
13137.868 |
| transcript.whisperx[492].end |
13157.208 |
| transcript.whisperx[492].text |
像是在大腸癌就跟全國平均是一樣可是在乳癌跟子宮頸癌的部分就比較偏低那我們會再針對這個數據去回饋給縣市跟縣市檢討如何去強化好 謝謝我想數據最重要的意義就是希望有好的運用那我們希望讓這個運用可以符合 |
| transcript.whisperx[493].start |
13157.828 |
| transcript.whisperx[493].end |
13180.576 |
| transcript.whisperx[493].text |
在推政策的過程裡面將來可以有更好的成果謝謝署長也謝謝院長再過來想要跟部長討論就是有關於這個制定慢性病防治法的評估那剛好幾位長官都在這邊我們知道國務院在2023年其實就曾經發布一個後疫時代這個慢性病防治問題與對策那在這個 |
| transcript.whisperx[494].start |
13184.897 |
| transcript.whisperx[494].end |
13211.387 |
| transcript.whisperx[494].text |
相關的這個出版品裡面我們也了解大家掌握到就是慢性病防治策略目前的現況就有下列這個幾個重點包括健保制度的檢討還有如何的調整還有確立這個初級預防評估的指標減少健康不平等引導國人來重視慢性病的風險還有落實慢性病的這個共管那也透過這樣的這個理解以後 |
| transcript.whisperx[495].start |
13211.827 |
| transcript.whisperx[495].end |
13234.148 |
| transcript.whisperx[495].text |
致大慢性病風險的因素的類型有包括這幾個就是生活型態環境與社會性的因素心理健康管理因素還有生物遺傳因素等等那我們也了解這個政策來針對這些因素做處理的時候呢就會提出很多很多的一些相關政策包括 |
| transcript.whisperx[496].start |
13234.648 |
| transcript.whisperx[496].end |
13256.455 |
| transcript.whisperx[496].text |
在健康臺灣裡面賴總統也非常關心如何能夠將山高的防治888計畫可以做落實的更好那其實在國連的十大時運裡面在前十大時運裡面有七項就是跟慢性病是有關係的那在這個七項裡面有五項又是跟山高有很密切的關係 |
| transcript.whisperx[497].start |
13257.575 |
| transcript.whisperx[497].end |
13275.577 |
| transcript.whisperx[497].text |
那整個醫療支出三高本身就耗用了我們的健保高達1700億這是非常重的一個負擔所以如果我們能夠把三高做得非常好如果能夠透過法治法的方式來做相關的規範 |
| transcript.whisperx[498].start |
13276.678 |
| transcript.whisperx[498].end |
13300.083 |
| transcript.whisperx[498].text |
我相信應該會更有成效剛剛我們師分會員也非常的知道說類似的事情我們怎麼樣有更好的處理模式那新人代謝 代謝症候群的部分其實從2022年開始推動到目前有一共有3100家的診所我相信部長在當時署長的時候也努力的去推動 |
| transcript.whisperx[499].start |
13300.883 |
| transcript.whisperx[499].end |
13329.471 |
| transcript.whisperx[499].text |
還有5200位的醫師來參與超過142萬人透過這個方式來改善整體的他的三高的部分所以到目前為止在12萬人已經有至少追蹤管理有6個月以上的時間而且其中有37%是成功改善至少一項的指標還有17.8%成功的脫離了代謝症候選我相信對這個民眾來講應該是非常有感的一個部分 |
| transcript.whisperx[500].start |
13330.171 |
| transcript.whisperx[500].end |
13346.483 |
| transcript.whisperx[500].text |
那在社會處方健康促進大家也都有努力包括部長也在推健康幣等等的措施所以意思就是說在這麼多的防治政策裡面那如果我們參考之前的營養跟健康飲食防治法讓它法治化 |
| transcript.whisperx[501].start |
13347.203 |
| transcript.whisperx[501].end |
13364.148 |
| transcript.whisperx[501].text |
相信相信透過法治化以後對於這些慢性病的防治會有更大的一個幫助那也更有所依選那我們最後來看一下關於起動這個慢性病防治法的原理過程當中如果將來希望能夠更確實的來落實這項 |
| transcript.whisperx[502].start |
13367.589 |
| transcript.whisperx[502].end |
13387.105 |
| transcript.whisperx[502].text |
想法或者是做法的話那以國務院他們在合併跟其他的專家學者在2025年有一個相關希望能夠提卡雷米的台北宣言來落實三高政策的這個幫助包括風險分級精準醫療數位管理跟餘命 |
| transcript.whisperx[503].start |
13387.945 |
| transcript.whisperx[503].end |
13403.715 |
| transcript.whisperx[503].text |
提升了這個願景之下我們認為這個法治法是非常迫切需要的那針對這部分不知道部長有沒有特別的想法或者是有機會來讓這樣的法治法可以有進一步的推動 |
| transcript.whisperx[504].start |
13404.955 |
| transcript.whisperx[504].end |
13427.384 |
| transcript.whisperx[504].text |
好 謝謝委員 不僅是癌症的專家對慢性病的防治也這麼的重視確實這個慢性病已經是我們這個國人的健康負荷裡面比這個癌症的負荷還要重的這disease burden來看是更重那麼確實應該要重視那我們也推出了多項的方案那麼但是要不要 |
| transcript.whisperx[505].start |
13428.304 |
| transcript.whisperx[505].end |
13453.608 |
| transcript.whisperx[505].text |
專法的這個事情因為我們也要考慮到說其實我們很多的慢性病都有一些共通的common factor那像這個菸就是一個common factor所以我們已經有菸害防治法其實它跟這個慢性病有很高的關聯性另外慢性病跟營養也有關係所以我們也有已經有的就是營養及健康飲食促進法也有這個法 |
| transcript.whisperx[506].start |
13453.908 |
| transcript.whisperx[506].end |
13474.288 |
| transcript.whisperx[506].text |
所以我們就要再來看看說這個慢性病防治法這個專法那麼它的scope還有跟其他的這個目前我們的整個相關的法律制定跟政策推動上那麼它的這個相關聯繫這我們來研究看看我們找一些專家學者大家來討論全盤的來做這個盤點這樣 |
| transcript.whisperx[507].start |
13478.152 |
| transcript.whisperx[507].end |
13489.967 |
| transcript.whisperx[507].text |
好 那就大家一起努力好 謝謝副市長 謝謝委員謝謝王正信委員現在除了臨時提案 既有三案請一併宣讀 |
| transcript.whisperx[508].start |
13493.349 |
| transcript.whisperx[508].end |
13517.158 |
| transcript.whisperx[508].text |
臨時提案 議案請衛生福利部會商財政部研擬醫療法第八十八條修正草案增訂第三項規定醫事人員服務於離島偏鄉各級醫院及衛生所之部分收入免於計入年度因課稅所得額之修法或政策可行性並請於三個月內將研議書面報告送交立法院社會福利及衛生環境委員會提案委員王振旭 原署委員林悅請黃秀芳 |
| transcript.whisperx[509].start |
13522.435 |
| transcript.whisperx[509].end |
13538.482 |
| transcript.whisperx[509].text |
二 请卫生福利部研拟委托研究案或国务院论坛等适当形式启动慢性病防治法立法之相关研究针对实质法案框架及具体内容进行研拟并提出修法草案提案委员王振旭 联署委员林月 请黄秀芳 |
| transcript.whisperx[510].start |
13540.894 |
| transcript.whisperx[510].end |
13565.892 |
| transcript.whisperx[510].text |
三 衛生福利部國民健康署原因發布之一四年青少年吸菸行為調查報告迄今仍未公布衛生福利部因緊述公布一四年最新調查數據已視群疑並於一個月內研擬會同教育部內政部等相關單位成立青少年跨部會電子菸及新興菸品防治行動小組並針對違法販售取締校園防治及毒品溯源 |
| transcript.whisperx[511].start |
13566.693 |
| transcript.whisperx[511].end |
13583.562 |
| transcript.whisperx[511].text |
查緝提出具體行動方案與時程表向立法院社會福利及衛生環境委員會提出書面報告提案委員陳金輝 邱慧如 邱振鈞宣讀完畢請問第一案行政單位有意見第一案我們就遵照辦理 |
| transcript.whisperx[512].start |
13587.031 |
| transcript.whisperx[512].end |
13591.754 |
| transcript.whisperx[512].text |
針對我國青少年電子菸使用率與併用率於今年快速翻倍 |
| transcript.whisperx[513].start |
13618.52 |
| transcript.whisperx[513].end |
13629.488 |
| transcript.whisperx[513].text |
經查國人十大死因中預期項與慢性病有關有鑑於此政府長期投注資源訂定並執行慢性病防治相關策略對策 |
| transcript.whisperx[514].start |
13630.388 |
| transcript.whisperx[514].end |
13656.723 |
| transcript.whisperx[514].text |
衛福部近年逐步推動代謝症候群防治計畫、大家醫計畫、健保論人濟酬事辦計畫等透過照顧品質提升、早期介入及預防等有效掌握並減低國人慢性病風險在賴總統健康台灣願景下已啟動三高888防治計畫在未來針對慢性病風險因素之一的生活型態 |
| transcript.whisperx[515].start |
13657.443 |
| transcript.whisperx[515].end |
13683.277 |
| transcript.whisperx[515].text |
透过社会处方健康促进之政策推动降低因不良生活形态滞生之风险将是因应及防治重点国内工协学会以及专家学者并有团体等对于政府如何以更高层级因应慢性病防治制定更全面且实质的防治对策具高度期待 |
| transcript.whisperx[516].start |
13683.797 |
| transcript.whisperx[516].end |
13703.646 |
| transcript.whisperx[516].text |
此外针对在多项防治政策落实之基础下推动慢性病防治法治化之可行性及必要性亦持续有许多讨论及建议原此请卫生福利部严礼以专家会议委托研究案或国卫院论坛 |
| transcript.whisperx[517].start |
13704.386 |
| transcript.whisperx[517].end |
13725.275 |
| transcript.whisperx[517].text |
等適當形式啟動慢性病防治法立法之相關研究針對實質法案框架及具體內容進行研擬以上是所以署長意思就是說除了我們所的內容有研究要跟國務院論壇以外還要 |
| transcript.whisperx[518].start |
13726.776 |
| transcript.whisperx[518].end |
13727.276 |
| transcript.whisperx[518].text |
第三案 |
| transcript.whisperx[519].start |
13751.329 |
| transcript.whisperx[519].end |
13769.347 |
| transcript.whisperx[519].text |
修正修正的部分我們建議修正在一個月改成三個月然後在後續研擬會同教育部內政部等跨部會相關單位就青少年電子煙及新興煙品防治 |
| transcript.whisperx[520].start |
13771.329 |
| transcript.whisperx[520].end |
13795.388 |
| transcript.whisperx[520].text |
並針對違法取締販售所以增加 把跨部會挪到內政部等後面然後把行動小組的部分刪除可以 謝謝好 謝謝委員那謝謝提案委員 謝謝行政單位那我們就修正通過好 臨時提案全部處理完畢接下來繼續詢答 請謝一芬委員發言 |
| transcript.whisperx[521].start |
13812.53 |
| transcript.whisperx[521].end |
13815.374 |
| transcript.whisperx[521].text |
謝謝主席 我想要請石部長石部長早安喔電太高了 |
| transcript.whisperx[522].start |
13829.336 |
| transcript.whisperx[522].end |
13843.195 |
| transcript.whisperx[522].text |
市部長早安我昨天去看了我們彰化縣的全齡的長照就是照護中心就是有拖鷹啦 有失智啦還有日照等等就是一些住宿型的 整合型的 |
| transcript.whisperx[523].start |
13844.136 |
| transcript.whisperx[523].end |
13872.407 |
| transcript.whisperx[523].text |
未來這樣子的一個就是說機構因為你們衛福部也有補助嘛那未來是不是會繼續支持彰化縣做這樣子一個整合型的應該是跟委員說明說前面我們有一些前瞻計畫的補助然後就讓各縣市來提所以有一些就是在做這個長照的這個中心的整建因為彰化縣的進度都很好嘛有一點落後啦彰化 |
| transcript.whisperx[524].start |
13873.988 |
| transcript.whisperx[524].end |
13893.886 |
| transcript.whisperx[524].text |
哪裡落後啊很好耶其他才落後他應該是這樣我們是核准最多案的彰化縣是核准最多案的也因為他是最多案所以他有一些工程就落後了所以我們在幫他做預算的保留我們有把他的預算保留下來所以他可以繼續做 |
| transcript.whisperx[525].start |
13894.626 |
| transcript.whisperx[525].end |
13919.251 |
| transcript.whisperx[525].text |
那未來呢因為你知道嗎現在第一個就是零到六歲國家養嘛然後再來就是那個高齡化的這個人口增加嘛那所以這樣子一個整合型的就是照護機構那事實上就是有存在必要那是不是應該對你要你們要執行就是醫學區一日照這樣子的一個 |
| transcript.whisperx[526].start |
13920.671 |
| transcript.whisperx[526].end |
13936.843 |
| transcript.whisperx[526].text |
一個目標嘛那再加上這樣整合型的又可以拖陰然後又可以拖一些就是說高齡的照護那對於上班族的家庭來講就是很需要的 |
| transcript.whisperx[527].start |
13938.003 |
| transcript.whisperx[527].end |
13959.208 |
| transcript.whisperx[527].text |
跟委員說明其實在這個一學區一日照這個部分其實彰化縣做得很好它的那個覆蓋率其實將近百分之百的達成了那等到我們下一階段我們再來評估看它還有什麼需要像剛剛我們提的是這種比較屬於整合型的甚至它有這個輕盈共照的這種概念 |
| transcript.whisperx[528].start |
13959.848 |
| transcript.whisperx[528].end |
13983.601 |
| transcript.whisperx[528].text |
對 現在這個有啊 因為它有拖音啊對不對 二歲以下的拖音那再加上失智啊還有一些就是日照的一個 對 一個日照的機構啊那這是整合型的那這也是符合未來就是說高齡社會以及就是三明治的家族等等就是的世代喔 它需要照顧小孩 |
| transcript.whisperx[529].start |
13985.362 |
| transcript.whisperx[529].end |
13995.667 |
| transcript.whisperx[529].text |
或是有家裡有高齡的長輩等等都很需要這樣的機構那以就是說目前就是彰化我看到了好幾個機構他都執行的蠻好的那是不是就是未來能夠繼續的協助 |
| transcript.whisperx[530].start |
13997.579 |
| transcript.whisperx[530].end |
14016.566 |
| transcript.whisperx[530].text |
對 如果有這個需求的時候我們再來協助應該是這樣講他還有一些案子還沒有執行完他繼續執行我們已經有幫他把那個預算保留住了所以他會繼續執行等他這邊執行完再有需求的時候我們再來研議繼續來協助好不好繼續協助彰化縣做這個部分好不好 |
| transcript.whisperx[531].start |
14020.828 |
| transcript.whisperx[531].end |
14048.561 |
| transcript.whisperx[531].text |
那再來就是偏鄉醫療的部分嘛我也是一直極力跟那個就是部長說啊我們20啊2級有沒有對不對就是是一個就是那邊都幾乎都沒有夜間急診的地方那是不是對於這些偏鄉醫療的人力資源那是不是公司共同協力來協助就是偏鄉的醫生能夠早日就是說早日得到那個 |
| transcript.whisperx[532].start |
14049.241 |
| transcript.whisperx[532].end |
14064.707 |
| transcript.whisperx[532].text |
相關的人力的這個缺口好不好我了解這個彰化也是有一個狀況就是他的醫療比較集中在北彰那南彰的部分的資源是比較弱也只有大概兩家主要的小型醫院 |
| transcript.whisperx[533].start |
14065.647 |
| transcript.whisperx[533].end |
14080.694 |
| transcript.whisperx[533].text |
我們已經也都把他納入在這個健保的燈塔計畫給他保障不過他還是有人力的困難那個負責醫師院長年紀也有了所以我們來看看連結其他的體系的資源去進駐我們來給他 |
| transcript.whisperx[534].start |
14082.615 |
| transcript.whisperx[534].end |
14097.205 |
| transcript.whisperx[534].text |
他相關的醫療的人員進一步的給予相關的協助在獎勵的部分讓他可以在囊張這個地方可以維持下來包含健保的獎勵措施整合起來做 |
| transcript.whisperx[535].start |
14099.207 |
| transcript.whisperx[535].end |
14114.463 |
| transcript.whisperx[535].text |
就搭配那個醫學中心的計畫還有未來我們公費生的服務跟健保的這個保障措施這樣還有現在在推動就是兆元投資台灣了你知道嗎 |
| transcript.whisperx[536].start |
14115.325 |
| transcript.whisperx[536].end |
14130.93 |
| transcript.whisperx[536].text |
兆元投資台灣對啊就是希望說公認性嗎您說的是不是不是讓就是說我們一些就是受險業的資金等等可以留在台灣投資就是相關的我們的產業那就這個當然就他們的風險係數的誘因來講他們就很希望說可以投資長照的機構那 |
| transcript.whisperx[537].start |
14142.094 |
| transcript.whisperx[537].end |
14151.353 |
| transcript.whisperx[537].text |
就這部分法令法規有沒有什麼樣子的協助當然是目前的法規長照法人 |
| transcript.whisperx[538].start |
14152.535 |
| transcript.whisperx[538].end |
14175.402 |
| transcript.whisperx[538].text |
受險業者是可以投資只是他有一些限制啦我了解他的限制上讓他們覺得像是他沒有辦法掌握他雖然這個投資有限制然後對這個長照機構的這個治理權他也有被限制嘛所以這個部分我們再來研議看看這個部分有沒有辦法解決就是說現在我了解很多的這個保險 |
| transcript.whisperx[539].start |
14177.583 |
| transcript.whisperx[539].end |
14190.659 |
| transcript.whisperx[539].text |
保險的那個資源都回到這個國內來嘛因為就是第一個啦你如果要發展亞之中心或者是要發展這樣子的一個因為你看最近 |
| transcript.whisperx[540].start |
14191.846 |
| transcript.whisperx[540].end |
14208.839 |
| transcript.whisperx[540].text |
那個我們的金融業在中東地區的曝險是2.35兆那你要藉著這種情況下讓資金可以回流到台灣那你要有一個適切性的尤其是像保險的這樣他們需要有一些就是說長期性的 |
| transcript.whisperx[541].start |
14210.56 |
| transcript.whisperx[541].end |
14233.987 |
| transcript.whisperx[541].text |
我們現在的方向是讓他來興建興建硬體的部分然後再交給專業團體來做營運他就可以有租金的收入甚至讓他直接投資在長照法人裡面我想這個應該我們再瞭解看看他還有什麼 |
| transcript.whisperx[542].start |
14235.768 |
| transcript.whisperx[542].end |
14246.378 |
| transcript.whisperx[542].text |
這個找這保險業者來談一談看看他們還有什麼樣覺得還要再調整的不然政策上是目前是這個方向好謝謝謝謝部長謝謝謝謝謝委員謝謝謝一鋒委員現在休息用餐 |
| transcript.whisperx[543].start |
14274.526 |
| transcript.whisperx[543].end |
14275.812 |
| transcript.whisperx[543].text |
謝謝大家 |
| transcript.whisperx[544].start |
14280.41 |
| transcript.whisperx[544].end |
14281.951 |
| transcript.whisperx[544].text |
這裏有個大廈,這裏有個餐廳。 |
| transcript.whisperx[545].start |
14305.253 |
| transcript.whisperx[545].end |
14322.858 |
| transcript.whisperx[545].text |
我聽他說是有偷光的用途,大家可以接受,所以才會有這些審問,如果說偷光都沒有什麼用途。現在強盜的專業性很高,他說有四次控制,你要抵抗這樣的想法,你希望平安法開放要保單光嗎? |
| transcript.whisperx[546].start |
14328.2 |
| transcript.whisperx[546].end |
14329.421 |
| transcript.whisperx[546].text |
但是他就沒有辦法 |
| transcript.whisperx[547].start |
14348.368 |
| transcript.whisperx[547].end |
14353.431 |
| transcript.whisperx[547].text |
對啦 安慰如果你們不要的話 同時一般我們都會有過程當中 拿東西給朋友吃 |
| transcript.whisperx[548].start |
14373.863 |
| transcript.whisperx[548].end |
14375.184 |
| transcript.whisperx[548].text |
這裏有個大廈,這裏有個餐廳 |
| transcript.whisperx[549].start |
14403.431 |
| transcript.whisperx[549].end |
14403.911 |
| transcript.whisperx[549].text |
這裏是隔壁大廈 |
| transcript.whisperx[550].start |
14431.391 |
| transcript.whisperx[550].end |
14453.916 |
| transcript.whisperx[550].text |
鞠躬 鞠躬 |
| transcript.whisperx[551].start |
14462.637 |
| transcript.whisperx[551].end |
14464.115 |
| transcript.whisperx[551].text |
谢谢大家 |
| transcript.whisperx[552].start |
14473.506 |
| transcript.whisperx[552].end |
14473.526 |
| transcript.whisperx[552].text |
韓國瑜 |
| transcript.whisperx[553].start |
14498.662 |
| transcript.whisperx[553].end |
14510.732 |
| transcript.whisperx[553].text |
這間餐廳的餐廳有很多不同的餐廳 |
| transcript.whisperx[554].start |
14523.346 |
| transcript.whisperx[554].end |
14523.366 |
| transcript.whisperx[554].text |
好 |
| transcript.whisperx[555].start |
14546.307 |
| transcript.whisperx[555].end |
14546.929 |
| transcript.whisperx[555].text |
谢谢观看 |
| transcript.whisperx[556].start |
14556.645 |
| transcript.whisperx[556].end |
14565.249 |
| transcript.whisperx[556].text |
謝謝大家 |
| transcript.whisperx[557].start |
14588.298 |
| transcript.whisperx[557].end |
14588.478 |
| transcript.whisperx[557].text |
謝謝大家 |
| transcript.whisperx[558].start |
14609.87 |
| transcript.whisperx[558].end |
14609.89 |
| transcript.whisperx[558].text |
謝謝觀看 |
| transcript.whisperx[559].start |
14630.102 |
| transcript.whisperx[559].end |
14630.863 |
| transcript.whisperx[559].text |
嗯,就是這個, |
| transcript.whisperx[560].start |
14669.373 |
| transcript.whisperx[560].end |
14676.177 |
| transcript.whisperx[560].text |
我以為你也沒有吵我以為你沒有吵我以為你沒有吵 |
| transcript.whisperx[561].start |
14680.179 |
| transcript.whisperx[561].end |
14681.159 |
| transcript.whisperx[561].text |
那是 |
| transcript.whisperx[562].start |
14704.405 |
| transcript.whisperx[562].end |
14713.968 |
| transcript.whisperx[562].text |
還沒交報告還沒交報告還沒交報告還沒交報告還沒交報告還沒交報告還沒交報告還沒交報告 |
| transcript.whisperx[563].start |
14731.425 |
| transcript.whisperx[563].end |
14752.346 |
| transcript.whisperx[563].text |
呃呃呃 |
| transcript.whisperx[564].start |
14762.057 |
| transcript.whisperx[564].end |
14762.077 |
| transcript.whisperx[564].text |
是 |
| transcript.whisperx[565].start |
14774.363 |
| transcript.whisperx[565].end |
14775.443 |
| transcript.whisperx[565].text |
所以是否被這碗的 |
| transcript.whisperx[566].start |
14800.489 |
| transcript.whisperx[566].end |
14801.15 |
| transcript.whisperx[566].text |
所以25億的總計會不會變 |
| transcript.whisperx[567].start |
14816.451 |
| transcript.whisperx[567].end |
14818.352 |
| transcript.whisperx[567].text |
他字頭字頭下降了 |
| transcript.whisperx[568].start |
14836.031 |
| transcript.whisperx[568].end |
14851.924 |
| transcript.whisperx[568].text |
所以現在人家當最後核定 該料總結核定該製作 製作組組會增加那樣嗎那最近什麼已經有核定了 什麼最近正在成為核定核定正在成為核定你要立即核定 |
| transcript.whisperx[569].start |
14866.403 |
| transcript.whisperx[569].end |
14872.064 |
| transcript.whisperx[569].text |
一個合併啦 還是條例合併喔喔喔喔喔喔喔喔喔喔喔喔喔喔喔喔喔 |
| transcript.whisperx[570].start |
14894.29 |
| transcript.whisperx[570].end |
14898.612 |
| transcript.whisperx[570].text |
二二二二二二二二二二二二二二二二 |
| transcript.whisperx[571].start |
14922.326 |
| transcript.whisperx[571].end |
14939.02 |
| transcript.whisperx[571].text |
對阿 我報考啦 阿這離島的 離島的前面有辦法他不會讓人家都亂 離島的 離島的 讓人家上去離島阿他說你再度研討 阿就有辦法我覺得離島是比較可以做先跑的那我另去他離島的人 我兩次都會去 |
| transcript.whisperx[572].start |
14949.909 |
| transcript.whisperx[572].end |
14951.15 |
| transcript.whisperx[572].text |
就給他們來一桌飯 |
| transcript.whisperx[573].start |
14978.183 |
| transcript.whisperx[573].end |
15006.488 |
| transcript.whisperx[573].text |
我自己覺得說,幸運的能夠跟這個人溫馨一點,對,然後我會覺得,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有,沒有, |
| transcript.whisperx[574].start |
15015.839 |
| transcript.whisperx[574].end |
15016.98 |
| transcript.whisperx[574].text |
謝謝大家 |
| transcript.whisperx[575].start |
15033.134 |
| transcript.whisperx[575].end |
15033.415 |
| transcript.whisperx[575].text |
谢谢大家 |
| transcript.whisperx[576].start |
15046.328 |
| transcript.whisperx[576].end |
15047.069 |
| transcript.whisperx[576].text |
對,我就想說 |
| transcript.whisperx[577].start |
15068.799 |
| transcript.whisperx[577].end |
15069.781 |
| transcript.whisperx[577].text |
這裏是沙發油廠 |
| transcript.whisperx[578].start |
15092.329 |
| transcript.whisperx[578].end |
15093.009 |
| transcript.whisperx[578].text |
謝謝大家 |
| transcript.whisperx[579].start |
15122.857 |
| transcript.whisperx[579].end |
15133.711 |
| transcript.whisperx[579].text |
这不确定 |
| transcript.whisperx[580].start |
15135.052 |
| transcript.whisperx[580].end |
15156.899 |
| transcript.whisperx[580].text |
這裏有兩種餐廳,白色的餐廳,黑色的餐廳,黑色的餐廳,黑色的餐廳,黑色的餐廳,黑色的餐廳,黑色的餐廳 |
| transcript.whisperx[581].start |
15161.178 |
| transcript.whisperx[581].end |
15161.198 |
| transcript.whisperx[581].text |
喔 |
| transcript.whisperx[582].start |
15173.68 |
| transcript.whisperx[582].end |
15174.121 |
| transcript.whisperx[582].text |
好久不見 |
| transcript.whisperx[583].start |
15193.563 |
| transcript.whisperx[583].end |
15193.943 |
| transcript.whisperx[583].text |
謝謝大家 |
| transcript.whisperx[584].start |
15208.86 |
| transcript.whisperx[584].end |
15212.502 |
| transcript.whisperx[584].text |
先給我 不好意思 我要離開現場誰來的 |
| transcript.whisperx[585].start |
15234.436 |
| transcript.whisperx[585].end |
15234.716 |
| transcript.whisperx[585].text |
謝謝大家 |
| transcript.whisperx[586].start |
15265.577 |
| transcript.whisperx[586].end |
15267.098 |
| transcript.whisperx[586].text |
副市長 副市長 |
| transcript.whisperx[587].start |
15287.789 |
| transcript.whisperx[587].end |
15288.209 |
| transcript.whisperx[587].text |
嗯嗯嗯嗯 |
| transcript.whisperx[588].start |
15315.772 |
| transcript.whisperx[588].end |
15315.792 |
| transcript.whisperx[588].text |
鞭筍 |
| transcript.whisperx[589].start |
15346.053 |
| transcript.whisperx[589].end |
15346.394 |
| transcript.whisperx[589].text |
謝謝大家 |
| transcript.whisperx[590].start |
15363.067 |
| transcript.whisperx[590].end |
15366.689 |
| transcript.whisperx[590].text |
好,我們看這裏就行了,謝謝你,謝謝你,謝謝你,謝謝你,謝謝你,謝謝你,謝謝你,謝謝你,謝謝你, |
| transcript.whisperx[591].start |
15390.704 |
| transcript.whisperx[591].end |
15397.587 |
| transcript.whisperx[591].text |
這幾乎真的還好,只要挖到幾乎就好那就是鋒湖,布里鋒湖一邊的 |
| transcript.whisperx[592].start |
15425.033 |
| transcript.whisperx[592].end |
15425.073 |
| transcript.whisperx[592].text |
謝謝大家 |
| transcript.whisperx[593].start |
15459.441 |
| transcript.whisperx[593].end |
15459.781 |
| transcript.whisperx[593].text |
謝謝大家 |
| transcript.whisperx[594].start |
15488.73 |
| transcript.whisperx[594].end |
15490.931 |
| transcript.whisperx[594].text |
我比較喜歡你我還是比較喜歡你沒有說比較誰啦比較喜歡 |
| transcript.whisperx[595].start |
15538.784 |
| transcript.whisperx[595].end |
15540.185 |
| transcript.whisperx[595].text |
現在開始開會繼續詢問請陳昭智委員發言 |
| transcript.whisperx[596].start |
15549.192 |
| transcript.whisperx[596].end |
15555.626 |
| transcript.whisperx[596].text |
謝謝主席 有請部長 部長沒吃飯在吃米糕部長辛苦了 不好意思 |
| transcript.whisperx[597].start |
15558.732 |
| transcript.whisperx[597].end |
15584.876 |
| transcript.whisperx[597].text |
部長謝謝你陳委員好好久不見不好意思我會繼續出現在這一組的那之前我們在審查那個身心障礙者權益保護法的時候因為大部分的時候是呂次長出席所以您未必就是我以前了解當時有討論情形那我自己當時也有一些想法我今天稍微跟部長這個稍微前情提要一下我當時提過一個觀念就是輔具的目的輔具的目的就是一個這個補足功能上的不足 |
| transcript.whisperx[598].start |
15585.816 |
| transcript.whisperx[598].end |
15605.868 |
| transcript.whisperx[598].text |
所以就是說讓需求者都能夠持續的生活而且能夠接受這個支持這個觀點那從這個角度來看我想請教部長您認為這個無障礙計程車是不是也可以算是一種移動性的輔具無障礙計程車它可以幫助需要的人可以順利抵達那個治療場所 |
| transcript.whisperx[599].start |
15607.076 |
| transcript.whisperx[599].end |
15628.197 |
| transcript.whisperx[599].text |
不障礙計程車您覺得您同意我這個說法嗎因為輔具我們現在大家定義在都還是以個人使用為主你這個是運輸工具但是也是讓他去能夠順利治療我的意思說我現在最近接到一位家長的陳情那他的孩子是罕見疾病但是他是那種多重障礙的孩子 |
| transcript.whisperx[600].start |
15629.378 |
| transcript.whisperx[600].end |
15648.469 |
| transcript.whisperx[600].text |
那他就需要長期每天的一個復健包括職能的這個治療等等來維持他的身體的機能就是對這樣的家庭來說他的復健他不是可有可無的而是說他為了維持每天的生活機能他必須成為他生命的一部分他必須每天都做這樣的一個努力 |
| transcript.whisperx[601].start |
15650.97 |
| transcript.whisperx[601].end |
15669.659 |
| transcript.whisperx[601].text |
所以復健不是這個可有可無我剛剛才提到說我這個觀點您同意嗎對他來說他就是必須如此要多重障礙多重的功能障礙那我想先向部長確認一個問題那請問現在長照交通接送服務是不是只能在往返這個醫療院所如果部長您如果不熟可以請教 |
| transcript.whisperx[602].start |
15670.479 |
| transcript.whisperx[602].end |
15697.561 |
| transcript.whisperx[602].text |
我們目前的長照交通車主要就是長照服務據點還有據點也可以可是部長現在很多人的狀況是需求者其實是在社區社區治療所進行復健譬如說職能治療所復健物理治療所但是再請教部長這些依法設立而且專業服務的提供復健功能的治療所目前是不是被長照交通接送法排除在外 |
| transcript.whisperx[603].start |
15698.363 |
| transcript.whisperx[603].end |
15724.08 |
| transcript.whisperx[603].text |
目前它是就醫接送啦我們現在長照的那個幾字婦是就醫接送啦另外也會去送長照據點啦就是照中心那些它也會送但是目前它是被排除在外嘛那但是剛剛你提的是說應該是這樣講它是屬於這個像物理治療所啦那麼像這些屬於這個治療所的部分我們來研議看看如果 |
| transcript.whisperx[604].start |
15724.38 |
| transcript.whisperx[604].end |
15729.421 |
| transcript.whisperx[604].text |
因為我們現在是把醫療定位在醫院其實還沒有開放到治療所的部分我想提醒部長現在就有一個很大的制度矛盾你們推的這個長照3.0強調什麼社區共榮圈照顧那都希望可以在社區就近取得資源來接受照顧但是卻只限於醫療院所反而把社區裡的治療資源先暫時排除在外如果一個孩子部長 |
| transcript.whisperx[605].start |
15753.906 |
| transcript.whisperx[605].end |
15783.343 |
| transcript.whisperx[605].text |
他在醫療院所治療所他可以接受他可以享受這個就使用長照交通接受但是他到社區的職能治療所接受復健治療所他卻不能夠使用這樣的制度有符合長照3.0的這個往這個社區照顧這個部分我們可以來檢討因為過去的想像是比較單純就是說因為在這些物理治療的時候呢他需要有醫師的處方因為要醫師的處方的關係他就是以診所或者是醫院為主啦 |
| transcript.whisperx[606].start |
15783.823 |
| transcript.whisperx[606].end |
15799.23 |
| transcript.whisperx[606].text |
但是我現在理解說有些可能他以釋出處方的方式在治療所而且這個不會很多啦這個我請長照師研議看看如果他的需求上是有需求的話我們把它開放就OK |
| transcript.whisperx[607].start |
15800.151 |
| transcript.whisperx[607].end |
15814.645 |
| transcript.whisperx[607].text |
這個概念是一樣至少要先納入檢討好嗎你先檢討那這個檢討可不可以盡快也讓我知道那不等我還是要談到這個肺癌的部分那當然早期發現很重要那社會上現在出現很大的疑慮當然大家都看過高志文教授的這個文章 |
| transcript.whisperx[608].start |
15816.066 |
| transcript.whisperx[608].end |
15838.184 |
| transcript.whisperx[608].text |
他擔心說過去十幾年肺炎切除這個是個大手術那他可能出現過度診斷或太多不必要的手術那我想請教衛福有沒有掌握真實狀況有沒有要回頭去檢討就是你篩檢的部分跟艾登跟健保申報的資料那你有掌握過去十多年來肺炎切除手術的一些 |
| transcript.whisperx[609].start |
15839.044 |
| transcript.whisperx[609].end |
15867.332 |
| transcript.whisperx[609].text |
我有請這個健保特別把它分析其實這個肺的這個切除它是分成三種一種是整個大葉的切除一個是就是那個分葉一個是就是氣狀的切除小的的話它是做另外才來做到這個最大才是做那現在看起來大葉切除的部分的個案增加不多 |
| transcript.whisperx[610].start |
15868.693 |
| transcript.whisperx[610].end |
15884.132 |
| transcript.whisperx[610].text |
增加不多所以表示都是找到小的我知道找到的都是一些比較小的這個Nodule Legion去切所以切出來的大概都是分葉或者是器狀切除部長你也是那個 |
| transcript.whisperx[611].start |
15885.073 |
| transcript.whisperx[611].end |
15891.338 |
| transcript.whisperx[611].text |
國健署今天是副署長在這邊你也明明都是專家我們當然希望經過篩檢然後診斷然後你的治療可以證明確實他是惡性我想重點是這個所以跟委員說明就是說如果是現在按照國健署的篩檢的條件然後動完手術的確診率大概是1.2% |
| transcript.whisperx[612].start |
15908.65 |
| transcript.whisperx[612].end |
15933.902 |
| transcript.whisperx[612].text |
所以跟世界上的文獻大概是相近但是因為有一些現在是自費或者是地方政府補助他那個快寬鬆了那非常好所以我們還是需要去強化這個指引的遵從性以前我說你只管健保現在你必須多管自費醫療你也多管那您就說要做一些那我也希望儘快看到這個資料不好意思再再來是一個比較 |
| transcript.whisperx[613].start |
15934.802 |
| transcript.whisperx[613].end |
15948.554 |
| transcript.whisperx[613].text |
麻煩的問題喔 少子女化對策這個行動計畫您剪幾天再講因為立法院沒有審查預算啦所以有些項目沒有辦法推動那部長你的意思是說如果審查預算過了那你就能夠挽救這個持續這個 |
| transcript.whisperx[614].start |
15952.057 |
| transcript.whisperx[614].end |
15975.563 |
| transcript.whisperx[614].text |
破底的生育率嗎也應該這麼說啦跟委員講得更清楚一點就是說這個少子化的問題當然很嚴重然後因素也很多但是呢因為這個今年呢行政院有核定了這個少子少子女化對策行動計畫的2.0那裡面有擴大包含像新手爸媽的寫手包含了這個 |
| transcript.whisperx[615].start |
15976.863 |
| transcript.whisperx[615].end |
16004.456 |
| transcript.whisperx[615].text |
我們在這個過去的生育這個補助的部分把它拉高還有很多很多項目其實我們就沒有辦法繼續去推動我給你看一張圖他有做證明就是說可能不能輕易的在談總預算你看這個圖是真的你都瞭解這個圖大家都很熟悉你看一直從2016年開始下滑那現在前一年更很可怕再也不回頭之前還回頭了一下這個是真實的部分那請你看因為你提到總預算 |
| transcript.whisperx[616].start |
16005.896 |
| transcript.whisperx[616].end |
16020.625 |
| transcript.whisperx[616].text |
我針對立委責任我還是要告訴你當然總預算審不審這個有它的背景可是你來看從2016年民進黨執政開始到2025年去年你看那個三讀日應該不錯吧你稍微看一下這很快啊是不是都不錯對不對 |
| transcript.whisperx[617].start |
16022.006 |
| transcript.whisperx[617].end |
16040.541 |
| transcript.whisperx[617].text |
還不錯啊就是他的那個三讀日的時間啊可是這樣這條線照樣往下走你這個人這個少子化對這個投入了幾千億你知道投入幾千億嗎從2018年到2025年你知道投入幾千億目前是編列到1200億左右我是指這個你概括承受一下2018年到2025年 |
| transcript.whisperx[618].start |
16043.163 |
| transcript.whisperx[618].end |
16062.604 |
| transcript.whisperx[618].text |
官方數字是5931億很可怕喔很可怕所以台灣的年輕人他不會因為你預算過了我就生嘛你預算沒過我就不生小孩嘛所以老實說應該現在要檢討的不是這個東西因為我現在也在等待一個醫學奇蹟啦因為當然你也必須說有很多因素 |
| transcript.whisperx[619].start |
16062.904 |
| transcript.whisperx[619].end |
16077.634 |
| transcript.whisperx[619].text |
你不能說預算沒有過所以我沒辦法做這個超子化政策這個等於要創造醫學奇蹟你知道我現在等著看一個醫學奇蹟叫做什麼呢2030年你們的癌症死亡率要降低三分之一我等著看這個醫學奇蹟會不會發生我定義它是個奇蹟 |
| transcript.whisperx[620].start |
16079.856 |
| transcript.whisperx[620].end |
16101.532 |
| transcript.whisperx[620].text |
一定會下降那你剛剛可以理解那個2018到2020我們花了5930億在這個少子化政策但是結果出生率還是慘不忍睹嘛到去年為止慘不忍睹嘛那少子化辦公室空的假的虛擬的啊根本就不存在啊那是偶爾的開會不定期不定時又不檢討的一個會議這個執政長要檢討的真的不是預算因為預算夠多啦但是 |
| transcript.whisperx[621].start |
16107.296 |
| transcript.whisperx[621].end |
16121.112 |
| transcript.whisperx[621].text |
他只是想說政策哪有但是因為委員只教是說還不夠多啊5930但是你看到年齡下降啊就算你說很努力用到對的地方我們現在也還沒有去了解用錢用到哪我問很多立委他們都不知道但是你看這條線 |
| transcript.whisperx[622].start |
16122.393 |
| transcript.whisperx[622].end |
16129.418 |
| transcript.whisperx[622].text |
對不對現在是最鐵的事實這個是事實就是花五千多億還結果結果死意思是說我們還沒有所以我才說請部長不曾申供預算還沒來所以我們沒辦法做應該是這樣講預算沒有省沒有辦法讓我們一氣地的計畫推動這個也是事實 |
| transcript.whisperx[623].start |
16141.966 |
| transcript.whisperx[623].end |
16167.798 |
| transcript.whisperx[623].text |
那麼生育率的下降呢還沒有止跌回升也是事實這兩個不見得有絕對的關係但是呢沒有預算是絕對沒有辦法推動的但是我只告訴你過去2015年蓋瓜承受嘛我有陳理官2010年來預算三讀照樣很順利很好的時間通過但是結果還是慘不忍睹所以部長檢討一下到底有什麼方法可以讓大家生小孩好嗎 |
| transcript.whisperx[624].start |
16168.758 |
| transcript.whisperx[624].end |
16172.539 |
| transcript.whisperx[624].text |
好包括我的人工生殖法案好謝謝謝謝委員好謝謝陳昭志委員接下來請鄭天才委員發言好 |
| transcript.whisperx[625].start |
16205.876 |
| transcript.whisperx[625].end |
16221.709 |
| transcript.whisperx[625].text |
主席有請部長有請施部長政委也好部長辛苦了還有所有的官員都辛苦了這個我還再提一下預算法第54條 |
| transcript.whisperx[626].start |
16224.4 |
| transcript.whisperx[626].end |
16245.972 |
| transcript.whisperx[626].text |
原來的預算可以繼續執行新興的計畫或者是新增的只要行政院送來立法院同意就可以動之所以都有解套的方法這個也讓衛福部瞭解好我們看今天的議題這個沒有辦法 |
| transcript.whisperx[627].start |
16256.263 |
| transcript.whisperx[627].end |
16273.593 |
| transcript.whisperx[627].text |
好接下來下一張這個全國跟原住民的平均移民落差依然的很大這個113年度是7.54的落差下一張這個原住民族健康法112年6月21號公佈施行公佈施行現在已經兩年半多了 |
| transcript.whisperx[628].start |
16286.505 |
| transcript.whisperx[628].end |
16311.316 |
| transcript.whisperx[628].text |
這個有了這個法我們有非常多的期待當然當初在審查的時候並沒有如我們原住民族立委的滿意但是畢竟還是通過了好我們看這個第二條中央主管機關應指定專責單位辦理原住民族健康事務 |
| transcript.whisperx[629].start |
16313.086 |
| transcript.whisperx[629].end |
16340.558 |
| transcript.whisperx[629].text |
在你們的報告裡面特別提到指定婦理及健康照護師為原住民族健康事務專責單位事實上就是原來的婦理及健康照護師之下的原住民族籬討建設科一個科 |
| transcript.whisperx[630].start |
16341.994 |
| transcript.whisperx[630].end |
16364.802 |
| transcript.whisperx[630].text |
部長也要讓你知道包括其他的衛福部的人員在過去台灣省政府時代在台灣省政府時代就是一個科原住民的部分就是一個科跟其他的都是平行的就是在那個 |
| transcript.whisperx[631].start |
16366.384 |
| transcript.whisperx[631].end |
16394.781 |
| transcript.whisperx[631].text |
那個什麼過去的省政府聽促一級單位就是科啦所以以前就是一個科到今省之後事實上是沒有成長上次來是退步然後有了原住民族健康法之後仍然維持一個科我們看這個當初的三讀通過 |
| transcript.whisperx[632].start |
16396.414 |
| transcript.whisperx[632].end |
16421.073 |
| transcript.whisperx[632].text |
原住民主健康法112年5月26日三讀通過的時候國民黨團及民進黨團共同所提的附帶決議特別提到請衛生福利部研議設置這個原住民主健康室或原住民主健康照護發展中心 |
| transcript.whisperx[633].start |
16423.117 |
| transcript.whisperx[633].end |
16433.283 |
| transcript.whisperx[633].text |
特別也讓部長跟我們的同仁了解中興它是一個機構它就不會受到這個 |
| transcript.whisperx[634].start |
16436.823 |
| transcript.whisperx[634].end |
16465.169 |
| transcript.whisperx[634].text |
一個部只能幾個師那個限制中心也不會受到幾個一個部只能有幾個或是前中華民國中央單位只能有幾個署或是局這些的一個限制七十個或七十個不會有那個限制中心機構不在那個限制裡面所以你們在規劃的時候不要受制於那個 |
| transcript.whisperx[635].start |
16466.987 |
| transcript.whisperx[635].end |
16485.469 |
| transcript.whisperx[635].text |
我們是很遺憾的這個行政院在今年1月6號送了這個兒少及家庭支持署的組織法長期照顧及社會發展署的組織法 |
| transcript.whisperx[636].start |
16486.875 |
| transcript.whisperx[636].end |
16513.641 |
| transcript.whisperx[636].text |
還有一個中心的組織法還有一個研究院的組織法就是沒有原住民的部分因為當初有提到是不是可以設原住民族健康照護發展中心結果也沒有這是我們覺得說非常遺憾好既然 |
| transcript.whisperx[637].start |
16515.345 |
| transcript.whisperx[637].end |
16536.19 |
| transcript.whisperx[637].text |
有了這個長期照顧級社會發展署原來有一個長期照顧師他提升為一個署了那我們有就是請部長可以決定就把這個原住民族 |
| transcript.whisperx[638].start |
16539.11 |
| transcript.whisperx[638].end |
16565.467 |
| transcript.whisperx[638].text |
的部分提高為私的層級可以嗎好跟委員報告在這個原住民族健康法通過之後其實我們也有不少的進展那第一個我們在國衛院裡面就成立了原住民族的這個研究中心這個健康法裡面有名對所以這個我們也落實了那也做了不少的東西那第二個我們也成立了這個原住民健康政策會 |
| transcript.whisperx[639].start |
16566.847 |
| transcript.whisperx[639].end |
16593.939 |
| transcript.whisperx[639].text |
廣納了我們的這個代表專家然後我們現在把這個位階提高那麼再來的話這個科我相信未來也會擴大這個師未來在扮演這個援助民族健康的角色也會更重所以也請委員放心我們未來可以逐步的擴大可以趕快做了可以開始再提報 |
| transcript.whisperx[640].start |
16595.18 |
| transcript.whisperx[640].end |
16618.567 |
| transcript.whisperx[640].text |
然後我的所謂的提報是人事單位還有業務單位要提報給部長來批核接下來有關中低收入老人假押的補助請問一下部長今年度衛福部就不執行了嗎 |
| transcript.whisperx[641].start |
16620.168 |
| transcript.whisperx[641].end |
16630.116 |
| transcript.whisperx[641].text |
中低收入戶老人假牙補助假牙的補助這應該是哪一個業務單位好說明一下 |
| transcript.whisperx[642].start |
16632.165 |
| transcript.whisperx[642].end |
16660.159 |
| transcript.whisperx[642].text |
地方政府來處理吧應該是這樣吧你來說明一下那個你是哪一個說明一下沒關係講清楚說明白根本報告今年度開始就是回到地方由地方政府來辦理那目前了解的結果各縣市政府都有繼續持續的辦理下去這個我要特別請這個我們公務員我也是公務員出身第一個我先問你我先請教你 |
| transcript.whisperx[643].start |
16661.463 |
| transcript.whisperx[643].end |
16689.315 |
| transcript.whisperx[643].text |
什麼時候發文給地方政府的包委員這個部分我沒有掌握那麼的清楚因為我不在業務單位裡面這個部分我們可以再了解以後再給委員這邊我的意思是說這個新聞你們發布的新聞已經是今年二月了我們從預算的編列來看根本就是來不及為什麼呢以地方政府的話編列預算 |
| transcript.whisperx[644].start |
16691.092 |
| transcript.whisperx[644].end |
16719.201 |
| transcript.whisperx[644].text |
也都是去年的115年度的預算也都是去年的八九月就一定送到議會了所以這個部分根本是來不及何況這個因為中低收入畢竟是肉市所以這個部分這個沒有在跟地方政府先溝通之前自己就決定這個不太好另外 |
| transcript.whisperx[645].start |
16721.664 |
| transcript.whisperx[645].end |
16748.383 |
| transcript.whisperx[645].text |
事實上我們看長照基金長照服務發展基金強化及延緩弱勢族群口腔衰弱計畫然後包括投注於原住民族地區的強化及延緩弱勢族群口腔這個計畫都有啊經費也有啊如果我們看這個長照服務發展基金 |
| transcript.whisperx[646].start |
16754.298 |
| transcript.whisperx[646].end |
16778.804 |
| transcript.whisperx[646].text |
115年度的預算數比114年度的預算數還多很多如果你回頭去看你們的公務預算也沒有減少所以這個部分這個請衛福部不要輕易的就尤其是弱勢的部分至少你要下放的話也要跟地方政府 |
| transcript.whisperx[647].start |
16779.344 |
| transcript.whisperx[647].end |
16800.255 |
| transcript.whisperx[647].text |
有所溝通因為這個預算用的是長照基金所以我們有持續在編列但是公務預算的部分確實受到財化法的影響所以才會做調整所以本來那個假牙的部分其實是公務預算的部分去支應的那個部長 |
| transcript.whisperx[648].start |
16801.954 |
| transcript.whisperx[648].end |
16815.766 |
| transcript.whisperx[648].text |
尤其是原住民族的部分因為原住民的部分不是只有在原鄉我們現在在都會期已經52%點多了在都會期而且我們又有55歲 |
| transcript.whisperx[649].start |
16817.908 |
| transcript.whisperx[649].end |
16844.978 |
| transcript.whisperx[649].text |
的那個部分那其地方政府未必會能夠符合會去比照原理你的政策好不好好我們會督促這件事情因為地方的預算也增多了嘛所以我們會來督促這件事情但是弱勢的部分盡量不要去處理那個輕易的我們會瞭解瞭解謝謝委員的提醒謝謝鄭天才委員接下來請黃孟凱委員 |
| transcript.whisperx[650].start |
16853.452 |
| transcript.whisperx[650].end |
16876.39 |
| transcript.whisperx[650].text |
主席謝謝麻煩請我們石部長我請石部長部長好部長好部長本席過去到現在一直很關心就是我們電子菸的問題我想你也知道今天我看到有個臨時提案我也覺得非常認同然後我簽名但是內容的部分還可以更積極為什麼因為 |
| transcript.whisperx[651].start |
16878.467 |
| transcript.whisperx[651].end |
16902.78 |
| transcript.whisperx[651].text |
如同部長你瞭解或說我們國建署這邊的瞭解狀況青少年一般民眾會買有機會購買到電子煙主要管道是什麼因為我們電子煙是禁止的是我們那個其實照理講不應該在台灣社會有任何販賣的行為因為它就是違法非法的好那但是有沒有這樣的樣態有那主要的取得管道是什麼 |
| transcript.whisperx[652].start |
16904.953 |
| transcript.whisperx[652].end |
16924.183 |
| transcript.whisperx[652].text |
我想一個當然用一般常識來講一個就是走私販賣那另外一個就是從網路取得對 網路取得走私販賣走私販賣一個一個跟你講說我這邊有貨要不要這種屬於傳統老派而且一對一不容易拓展主要還是網路嘛那本席之前就已經有提過就說 |
| transcript.whisperx[653].start |
16925.543 |
| transcript.whisperx[653].end |
16943.182 |
| transcript.whisperx[653].text |
能夠增加溝通成本不要那麼輕易的讓民眾隨便搜尋都搜尋得到所以過去我提出來說你如果說打電子菸三個字Google還可以出現人家官方網站然後買千送版加會員省五十幾十種口味在上面好 |
| transcript.whisperx[654].start |
16944.335 |
| transcript.whisperx[654].end |
16970.771 |
| transcript.whisperx[654].text |
但衛福部有沒有做事我也先稍微肯定有因為本席已經職權快一年的時間現在Google在打電子煙三個字確實比較少沒有說完全找不到有些時候完全找不到因為我差不多每個禮拜每兩個禮拜就去搜尋一次有些時候是找不到有些時候是在第二頁第三頁它已經不再像以前一樣大剌剌放在第一頁但我們一直沒有辦法根治的原因是什麼 |
| transcript.whisperx[655].start |
16971.604 |
| transcript.whisperx[655].end |
16997.429 |
| transcript.whisperx[655].text |
沒有辦法遮蔽那本席先講因為剛剛在交通委員會我也詢問了速發部長我另外一個議題就是前一個禮拜新北市府因為衛福部有通報性私密影像的影片應該要下架所以有成人影音網站請新北市去下架那下架一天之後這一個網站他又另起爐灶並且還講是說這裡管不到大家來喔 |
| transcript.whisperx[656].start |
16998.985 |
| transcript.whisperx[656].end |
17024.391 |
| transcript.whisperx[656].text |
好 那我們現在要問的是我們衛福部跟速發部的通報系統能不能針對這個網站上面至少一般正常的搜尋我不是講駭客什麼你很厲害那邊按網然後去搜尋 不是但一般民眾最直覺的上Google上Yahoo他去搜尋的時候你不要看到這些非法網站我想這是做得到的吧 |
| transcript.whisperx[657].start |
17025.231 |
| transcript.whisperx[657].end |
17044.691 |
| transcript.whisperx[657].text |
就是說跟委員說明我們第一個就是在行政作業上強化跟速發部的合作來強化下架跟遮蔽的反應這個我們會來做第二個我們也研擬要修這個厭害防治法把這個電商平台強化它的管理責任它應該也要有這種 |
| transcript.whisperx[658].start |
17045.905 |
| transcript.whisperx[658].end |
17069.731 |
| transcript.whisperx[658].text |
是自動要把這個其實電商平台譬如說蝦皮譬如說這些電商平台其實你真的相對少這個本席因為持續都有在做了解所以說相對少但是我們現在講的是它是直接變成它成立一個官方網站Google可以搜尋到然後它直接告訴你甚至它還跟你講現在沒有警語喔放心這個包裹外面不會有任何的識別 |
| transcript.whisperx[659].start |
17070.352 |
| transcript.whisperx[659].end |
17076.188 |
| transcript.whisperx[659].text |
所以你買了之後即便你穿校服去7-11去全家領貨他也不會要求你身份證 |
| transcript.whisperx[660].start |
17077.318 |
| transcript.whisperx[660].end |
17103.326 |
| transcript.whisperx[660].text |
那這樣就有問題啦就變成是說他取得的管道某種程度上廣義上還比一般的合法止煙合法加熱煙還要更容易因為你防不勝防那速發部剛剛部長跟我講他還誇胸脯保證說速發部現在已經跟這個Google跟Meta都已經談好了兩個小時內通報之後就可以讓他但是衛福部要有行政作業流程換言之現在是卡在衛福部這邊 |
| transcript.whisperx[661].start |
17106.836 |
| transcript.whisperx[661].end |
17125.649 |
| transcript.whisperx[661].text |
這個我們來加強跟那個速發部的合作讓這個行政的銜接更密切我想這件事情不是黨派不是朝野而是對全國2300萬人共同的身體健康今天提到為什麼加勒菸如此惡劣跟重要是因為它有可能變成是毒品的載具 |
| transcript.whisperx[662].start |
17127.27 |
| transcript.whisperx[662].end |
17155.51 |
| transcript.whisperx[662].text |
你如果說成為毒品的載具的話那就是毒價這一些部分你就更防不勝防所以我們今天要的是源頭管理你說後續要什麼違法取締 校園防治 毒品溯源這個有沒有在做 其實都有在做但我覺得最根本是你讓他買不到違法的東西本來就不應該在台灣可以輕易的購買這個是最基本的ABC嘛好 部長所以這樣講那麼多因為我真的已經質詢了一年了 |
| transcript.whisperx[663].start |
17156.601 |
| transcript.whisperx[663].end |
17182.683 |
| transcript.whisperx[663].text |
我們石部長的魄力能不能讓我看到我們一定一定這樣做好所以跟速發布那你們讓我知道然後我要看具體的成果就是未來我真的因為這已經是太多我們地方的國小國中家長們都跟我們反映我每一次去家長會我都跟他們講說我這一定會努力是因為這個是要保護我們孩童不要第一步受到好不好好 |
| transcript.whisperx[664].start |
17183.243 |
| transcript.whisperx[664].end |
17210.212 |
| transcript.whisperx[664].text |
好 那部長我給予這個會期的期待希望你可以拿出成果那另外一個小議題我稍微抱歉一分鐘我們淡海新市政啊大家一直講是說因為淡水現在20萬人那今天也跟今天的主題有相關就是偏鄉地區其實你想說新北市我們的北海岸石門山芝夢城村也算偏鄉啊人口真的不多老人家居多醫療的需求多 |
| transcript.whisperx[665].start |
17210.753 |
| transcript.whisperx[665].end |
17215.352 |
| transcript.whisperx[665].text |
那現在大家也講說那淡海新市政因為今年5月12號丹江大橋要通車 |
| transcript.whisperx[666].start |
17216.516 |
| transcript.whisperx[666].end |
17242.151 |
| transcript.whisperx[666].text |
未來淡海新市鎮可以發展那我們也要求說內政部在做二期的通盤檢討要把醫療專區放進去那現在這個部分但後續有醫療專區之後到底是什麼醫院來這個可能就需要中央地方一起來協助因為有地了我相信未來如果說那個醫療專區真的可以做起來可以甚至北海岸變成是一個陽光風景明媚的長照休閒這個醫療專區醫療 |
| transcript.whisperx[667].start |
17246.246 |
| transcript.whisperx[667].end |
17273.099 |
| transcript.whisperx[667].text |
甚至度假村等等的我覺得這可能都是解決我們未來長照的需求問題所以在這個部分是不是能夠請部長哲成看哪一個我們中央部會也跟我們新北衛生局進一步的溝通看怎麼樣在這個議題上可以往前進一步好 我會請那個議事司跟那個新北衛生局 副司長笑容滿面的 非常好來跟這個衛生局了解一下它整體的規劃方向 |
| transcript.whisperx[668].start |
17274.199 |
| transcript.whisperx[668].end |
17292.23 |
| transcript.whisperx[668].text |
衛生局陳潤秋局長我想也都是我們醫療專業的老朋友了是所以說在這個議題上面我想我們就真的拜託我們副市長跟我們局長這邊可以溝通一下那本席會再追這個進度好不好但是我希望是說能夠看到因為這是我們北海岸鄉親我們來了解一下他整個這個所謂的專區的規劃是 |
| transcript.whisperx[669].start |
17294.131 |
| transcript.whisperx[669].end |
17312.43 |
| transcript.whisperx[669].text |
他現在初步的概念是說會訂專區那未來可以考慮採取比如說BOT還是OT的方式但是重點是要有人來經營那還有說是不是做醫院因為醫院的話可能就要有門診中心有急診中心24小時待命但是現在又講是說因為缺工的問題 |
| transcript.whisperx[670].start |
17313.371 |
| transcript.whisperx[670].end |
17334.458 |
| transcript.whisperx[670].text |
也不一定有那麼多量能這些我們都理解但我先講說至少我們第一步專區取得之後我們媒合或者是說來引進更多的不同可能性讓北海岸地方真的可以變成是大家醫療需求解決那還有也可以做未來的你說國際醫療觀光也不一定不可行啊 |
| transcript.whisperx[671].start |
17334.958 |
| transcript.whisperx[671].end |
17362.808 |
| transcript.whisperx[671].text |
淡江大橋完畢之後未來桃園機場下來然後走這個相關我們的一個交通建設到淡水其實半個小時40分鐘就可以到所以我們也期待說未來它是另外一個產業的一個聚落好不好好這個就拜託部長可以責成我們複思一下我們來了解一起努力這個很好那本席也會再持續追這個議題希望它可以變成是中央地方共同合作的一個新亮點好感謝部長謝謝謝謝洪委員謝謝洪孟凱委員 |
| transcript.whisperx[672].start |
17365.598 |
| transcript.whisperx[672].end |
17382.036 |
| transcript.whisperx[672].text |
接下來請許富奎委員謝謝主席 有請我們石部長有請石崇亮部長 |
| transcript.whisperx[673].start |
17384.724 |
| transcript.whisperx[673].end |
17401.186 |
| transcript.whisperx[673].text |
好 習委員好 部長午安首先要先謝謝部長我記得這個上個會期我有特別拜託部長針對我們小琉球跟恆春半島醫療的問題那我想部長也真的用行動力展現所以我們今年 |
| transcript.whisperx[674].start |
17403.068 |
| transcript.whisperx[674].end |
17424.521 |
| transcript.whisperx[674].text |
前一兩個月我們跟屏東縣長我們鄒村民縣長跟我們相關的團隊我們到小琉球衛生所那我們也很感謝就是我們也號召了我們小琉球的做醫生的主席能夠返鄉去服務那當然也謝謝部長的媒合我們高屏地區有幾家醫院共同來支援我們小琉球的醫療的問題 |
| transcript.whisperx[675].start |
17425.962 |
| transcript.whisperx[675].end |
17437.278 |
| transcript.whisperx[675].text |
那但是這個是一個開頭因為這個小琉球的醫療的問題因為不是只有島上一萬多個居民每一年有超過120萬的遊客所以觀光醫療的問題我們責無旁貸所以有幾個問題還是要請部長來幫忙部長 |
| transcript.whisperx[676].start |
17442.685 |
| transcript.whisperx[676].end |
17470.705 |
| transcript.whisperx[676].text |
我想這個目前小琉球衛生所的這個科別也好或是醫師人力確實是比過去充足但是他們現在面臨的問題就是我們現在衛生所的建物輸入已經超過五十年不但是這個結構老舊空間狹小而且還有滲水漏水的問題我想這個對一個整個醫療的環境非常非常的不理想而且我覺得對於這個醫護人員也好跟鄉親的這個安全也造成一個疑慮部長 |
| transcript.whisperx[677].start |
17472.126 |
| transcript.whisperx[677].end |
17482.372 |
| transcript.whisperx[677].text |
屏東縣政府最近會提出一個整建改建的一個計畫部長願不願意來支持這樣的一個計畫我們一起來支持他對 柏廷你不要大用那麼快的你知不知道你還要下很多錢 |
| transcript.whisperx[678].start |
17485.16 |
| transcript.whisperx[678].end |
17503.398 |
| transcript.whisperx[678].text |
這不是問題啦這個現在其實重要的是因為他有這個地理限制嘛那是一個離島啦所以這不是什麼問題我們都已經承諾也在這個蘭嶼也要蓋醫院啦好所以我想因為現在他不是只有如果是老舊啊這個衛生所的條件 |
| transcript.whisperx[679].start |
17505.099 |
| transcript.whisperx[679].end |
17520.209 |
| transcript.whisperx[679].text |
確實已經超過50年應該要翻新或者是重建的話我們來仔細的評估之後全力支持因為現在琉球衛生所不是只有一個衛生所的規模他目前的這個醫療的量能應該具備一個小型醫院的一個功能 |
| transcript.whisperx[680].start |
17520.809 |
| transcript.whisperx[680].end |
17547.134 |
| transcript.whisperx[680].text |
所以我們應該是要把它當作一個醫院的規模來看待因為過去如果發生一些集中症或是不能處理的 還要坐救護船去到東港去到屏東我想我們如果可以就近那邊把這個醫療量能充足的話我想應該是大幅這個可以拯救我們相信的生命的安全你應該支持這個看法所以這個部分我想我們還是會趕快請縣政府把案子提出來之後請部長來支持 |
| transcript.whisperx[681].start |
17548.234 |
| transcript.whisperx[681].end |
17562.23 |
| transcript.whisperx[681].text |
好第二個這個針對恆春半輛的部分那當然我前陣子也跟我們周縣長去參加了橫旅的一個針對新島館也好跟尼亞科的一個成果的一個說明那這邊也特別謝謝部長那目前 |
| transcript.whisperx[682].start |
17563.471 |
| transcript.whisperx[682].end |
17580.185 |
| transcript.whisperx[682].text |
衛福部我們透過醫學中心支援的部分有核定了14個醫師的名額衡旅4位 衡基5位還有南門5位那其中還有增加一個最重要那個麻醉科醫師這個部分但是因為目前衡旅有新導管有高壓氧 |
| transcript.whisperx[683].start |
17580.845 |
| transcript.whisperx[683].end |
17601.075 |
| transcript.whisperx[683].text |
不然這不可以做一半而已,我想我們最近要導入一個叫做重症低溫的一個照護設備所以我們必須要有這樣的一個急重症的照護體系目前還欠什麼?心臟內科、胸腔科,還有這個急重症病房部長,這也是要你支持的好,支持好齁,這都有用,你要講大聲一點 |
| transcript.whisperx[684].start |
17603.288 |
| transcript.whisperx[684].end |
17626.791 |
| transcript.whisperx[684].text |
不然我想這個我們也會請亨利趕快加快來提案我想這個國境之南的醫療就如同委員講的不是只有在地還有每年的 超過四五百萬人對 那個觀光的量能很大那所以我們極力的在提升這三家醫院的醫療量能就像委員講我們過去有兩波兩的三個到現在五個 一間便宜 |
| transcript.whisperx[685].start |
17627.694 |
| transcript.whisperx[685].end |
17643.601 |
| transcript.whisperx[685].text |
然後大家互相分工 現在也組成了一個區域聯防區域聯防三間各自有分工我覺得這個是比過去進步很多了但是畢竟橫履是領頭羊的角色因為橫履是我們自己的名義 所以我們責務龐大所以發展的這一些需要 |
| transcript.whisperx[686].start |
17652.665 |
| transcript.whisperx[686].end |
17676.884 |
| transcript.whisperx[686].text |
那最後我還是要幫我們這個第一線的醫護人員來請命啦齁當然因為我們過去的這個醫療的部分醫院負責這個專科跟集中症那衛生所第一線應該是我們鄉親齁炮弄企業基層醫療跟日間照護的一個很重要的一個場域但是齁博士你覺得怎麼樣目前衛生所我們的醫師的志願費用每一個整市多少錢三千四百三十五塊 |
| transcript.whisperx[687].start |
17678.325 |
| transcript.whisperx[687].end |
17704.813 |
| transcript.whisperx[687].text |
比起一般的市場行情那個盧偉遠也是醫生一般行情應該是五千到六千這有相當大的落差耶不然你們從一百零六年到現在十年沒有調整過這對這個醫生情何以堪這不可以調整嗎這個是不是IDS的費用應該是IDS但是那個不夠啊盧偉遠是不是這是IDS的這是資源費用IDS是五千塊那資源費用這個就是公共機關訂的那個啦 |
| transcript.whisperx[688].start |
17708.854 |
| transcript.whisperx[688].end |
17729.373 |
| transcript.whisperx[688].text |
那是公務機關這也太少了太少啦因為如果是要去小琉球要坐船要住宿去恆春寺也要開車靠靠的農作業因為我們一直在檢討那個IDS的費用會給他今年我們有空間在健保的IDS的話支援的那個服務費用會給他提高啦 |
| transcript.whisperx[689].start |
17729.713 |
| transcript.whisperx[689].end |
17747.998 |
| transcript.whisperx[689].text |
那我來瞭解一下這個是什麼費用有的是地方核定的就是那個醫師的資源費用那個核定的我來瞭解一下就應該要提升我們要拜託偏鄉離島你收不收一個合理的報酬這對人家也很不公平費用太低了 |
| transcript.whisperx[690].start |
17750.018 |
| transcript.whisperx[690].end |
17776.824 |
| transcript.whisperx[690].text |
交洗人家的熱情這樣也不好啦最後我還是要提醒一個事情我知道你很認真你很用心我們跟你說的事情你都給我應好但是我更快樂因為你從衛生署到衛福部你歷練了很多重要的主管職務所以整個醫療體系你都更清楚我是快樂說你答應的事情到你下課的時候都不是打折就是跳票啦 |
| transcript.whisperx[691].start |
17778.105 |
| transcript.whisperx[691].end |
17779.775 |
| transcript.whisperx[691].text |
這一點我想要注意一下我們會來追蹤 |
| transcript.whisperx[692].start |
17782.13 |
| transcript.whisperx[692].end |
17802.159 |
| transcript.whisperx[692].text |
我跟你談完之後,走你們下面的人,你們下面的人都沒有要引渡啦這點我是真的覺得很生氣啊我相信,我認為,我們是雖然是這麼好的一個感情齁但是我想公事歸公事,你要拿出你做部長的power你既然答應了事情,既然要照顧我們的鄉親,就要照顧到,這樣好不好?好,我來了解好,謝謝,謝謝徐副委員接下來請劉建國委員發言 |
| transcript.whisperx[693].start |
17819.735 |
| transcript.whisperx[693].end |
17838.529 |
| transcript.whisperx[693].text |
來 謝謝主席有請這個破例始祖全都不是問題全力支持的史部長柏定你好這 做民意代表同樣聽到行政官員 應濟顧問 錢不是問題專烈支持我這幾位差不多要賺兩百三十幾億這要麻煩柏定什麼意思 |
| transcript.whisperx[694].start |
17844.414 |
| transcript.whisperx[694].end |
17846.799 |
| transcript.whisperx[694].text |
希望補充給我回答一下,質疑不是問題,專業支持 |
| transcript.whisperx[695].start |
17852.83 |
| transcript.whisperx[695].end |
17866.663 |
| transcript.whisperx[695].text |
被申訴我知道行情,但是委員沒說我不知道這是什麼意思以前是衛生署,現在是衛生福利部,那幾屆關頭都說不公平了尤其你是對衛生署的利益,就是這樣,不簡單,比較補充所以你的意念,跟你的經驗,跟這幾年多餘,要怎麼支持,要怎麼協同,應該都是大家可以信賴的 |
| transcript.whisperx[696].start |
17877.185 |
| transcript.whisperx[696].end |
17891.456 |
| transcript.whisperx[696].text |
所以不一定算運氣你給感情高 給我感情豐厚這點我給你記起來錄影把它加起來對照那個剛才徐副國跟他的對話好啦 我先感謝我們朝夕今天安排這個專案報告我們要整整這個平衡醫療跟當教的阻礙落差嘛我想我們在這裡 因為我可能有很多 |
| transcript.whisperx[697].start |
17905.934 |
| transcript.whisperx[697].end |
17922.134 |
| transcript.whisperx[697].text |
這個長者比賴這麼高還有一點 其實真的是在衛生署的時代那時候是楊志良署長然後蕭美齡副署長我曾經還把蕭美齡副署長邀集到台中去去看這個在宅醫療當時是針對牙醫的部分 |
| transcript.whisperx[698].start |
17923.015 |
| transcript.whisperx[698].end |
17943.941 |
| transcript.whisperx[698].text |
然後在林前部長林卓人部長的時候是在2016我要特別召集到這一個樂事醫院去召開我們改善雲林的可靜性的這樣的一個醫療的可靜性我們也要感謝委會部這幾天的努力所以補充化學對照病我們這幾天居家醫療的經費跟使用人數人數都足以在增加 |
| transcript.whisperx[699].start |
17944.502 |
| transcript.whisperx[699].end |
17951.406 |
| transcript.whisperx[699].text |
如果從居家醫療及照護的經費109436.54億那每年出院增加一直到11343.09億然後這個輔助人次居家醫療181109然後到113423萬多重度居家醫療29萬多一直到113437萬8左右 |
| transcript.whisperx[700].start |
17968.254 |
| transcript.whisperx[700].end |
17981.919 |
| transcript.whisperx[700].text |
居家中醫這個成長速度更快2523一直到1134一萬五千多但是不能再看最後一個居家藥師照護一百多年四十三一百十年 |
| transcript.whisperx[701].start |
17985.154 |
| transcript.whisperx[701].end |
18009.636 |
| transcript.whisperx[701].text |
一百四十一百十一年一百七十四一百十二年到三百二十六一百十三八十七部長也注意到了啦部長也有特別去在週六好像週六的時候有受訪嘛就跟你說未來在長沙3.0在宅醫療及急性後期照護等政策中中醫都將有更要的參與的角色 |
| transcript.whisperx[702].start |
18012.456 |
| transcript.whisperx[702].end |
18037.979 |
| transcript.whisperx[702].text |
這個我們當然全力支持也對關西省過去一直希望中醫可以再跟長照連結更加的內取2019年的時候6月健保署公告居家醫療整個計畫將藥師納入居家醫療的一份子針對末期病人的管制藥品以及特殊劑型的用藥指導來提供服務 |
| transcript.whisperx[703].start |
18038.96 |
| transcript.whisperx[703].end |
18046.547 |
| transcript.whisperx[703].text |
但是我們我們看到現在這樣的一個數據不曉得有掌握嗎為什麼在居家要事的招呼是 |
| transcript.whisperx[704].start |
18047.975 |
| transcript.whisperx[704].end |
18075.186 |
| transcript.whisperx[704].text |
是這麼低的人次在使用原因出在什麼地方謝謝委員提醒這些健保的服務數據我真的是忽略掉那個藥事服務我沒注意到謝謝你給我提醒我還要了解為什麼會掉下來因為健警的穩定在成長每一項的服務居家整合的每一項服務其實都是穩定在成長怎麼會藥事服務突然間掉下來我會來了解一下副署長也在這裡 |
| transcript.whisperx[705].start |
18077.367 |
| transcript.whisperx[705].end |
18083.632 |
| transcript.whisperx[705].text |
我們再分析一下這樣分析一下好嗎?這應該是經紀人嘛,一個禮拜應該怎麼做一些應變跟調整也好,好謝謝因為我們對日本的長照,居家的醫療的服務,日本的藥師能夠執行的服務像這麼多 |
| transcript.whisperx[706].start |
18095.578 |
| transcript.whisperx[706].end |
18109.576 |
| transcript.whisperx[706].text |
對不對 送藥到宅 緊急送藥到宅產藥計算 藥力管理用藥的整合評估 用藥諮詢指導分裝 特殊製劑調製與管理大大大一堆啦那事實上如果你根據食藥署在 |
| transcript.whisperx[707].start |
18111.533 |
| transcript.whisperx[707].end |
18132.92 |
| transcript.whisperx[707].text |
113年度的國內上市後藥品的不良的反應通報案例的分析全國藥物不良反應通報中心共接獲到一萬三千多件然後集中在40到79歲的壯年及老年的病患共佔整體通報案件的54%也就是說長者同時在使用過五種藥物我們媽媽就要照過五款藥物 |
| transcript.whisperx[708].start |
18137.698 |
| transcript.whisperx[708].end |
18151.577 |
| transcript.whisperx[708].text |
有一些狀況會發生他也就會忽略這個國際上對多重用藥的定義醫師藥師就會去提醒用藥不了環境可能就因為這個多重用藥還是藥物的交互作用 |
| transcript.whisperx[709].start |
18152.919 |
| transcript.whisperx[709].end |
18175.698 |
| transcript.whisperx[709].text |
而發生或是假種所以這其實有數我覺得是而且還有針對長者如果是家長記憶的衰退失智、獨居、難老照顧等等除了多重用藥也容易出現吃錯藥的這些狀況重重用藥的狀況還是服務劑量錯誤等等 |
| transcript.whisperx[710].start |
18176.98 |
| transcript.whisperx[710].end |
18200.852 |
| transcript.whisperx[710].text |
所以藥師在這個居家醫療照護他扮演的角色絕對是用藥的一個守門人所以特別拜託部長來重視這件事情因為部長有特別提到我去看這個居家醫療照護其實藥師扮演的角色很好他會幫那個病人整理藥還會幫他分隔分天分類 |
| transcript.whisperx[711].start |
18202.133 |
| transcript.whisperx[711].end |
18230.473 |
| transcript.whisperx[711].text |
我覺得這個藥師服務是在社區藥局可以扮演很重的角色我會來瞭解為什麼這個服務量會下降好 就一個禮拜嘛我們也可以就是說參照日本的一些藥師的功能的提升加強他的一些資物讓這個藥師可以扮演的更在3.0裡面可以協助病人提高他的自我照顧能力對 好然後這個跟健保署有關還是請教部長 |
| transcript.whisperx[712].start |
18232.134 |
| transcript.whisperx[712].end |
18252.93 |
| transcript.whisperx[712].text |
除了居家的藥事照顧之外在者醫療還有很多問題健康署宣稱目前有數千家院所參與居家醫療整合計畫那過去一年這個出診次數為零或僅出診個位數的診所比例有多少能說明嗎出診 |
| transcript.whisperx[713].start |
18254.311 |
| transcript.whisperx[713].end |
18280.808 |
| transcript.whisperx[713].text |
為零因為我們這個這個它是有這個叫做合作關係合作關係的意思是說它有的是診所跟居戶所去合作提供居家醫療啦然後我們那個那個這個居戶所去提供照顧那醫師有的時候是靠遠距那個居家住院嘛那個在宅住院那個街尾是遠距但是至少他要去看一次啦 |
| transcript.whisperx[714].start |
18281.789 |
| transcript.whisperx[714].end |
18289.665 |
| transcript.whisperx[714].text |
所以不應該有出證為零的這應該是不可能才對這應該是嘛所以你又說應該就代表不可能喔 |
| transcript.whisperx[715].start |
18292.943 |
| transcript.whisperx[715].end |
18317.159 |
| transcript.whisperx[715].text |
所以是不是要把這個治療我們再整理一下然後第二個是這個另外使用居家醫療的民眾最終還是在醫院死亡的狀況這是不是跟我們叫做醫療不需要離開所居的社區對我們居家醫療有另一個目標就希望他能夠在家往生能夠在居家我們現在還是將近差不多 |
| transcript.whisperx[716].start |
18318.44 |
| transcript.whisperx[716].end |
18347.319 |
| transcript.whisperx[716].text |
8成的會在醫院不過如果是進入安寧的計畫的就比較多進入安寧的就會比較多在居家安寧計畫的就會比較多在載往生這個還有一個數據因為時間關係請部長看第三點因為印尼週日對外的一個收網裡面長照三點來我們就是要做各方面的一個強化但是你看到居家 |
| transcript.whisperx[717].start |
18348.602 |
| transcript.whisperx[717].end |
18353.136 |
| transcript.whisperx[717].text |
醫療的醫師常在反應不知道病人的腸道需求腸道端也不知道這個居家醫療醫師的意囑 |
| transcript.whisperx[718].start |
18355.204 |
| transcript.whisperx[718].end |
18379.138 |
| transcript.whisperx[718].text |
所以這兩者應該是相互相整啊怎麼會變成兩邊各做各的對對對 這個委員點出我們之前的問題就是那個兩個資料沒有互接啦所以我們現在正在做資料的互接已經在進行中了嘛 就是健保的資料先整合然後長照也有一個長照系統那現在長照跟健保兩邊的資料在就對接了 |
| transcript.whisperx[719].start |
18380.038 |
| transcript.whisperx[719].end |
18391.462 |
| transcript.whisperx[719].text |
不然你回想一下,這其實喔,離奇點公開是要實施其實我們也去參訪日本很多案,很多他們這個對折要經營,我們有理由讓我們看但是我們到現在,2.0變3.0了,還有這種問題就是不應該發生的啦阿現在這個3.0的重點就是要讓它這邊兩邊可以對接應該已經在進行嘗試了嘛,已經在嘗試了好一定要試辦啦,不用對接你要試辦多久? |
| transcript.whisperx[720].start |
18409.661 |
| transcript.whisperx[720].end |
18430.208 |
| transcript.whisperx[720].text |
已經跟差不多現在開始我們看今年可以開始今年內就開始今年內對不起今年還有8個多月應該上半年就可以了吧上半年準備要差不多啦OK啦好謝謝謝謝部長謝謝委員謝謝中國委員 |
| transcript.whisperx[721].start |
18438.03 |
| transcript.whisperx[721].end |
18461.529 |
| transcript.whisperx[721].text |
接下來請高津樹梅委員高津樹梅委員高津樹梅委員不在 接著請蔡奕宇委員蔡奕宇委員蔡奕宇委員不在 接著請林德福委員林德福委員林德福委員不在 接著請鄭振淺委員鄭振淺委員鄭振淺委員不在 接著請楊耀遠發言 |
| transcript.whisperx[722].start |
18473.732 |
| transcript.whisperx[722].end |
18501.028 |
| transcript.whisperx[722].text |
謝謝主席 主席請一下施部長好 邀請施部長恭送劉建國委員邀委員好部長好 部長我們先來討論一下第三期公費醫生養成計畫的相關問題我想請問一下你們這一次就是有分成兩大類別對 |
| transcript.whisperx[723].start |
18504.264 |
| transcript.whisperx[723].end |
18518.973 |
| transcript.whisperx[723].text |
政策任務科別跟人才羅製困難科別我問一下人才羅製困難科別大概是不是最主要是以後要在離島偏鄉做服務 |
| transcript.whisperx[724].start |
18521.514 |
| transcript.whisperx[724].end |
18545.949 |
| transcript.whisperx[724].text |
對就是在偏鄉比較難羅釋的那我在這邊提醒一下部長就是這個每一年科別會怎麼分配名額可能要我們會去預估各地報出來的需求就是會先前置作業先去調查那個每個縣市他認為這個地方他的科別需求是什麼然後我們才會開出那個科別 |
| transcript.whisperx[725].start |
18547.421 |
| transcript.whisperx[725].end |
18571.264 |
| transcript.whisperx[725].text |
那先做調查可是我看資料是政策任務科別的次專科是你們是指定這個是兩類可是人才羅志困難科別是沒有對對對對對那沒有的話就是簡單講就是人才羅志困難科別就是一般講的五大科啦兒科啦內科啦婦產科啦老外科大概就是這些基本科啦 |
| transcript.whisperx[726].start |
18571.644 |
| transcript.whisperx[726].end |
18599.292 |
| transcript.whisperx[726].text |
那政策科別就是說我們有一些因為量的關係不多所以我們必須要集中有這樣的人才可是呢這個可能大家比較不想走的像比如說小兒神經科這個很少服務量很少市場很小但是確實需要有這樣的人才那我們如果沒有辦法我們就是用公費來培養這個是叫做政策比如說有一些是屬於特殊的這個精神科的刺莊科 |
| transcript.whisperx[727].start |
18600.432 |
| transcript.whisperx[727].end |
18624.125 |
| transcript.whisperx[727].text |
那些類似的我們會這樣請教一下部長就是說因為政策任務的次專科是由部裡面這邊來試實際情況那學生入學的時候就決定還是什麼時候決定要畢業的時候選科的時候決定那萬一我說萬一萬一沒有人走對 |
| transcript.whisperx[728].start |
18626.932 |
| transcript.whisperx[728].end |
18647.333 |
| transcript.whisperx[728].text |
這個我今天都只提問題啦你們有沒有可能就是說這些學生他就志向不在這裡也可能他專長興趣不在這裡這個你們要趕快去想說怎麼處理我今天最主要是要講人才羅志困難課別的問題就這幾年啊 |
| transcript.whisperx[729].start |
18649.248 |
| transcript.whisperx[729].end |
18672.746 |
| transcript.whisperx[729].text |
因為離島的在地養成公費醫生其實不少在我立委任期內澎湖大概就培養了一百個我現在都擔心以後醫生的人數太多得不到應有的待遇所以這是一個很大的問題我相信 |
| transcript.whisperx[730].start |
18674.177 |
| transcript.whisperx[730].end |
18702.755 |
| transcript.whisperx[730].text |
原住民地區也會有這個問題因為義大設了一個專收原住民的醫學系這幾年他們那裡培育多少我不知道金門跟澎湖其實現在就是澎湖現在還沒有這個問題金門可能已經有這個問題了那在地養成的醫生其實我坦白講我的在地觀察培養出來的醫生都非常優秀 |
| transcript.whisperx[731].start |
18703.905 |
| transcript.whisperx[731].end |
18729.775 |
| transcript.whisperx[731].text |
可是我們要怎麼去管制這個量你知道在我的任內曾經我自己要求造物師把每年九個變成每年六個理論上是應該要再逐步減下來那現在在地養成已經這麼多了你們又用了這個科別以後會不會 |
| transcript.whisperx[732].start |
18731.349 |
| transcript.whisperx[732].end |
18739.536 |
| transcript.whisperx[732].text |
會不會離島偏鄉反而醫生的量太多我現在先不討論科別的失衡的問題我只講總量有沒有可能會發生 |
| transcript.whisperx[733].start |
18749.484 |
| transcript.whisperx[733].end |
18774.464 |
| transcript.whisperx[733].text |
跟委員說明就是說您的觀點很好一個是總量一個是系的分科分部這是兩個不同的問題以量來講目前是還好因為我們除了離島本身之外我們還有一些衛生所這個原鄉地區還有一些偏遠地區的我們的公立醫院也缺人所以目前來講量的部分是不會過剩 |
| transcript.whisperx[734].start |
18775.809 |
| transcript.whisperx[734].end |
18801.332 |
| transcript.whisperx[734].text |
但是科別就是要很小心因為我們並沒有強制他要選什麼科的機制因為每個人的興趣不同所以科別上怎麼樣拿捏好他的科我們再來這個非常困難因為有一些科是我們要特殊譬如說現在偏鄉地區因為我們人口下降出生率下降 |
| transcript.whisperx[735].start |
18802.533 |
| transcript.whisperx[735].end |
18829.723 |
| transcript.whisperx[735].text |
產科會缺啦因為沒有市場嘛產科會缺所以我們就要供費深去但是呢會不會這一屆雖然有50個但是沒有人願意走沒有人要選副產科所以這個就是在第三期上路的同時你們有一些獎勵機制就要同時出來那我也在提醒部長就是說現在 |
| transcript.whisperx[736].start |
18830.603 |
| transcript.whisperx[736].end |
18838.925 |
| transcript.whisperx[736].text |
看起來離島偏鄉的醫生量能沒有過剩的問題可是等到第三期公費生 |
| transcript.whisperx[737].start |
18840.841 |
| transcript.whisperx[737].end |
18863.953 |
| transcript.whisperx[737].text |
投入醫療行業的時候我們現在看的是已經看到10年以後的問題了就是說10年以後會不會真的離島離島跟偏鄉其實已經不缺醫生了所以我的建議是這樣子就是說你們要不要不要把第三期公費生弄得那麼複雜 |
| transcript.whisperx[738].start |
18866.541 |
| transcript.whisperx[738].end |
18884.607 |
| transcript.whisperx[738].text |
因為你現在分兩個類別其實我是覺得反而會造成比較大的問題就是直接用單一類別然後罰則什麼也都一致 |
| transcript.whisperx[739].start |
18887.032 |
| transcript.whisperx[739].end |
18903.79 |
| transcript.whisperx[739].text |
這樣服務連線也都一致這樣子可能會比較簡單一點也比較不會造成像我剛剛講的你這個科別就是專門訪理療偏鄉的可是到那個時候他的醫師量能已經足夠了 |
| transcript.whisperx[740].start |
18906.84 |
| transcript.whisperx[740].end |
18916.666 |
| transcript.whisperx[740].text |
反而會造成很大的問題當然這個問題已經不需要我們解決了只是說我們現在在這個位置我們先拿出來探討因為我們本來的設計上就是有一些 |
| transcript.whisperx[741].start |
18922.949 |
| transcript.whisperx[741].end |
18950.628 |
| transcript.whisperx[741].text |
這個政策科別的他可能在醫院服務了所以他的時間會長一點我就說政策科別的是很好因為既然五大科特別有一些次專科沒有人走我們盡量鼓勵甚至像我剛才講的我們在推動的過程就把獎勵機制推出來這個當然是有需要我現在講的是說你們假如說萬一又特別開了一個 |
| transcript.whisperx[742].start |
18952.182 |
| transcript.whisperx[742].end |
18977.657 |
| transcript.whisperx[742].text |
沒關係 保證你先喝水假如說我們萬一又多開了一個一個離島偏鄉我是就我在我來自離島的委員我的觀點我的觀察做這樣子的建議我覺得你們再討論看看 |
| transcript.whisperx[743].start |
18981.557 |
| transcript.whisperx[743].end |
18990.387 |
| transcript.whisperx[743].text |
我最後還是要問一個彭茹早聊的問題就是我曾經講過就是彭茹的聯評時間太短沒有關係因為時間的關係我就把問題點出來讓你們回去 |
| transcript.whisperx[744].start |
19002.691 |
| transcript.whisperx[744].end |
19010.43 |
| transcript.whisperx[744].text |
聯合門診評估的量能太低所以有的時候要等很久那國健署 |
| transcript.whisperx[745].start |
19012.321 |
| transcript.whisperx[745].end |
19035.168 |
| transcript.whisperx[745].text |
基本補助是一百萬那離島的縣市只多五萬對於離島醫事人員招募本來就不易是不是可以請國建署我也替曹偉講一下就是離島跟偏鄉的部分你們研議一下把 |
| transcript.whisperx[746].start |
19036.96 |
| transcript.whisperx[746].end |
19053.885 |
| transcript.whisperx[746].text |
把補助金額再提高因為沒有啦 多錢啦沒有啦 多錢啦 好不好這個跟委員報告澎湖的部分我們今年第四季會成立第二個聯平中心對 我知道那第二個我也請你們競速成立 |
| transcript.whisperx[747].start |
19055.505 |
| transcript.whisperx[747].end |
19077.612 |
| transcript.whisperx[747].text |
再研議看看有沒有那個遠距的協助遠距的評估協助這個也是一個那另外那個費用的部分考慮到離島跟偏鄉的加成給付這個我們目前是已經有提高但是我們再瞭解一下是不是這樣的額度適當補充你這樣不容易 你連我都要問遠距你就直接說出來 |
| transcript.whisperx[748].start |
19081.873 |
| transcript.whisperx[748].end |
19107.075 |
| transcript.whisperx[748].text |
我知道你關心嘛就是我們進口因為早療早療早療是及早發現及早治療嘛那假如說是因為因為我們的各項人力設備不足造成治療的推遲就變成我們的責任好不好我們來研究一下試辦看看好 謝謝部長 謝謝主席 |
| transcript.whisperx[749].start |
19107.796 |
| transcript.whisperx[749].end |
19135.967 |
| transcript.whisperx[749].text |
好謝謝楊耀委員接下來請楊瓊英委員楊瓊英委員楊瓊英不在接著請陳培宇委員陳培宇委員陳培宇不在接著請林倩琦委員林倩琦委員林倩琦委員不在接著請武力華委員發言謝謝主席有請施部長有請施部長 |
| transcript.whisperx[750].start |
19140.186 |
| transcript.whisperx[750].end |
19166.02 |
| transcript.whisperx[750].text |
吳委員好部長好賴總統上任之後有在總統府成立一個健康台灣推動委員會目前我們看到也開過7次的會議那我知道在當中健康台灣有一個目標就是8年內要提升國人的平均餘命到82歲所以如果我們看一下最新的資料 |
| transcript.whisperx[751].start |
19167.961 |
| transcript.whisperx[751].end |
19183.757 |
| transcript.whisperx[751].text |
113年呢全體國民的平均壽命是80.77歲那也就是說如果要再增加1.23就可以達標那再細看平均每一年希望可以達到0.15歲的增長可是 |
| transcript.whisperx[752].start |
19187.701 |
| transcript.whisperx[752].end |
19207.407 |
| transcript.whisperx[752].text |
當我們再去細看原住民族群這一塊那目前我們在113年的原住民平均的餘命是73.23但是數學我們當然沒有辦法這樣看我只是想表達原住民的人口是2.5% |
| transcript.whisperx[753].start |
19209.167 |
| transcript.whisperx[753].end |
19224.442 |
| transcript.whisperx[753].text |
所以呢當用這個大水池去算的時候其實原住民這一塊可能是被淹沒的因為他的人口非常的少所以很容易被忽略那我要談的是如果我們要達成這個目標也許不難 |
| transcript.whisperx[754].start |
19227.245 |
| transcript.whisperx[754].end |
19245.339 |
| transcript.whisperx[754].text |
因為其他的非原住民人口佔了絕大多數然後他們的醫療可及性可能在醫療的作為之上呢能夠有顯著的一個成效可是原住民就會被忽略了那我不曉得這個部分部長您覺得 |
| transcript.whisperx[755].start |
19247.5 |
| transcript.whisperx[755].end |
19272.973 |
| transcript.whisperx[755].text |
會怎麼樣去看待這個問題我們對這個原住民族健康也有一個中長城計畫現在也在做review當中了那也會搭配整個健康台灣的施政目標去擬定那未來在這個除了我們是全民的餘命希望延長之外我們另外一個也希望去縮短原住民跟我們國人的餘命的這個落差 |
| transcript.whisperx[756].start |
19273.473 |
| transcript.whisperx[756].end |
19289.815 |
| transcript.whisperx[756].text |
所以如果這個落差能夠縮短那等於是我們原住民同胞的這個餘命也在延長謝謝那我請教一下部長假設說大水池那一塊我們花一塊錢就可以看到成效那按這個比例來講原住民應該要花多少錢 |
| transcript.whisperx[757].start |
19292.573 |
| transcript.whisperx[757].end |
19306.542 |
| transcript.whisperx[757].text |
這個錢真的是很難估啦因為這個是但至少應該是很多倍對不對因為我們原民您也知道有一些是已經是在都會區的那有一些是在原鄉的那都會區的話就會在整個大系統裡頭 |
| transcript.whisperx[758].start |
19307.583 |
| transcript.whisperx[758].end |
19330.884 |
| transcript.whisperx[758].text |
那原鄉當然我們有特別的這個政策的介入那部長請教一下像我們在那個花蓮的秀林鄉就做那個全能照護那個效果很好他的那個餘命會延長而且更健康了所以我們把這個模式擴大所以擴大到在這個花蓮的話就有八個鄉鎮就是八個鄉要做這件事情 |
| transcript.whisperx[759].start |
19331.164 |
| transcript.whisperx[759].end |
19356.585 |
| transcript.whisperx[759].text |
不講因為說一句實在話蔡英文上任之後我們推動文化健康戰大家都很有感也許不知道是因為執政的關係但是我要提的是說我們也常常會去告訴人家自從推了文化健康戰之後我們的平均餘命好像跟全體國人有在縮短而且速度非常快 |
| transcript.whisperx[760].start |
19357.611 |
| transcript.whisperx[760].end |
19374.171 |
| transcript.whisperx[760].text |
可是没有科学的根据这个只是我们这样子讲而已所以呢这个有一个专门在做这样的一个研究也是我们原建法通过之后我们很期待有的那我先请教一下健康台湾推动委员会有没有原住民 |
| transcript.whisperx[761].start |
19375.092 |
| transcript.whisperx[761].end |
19380.697 |
| transcript.whisperx[761].text |
有哪一位 林醫師 溫德那我希望這一些我們剛剛講的我希望你們請林醫師一定要好好的擬出對策我也希望你們能夠尊重他的看法可以嗎那我再請教一下因為台灣的四級醫療分級我都覺得都很好可是現實在原鄉 |
| transcript.whisperx[762].start |
19396.852 |
| transcript.whisperx[762].end |
19422.184 |
| transcript.whisperx[762].text |
他就是只有衛生所或者是基層的醫療診所所以我們一直在談遠距醫療 遠距醫療疫情期間有我們看到衛福部在很多地方有在推動可是疫情過後我們發現又縮減了所以我想問一下部長什麼時候能夠全面的開放偏鄉的遠距醫療的科別跟他合作醫院的限制跟我們報我們去年8月鬆綁了 |
| transcript.whisperx[763].start |
19423.064 |
| transcript.whisperx[763].end |
19434.647 |
| transcript.whisperx[763].text |
已經鬆綁了對對對我們那個所有科別不限了只要當地的這個科的專科醫師少名三名以下的就可以用就可以用遠距然後他的那個區域我們過去只限定在那個離島跟這個園鄉現在我們連那個 |
| transcript.whisperx[764].start |
19442.449 |
| transcript.whisperx[764].end |
19464.995 |
| transcript.whisperx[764].text |
都市邊緣的就是資源比較不夠的也開放了所以是有135個鄉鎮可以適用唐蓋的那個人口服務人口是180萬人我們逐步再增加我希望知道目前參與的情形也希望給我一份書面資料那我請教一下因為談到這個還有一個部分我們要注意很多偏鄉不是只有蘭嶼 |
| transcript.whisperx[765].start |
19466.235 |
| transcript.whisperx[765].end |
19487.749 |
| transcript.whisperx[765].text |
因為他就是只能面對衛生所他只要有重病他就必須要去醫院可是因為距離的關係很多人不去看病因為他要負擔很大的交通費那我不太曉得說現在有沒有去看重這個問題有沒有列入政策就是那個交通費的補助嘛我們有這個費用 |
| transcript.whisperx[766].start |
19491.567 |
| transcript.whisperx[766].end |
19505.05 |
| transcript.whisperx[766].text |
就是所有的偏鄉 所有的原鄉然後不限距離他只要出去一次就兩千塊嗎有 有一點限制啦 有啦 |
| transcript.whisperx[767].start |
19505.967 |
| transcript.whisperx[767].end |
19525.72 |
| transcript.whisperx[767].text |
好那我再請教一下所以我們部落裡面的這個長照也是很重要的一個地方那我是希望說其實文化健康站就是一個希望他能夠長照跟心理支持的一個核心啦但是我知道大家都會提到 |
| transcript.whisperx[768].start |
19526.812 |
| transcript.whisperx[768].end |
19552.141 |
| transcript.whisperx[768].text |
日照中心會提到加拖站但是我要讓部長知道我也接到好多的陳情日照中心的負責人其實他們也很多的苦衷因為他們說即便如此他們經常都收不到自付額就是很勉強的經營維持下去他們也跟我們陳情說這個部分政府能不能幫忙 |
| transcript.whisperx[769].start |
19555.856 |
| transcript.whisperx[769].end |
19581.103 |
| transcript.whisperx[769].text |
委員講的是文建站還是日照中心我們了解一下說不到那部長我只是要表達其實現在有很多的長照機構大家說空床率很高也不需要再給原住民另外蓋但是我就是要讓部長知道你看我們很多人其實是因為他負擔不起 |
| transcript.whisperx[770].start |
19582.339 |
| transcript.whisperx[770].end |
19610.891 |
| transcript.whisperx[770].text |
才會有所謂的空床率很高那另外一個部分他即便到現在鄉裡面的日照中心他也負擔不起那樣的費用所以這個事實是存在的所以我們很希望說不論是在我們健康台灣裡面我知道有委員提到要催生原住民醫院那衣服會呢好像也有在規劃但是我不知道進度那現在都會區的原住民長照大樓也在興建 |
| transcript.whisperx[771].start |
19611.451 |
| transcript.whisperx[771].end |
19640.345 |
| transcript.whisperx[771].text |
那因為時間的關係是不是簡單回答跟委員說明為了導入這個文化安全其實那個我們醫院能夠有友善的這個服務我們找了三家醫院在試辦一個是那個就是您提的這個樂生醫院那另外屏東醫院還有一個花蓮醫院這三家醫院在試辦這個把這個文化安全的概念把它導進去那會不會又有 |
| transcript.whisperx[772].start |
19640.925 |
| transcript.whisperx[772].end |
19669.731 |
| transcript.whisperx[772].text |
回來的聲音讓你們覺得說哎呀空床率很高他應該是指整個那個環境的營造跟服務上的友善我只是要凸顯的就是其實這不是空床率的問題而是負擔不起的問題所以我覺得原住民這個部分就是長照的部分照顧的部分這個其實我們還是希望衛福部能夠去多多的討論看看要怎麼去改善 |
| transcript.whisperx[773].start |
19670.671 |
| transcript.whisperx[773].end |
19689.977 |
| transcript.whisperx[773].text |
那最後我總而言之要講的是說我們一直期待原住民族健康法他能夠有所謂的一個專責機構那我也知道目前所謂的專責單位叫做原住民族及離島健康科那我也不知道這樣算不算是一個專責的單位或專責的機關啦但是我們 |
| transcript.whisperx[774].start |
19693.779 |
| transcript.whisperx[774].end |
19706.289 |
| transcript.whisperx[774].text |
當時要立法又說礙於財政紀律法也不能夠去匡列經費但是我們看一下當時雖然說會給很多經費可是我們看了一下公務預算113到115公務預算 |
| transcript.whisperx[775].start |
19708.971 |
| transcript.whisperx[775].end |
19732.205 |
| transcript.whisperx[775].text |
其實是沒有顯著的提高然後又去看特別預算115年也沒有特別前瞻特別預算然後去看基金各類基金原建法上路已經三年好像各類的基金也沒有提出相關的新興計畫所以這個部分我們不太曉得說在原住民族的健康照護這一塊到底該怎麼做所以我們覺得 |
| transcript.whisperx[776].start |
19733.206 |
| transcript.whisperx[776].end |
19755.905 |
| transcript.whisperx[776].text |
最好的解方那就是透過組織法的修正來擴充相關的專責預算跟人力我們是覺得說這才是最好的解方所以我相信很多的委員都有提出衛福部組織法的一個版本那我個人也有就是希望能夠增加援助民族健康照顧署我不曉得部長的意見如何 |
| transcript.whisperx[777].start |
19756.825 |
| transcript.whisperx[777].end |
19773.913 |
| transcript.whisperx[777].text |
跟委員說明就是說我們現在的這個關於這個原住民健康的事務的推動其實他是要跨單位大家都要做的不會只有一個即使是一個師一個署都不足以承擔所以他應該是有一個專責的政策規劃 |
| transcript.whisperx[778].start |
19775.514 |
| transcript.whisperx[778].end |
19793.845 |
| transcript.whisperx[778].text |
但是要推動的時候還是要回到各業務執掌單位去推動有的是健保的有的是長照的有的是國健署的預防保健這個還是要回到各個單位去推動才不會脫節只有單靠一個師也好一個署也好來推動是不夠的 |
| transcript.whisperx[779].start |
19795.406 |
| transcript.whisperx[779].end |
19822.663 |
| transcript.whisperx[779].text |
預算也是一樣它是分散在各個單位的我們理解但是我們只看最後的效果有沒有顯著那顯然從各個方面來看其實還是有一大段的落差那我們真的是期待說給我們一個專門的機關署司都可以那我們希望原住民族的健康能夠由他們來跟各個單位各個部會 |
| transcript.whisperx[780].start |
19825.344 |
| transcript.whisperx[780].end |
19831.168 |
| transcript.whisperx[780].text |
來去做一個最重要的那更重要的是裡面的人就像剛才聽到的推動委員會有一位林醫師我們希望有這樣的人讓大家聽見原住民的想法去做原住民專屬的規劃才能夠真正的去解決根本的問題這是我們的期待啦所以我們還是希望我們部長這邊能夠繼續的來做這方面的溝通可以嗎 |
| transcript.whisperx[781].start |
19850.759 |
| transcript.whisperx[781].end |
19871.947 |
| transcript.whisperx[781].text |
好 我繼續努力其實在我們那個原住民族健康政策會裡面的每一組其實都有我們的原住民的代表在也好幾位醫師在裡面好 謝謝部長好 謝謝主席謝謝吳立華委員鍾嘉斌委員鍾嘉斌委員不在 接著請陳雲委員 |
| transcript.whisperx[782].start |
19884.66 |
| transcript.whisperx[782].end |
19887.662 |
| transcript.whisperx[782].text |
麻煩請衛福部長請石部長張委員好部長好我想在這邊我們也是先謝謝昭緯他這次特別安排這次的專案報告那當然就是說特別援建法的部分是本席在擔任昭緯的時候112年 |
| transcript.whisperx[783].start |
19908.917 |
| transcript.whisperx[783].end |
19927.996 |
| transcript.whisperx[783].text |
那個時候我們一起大家一起努力通過的那當然那個時候我也還要再特別謝謝我們當時的次長石次長那時候在沒有行政院版本推出的時候共同和本席一起密謀沒有密謀我們是協助委員 |
| transcript.whisperx[784].start |
19932.381 |
| transcript.whisperx[784].end |
19944.893 |
| transcript.whisperx[784].text |
那就是也非常站在我們原住民這邊就是一起幫忙把這個法案通過那當然就是說我們都很關心現在落實的狀況那當然 |
| transcript.whisperx[785].start |
19948.777 |
| transcript.whisperx[785].end |
19963.47 |
| transcript.whisperx[785].text |
就是前面在你們的這個報告裡面有提到落實了哪些但是我想很多委員特別是招委特別他要爭取擔任招委應該很重要的一個目的也還是回到這個專責單位這個問題 |
| transcript.whisperx[786].start |
19965.792 |
| transcript.whisperx[786].end |
19984.337 |
| transcript.whisperx[786].text |
那我想其實不管他的專責單位是設定成什麼那最重要還是事在人為就是重要那個人到底有沒有去執行有沒有落實才是最重要的那當然我這樣講也不是要讓你們打折扣啦因為我就想說來先了解一下 |
| transcript.whisperx[787].start |
19985.097 |
| transcript.whisperx[787].end |
20008.962 |
| transcript.whisperx[787].text |
在你們這個原件法通過之後你們特別指定了這個照護司來作為這個專責單位那我想請教在你們指定他們成為專責單位之後呢在業務上的執行上還有你們的人力運用上跟就是過去跟現在有什麼差別 |
| transcript.whisperx[788].start |
20010.332 |
| transcript.whisperx[788].end |
20037.43 |
| transcript.whisperx[788].text |
我跟委員報告當然在人力上並沒有擴編但是未來我們現在進行主改未來我也討論到原本在這個護理及健康照護師裡面的有一些業務他會整併到這個未來的那個長照署去但是我們的人力會把它維持住來多增加一些人來協助做援助民主健康的政策的規劃擬定跟推動 |
| transcript.whisperx[789].start |
20038.27 |
| transcript.whisperx[789].end |
20053.863 |
| transcript.whisperx[789].text |
所以這個我們會去放大它的份量因為在這個法通過至今已經將近三年在過去這個兩三年的當中其實也做了不少的事情包含我們的研究中心那個開始建的資料庫研究計畫的推動 |
| transcript.whisperx[790].start |
20056.746 |
| transcript.whisperx[790].end |
20077.028 |
| transcript.whisperx[790].text |
這個委員會政策會的成立四個小組的運作那我看也有不少的產出跟建議讓我們在政策上落實然後現在也在擬定這個中長城計畫當中就原住民族健康的中長城計畫我想主要我想在這個過程我大概還原一些事情 |
| transcript.whisperx[791].start |
20078.149 |
| transcript.whisperx[791].end |
20093.184 |
| transcript.whisperx[791].text |
那因為畢竟就是說在原先最早期叫做山地離島科那現在叫第三科嘛那當然我們就是說在協商的過程大家想先求有再求好那大家各退一步 |
| transcript.whisperx[792].start |
20093.684 |
| transcript.whisperx[792].end |
20118.943 |
| transcript.whisperx[792].text |
所以在這個專責單位的部分其實我們也我自己本身當然就是要用成立這個署那但是我想協商過程當中我們也同意說那是不是在這個我們在這個私之下還有這麼還有一個名額那是不是還可以成立第四科那但是也後來也沒有但 |
| transcript.whisperx[793].start |
20119.883 |
| transcript.whisperx[793].end |
20147.04 |
| transcript.whisperx[793].text |
這將近三年的時間因為我在看第三科的這個預算跟人力甚至預算也還是有流用的狀況所以這個人力也沒有增加那剛剛部長也特別提了所以當然你也講到說未來但我不知道這個未來還需要多久的時間我們就很怕這個時光匆匆就這樣虛晃過去所以今天也特別再提一下就是說 |
| transcript.whisperx[794].start |
20149.041 |
| transcript.whisperx[794].end |
20174.05 |
| transcript.whisperx[794].text |
也特別要求就是在人力跟經費上的這個投入我們都一定要把它當作一回事很重要的事情來推動不然我們通過這個法就沒有用了跟委員說明就剛我特別提到現在正在擬定這個原住民族健康的中長城計畫在那個計畫裡面我們會來爭取更多的預算投入在原住民族健康的促進跟改善這樣 |
| transcript.whisperx[795].start |
20175.03 |
| transcript.whisperx[795].end |
20195.051 |
| transcript.whisperx[795].text |
那在另外我想很多委員都關心這個原住民族跟全國人口的平均餘命差距的問題那從你們的這個健康紀刊有登載就是從2017年的差距8.17歲那已經改善到2021年的6.94歲而且本席還有發現不論是哪 |
| transcript.whisperx[796].start |
20197.773 |
| transcript.whisperx[796].end |
20217.781 |
| transcript.whisperx[796].text |
哪一個人口族群本來平均餘命都是逐年增加的但是全國人口的平均餘命竟然在2021年的時候還比2020年還低少了0.46年而且原住民的差距的部分還繼續在成長增加了0.26年 |
| transcript.whisperx[797].start |
20219.682 |
| transcript.whisperx[797].end |
20241.54 |
| transcript.whisperx[797].text |
那本席的猜測可能是當時有受到這個COVID-19的影響所以全國人口平均餘命說才減少當然也有可能在短時間內他可能或許還會再變動目前原住民跟這個全國平均餘命全國人民的這個平均餘命差距是多少7.5 7.54 |
| transcript.whisperx[798].start |
20245.123 |
| transcript.whisperx[798].end |
20270.702 |
| transcript.whisperx[798].text |
那剛才的資料顯示因為原住民族在這個嚴重傳染流行嚴重傳染病流行有沒有因為健康不平等受到影響那成為一個我們大家都很關心一個很重要的一個課題那甚至在未來呢可以成為這個檢定你們對於這個法案執行的這個成效目標 |
| transcript.whisperx[799].start |
20272.343 |
| transcript.whisperx[799].end |
20295.919 |
| transcript.whisperx[799].text |
是一個成效的指標那部長是否同意這樣子的可能性其實您提我也回想到其實在COVID當中我們也很擔心這個城鄉落差偏遠地區的健康不平等的問題所以那時候委員還特別提醒還有那個快篩啊還有一些那個藥物啊那些要對這個 |
| transcript.whisperx[800].start |
20298.24 |
| transcript.whisperx[800].end |
20314.557 |
| transcript.whisperx[800].text |
原鄉地區啊那個時候你還特別提了好幾個地點給我那個確實不過現在看起來好像比那個全國的要好就是看起來原住民那邊的年齡是反而他是繼續再延長的 |
| transcript.whisperx[801].start |
20316.078 |
| transcript.whisperx[801].end |
20333.924 |
| transcript.whisperx[801].text |
因為在這部法案通過的時候COVID-19疫情當然它是持續退散的那急性傳染病的防疫也當然涉及很多這個醫藥衛生的專業那地方主管機關的協調甚至跟這個原住民族文化特性有關的這些 |
| transcript.whisperx[802].start |
20335.164 |
| transcript.whisperx[802].end |
20350.523 |
| transcript.whisperx[802].text |
也是提醒衛福部應該要重視原住民那所以在未來我們這個重大的這個傳染病或疾病的預防控制可以更嚴謹的態度去看待所以也希望部長可以教辦下去那 |
| transcript.whisperx[803].start |
20354.619 |
| transcript.whisperx[803].end |
20381.164 |
| transcript.whisperx[803].text |
因為這部法案的立法精神是促進原住民族健康建構以原住民族為主體的健康政策改善原住民族健康不平等的情形所以本法的目的當然是這樣所以針對原住民的健康政策我們明定就是應該要尊重原住民族意願自主的發展所以在法案的重點 |
| transcript.whisperx[804].start |
20384.185 |
| transcript.whisperx[804].end |
20410.357 |
| transcript.whisperx[804].text |
在於這個原住民族健康政策制定的品質跟落實的情形那目前你們有訂定相關的這個政策白皮書嗎就是你們的這個讓外界知道衛福部的理念跟方向之前是有一本專章啦就是在之前我們是在有一個健康白皮書裡面有一個原住民族專章啦 |
| transcript.whisperx[805].start |
20411.172 |
| transcript.whisperx[805].end |
20426.393 |
| transcript.whisperx[805].text |
那現在我們要你的就是這個中長城計畫專門對這個原民健康所以這個也等同你們的政策白皮書應該也可以算你們大概什麼時候會完成 |
| transcript.whisperx[806].start |
20428.052 |
| transcript.whisperx[806].end |
20453.549 |
| transcript.whisperx[806].text |
因為這個我們會希望在明年的預算裡面去編列所以現在正在撰寫這個中長城計劃爭取明年的預算當然是希望明年預算要省所以爭取到了我們才有辦法因為它就變成新興新興計劃對所以如果總預算再不省的話我們這些也就一樣又回來又害到我們原住民自己所以那個可能也拜託趙偉跟你們黨團講一下那 |
| transcript.whisperx[807].start |
20458.049 |
| transcript.whisperx[807].end |
20475.291 |
| transcript.whisperx[807].text |
好像沒有反應 可以嗎 可以齁 好那個趙偉 新新計畫啦 趙偉很害羞嗎 好那沒關係 我們今天這個都有列入公報齁 所以我幫忙那個 剛剛趙偉您是點頭嗎 |
| transcript.whisperx[808].start |
20478.064 |
| transcript.whisperx[808].end |
20498.359 |
| transcript.whisperx[808].text |
同意就跟黨團溝通一下免得我們接下來這個原住民的這個健康的這個原建法的這個政策白皮書中長城計畫會難產所以這個部分就拜託召委要多幫忙那我想我最後 |
| transcript.whisperx[809].start |
20499.48 |
| transcript.whisperx[809].end |
20520.704 |
| transcript.whisperx[809].text |
提一下在這個我們政策實質內容上我們應該要從這個數據找目標然後從這個調查研究跟統計了解原住民的這個我們十大死因十大癌症死因跟其他影響健康的因素因為在過去呢我們都是跟全國性的統計資料都混在一起嘛那我們 |
| transcript.whisperx[810].start |
20521.204 |
| transcript.whisperx[810].end |
20544.739 |
| transcript.whisperx[810].text |
只有占全國的2.5%的人口數所以你說這些數據原住民在裡面往往都被稀釋掉所以自然就沒有辦法從數據中被看見實質上的結果跟原因目前衛福部有沒有依照原住民族特殊的健康問題 |
| transcript.whisperx[811].start |
20546.8 |
| transcript.whisperx[811].end |
20560.412 |
| transcript.whisperx[811].text |
這個生活型態環境生物因子還有醫療資源等面向定期的做調查跟研究那原住民的這個健康狀況跟健康需求就是說你們有沒有去建置原住民族的健康資料庫這個部分 |
| transcript.whisperx[812].start |
20561.898 |
| transcript.whisperx[812].end |
20588.307 |
| transcript.whisperx[812].text |
跟委員報告這個資料庫的這個主辦單位那個國衛院的院長也在這裡他們很努力的去把這個不同的資料庫把它以這個原住民為中心把它整合在一起那就如同剛剛這個委員也特別提醒到的因為這個原住民的人口相對少所以在做分析的時候有時候會遇到一些難處譬如說以漁民來講他的變動就會比較大 |
| transcript.whisperx[813].start |
20590.848 |
| transcript.whisperx[813].end |
20619.307 |
| transcript.whisperx[813].text |
所以我們才會抓以這個三年的這個移動平均來做這個統計所以類似像這樣它要做一點校正所以在資料收集之後在做細分類的時候細分析的時候有時候誘於這個人口數比較少那可能也會受到一些障礙所以才需要有一個專責專門來做這個研究的單位對 因為我們畢竟有一些不然混在大 |
| transcript.whisperx[814].start |
20620.007 |
| transcript.whisperx[814].end |
20641.641 |
| transcript.whisperx[814].text |
大數據裡面就不容易凸顯出它的差異是因為在這個文化畢竟有這個特殊性所以我們希望可以就針對原住民族的部分把剛剛提的這些十大死因十大癌症死因的這些特別獨立出來再做研究這樣會比較清楚那在 |
| transcript.whisperx[815].start |
20642.982 |
| transcript.whisperx[815].end |
20667.283 |
| transcript.whisperx[815].text |
就是法案14條因為也有講到這個中央主管機關應該針對這個原住民族的傳統醫療保健知識的研究推廣來促進原住民族的傳統醫療跟健康生活的發展那部長不知道部長要如何去推廣原住民族被證實有效的中草藥或食品你大概會 部長會用什麼樣的話術 |
| transcript.whisperx[816].start |
20670.304 |
| transcript.whisperx[816].end |
20674.486 |
| transcript.whisperx[816].text |
因為這個要很小心不小心江署長可能會罰部長因為在推廣的過程難免都會因為這個會如實運用 |
| transcript.whisperx[817].start |
20688.291 |
| transcript.whisperx[817].end |
20703.356 |
| transcript.whisperx[817].text |
期刊論文上已經被證實的這個有效資料所以會不會因為宣稱療效然後抵觸食品安全衛生然後被裁罰這個搞不好也是未來我們會面臨的問題這個其實我們那個原住民傳統醫療跟這個中醫藥有點像啦 |
| transcript.whisperx[818].start |
20708.338 |
| transcript.whisperx[818].end |
20737.309 |
| transcript.whisperx[818].text |
因為它取材來自於自然界嘛不是這種這個合成或化學的成分藥那但是呢因為有這麼悠遊的悠長的歷史經過這麼多的人體經驗累積的但是跟我們現在西方醫學所講的這個實證依據的臨床效果確實這個中間是有認知上的落差啦 |
| transcript.whisperx[819].start |
20737.449 |
| transcript.whisperx[819].end |
20754.219 |
| transcript.whisperx[819].text |
我們畢竟中藥其實裡面它是一個大數據的累積但是它未必每一項都有科學實證所以這兩項比較起來其實是非常不公平的所以我也特別指出這一點要有不同的思維供各位參考 |
| transcript.whisperx[820].start |
20755.9 |
| transcript.whisperx[820].end |
20783.152 |
| transcript.whisperx[820].text |
還是在這裡特別感謝部長就是對於原建法的這個重視跟支持那所以我想我也要有所回饋那對於就是勞動部偷人偷你們衛福部的這個護理人員人力這件事情看起來好像部長到目前都還束手無策所以 |
| transcript.whisperx[821].start |
20784.588 |
| transcript.whisperx[821].end |
20812.009 |
| transcript.whisperx[821].text |
部長一直笑 不知道是你有解決了嗎沒有 還沒解決好 那我想對 這是很嚴重的問題啦所以如果部長還沒辦法去協商解決我可能考慮在總諮詢的時候幫幫你們去跟請院長主持公道好看這個部分要怎麼調整因為畢竟這個關係到全體國人的這個健康需求 |
| transcript.whisperx[822].start |
20813.304 |
| transcript.whisperx[822].end |
20817.846 |
| transcript.whisperx[822].text |
謝謝委員的指導所以OK啦好 謝謝好 那我們繼續努力好 謝謝好 謝謝陳委員發言 |
| transcript.whisperx[823].start |
20825.353 |
| transcript.whisperx[823].end |
20849.32 |
| transcript.whisperx[823].text |
本日會議詢答全部結束委員高津素美 林倩琦委員 徐欣穎委員所提書面質詢六日記錄刊登公報現在做以下決定報告及詢答完畢委員質詢未及答覆或請補充資料者請相關機關於兩周內以書面答覆委員另有要求期限者從其所定 |
| transcript.whisperx[824].start |
20850.16 |
| transcript.whisperx[824].end |
20855.688 |
| transcript.whisperx[824].text |
本日会议到此结束现在休息明天上午九点继续开会 |
| transcript.whisperx[825].start |
20872.756 |
| transcript.whisperx[825].end |
20876.902 |
| transcript.whisperx[825].text |
謝謝 從小在澳大利亞長大 很多經歷 從小在澳大利亞 從小在澳大利亞 |