| IVOD_ID |
17426 |
| IVOD_URL |
https://ivod.ly.gov.tw/Play/Full/1M/17426 |
| 日期 |
2026-05-11 |
| 會議資料.會議代碼 |
委員會-11-5-26-10 |
| 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10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 |
10 |
| 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10次全體委員會議 |
| 影片種類 |
Full |
| 開始時間 |
2026-05-11T08:38:05+08:00 |
| 結束時間 |
2026-05-11T14:21:00+08:00 |
| 影片長度 |
05:42:55 |
| 支援功能[0] |
ai-transcript |
| video_url |
https://h264media01.ly.gov.tw:443/vod_1/_definst_/mp4:1M/bfaf9b39ac01a685979b49e85773c2c65eff2011ce5661eeb7b695d4fecf9ee9478a746e34c81c6f5ea18f28b6918d91.mp4/playlist.m3u8 |
| 會議時間 |
2026-05-11T09:00:00+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10次全體委員會議（事由：一、審查中華民國115年度中央政府總預算案關於衛生福利部主管預算。(公務及非營業特種基金預算案)
二、審查中華民國115年度中央政府總預算案直轄市及縣市政府一般性補助款衛生福利部主管部分預算。
【僅詢答，115年5月25日下午5時截止收案】） |
| 委員名稱 |
完整會議 |
| 委員發言時間 |
08:38:05 - 14:21:00 |
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現在開會請準備報告出席人數報告委員會出席委員人數11人已足法定人數請議事委員先讀三次會議事錄 |
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1339.158 |
| transcript.whisperx[1].text |
立法院第11届第5會期社會福利及衛生環境委員會第9次群體委員會議事錄時間115年5月4日9時18分至17時11分115年5月6日9時14分至14時45分115年5月7日9時12分至13時54分地點群憲樓801會議室出席委員邱慧如等15人列席委員鍾嘉斌等16人列席官員5月4日及6日環境部部長彭啟明及各相關部會首長 |
| transcript.whisperx[2].start |
1357.248 |
| transcript.whisperx[2].end |
1373.407 |
| transcript.whisperx[2].text |
5月7日勞動部部長洪森漢及各相關部會主管主席林昭吉委員約情5月4日報告事項宣讀上次會議事錄決定確定5月4日及6日討論事項審查行政院罕見審議資源回收再利用法修正草案案等11案 |
| transcript.whisperx[3].start |
1376.613 |
| transcript.whisperx[3].end |
1405.114 |
| transcript.whisperx[3].text |
5月4日會議經委員王振旭張日輪林月傾說明提案指去由環境部資源循環署署長賴應說明由委員林淑芬等三人提出修正動議委員王振旭等三人提出第一條及第十二條條文修正動議委員林月傾等三人提出第十二條條文修正動議委員林月傾等三人提出三十六條條文修正動議5月6日會議即有林月傾林淑芬王振旭盧縣一級陳集會等五人提出第十二條條文修正動議 |
| transcript.whisperx[4].start |
1406.154 |
| transcript.whisperx[4].end |
1430.247 |
| transcript.whisperx[4].text |
决议资源回收再利用法修正草案等十一案审查完据内容如审查结果并按拟据审查报告提报院会讨论院会讨论时有零召集委员员请补充说明不需交党团协商二本法案调次条文中援引调次及法制用与调整授权议事人员整理相关立法说明授权行政单位提供审查结果一照行政院提案通过 |
| transcript.whisperx[5].start |
1431.007 |
| transcript.whisperx[5].end |
1449.05 |
| transcript.whisperx[5].text |
依法案名称第一章至第七章章名第三章第一节至第三节节名二第二条至第四条第六条至第十一条第十三条第十五条第十六条第十九条至第二十一条第二十三条至第三十一条第三四条第三十五条及第三七条至第五十一条条文 |
| transcript.whisperx[6].start |
1451.458 |
| transcript.whisperx[6].end |
1477.021 |
| transcript.whisperx[6].text |
三删除现行法第七条第八条第二十五条及第二十八条条文二第一条照委员联署分等三人所提修正动议修正通过第一条为节约资源支援使用促进资源循环减少废弃物产生减轻环境负荷建立永续发展这循环型社会特制定本法三第五条造型资源提案修正通过第五条失业于进行失业活动时应选下列原则以减少资源 |
| transcript.whisperx[7].start |
1477.782 |
| transcript.whisperx[7].end |
1496.415 |
| transcript.whisperx[7].text |
只消耗抑制废弃物质产生及促进资源循环一选用清洁生产技术二对原料的使用应采取减少废弃物产生之必要措施三原材料失去原效用后应自行或供循环利用无法循环利用者应进行能源回收或妥善处理四 |
| transcript.whisperx[8].start |
1497.216 |
| transcript.whisperx[8].end |
1522.177 |
| transcript.whisperx[8].text |
从事物品容器制制造贩卖之事业有责任提升产品耐用年限及落实修缮服务以抑制该物品容器成为废弃物并因潮促使该产品利于资源循环之方向进行产品之研发设计及标识材质种类五层式网络交易平台服务提供者应定定并执行相关管理机制促使并引导利用其平台进行交易之事业或个人 |
| transcript.whisperx[9].start |
1523.038 |
| transcript.whisperx[9].end |
1546.728 |
| transcript.whisperx[9].text |
落实包装减量及促进资源循环第十二条 赵委员林岳请林淑芬王郑旭卢献一及陈金辉等五人所提修正动议通过如下 第十二条 中央主管机关为执行前条第一项至第三项职权应组成资源循环推动会以下简称 推动会负责召集督导相关部会研议协商评估整合制定及推动前条资源循环政策措施 |
| transcript.whisperx[10].start |
1547.588 |
| transcript.whisperx[10].end |
1568.127 |
| transcript.whisperx[10].text |
推动会制召集人员由环境部部长担任委任期二年由相关政府机关学者专家及环境保护团体代表组成其中政府机关代表应由副首长以上主管担任学者专家及环境保护团体代表不得少于二分之一环境保护团体代表不得少于推动会整体之四分之一 |
| transcript.whisperx[11].start |
1570.816 |
| transcript.whisperx[11].end |
1590.814 |
| transcript.whisperx[11].text |
推動會議之會議記錄因對外公開但涉及國家機密或營業秘密則不在此限第十四條造型證人提案即為臨時分等三元所提修正動議修正通過如下第十四條莊主管機關得指定公告一定種類規模之產品應遵循綠色設計準則指定項目其製造輸入業者應於公告所定期限 |
| transcript.whisperx[12].start |
1591.574 |
| transcript.whisperx[12].end |
1609.031 |
| transcript.whisperx[12].text |
检据产品绿色设计文件向中央主管机关申请核定符合绿色设计准则及发给循环标志非属前项指定公告这产品其制造输入业者得自愿遵循绿色设计准则并检据产品绿色设计文件向中央主管机关申请核定 |
| transcript.whisperx[13].start |
1609.791 |
| transcript.whisperx[13].end |
1635.274 |
| transcript.whisperx[13].text |
符合绿色设计准则及发给循环标志依第一项指定公告之产品应使用一定比率或数量再生力材料者其制造输入业者应提送再生力材料来源使用总量产品产量及销量等资料经中央主管机关认可之验证方式或机构查验后报中央主管机关备查第一项第二项之申请程序绿色设计准则之性能规范 |
| transcript.whisperx[14].start |
1636.094 |
| transcript.whisperx[14].end |
1652.329 |
| transcript.whisperx[14].text |
与评估验证机制应遵循之原则项目产品绿色设计文件应记载事项审查标志核电事项变更查和重样检验废纸与前项资料被查及其他应遵循事项之办法由中央主管机关定制 |
| transcript.whisperx[15].start |
1653.07 |
| transcript.whisperx[15].end |
1672.947 |
| transcript.whisperx[15].text |
第十七条造行证院提案及委员联署分等三人所提修正动议修正通过如下第十七条庄主管机关得指定公告物品或其包装容量减量目标及方式指定事业因于公告所定期限减去减量计划申请庄主管机关核准并提送执行成果报庄主管机关备查 |
| transcript.whisperx[16].start |
1673.627 |
| transcript.whisperx[16].end |
1695.795 |
| transcript.whisperx[16].text |
非屬前項指定公告之物品或其包裝容器其製造輸入或販賣業者得自願檢據減量計劃送中央主管機關核准並提送執行成果報中央主管機關被查前二項減量計劃應記載事項申請應被文件審查核准事項管理變更廢止執行成果被查及其他應遵行事項執辦法由中央主管機關定之 |
| transcript.whisperx[17].start |
1697.062 |
| transcript.whisperx[17].end |
1706.233 |
| transcript.whisperx[17].text |
第十八条,照行政院提案及委联署分等三人所提修正动力修正通过如下。第十八条,物品或其包装容器有下列情形之一者专属管理机关。 |
| transcript.whisperx[18].start |
1707.315 |
| transcript.whisperx[18].end |
1736.867 |
| transcript.whisperx[18].text |
得禁止或限制制造输入贩卖使用经限制制造输入贩卖或使用者其制造输入贩卖或使用业者应定其提送营业量生产量进口量销售量及销售对象使用量原料供应来源相关资料保装主管机关备查1.过度耗用能资源2.含长期不易腐化之成分3.含有害物质之成分4.有回收困难或干扰回收体系之余5.有严重污染环境之余前项物品或其包装容器禁止限制之 |
| transcript.whisperx[19].start |
1737.347 |
| transcript.whisperx[19].end |
1752.832 |
| transcript.whisperx[19].text |
方式与范围各款锁定情形之认定资料被查及其他因遵行事项要专属管机关公告之之下是县市主管机关得失环境治理条件差异就限制制造输入贩卖使用物品或其包装容器之管之对象 |
| transcript.whisperx[20].start |
1753.892 |
| transcript.whisperx[20].end |
1769.328 |
| transcript.whisperx[20].text |
項目期限減量限制使用方式訂定較前項公告更加嚴格之自治法規或管制措施報警中央主管機關核定物品或其包裝容器不符合第二項公告前項自治法規或管制措施 |
| transcript.whisperx[21].start |
1770.069 |
| transcript.whisperx[21].end |
1790.25 |
| transcript.whisperx[21].text |
指向市县市主管机关得令产品之制造、输入、贩卖或及使用业者将产品下架、销毁、退运或为其他适当处置。第22条造型增援提案及为您书分的三人所提修正动于修正通过如下。第22条装处管机关得指定公告物品或其包装容器其制造、输入或贩卖业者。 |
| transcript.whisperx[22].start |
1790.951 |
| transcript.whisperx[22].end |
1817.486 |
| transcript.whisperx[22].text |
因依公告所定期限方式揭露及标示下列资讯1.使用之材质及再生力材料比率2.包装材质及重量3.可维修性耐用性及维修方式4.回收拆解及再利用方式5.分类回收标志6.使用具唯一产品识别码者因动态更新流向追溯及品质验证资讯7.其他经中央主管机关指定之事项 |
| transcript.whisperx[23].start |
1818.226 |
| transcript.whisperx[23].end |
1845.523 |
| transcript.whisperx[23].text |
非属前项指定公告之物品或其包装容器其制造输入或贩卖业者的自愿揭露及标示前项各款资讯前二项物品或其包装容器资讯之计算方式可维修性耐用性评估方式标志图案揭露及标示内容与方式管理及其他应遵行事项之办法由庄主管机关定之文联署分等三人所提第26条条文修正动议修正通过如下 |
| transcript.whisperx[24].start |
1846.67 |
| transcript.whisperx[24].end |
1874.937 |
| transcript.whisperx[24].text |
第26条再生资源为肥器物品包装或容器者中央主管机关得指定其制造输入贩卖或使用业者共同成立或加入既有生产者责任组织以下简称生产者责任组织负担再生资源之回收清除及循环利用之财务与实际执行责任中央主管机关得指定前项生产者责任组织应依指定之目标循环利用方式及必要设施 |
| transcript.whisperx[25].start |
1875.717 |
| transcript.whisperx[25].end |
1884.155 |
| transcript.whisperx[25].text |
规划循环利用计划并于公告期限内检据该计划送请庄主管机关审查并依庄主管机关核准之计划办理 |
| transcript.whisperx[26].start |
1885.7 |
| transcript.whisperx[26].end |
1905.596 |
| transcript.whisperx[26].text |
生产者责任组织应依中央主管机关指定之资料传输方式定期申报循环利用情形第二项生产者责任组织应遵循之循环利用目标方式设置设施设置循环利用设循环利用计划应有之内容及前项申报方式及频率由中央主管机关定之中央 |
| transcript.whisperx[27].start |
1906.096 |
| transcript.whisperx[27].end |
1924.945 |
| transcript.whisperx[27].text |
再生资源为事业活动产生之物品包装或容器者则第二项循环利用计划的审查与核准以及循环利用计划执行情形之监督与考核由专务目的事业主管机关为之第32条造型质量提案级委联署分等三人所提修正动议修正通过如下 |
| transcript.whisperx[28].start |
1926.124 |
| transcript.whisperx[28].end |
1952.5 |
| transcript.whisperx[28].text |
第32条为促进资源循环事业自愿提供物品或其包装容器之源头减量重复使用延长使用或其他有利资源循环服务绩效业有两者中央主管机关得于奖励或补助使用第33条造型证明提案及为颅限一等16人提案修正通过颅下第33条事业或个人办理绿色设计源头减量永续消费再使用再生利用之相关技术开发人才培训 |
| transcript.whisperx[29].start |
1953.3 |
| transcript.whisperx[29].end |
1981.132 |
| transcript.whisperx[29].text |
实际运用执行与管理绩效优良者双主管机关得以奖励或补助为促进资源循环产业发展事业投资与循环利用及循环永续管理之研究发展人才培育及设备购置支出积累得以有关税法产业创新条例或其他法律规定减免税捐主管机关得考量偏远援助民族地区及领导地区之需要定定辅导补助计划 |
| transcript.whisperx[30].start |
1981.912 |
| transcript.whisperx[30].end |
1998.35 |
| transcript.whisperx[30].text |
第一项第31条第4项及前条奖励或补助之条件方式审查程序废纸及其他有关事项之办法由双主管机关定之12第36条造型赠予提案委员林月琴的21人提案及委员林淑芬等3人所提修正同意修正通过如下 |
| transcript.whisperx[31].start |
1999.171 |
| transcript.whisperx[31].end |
2025.459 |
| transcript.whisperx[31].text |
第36条为促进资源循环技术或数位科技治理发展之目的事业的减去资源循环创新实验计划向庄主管机关申请核准办理资源循环创新实验并提送执行成果跑庄主管机关备查庄主管机关审查创新实验计划时应审着其创新性必要性可行性风险控管环境影响庄主管机关核准创新实验计划的附加实验期间 |
| transcript.whisperx[32].start |
2026.18 |
| transcript.whisperx[32].end |
2029.912 |
| transcript.whisperx[32].text |
范围规模方式监测通报返还奖励或补助 |
| transcript.whisperx[33].start |
2034.918 |
| transcript.whisperx[33].end |
2058.206 |
| transcript.whisperx[33].text |
限期改善或停止实验,非指核准及其他付款一并纳入核准事项事业因依核准内容执行。庄主管机关因会上庄及地方有关机关后,核准创新实验计划于创新实验期间内,排除下列法律全部或一部之适用,但排除法律适用范围因已达成实验目的或为必要且相当者违宪。 |
| transcript.whisperx[34].start |
2058.986 |
| transcript.whisperx[34].end |
2078.633 |
| transcript.whisperx[34].text |
且不得排除涉及人体健康公共安全及其他重大环境风险之强制规定与民事刑事责任及行政机关依法应采取之紧急处置措施规定1.第25条第26条2.非欺负心理法第12条第14条第18条第1项第31条第1项第1款第36条第39条第1项第41条第1项 |
| transcript.whisperx[35].start |
2080.974 |
| transcript.whisperx[35].end |
2109.01 |
| transcript.whisperx[35].text |
莊主管即关于核准创新实验计划后应将事业名称创新实验内容期间范围排除适用之规定及其他相关资讯揭露于指定网站创新实验计划经展延变更测销或废止者应揭露之前四项资源循环创新实验计划之申请审查核准管理变更展延执行成果提送与备查资讯公开风险控管监测通报返还奖励或补助 |
| transcript.whisperx[36].start |
2109.89 |
| transcript.whisperx[36].end |
2125.312 |
| transcript.whisperx[36].text |
限期改善或停止实验撤销后废纸和准计其他因遵行事项之办法由中央主管机关定制5月7日邀请劳动部部长列席报告业务概况并被质询讨论事项审查中华民国115年中央政府总预算案关于劳动部主管预算 |
| transcript.whisperx[37].start |
2126.273 |
| transcript.whisperx[37].end |
2151.01 |
| transcript.whisperx[37].text |
2.省厂劳动部含送财团法人职业灾害预防及重建中心115年预算书案本日会议业务报告及讨论事项才综合询答劳动部部长洪生汉报告及说明后委员林月琴等19人提出质询均经劳动部部长洪生汉及常务次长陈明仁及各相关主管及其答复文审博洋及邱志伟所提书面质询列入记录刊登公报决定及决议一报告说明及询答完毕二 |
| transcript.whisperx[38].start |
2151.65 |
| transcript.whisperx[38].end |
2152.351 |
| transcript.whisperx[38].text |
請問委員會上次有錯誤或遺漏之處 |
| transcript.whisperx[39].start |
2181.684 |
| transcript.whisperx[39].end |
2203.374 |
| transcript.whisperx[39].text |
本日會議議程為審查中華民國115年度中央政府總預算案關於衛生福利部主管預算公務及非營業特種基金預算案審查中華民國115年度中央政府總預算案直轄市及縣市政府一般性補助款衛生福利部主管部分預算 |
| transcript.whisperx[40].start |
2206.567 |
| transcript.whisperx[40].end |
2227.901 |
| transcript.whisperx[40].text |
介紹在場委員第一個由我們召委林月琴委員黃振旭委員介紹列席官員衛福部部長施崇良會計處處長張玉珍綜合規劃室市長廖坤富設公司市長蘇昭如 |
| transcript.whisperx[41].start |
2238.635 |
| transcript.whisperx[41].end |
2253.084 |
| transcript.whisperx[41].text |
保護師師長郭采榮護理局健康照護師師長蔡淑鳳醫事師師長劉悅平口腔健康師師長張雍敏中醫藥師所長兼師師長兼所長蘇益璋長級照護師師長祝建芳 |
| transcript.whisperx[42].start |
2268.675 |
| transcript.whisperx[42].end |
2297.134 |
| transcript.whisperx[42].text |
心理健康司司长陈伯喜社会保险师代理司长张玉璇秘书处处长许乔成人事处处长林翠玲统计处处长李秋燕自信处副处长王美珠政风处处长刘耀忠 |
| transcript.whisperx[43].start |
2299.635 |
| transcript.whisperx[43].end |
2321.735 |
| transcript.whisperx[43].text |
國際合作組參事兼主任施金水部署醫療及社會福利機構管理委員會執行長林慶豐簽名健康保險會秘書周淑婉衛生福利人員訓練中心參事兼主任林金富 |
| transcript.whisperx[44].start |
2324.577 |
| transcript.whisperx[44].end |
2351.796 |
| transcript.whisperx[44].text |
國民年金監理會參事監執行秘書石春梅前名健康保險正義審議會帶領執行秘書楊樹梅科技發展組技界監劉明勳國民健康署署長沈靜芬疾病管制署署長羅一鈞 |
| transcript.whisperx[45].start |
2355.397 |
| transcript.whisperx[45].end |
2375.092 |
| transcript.whisperx[45].text |
視頻藥物管理署署長江志剛中央健保中央健康保險署署長陳亮宇社會及家庭署署長周道軍國務院院長師徒惠康勞動部國民年金組組長烏維揚勞動基金運用局專門委員陳秀娃什麼什麼 |
| transcript.whisperx[46].start |
2385.106 |
| transcript.whisperx[46].end |
2391.352 |
| transcript.whisperx[46].text |
公共預算處專委陳淑萍基金預算處科長劉雅文 |
| transcript.whisperx[47].start |
2396.058 |
| transcript.whisperx[47].end |
2421.758 |
| transcript.whisperx[47].text |
在部長報告前先做一下宣告一五年度衛生福利部主管公務及基金預算案知曉市及縣市政府一般補助款衛生福利部主管部分預算案委員對審查的書面提案請於五月二十五號星期一下午五點前以書面送交本委員會辦公室接下來請衛生福利部石崇良部長併案說明時間十五分鐘 |
| transcript.whisperx[48].start |
2429.338 |
| transcript.whisperx[48].end |
2452.916 |
| transcript.whisperx[48].text |
主席還有各位委員、女士先生今天陳大願安排針對本部主管的115年的預算案來進行報告那麼以下就以簡報來跟各位委員做說明那是不是可以播放 |
| transcript.whisperx[49].start |
2454.875 |
| transcript.whisperx[49].end |
2475.348 |
| transcript.whisperx[49].text |
好那這個是今天的報告的大綱再請各位委員參閱好那麼首先呢報告有關於這個115年度的年度施政的目標跟預算那我們是按照這個行政院的115年度的施政方針那麼編定的施政計畫 |
| transcript.whisperx[50].start |
2477.069 |
| transcript.whisperx[50].end |
2491.065 |
| transcript.whisperx[50].text |
目標是希望能夠達成健全的衛生福利服務體系確保健保的永續經營等八大市政目標來據以編列115年的公務預算以及基金預算 |
| transcript.whisperx[51].start |
2491.846 |
| transcript.whisperx[51].end |
2507.156 |
| transcript.whisperx[51].text |
那麼下一張為了達成施政的目標那麼在這個公務預算跟基金預算的部分呢那麼分別編列公務預算稅率是33.2億稅出是3,556.7億而一般性的補助款呢則編列了336.6億元基金預算呢則共編列那麼稅率一兆2,555.8億元總支出為一兆 |
| transcript.whisperx[52].start |
2522.366 |
| transcript.whisperx[52].end |
2549.4 |
| transcript.whisperx[52].text |
2532.4億元看下一張那麼以下分別說明公務預算的變略情形下一張那麼有關公務預算的稅率那麼如同所述是一共是33.2億元那麼以歸會收入25.9億元最高佔78%那麼主要來自於食品食品藥物管理署的藥品衣材化妝品跟食品查驗登記的檢驗等審查費的收入看下一張 |
| transcript.whisperx[53].start |
2550.22 |
| transcript.whisperx[53].end |
2577.13 |
| transcript.whisperx[53].text |
至於在公務預算的稅出預算部分共3893.3億元那麼包含了單位預算3556.7億元及一般性的補助款336.6億元那麼中間也以法律義務的支出最高為2602.7億元那麼其次則是基本需求看下一張那麼為了施政所需的預算 |
| transcript.whisperx[54].start |
2577.95 |
| transcript.whisperx[54].end |
2588.566 |
| transcript.whisperx[54].text |
那麼分別有本部跟所屬機關那麼按照職長分別編列預算如果以單位別來看那麼本部是佔了2938.4億元那麼其次是 |
| transcript.whisperx[55].start |
2593.653 |
| transcript.whisperx[55].end |
2617.067 |
| transcript.whisperx[55].text |
社家署的435.8億元跟疾管署173.9億元跟健保署167.9億元那麼國健署食藥署跟中醫所那麼如上這個編列那麼至於在稅出的主管預算按照正式別來分列的話那麼也以社會福利支出佔了98%那麼共3818.5億元 |
| transcript.whisperx[56].start |
2622.31 |
| transcript.whisperx[56].end |
2650.62 |
| transcript.whisperx[56].text |
那麼至於用途的部分則是以獎補助費那麼佔最高最大中3608.6億元看下一張至於在特種基金的編列的部分那麼本部所主管的基金含了四個作業基金分別是醫療藥品基金那麼還有國民年金的保險基金全民健康保險基金跟管制藥品的製藥 |
| transcript.whisperx[57].start |
2652.3 |
| transcript.whisperx[57].end |
2676.456 |
| transcript.whisperx[57].text |
工廠的作業基金那麼另外呢那麼有一個特別收入基金那麼如這個上面所列的那麼在特別收入基金的部分則設了11個這個分預算那麼另外呢在本部所屬的26家的部立醫院的預算呢那麼則是有編載這個醫藥品醫療藥品基金裡頭那麼來執行下一張 |
| transcript.whisperx[58].start |
2683.421 |
| transcript.whisperx[58].end |
2706.661 |
| transcript.whisperx[58].text |
至於這四個作業基金分別辦理醫療服務這個是以醫療藥品作業基金為主要另外有管制藥品的產銷以管制藥品製藥工廠作業基金來執行另外還有健保跟國保分別有兩個基金來執行 |
| transcript.whisperx[59].start |
2709.177 |
| transcript.whisperx[59].end |
2713.061 |
| transcript.whisperx[59].text |
共編列收入是1兆156.2億元支出是1兆133.5億元收支戶抵後 |
| transcript.whisperx[60].start |
2724.591 |
| transcript.whisperx[60].end |
2743.759 |
| transcript.whisperx[60].text |
那麼預計本期的結餘是22.7億元那麼其中呢健保基金跟國保基金是沒有餘處的因為他們在這個有收支差短的部分呢則是收為安全準備來因應那麼國保基金的話呢那麼原來的收支結餘361.7億元則全數提列為安全準備金來下一張 |
| transcript.whisperx[61].start |
2749.562 |
| transcript.whisperx[61].end |
2762.415 |
| transcript.whisperx[61].text |
那麼至於在這個特別收入基金的編列來源是1399.6億元那麼本年度呢運用基金的可用財源那麼來辦理長照就是由長照基金來辦理這個 |
| transcript.whisperx[62].start |
2764.586 |
| transcript.whisperx[62].end |
2778.475 |
| transcript.whisperx[62].text |
是1000多億長期照顧另外還有其他像醫療發展基金、藥害救濟基金等整個大概是投入1399億元 |
| transcript.whisperx[63].start |
2780.936 |
| transcript.whisperx[63].end |
2802.51 |
| transcript.whisperx[63].text |
那麼以下呢那麼有部分是比較重要的項目呢也跟各位委員說明來看往下那麼為健全這個醫療服務的體系來提升全民健康的福祉那麼本部呢分別推動有這個健康台灣的深耕計畫編列那麼60億元另外推動國家 |
| transcript.whisperx[64].start |
2804.011 |
| transcript.whisperx[64].end |
2813.162 |
| transcript.whisperx[64].text |
癌症防治計畫編列73.1億元另外對於護理人力政策的整備的中長程計畫則是編列公務預算68.9億元等等那麼來持續優化醫療環境跟資源普及 |
| transcript.whisperx[65].start |
2821.252 |
| transcript.whisperx[65].end |
2840.318 |
| transcript.whisperx[65].text |
癌症的篩檢跟這個慢性病的防治那麼也擴大辦理心理健康支持措施加速引進癌症新藥那麼編列的這個癌症新藥基金50億元還有使國人能夠這個享有持續推動這個 |
| transcript.whisperx[66].start |
2842.118 |
| transcript.whisperx[66].end |
2857.645 |
| transcript.whisperx[66].text |
這個少子女化的這個對策等等好那麼讓國人能夠享有更完善跟卓全的照顧那麼往下那麼另外呢為了健全除了這個健全醫療服務體系之外呢那麼為了照顧弱勢那麼以及因應 |
| transcript.whisperx[67].start |
2859.025 |
| transcript.whisperx[67].end |
2880.354 |
| transcript.whisperx[67].text |
高齡化少子女化的議題也提出了長照3.0計畫還有這個社會安全網那麼2.0計畫還有這個少子女化對策那麼2.0等等那麼這些呢也都分別編列了相關的對應的計畫分別是 |
| transcript.whisperx[68].start |
2880.914 |
| transcript.whisperx[68].end |
2884.196 |
| transcript.whisperx[68].text |
整個長照1106.9億元少子女化對策2.0 335.8億元那麼社安網2.0 73.3億元那麼另外也有身心障礙照顧的服務資源的部件計畫76.5億元等等好 看一下 |
| transcript.whisperx[69].start |
2900.677 |
| transcript.whisperx[69].end |
2926.2 |
| transcript.whisperx[69].text |
那麼有關在長照服務的部分呢那麼主要是在辦理這個長期照顧服務的給付跟支付制度另外社區整體的照顧服務體系以及這個機構和社區的預防性照顧服務等等那麼分別編列這個預算再請各位委員參閱那麼最後呢是為了建構 |
| transcript.whisperx[70].start |
2928.162 |
| transcript.whisperx[70].end |
2938.65 |
| transcript.whisperx[70].text |
這個友善的育兒家庭的支持體系那麼優化生養的環境則持續的那麼推動少子女化對策計畫2.0共編列了335.8億元 |
| transcript.whisperx[71].start |
2944.977 |
| transcript.whisperx[71].end |
2974.02 |
| transcript.whisperx[71].text |
那麼另外為了減輕這個家庭照顧者的負擔擴增多元化的身心障礙的福利機構服務那麼也編列了身心障礙照顧服務支援部件計畫76.5億元那麼社安網的計畫則是編列73.3億元來完備整個社會的安全體系所以以上呢是就115年度的公務及基金預算的編列跟執行那麼做以上的報告 |
| transcript.whisperx[72].start |
2974.781 |
| transcript.whisperx[72].end |
2991.132 |
| transcript.whisperx[72].text |
那麼均與國民的健康福祉那麼相關那麼目的是在達成福利全民的政策目標再請各位委員支持本部的預算謝謝 謝謝各位委員謝謝石崇良部長 |
| transcript.whisperx[73].start |
2992.66 |
| transcript.whisperx[73].end |
3018.867 |
| transcript.whisperx[73].text |
現在開始詢答作以下宣告有關本次會議各項說明資料均列入記錄刊登公報本會委員訓導時間6加2分鐘列席委員4加1分鐘因今日下午令舉辦空氣污染防治法公聽會請詢導委員留意時間4點半截止發言登記委員入說明諮詢群上會前提出議題不受理暫定10點半休息10分鐘 |
| transcript.whisperx[74].start |
3020.147 |
| transcript.whisperx[74].end |
3026.291 |
| transcript.whisperx[74].text |
詢議本日不處理臨時提案現在請登記第一位李玉琴召委發言謝謝主席有請石部長有請石創陽部長好委員早部長早部長從上週的醫療法三讀到這兩天 |
| transcript.whisperx[75].start |
3048.462 |
| transcript.whisperx[75].end |
3070.211 |
| transcript.whisperx[75].text |
三班護病比的爭議非常的多啦那我今天有三個問題要請教部長今天是不是我覺得今天不是要去製造對立是想請你把制度講清楚讓護理師跟社會大眾聽得懂信得過啦首先修法過後護病比到底怎麼算為什麼這樣問呢三班護病比到底是看全院的平均還是分班別 |
| transcript.whisperx[76].start |
3071.011 |
| transcript.whisperx[76].end |
3099.736 |
| transcript.whisperx[76].text |
病房別科別比例怎麼定會不會白紙黑字放進執法或者是公告另外也有人在問精神科護理人員會不會人力會不會被排除請部長說明一下跟委員說明我們在推動那麼適當的三班戶病比其實從這個113年就討論了很多所以這一次呢我們的這個修訂醫療機構設置標準那麼他的三班戶病比呢就是採 |
| transcript.whisperx[77].start |
3101.356 |
| transcript.whisperx[77].end |
3124.083 |
| transcript.whisperx[77].text |
113年大家所討論出來的那個標準包含了他的計算方式所以這個是一個延續性的推動不是今日才三半戶併比其實早在113年我們就在行政院開始去爭取預算那麼才有這個114年到117年的這個12項的護理人力的改革的整備計畫來對應要推動這個三半戶併比的相關的 |
| transcript.whisperx[78].start |
3130.046 |
| transcript.whisperx[78].end |
3141.517 |
| transcript.whisperx[78].text |
所以剛剛提到的這個互併比的標準就是按照113年大家所共識的版本而它的計算方式是以全院的急性一般病床來統計那會不會寫到執法 |
| transcript.whisperx[79].start |
3147.023 |
| transcript.whisperx[79].end |
3166.576 |
| transcript.whisperx[79].text |
在指法在我們的設置標準裡面那麼就有計算標準就等於把當時候的共識的標準包含計算的方式都寫入醫療機構設置標準也就是醫療法的授權執法也是在上週那麼立法院通過那麼要求定在這個設置標準裡面 |
| transcript.whisperx[80].start |
3167.517 |
| transcript.whisperx[80].end |
3196.384 |
| transcript.whisperx[80].text |
那精神科的那麼至於精神科的病房的人力的標準因為當時候呢那麼一直沒有共識因為精神科的照顧的特性呢又跟一般的這個急性一般病床那麼又有不同的差異性特別是主要是在療養院這些專科醫院等等所以這個也還在持續討論當中那未來如果有共識討論的清楚定的合理那麼我們也會考慮把它再寫進去 |
| transcript.whisperx[81].start |
3197.564 |
| transcript.whisperx[81].end |
3211.231 |
| transcript.whisperx[81].text |
所以這個會再持續討論那外界批評最多的是施行時間也請部長說清楚正式上路前衛福部要怎麼補人留人改善班排班而且準備期會不會變成醫院的拖延期 |
| transcript.whisperx[82].start |
3211.687 |
| transcript.whisperx[82].end |
3240.216 |
| transcript.whisperx[82].text |
更能變成護理師權益的空窗期跟我們說明其實剛剛我提到我們在113年把這個標準大家討論清楚之後那麼就在114年就開始推動那麼在113年按照現在這樣的一個三半戶病比能夠達標的醫院大概只有三成113年的時候那到114年的下半年的統計大概可以達到七成不過這個七成達標的背後 |
| transcript.whisperx[83].start |
3240.996 |
| transcript.whisperx[83].end |
3264.95 |
| transcript.whisperx[83].text |
那麼是有部分的醫院應該有相當比例的醫院是以關床因應的那麼特別是以中小型的醫院這個尤其明顯所以如果在我們現在就立即實施入法之後立即實施之後那麼造成的衝擊勢必又會再加重另外這三層目前還沒有辦法打掉 |
| transcript.whisperx[84].start |
3266.931 |
| transcript.whisperx[84].end |
3281.796 |
| transcript.whisperx[84].text |
這個關床的規模會擴大這個會整個衝擊到這個醫療體系的運作那麼也會影響到那麼需要住院的病人急診的用車等等的那因此呢我們還是按照我們的這個計畫來推動 |
| transcript.whisperx[85].start |
3284.137 |
| transcript.whisperx[85].end |
3304.554 |
| transcript.whisperx[85].text |
還是會持續的這個該有的預算還是會挹注進去那麼循序的讓它提升上來那麼按照我們的這個統計按照目前的人力的回流情形然後在人力的缺口的預估那麼我們做的退估大概至少需要兩年的時間所以才會訂出這樣的緩衝期是 |
| transcript.whisperx[86].start |
3307.276 |
| transcript.whisperx[86].end |
3329.714 |
| transcript.whisperx[86].text |
第三個就是他們也在問的 諮詢會拿掉之後那護理團體怎麼參與因為當時設定的所謂的三分之一又是什麼意思當然我們知道所有的很多委員會即便是基本工資大概都會有各個利害關係的人進來所以有那樣的考量嗎是真的是偏向資方嗎 請部長今天是不是一併再說明清楚 |
| transcript.whisperx[87].start |
3330.034 |
| transcript.whisperx[87].end |
3356.296 |
| transcript.whisperx[87].text |
好 我想在任何一個那麼很重要的決策的時候都一定要納入相關的利害關係人那麼特別是在醫療機構設置標準裡面呢那麼不只是涉及到這個醫院的經營的這個永續那麼也涉及到各類的人員他的權益那麼還有一方呢是這個民眾的權益所以這個 |
| transcript.whisperx[88].start |
3357.677 |
| transcript.whisperx[88].end |
3374.618 |
| transcript.whisperx[88].text |
相關利害關係人其實在歷次在修訂醫療機構設置標準的時候都是有邀請的所以我們在這個即使現在的法裡面那麼沒有去明訂出這個委員會那但是呢在我們 |
| transcript.whisperx[89].start |
3375.799 |
| transcript.whisperx[89].end |
3397.306 |
| transcript.whisperx[89].text |
討論的時候就如同上個禮拜五我們對於這個這個設置標準修訂的討論也一樣邀請了這個護理團體的代表那麼包含醫院代表還有這個醫用者代表所以這個都是需要一起部長在修法過後你的因應的這些我覺得可能要快速一點 |
| transcript.whisperx[90].start |
3398.386 |
| transcript.whisperx[90].end |
3405.796 |
| transcript.whisperx[90].text |
讓民眾可以了解不要有一些是是而非或者事實上是沒有辦法講清楚反而讓民眾更多的誤解也讓我們的護理 |
| transcript.whisperx[91].start |
3406.636 |
| transcript.whisperx[91].end |
3428.256 |
| transcript.whisperx[91].text |
人員事實上是焦慮不安接下來我們就要問長照今天是省預算因為因應超高齡的社會跟長照3.0上路長照基金已大概突破了1000億未來社會發展跟長期照顧就是社發署成立之後事實上預算跟編制當然我相信會擴大 |
| transcript.whisperx[92].start |
3429.477 |
| transcript.whisperx[92].end |
3442.171 |
| transcript.whisperx[92].text |
那長照走到現在我們回頭檢視其實最大挑戰的就是人力那衛福部在長照3.0也提出兩個方向來去補足人力一個事實上是發展人力專業跟多元培訓另外一個是導入智慧照顧 |
| transcript.whisperx[93].start |
3443.024 |
| transcript.whisperx[93].end |
3458.656 |
| transcript.whisperx[93].text |
來善用輔助科技我注意到政府這幾年其實投入很多資源在推動我們的智慧照顧包括科技導入提升我們的照顧品質的計畫智慧雨林創意 |
| transcript.whisperx[94].start |
3459.997 |
| transcript.whisperx[94].end |
3472.983 |
| transcript.whisperx[94].text |
產業的創生計畫以及住宿機構的照顧品質獎勵計畫希望透過我們的智慧科技來減輕我們的造福源的負擔可是問題是我覺得政治效果似乎沒有達到預期因為根據2024年的我們的住宿機構照顧品質獎勵計畫成果指標裡面其他指標當中多數通過有7 |
| transcript.whisperx[95].start |
3480.066 |
| transcript.whisperx[95].end |
3507.151 |
| transcript.whisperx[95].text |
通過率大概都有七成到九成可是智慧輔助照顧科技運用的五項指標裡面最高只有38%那排泄資源也只有8.6%顯示住宿型照顧住宿型機構的智慧照顧科技導入能來嚴重的落後市長你有沒有掌握到這個問題為什麼我們這樣問我認為這不是機構願不願意做不是他們不願意做是因為政府根本沒有一個 |
| transcript.whisperx[96].start |
3508.492 |
| transcript.whisperx[96].end |
3533.428 |
| transcript.whisperx[96].text |
讓機構可以做得到的制度的一個環境很多注入型機構面對的事實上是設備成本很高 系統整合困難人員訓練不足 後續的維護缺乏資源甚至不同廠商之間的系統不相容機構即使想導入的話也沒辦法不知道從哪裡做尤其是通過率最低的反而是排泄資源 |
| transcript.whisperx[97].start |
3534.068 |
| transcript.whisperx[97].end |
3548.193 |
| transcript.whisperx[97].text |
那一位輔助的這些第一線最缺工最耗費體力的照顧工作那這也代表目前智慧照顧我們可能還停留在行政資訊化而沒有真正的照顧進入到照顧現場 |
| transcript.whisperx[98].start |
3549.932 |
| transcript.whisperx[98].end |
3563.498 |
| transcript.whisperx[98].text |
那我覺得這事實上我認為政府應該去盤點為什麼會通過那個原因到底是什麼因為前陣子我到日本去考察日本的那個善光會他們在推動智慧長照的一個經驗我認為非常值得台灣來做參考 |
| transcript.whisperx[99].start |
3567.1 |
| transcript.whisperx[99].end |
3595.383 |
| transcript.whisperx[99].text |
日本並不是只有補助設備他是建立了完整的照護的生產力的提升系統那也他們成立的跨專業領域的專業團隊來協助他們先做業務的流程分析時間研究然後呢再導入睡眠的感測器排泄預測的系統和儀位輔助設備和照護系統的一個記錄系統的科技的工具同時也搭配人力培訓跟營運改革 |
| transcript.whisperx[100].start |
3595.943 |
| transcript.whisperx[100].end |
3622.101 |
| transcript.whisperx[100].text |
讓每一位照護員事實上是在這樣的感受下他願意投入到現場甚至他們會發現說每位照護人員照護服務人數比日本全國平均提升40%非常的好這就是缺工底下我們要用到的重要工具而且更重要的是日本後生勞動省還在各地設置了照護生產力提升綜合諮詢中心提供機構 |
| transcript.whisperx[101].start |
3624.281 |
| transcript.whisperx[101].end |
3632.63 |
| transcript.whisperx[101].text |
暫時的輔導包含設備的展示專家進場然後呢教育訓練跟導入評估而不是只有發博助而已 |
| transcript.whisperx[102].start |
3633.211 |
| transcript.whisperx[102].end |
3655.831 |
| transcript.whisperx[102].text |
所以我不知道說部長我這以下的建議到底能做到嗎先你可不可以完整的盤點我們的智慧照顧科技通過率太低的原因到底問題是成本呢還是我們的技術成熟度我們去日本的時候他說他們也很常跟我們台灣有非常多的交流跟民間有很多的交流反而我們官方 |
| transcript.whisperx[103].start |
3656.411 |
| transcript.whisperx[103].end |
3685.971 |
| transcript.whisperx[103].text |
到底對這一塊到底有沒有著力因為人家表示說他很常跟民間交流所以民間有自己去採購一些東西那反而我們到底政府到底對這一塊又要指標人家做可是到底協助力有多少第二個是對機構的輔導不能只有說說明會跟補助申請協助而真正到現場去協助需求評估甚至設備導入跟人員訓練事實上是沒有可以做到嗎第三未來能不能比照日本經驗建立更完整的我們的智慧長照支持系統 |
| transcript.whisperx[104].start |
3687.291 |
| transcript.whisperx[104].end |
3714.738 |
| transcript.whisperx[104].text |
跟委員說明確實這幾年我們很努力的在增加長照的人力如果相較於105年來講我們是成長了4倍從過去大概2萬多人現在是10萬人左右但是各行各業都在缺工都在搶人所以如何持續的羅製甚至留任這個是在長照3.0裡面很重要的重點之一其中一個就是要導入 |
| transcript.whisperx[105].start |
3716.138 |
| transcript.whisperx[105].end |
3734.538 |
| transcript.whisperx[105].text |
智慧照顧科技進來讓這個長照人員的負荷也能夠降低才能夠留任那這個我們有這個預算編列在我們今天的預算書裡頭那剛剛這個委員所提到的那個排泄支持的用科技的部分相對是比較低 |
| transcript.whisperx[106].start |
3735.579 |
| transcript.whisperx[106].end |
3762.017 |
| transcript.whisperx[106].text |
那當然是一方面目前看起來這個成本也是比較高可選擇性也比較少就是沒有這一類的科技的導入那委員特別提醒我們這個日本的經驗我再來仔細的瞭解那麼從系統的支持上來做改善好再麻煩我覺得未來可能要考量這個否則我們沒辦法解決人力的問題那我們剛剛談到那個智慧照顧設備推動 |
| transcript.whisperx[107].start |
3765.659 |
| transcript.whisperx[107].end |
3788.995 |
| transcript.whisperx[107].text |
環境智慧的科技監測科技也就是我們的室內的空氣品質的管理好像也做不到位環境相對濕度其實事實上是也直接影響住民的健康我們的勞動部指案所的長照場所的通風環境的調查研究就指出長照機構除了要注意CO2的濃度外也必須控制濕度 |
| transcript.whisperx[108].start |
3789.455 |
| transcript.whisperx[108].end |
3815.68 |
| transcript.whisperx[108].text |
避免低溫低濕環境造成我們的長時間工作者跟臥床住民皮膚跟口腔黏膜的受損長照機構的長輩24小時住在一個密閉空間生活呼吸健康是基本的人權所以我覺得根據我們的室內空氣品質管理法第4條衛福部應該對護理跟長照機構附有因輔導改善的強制法定義務所以可是我看 |
| transcript.whisperx[109].start |
3816.48 |
| transcript.whisperx[109].end |
3840.749 |
| transcript.whisperx[109].text |
衛福部目前作為 似乎只是把IAQ的監測當成是獎勵計畫的一項指標 指項目而已所以部長這有什麼管控方法嗎好 跟委員說明 當然這個長照機構也好或護理支架也好 目前在評鑑裡面是有不過是屬於加分項目對 這就是我覺得最大的問題那我們應該是 |
| transcript.whisperx[110].start |
3842.189 |
| transcript.whisperx[110].end |
3865.059 |
| transcript.whisperx[110].text |
循序漸進第一個也是獎勵先行先有一些獎勵的補助什麼去讓他提升那之後呢就納入在評鑑裡面的一定要評的項目就不再只是一個加分項目我想按照這個循序來提升整個機構的照護品質這個是我們覺得是可行部長那是不是衛福部可以訂定獨立的護理跟長照機構的 |
| transcript.whisperx[111].start |
3866.059 |
| transcript.whisperx[111].end |
3886.62 |
| transcript.whisperx[111].text |
IAQ的那個輔導計畫輔導這些機構改善我們的環境空氣品質畢竟長輩我說長時間在那邊居住那或是演藝將空氣品質管理納入基本項目而非加分項目加分就別人我可以不要做我沒有要加分我其他都做好了會有沒有更可以可能改善的手段 |
| transcript.whisperx[112].start |
3886.8 |
| transcript.whisperx[112].end |
3904.331 |
| transcript.whisperx[112].text |
可以就是說剛剛我跟委員說明就是我們以輔導跟鼓勵先行獎勵輔導先行然後再納入現在是加分項目最後再移入為必要項目這個方向我覺得是可行那至於這一個IAQ的輔導計畫我也請長照師來儘速啟動好那儘速啟動時間多久今年可以吧我們要跟照顧師一起討論 |
| transcript.whisperx[113].start |
3917.25 |
| transcript.whisperx[113].end |
3931.059 |
| transcript.whisperx[113].text |
不是 我就說這IAQ輔導計畫啦 我們就 盡速啟動吧三個月 好 三個月好 好 謝謝好 謝謝 謝謝委員謝謝林耀群召委的諮詢現在請蘇清泉委員諮詢好 謝謝主席等一下十點要開記者會保定 拜託來我請施承良部長 |
| transcript.whisperx[114].start |
3950.491 |
| transcript.whisperx[114].end |
3971.254 |
| transcript.whisperx[114].text |
蘇委員長這個從5月8號下午我們醫療法第12條跟102條之一三讀通過之後到現在三天了三天了差不多就逍遙差不多了啦請餐沒啦,我給你買到要死,你也給我買到咧我大家都看你沒買,現在這次不錯 |
| transcript.whisperx[115].start |
3976.698 |
| transcript.whisperx[115].end |
3992.631 |
| transcript.whisperx[115].text |
我要跟大家報告,這個案子也是因挫洋殺,我們賴總統跟人家講說兩年要入法所以我們副總召、我、蔡其昌、莊瑞雄、陳清榮,大家都同同意就是要讓他通過 |
| transcript.whisperx[116].start |
3993.732 |
| transcript.whisperx[116].end |
4019.652 |
| transcript.whisperx[116].text |
所以再加上我們二部部長跟劉司長大家都在這樣協商、討論、修正、再修正、再修正事實上到最後講說這是三人的版本三人的版本都沒有意義啦我們美工輸出前版本、廖維強版本我覺得應該要有十重兩版本對不對好那現在我先講 |
| transcript.whisperx[117].start |
4022.199 |
| transcript.whisperx[117].end |
4037.203 |
| transcript.whisperx[117].text |
大家都很關心我們護理人員,幾十年來就是這樣那護理人員他們最辛苦,最辛苦所以這個法律要跟他們保障,那也通過啦那應該是,他們押一半押一半,押一半人家說拔掉,押掉要再押多久,沒人這樣啦所以在這裏補充你的保安人員,美麗說是怎樣 |
| transcript.whisperx[118].start |
4049.468 |
| transcript.whisperx[118].end |
4052.203 |
| transcript.whisperx[118].text |
三讀通過之後你要兩年的 |
| transcript.whisperx[119].start |
4053.14 |
| transcript.whisperx[119].end |
4080.905 |
| transcript.whisperx[119].text |
日落條款 你是憑什麼啊你還給人家嗆說 啊不然你給我罵有這麼多嗎沒有啦 我從來不會對人家放聲說這不是我的風格啦只是說當然這個那一天的討論那麼部分的護理代表比較激動啦最後說要去告我那當然這個要訴訟是人民的權益啦所以我也不會阻止他我就說 那我也只好接受啦我絕對不會去 |
| transcript.whisperx[120].start |
4081.745 |
| transcript.whisperx[120].end |
4106.098 |
| transcript.whisperx[120].text |
說你來跟他講這個是要澄清那重點是在這個實施的日期我想就如同剛剛委員所提到的那麼在當天的立法院的協商過程當中各黨其實大家都是提出了這個三班護病筆的入法那麼所以才最後會有一個共識就是修訂在醫療機構設置標準裡頭那麼這個是最後大家的共識 |
| transcript.whisperx[121].start |
4110.66 |
| transcript.whisperx[121].end |
4135.608 |
| transcript.whisperx[121].text |
所以那一天呢這個5月8號的下午我們原定就召開醫療機構設置標準的修訂的這個會議啦那在會議當中當然我們就按照了這個立法院的這個最後通過的要求是按照113年3月所通過的三般互併比的標準讓他直接寫進去的我們黨團國民黨黨團剛剛也表示說 |
| transcript.whisperx[122].start |
4139.409 |
| transcript.whisperx[122].end |
4166.465 |
| transcript.whisperx[122].text |
你華通過三讀總統公告行政院長附屬之後你就要趕快實施你這個兩年會太久了最好三個月六個月趕快實施那有什麼問題你要講出來剛剛你有解釋了一部分嘛這個我想委員非常清楚如果三個月或六個月實施會發生什麼事情這個衝擊會非常大那麼我必須很負責任的這個 |
| transcript.whisperx[123].start |
4169.86 |
| transcript.whisperx[123].end |
4195.575 |
| transcript.whisperx[123].text |
這個醫療體系的這個運作必須持續不能因為一個修法造成災難所以這個我們目前在推動三班護病米入法其實也是有它的步驟在進行我們114年就開始剛剛在這個委員列的這個簡報裡面也有我們有各項的12項的改革措施在推動那也初步看到一個這個 |
| transcript.whisperx[124].start |
4197.156 |
| transcript.whisperx[124].end |
4215.665 |
| transcript.whisperx[124].text |
現象了 已經開始有一些效應出來了但是人力的增加不是一觸可及好 那這兩天放射的心理的營養都有跟我反映說病人 一件病人不是只有醫生跟護理師而已還有13個 13個醫生放射檢驗 職能治療 物理治療藥師 都很厲害的這裡都說 這裡都現在都蠢蠢欲動 |
| transcript.whisperx[125].start |
4226.07 |
| transcript.whisperx[125].end |
4244.54 |
| transcript.whisperx[125].text |
這都差不多要發作了再來層次不窮所以我是覺得我們在爭執那個二分之一三分之一現在全部人都搞不清楚什麼說在挺二分之一挺三分之一我是覺得這個委員會終究要成立嘛你現在你的 |
| transcript.whisperx[126].start |
4247.484 |
| transcript.whisperx[126].end |
4250.69 |
| transcript.whisperx[126].text |
夠詳細,要把所有議事團體加起來,比較多人的,好好來檢討,總不能說給你一個委員會,檢檢一個委員會,不然你會看到什麼? |
| transcript.whisperx[127].start |
4259.625 |
| transcript.whisperx[127].end |
4287.238 |
| transcript.whisperx[127].text |
這應該是分成兩行 這是兩個一個是我們在修訂法規的時候相關的利害關係人要參與 這是一種那另外一個是對整個醫療相關的人力的優化的推動小組那當然就會含納所有的各類職類的所以這是兩件事情一個是一個推動的小組你要配套的時候 那應該怎麼配套 |
| transcript.whisperx[128].start |
4287.958 |
| transcript.whisperx[128].end |
4316.841 |
| transcript.whisperx[128].text |
但是另外在修法的時候要修這個設置標準的時候本來就是會邀請相關的利害關係人那麼不是相關的利害關係人那你跟他邀請不來那造成的那個效果是什麼所以你這個諮詢委員會就是有幾個是相關的所以這一塊是浮動的這一塊是動態的那下面的協助增加跟這個互惠者代表是固定的你的意思是這樣嗎 |
| transcript.whisperx[129].start |
4317.921 |
| transcript.whisperx[129].end |
4342.972 |
| transcript.whisperx[129].text |
這是兩回事嘛今天要修設置標準的哪一條那涉及到比如說你如果是修到要修急診的那當然你要相關急診的團體要進來那麼如果你是要修這個護理的那當然就護理的醫院的代表跟醫用者所以這要看到時候修的條文是涉及的利害關係的人來邀請啦 |
| transcript.whisperx[130].start |
4343.692 |
| transcript.whisperx[130].end |
4354.102 |
| transcript.whisperx[130].text |
阿至於整個的推動小組,那當然就韓納各類型的那我們要求,具體要求就是總統如果公告之後,你這個執行委員會,你就趕快趁熱躺在這趁熱嘛,讓製造這社會有高台啊,可以嗎? |
| transcript.whisperx[131].start |
4363.225 |
| transcript.whisperx[131].end |
4383.173 |
| transcript.whisperx[131].text |
諮詢委員會喔?對對對對對對對現在人家最客氣的是這塊這塊而已因為你這二十三個扯到最後扯不清嘛所有的喔我要說現在的委員會都是要法定的啦我們都不稱為委員會我們都是推動小組啦改正的推動小組這個我們會來本來就有啦這本來就有了 |
| transcript.whisperx[132].start |
4385.114 |
| transcript.whisperx[132].end |
4401.231 |
| transcript.whisperx[132].text |
不然就有了就每一個事情我們都會有一個推動小組嘛那對這件事情來講也會有一個推動小組因為後面還有很多配套你不是只有一個法寫下去而已後面的配套推動的時候我們就會有一個推動小組好 那市長你把小組給我看好 |
| transcript.whisperx[133].start |
4402.752 |
| transcript.whisperx[133].end |
4408.035 |
| transcript.whisperx[133].text |
我們會來成立這個推動小組啦不相信 再來最近這樣沸沸揚揚 整個民間什麼什麼那是都診所嗎艾爾利啦 光澤啦 聖遺啦 |
| transcript.whisperx[134].start |
4419.433 |
| transcript.whisperx[134].end |
4438.701 |
| transcript.whisperx[134].text |
嚴醫民這些都是診所嗎?還是都是理容院?目前我們掌握的還是醫療機構為主啦所以都是有醫師登錄在裡面的喔?目前都是啊這醫生怎麼知道?怎麼說死了他怎麼知道啊?裡面寫什麼寫什麼他怎麼知道啊? |
| transcript.whisperx[135].start |
4442.057 |
| transcript.whisperx[135].end |
4448.921 |
| transcript.whisperx[135].text |
這就要調查之後才會提請責任你也是無辜的受害者,只能讓他去掛名,普通你也醫生,市長你也醫生,站在你面前掛,掛掛你怎麼理事啊但是跟委員說明,我們每一家醫療機構有一個負責醫師,負責醫師不能說他不知情 |
| transcript.whisperx[136].start |
4462.897 |
| transcript.whisperx[136].end |
4479.229 |
| transcript.whisperx[136].text |
所以這個既當是負責移屍,你不能說我什麼都不知道我看這些連鎖的老闆,這些連鎖的老闆對大家都不三不四的,我不相信他們有什麼道德崇高不可能的事情,那些都賺錢而已 |
| transcript.whisperx[137].start |
4480.45 |
| transcript.whisperx[137].end |
4486.795 |
| transcript.whisperx[137].text |
這醫生,我做過全聯會理事長,這醫生要保護呢?這醫生這間診所有可能是把他拔脖子下來,從某一間公寓室把他承接下來,那裡設備設施,深淵器那裡放監視器,還在那些最恐怖的地方,施展皮皮會說什麼不可以國外去,不可以台中,不可以東南亞去,不可以幾十億,有這個事情嗎?不可以嗎?一幫大行都不知道呢?這些真的都要調查,有完有中啦! |
| transcript.whisperx[138].start |
4509.894 |
| transcript.whisperx[138].end |
4526.364 |
| transcript.whisperx[138].text |
那因為這些個案的情形有一些不同有些是有目的性那這個我剛剛之前就已經提到了這不可原諒啦這就是庭業的處分我會對施政要求的就是說我們這個醫療的醫生去做人家的負證人要人家給他告知也要給他教育啊不然我去用電競我看這個真慘 |
| transcript.whisperx[139].start |
4539.423 |
| transcript.whisperx[139].end |
4556.175 |
| transcript.whisperx[139].text |
市長 讓他講一下當然這個負責醫師就是他有一定應該負的法律責任啦這要遭不起啦不然這個阿伯這負責醫師的大家要輪流當就好啦沒有這種事情啦要去跟他們告知跟教育啦 我的意思是這樣啦 |
| transcript.whisperx[140].start |
4557.669 |
| transcript.whisperx[140].end |
4571.261 |
| transcript.whisperx[140].text |
我補充一下十年前在美容醫學那時候有一段有一陣子是真的很亂然後甚至就是說請那個已經七老八十的就是來真的就是掛牌在那時候其實就已經跟醫事公會全聯會做過合作 |
| transcript.whisperx[141].start |
4573.562 |
| transcript.whisperx[141].end |
4601.248 |
| transcript.whisperx[141].text |
超過70歲以上的醫師要重新第一次執業這件事情其實會加強監管所以相關的該去維護醫師權益的部分我們其實會跟醫師公會全聯會合作可是違反這件事情今天的重點第一件事情是違反我們醫療院所沒有用針孔攝影機的監視器的這種必要所以這類的行為是沒辦法接受第二件事情是 |
| transcript.whisperx[142].start |
4602.268 |
| transcript.whisperx[142].end |
4626.749 |
| transcript.whisperx[142].text |
怎麼樣讓醫師合規的走這條路這這邊的話其實我們其實已經跟相關的團體我們約好5月13號下午來做開會把該做的事情違法跟正常應該有的合理的行為或做一個領域譬如說哪個地方可以裝監視器就走道啦公共走公共的地方那診間啊什麼診療室那個不行要寫要講清楚啦 |
| transcript.whisperx[143].start |
4630.01 |
| transcript.whisperx[143].end |
4645.956 |
| transcript.whisperx[143].text |
過去就有訂過啦這個以這個公共場域為裝設的地點這是為了安全公共安全那麼不可針對特定人做設入營如果要做的話那必須要告知同意 |
| transcript.whisperx[144].start |
4647.054 |
| transcript.whisperx[144].end |
4654.136 |
| transcript.whisperx[144].text |
趙紫棟在一本高高高,在那裡寫兩三條,在那裡我看那些客串都沒有,都每個人說我簽,就像我們在買保險,七八十丁,我都好像勾簽而已,簽到未來簽什麼我不知道,我們買保險就這樣, |
| transcript.whisperx[145].start |
4663.6 |
| transcript.whisperx[145].end |
4684.081 |
| transcript.whisperx[145].text |
但過去都不會說只是簽同意書,一定是告知同意的,因為說明的過程是很重要的。對,對,對。沒有啦,這為無不如所無旁貸啦,因為本來是沒有醫生,怎麼簽字到醫師,有醫療行為的醫師跟部長裡面是要擔最大的責任呢?責任,一定責任你啊,不然要責任誰?沒有啦。 |
| transcript.whisperx[146].start |
4686.207 |
| transcript.whisperx[146].end |
4700.025 |
| transcript.whisperx[146].text |
這個一定我們會有一個統一的規範嘛要照照這個規範來執行地方會去落實集合這樣加強查緝要怎麼處理要趕快明確出來然後怎麼規範要趕快 |
| transcript.whisperx[147].start |
4701.724 |
| transcript.whisperx[147].end |
4710.708 |
| transcript.whisperx[147].text |
大家都 全國都盯著在看部長 任重道遠 責任重大這個 這一次是那個非常離譜的違法的行為這就是嚴查嚴處啦好 謝謝謝謝蘇青田委員的質詢現在請邱振軍委員質詢主席好啊 我們請石部長有請石崇良部長 |
| transcript.whisperx[148].start |
4734.89 |
| transcript.whisperx[148].end |
4751.033 |
| transcript.whisperx[148].text |
邱委員好部長好上週五國民黨跟民眾黨的這個通過醫師法的修正那把三班互避法入法那雖然過程當然還沒有很完整有點遺憾但大家都還能接受但我還是看到我們民進黨委員不贊成 |
| transcript.whisperx[149].start |
4752.074 |
| transcript.whisperx[149].end |
4766.054 |
| transcript.whisperx[149].text |
那當初提這個是我們賴清濤總統候選人說要提的那最初的承諾這個承諾呼併筆要立法的也是蔡英文主席那我看不到為什麼民進黨要反對勒 |
| transcript.whisperx[150].start |
4767.594 |
| transcript.whisperx[150].end |
4795.638 |
| transcript.whisperx[150].text |
跟委員說明這個民進黨沒有反對三黨都有版本可是我看到大家好像不太開心的樣子是不夠好還是怎麼樣主要是呢在這個我們民進黨委員的版本裡頭呢也有這個自議會的設計那麼主要有三個方面的代表包含護理代表三分之一那麼醫界的代表三分之一跟民眾這個醫用者跟專家學者代表三分之一 |
| transcript.whisperx[151].start |
4796.138 |
| transcript.whisperx[151].end |
4824.858 |
| transcript.whisperx[151].text |
所以是有這樣的設計但是最後的版本是沒有採納這樣的一個設計因為已經講了很久了那今年是第10年啦現在我替民進黨來完成10年沒有辦法兌現的這個承諾那部長又要說要到117年5月才真正執行那按照你的說法我想確認一下過去只要卓榮泰院長不滿意的法案他就是不附屬嘛不執行不編預算那現在照你們的說法這次卓院長是要 |
| transcript.whisperx[152].start |
4825.859 |
| transcript.whisperx[152].end |
4841.451 |
| transcript.whisperx[152].text |
履行義務嗎不會在這個他不要履行義務在這個立法這個醫療法的修法裡面他會附屬這項修正嗎會啊會啊因為在醫療機構設置標準裡面去修訂那既然法律要公佈為什麼你們要兩年 |
| transcript.whisperx[153].start |
4842.491 |
| transcript.whisperx[153].end |
4863.831 |
| transcript.whisperx[153].text |
我想這個委員來自苗栗最清楚像苗栗這樣醫療資源相對比較不容易羅織的如果我們現在就施行的話恐怕會造成苗栗地區的民眾的就醫會更困難這個我知道當然這一定會有一點衝擊但是我相信它會越來越好總是要跨出第一步 |
| transcript.whisperx[154].start |
4864.651 |
| transcript.whisperx[154].end |
4883.179 |
| transcript.whisperx[154].text |
對那當然這是剛開始一定會有一點點不順利那未來如果說人力投入之後我想慢慢就會改善對所以委員我們大家一起來努力讓他一定會逐步提升所以需要我們按照現在的人力缺口會團體是希望是116年12月開始那你們說 |
| transcript.whisperx[155].start |
4886.98 |
| transcript.whisperx[155].end |
4907.272 |
| transcript.whisperx[155].text |
傳染病可能會在冬天發生所以到117年5月才要真正執行這是為了選舉嗎還是怎麼樣不是不是因為我們每年大家都了解流感季的發生呢就是發生在冬季特別是在11、12月開始一些流感的重症會發生然後一直到過年這一段呢其實是 |
| transcript.whisperx[156].start |
4908.952 |
| transcript.whisperx[156].end |
4923.518 |
| transcript.whisperx[156].text |
這個疾病惡化或者急重症比較多的然後再碰到這個過年的長假那麼之後呢又有一撥的離職潮一般各行各業都有類似這樣所以我們希望降低這個衝擊不要讓急症擁捨的情形再發生那我再請問就114年度單位預算評估報告裡面在衛福部裡面說到114年度單位預算評估報告裡面說 |
| transcript.whisperx[157].start |
4938.323 |
| transcript.whisperx[157].end |
4966.61 |
| transcript.whisperx[157].text |
112年9月28日台灣護理人力供需分析與政策整備那預估三班戶並比新制實施之後會有7553人短缺嘛那您在5月8號開記者會說目前盤點還有3到5000人的缺口大概還有七成醫院達標那確實會有關床的這個狀況而且地區醫院關床率最高達標率也最高這說明這個達標率可能不是不能 |
| transcript.whisperx[158].start |
4967.19 |
| transcript.whisperx[158].end |
4988.011 |
| transcript.whisperx[158].text |
利而是補關床是吧你是用關床來調整他也是有鼓勵這個增加的人力他的這個獎勵有兩種一種是達標達標的目的就是讓護理人員臨床的第一線的負擔他已經下降了第二個是他有徵聘人力也有一個獎勵所以他的獎勵內容是有兩個 |
| transcript.whisperx[159].start |
4988.812 |
| transcript.whisperx[159].end |
5004.359 |
| transcript.whisperx[159].text |
我看到在115年2月在醫院的VPN的登錄極限的一班病床三班護病比那顯示有效醫院384家三班護病比都有達到91%那分開醫學中心89區域醫院91.5那地區醫院91.6都高於你說的7成啊 |
| transcript.whisperx[160].start |
5014.362 |
| transcript.whisperx[160].end |
5038.068 |
| transcript.whisperx[160].text |
為什麼數據會差這麼多是因為你們自己去調整還是說各講各的還是說花的錢沒有效果跟委員說明這個人力就是浮動的所以我講的七成是整個所有的醫院算起來的三班呼併那個是在去年的資料那現在更新的資料當然他又上來了不過這邊還有一部分是因為床數沒有開 |
| transcript.whisperx[161].start |
5039.028 |
| transcript.whisperx[161].end |
5057.774 |
| transcript.whisperx[161].text |
因為關了很多床嘛所以你們用關床來掩飾數字嘛不是不是但是呢實際上還是讓護理人員的負荷降下降了那我們的人力整個也是有成效有效就是我們以今年的三月來可是關床還是關啊 |
| transcript.whisperx[162].start |
5058.634 |
| transcript.whisperx[162].end |
5076.72 |
| transcript.whisperx[162].text |
以今年的3月為例,已經到去年同期3月是增加護理人力近5000名,4900多位,所以人力是有增加,但是因為你的護病比的關係,他需要的人力更多,這個還要再繼續有一個人力的缺口需要去補起來。 |
| transcript.whisperx[163].start |
5077.56 |
| transcript.whisperx[163].end |
5105.089 |
| transcript.whisperx[163].text |
所以對你們寫的數字就讓人家看不清楚你知道就是你們用官床然後把數字拉高可是護理人員有進來可能效果沒有那麼好對不對可能是這樣所以我希望部長您上任就是要把這個現在要把這個三藩護病比要把它做好那我希望你們不要你是學醫的不要被學法的帶壞好不好 |
| transcript.whisperx[164].start |
5105.549 |
| transcript.whisperx[164].end |
5133.002 |
| transcript.whisperx[164].text |
沒問題沒問題我們一定會讓他落地落實去推動我現在要請部長現場做一個澄清現在網路上有一些粉專正在煽動公開煽動醫師說醫師為什麼不要求這個比例入法那這種言論顯然是分化醫護關係那愛醫師護理人員爭取入法是多此一舉部長您身為醫療首長您有沒有必要導正這個視聽 |
| transcript.whisperx[165].start |
5135.556 |
| transcript.whisperx[165].end |
5150.214 |
| transcript.whisperx[165].text |
委員的問題是說有什麼那個我們有一個網路上有一個言論就是說醫師為什麼沒有這個比例入法像這個部分他們在炒這個嘛 |
| transcript.whisperx[166].start |
5153.365 |
| transcript.whisperx[166].end |
5173.997 |
| transcript.whisperx[166].text |
你知道嗎其實也不是沒有比例啦像我們過去就有這個合理門診量就是一位醫師呢在這個看診的過程當中那麼如果你人數太多那麼也是會造成品質的下降所以我們才會有合理門診量過去10年醫師團體要的是要受過醫師的 |
| transcript.whisperx[167].start |
5177.258 |
| transcript.whisperx[167].end |
5200.665 |
| transcript.whisperx[167].text |
醫師納入勞基法啦而非單純的比例入法那看診量直接掛過醫師薪資跟健保點子嘛那我目前還沒有聽到說醫師團體說要自我設限爭取這個醫師病人比的說法那這狀況跟護理師要求的這個24小時連續照顧的能力保障是完全不一樣的事情啦我希望說把這個事情跟我認為有需要跟外界來講清楚吧 |
| transcript.whisperx[168].start |
5202.445 |
| transcript.whisperx[168].end |
5229.975 |
| transcript.whisperx[168].text |
那再請教部長部立醫院苗栗醫院的急症狀大樓你說115年預算編列1327萬7千元加上以前這個前年的保留數那今年可用的預算超過2億4千萬元可是現在到115年3月底實際執行數只有5千元那執行率只有0.7%那部長招標現在是卡住嗎 |
| transcript.whisperx[169].start |
5231.683 |
| transcript.whisperx[169].end |
5253.397 |
| transcript.whisperx[169].text |
我請執行長說明一下苗栗業的進度跟委員報告他們現在正在上網找標中那就是之前有流標不過我們一般來講從這個裡面的他檢向在裡面變更裡面大概這次的應該是沒有問題要多久還要多久大概到六月份六月份可以上網嗎他已經上網了已經上了那他現在有什麼問題 |
| transcript.whisperx[170].start |
5254.378 |
| transcript.whisperx[170].end |
5271.707 |
| transcript.whisperx[170].text |
沒有 他現在不是 他在等標地幕那些呢 那些都弄好了都沒有問題了好 那我希望盡快啦 好不好因為大家都在期待好 謝謝部長謝謝委員謝謝邱政軍委員的發言接下來請完衛民委員質詢 |
| transcript.whisperx[171].start |
5281.109 |
| transcript.whisperx[171].end |
5283.932 |
| transcript.whisperx[171].text |
三班互併比上路現在看起來是一言再言這個護理師公會 |
| transcript.whisperx[172].start |
5298.615 |
| transcript.whisperx[172].end |
5321.99 |
| transcript.whisperx[172].text |
非常的憤怒 覺得他們的訴求這十年來就是已經等很久了那上個禮拜國民黨跟民眾黨在立法院我們合作把這個醫療法12條已經修改完成也把113年3月1號這個你們自己公告實施的這個護病比正式入法 |
| transcript.whisperx[173].start |
5322.93 |
| transcript.whisperx[173].end |
5351.479 |
| transcript.whisperx[173].text |
但是你現在告訴大家要實施的日期要等到117年的5月1號這真的是拖延太久了如果我們看當時你113年3月1號就已經公告實施標準事實上已經開始啟動準備你的準備期要一直延到117年5月1號才上路這整整準備的時間超過4年啊 |
| transcript.whisperx[174].start |
5353.1 |
| transcript.whisperx[174].end |
5370.131 |
| transcript.whisperx[174].text |
我覺得這個對於因期判的這一些護理師們真的是不公平那所以今天我要跟你探討的就是為什麼護理師公會他們的訴求也沒有讓你立即上路當天開會的時候他們要的是至少你要116年12月31號上路 |
| transcript.whisperx[175].start |
5374.179 |
| transcript.whisperx[175].end |
5397.452 |
| transcript.whisperx[175].text |
我分析過了在提前個五個月有這麼困難嗎我覺得一點都不困難你如果把從現在開始起算你事實上113年就開始準備了你如果從現在再準備也足足有超過一年半的時間按照你的標準你說113年這個落實三班互併比的有三成 |
| transcript.whisperx[176].start |
5398.493 |
| transcript.whisperx[176].end |
5426.02 |
| transcript.whisperx[176].text |
一年的時間就成長到114年就到七成了今年還沒年底我要問你的是那你今年的目標是多少如果再努力個一年半為什麼明年底沒有辦法正式實施只要你的相關配套繼續提供我覺得那個是一個很好的動力啊事實上衛福部你手上未有資源啊你獎勵跑在前面的嘛大家不會跟進嗎這個叫做正向循環 |
| transcript.whisperx[177].start |
5426.82 |
| transcript.whisperx[177].end |
5447.926 |
| transcript.whisperx[177].text |
但是你一言再言之後本席要告訴你的是你會造成的是惡性循環讓更多持有護理證的人在門外觀望因為他沒有看到政府的決心另外一個本席要告訴你的是如果你是117年5月1號才上路的話現賴總統於不易啊他是正式宣告跳票 |
| transcript.whisperx[178].start |
5448.866 |
| transcript.whisperx[178].end |
5473.431 |
| transcript.whisperx[178].text |
因為2028的選舉我直接告訴你2028選舉是不是5月1號才投票1月就投票了所以也等同正式宣告他其實就是跳票了所以我認為就你部長的職責你也認為三班互併比很好護理師也說這個法治化很好很好的事情為什麼不要加速前進為什麼116年12月31號實施有這麼的困難嗎部長 |
| transcript.whisperx[179].start |
5478.772 |
| transcript.whisperx[179].end |
5504.664 |
| transcript.whisperx[179].text |
好 先跟委員說明總統的任期是到117年5月20號啦我知道 投票1月就投了啦不會啦 這個如果怕跳票再投給總統他就一定會落實嘛都已經跳票怎麼會再投給他部長你真的失言了沒有輪替的話他一定會落實啊因為就是5月1號啊你真的失言了因為他保證是兩年入法已經跳票了啦所以你現在應該是要加速啦 |
| transcript.whisperx[180].start |
5505.985 |
| transcript.whisperx[180].end |
5521.317 |
| transcript.whisperx[180].text |
沒有跳票因為在114年我們是113年討論114年編列預算開始推動那麼經過一年才看到效果那所以我們按照推動推動的這個時間點從三成到七成成長很多 |
| transcript.whisperx[181].start |
5522.137 |
| transcript.whisperx[181].end |
5541.546 |
| transcript.whisperx[181].text |
但是要跟委員說明這個達標的背後其實還有相當比例的醫院其實它是沒有開床沒有開床所以我們希望的是在不關床的情形之下去達標而不是用關床來達標你達標之後是關床醫療量能萎縮之後會影響到病人這個我們也必須 |
| transcript.whisperx[182].start |
5548.649 |
| transcript.whisperx[182].end |
5572.873 |
| transcript.whisperx[182].text |
同時橫貧的考慮當然啊 那你不能一直倒果為因啊一方面讓護理人一直讓醫院拿關床作為藉口然後遲遲不肯去徵聘人力 不可以這樣子啊我們的獎勵是分兩種一種是達標獎勵一種是有徵聘人力的時候有獎勵所以我們是兩個在並行所以才可以看得到人力有回流嘛所以我說這個獎勵你要 |
| transcript.whisperx[183].start |
5575.794 |
| transcript.whisperx[183].end |
5596.503 |
| transcript.whisperx[183].text |
你也可以甚至再加碼嘛就是說獎勵是前提 這個我同意嘛你鼓勵 然後有資源 然後讓醫院盡快達標嘛但是你不能把關床當作理由讓有一些醫院不肯徵聘人力然後用關床 用這樣子的技術性來拿你的獎金這個我們也不允許啊 |
| transcript.whisperx[184].start |
5596.943 |
| transcript.whisperx[184].end |
5615.09 |
| transcript.whisperx[184].text |
整個醫療界要好就是他是真正聘了足夠的人力讓護理師願意長期久任你的醫療體系才會健全因為我看到你在說還要再多5個月到117年5月上路你講的理由不好意思我覺得那個都不是理由 |
| transcript.whisperx[185].start |
5615.35 |
| transcript.whisperx[185].end |
5643.106 |
| transcript.whisperx[185].text |
因為那個都是每一年會發生的事情你說冬季疾病比較多然後你說有的人就是領完年終獎金會離職那個每一年的情況都是一樣的所以那個不應該成為拖延的理由其實我真的要建議部長這件事情可以變成是你任內很好的政績你只要再加把力去推動我不認為這件事情有這麼困難多拖延五個月事實上你只是被罵而已不是五個月四個月啦 |
| transcript.whisperx[186].start |
5645.688 |
| transcript.whisperx[186].end |
5662.886 |
| transcript.whisperx[186].text |
因為5月1號就四個月你有一年半的時間去爭取其實剛好是碰到每年的流感高峰季然後又碰到過年的長假跟轉職的潮流那你每一年這個問題都是一樣的但是我們最後這一里路要走到的時候希望它是安全著陸 |
| transcript.whisperx[187].start |
5663.787 |
| transcript.whisperx[187].end |
5686.085 |
| transcript.whisperx[187].text |
一定是这一段的程序这一个过程现在才五月份而已你足足有超过一年半以上的时间你讲的安全着陆你讲的相关准备我都可以同意但是没有差这四个月如果你有决心要推动的话我相信你的能力你是一个做事情有效率的人 |
| transcript.whisperx[188].start |
5686.565 |
| transcript.whisperx[188].end |
5700.485 |
| transcript.whisperx[188].text |
然後我覺得你可以去溝通過年的時候的那一種去年的這個景象啊這個湧射在地上那麼多人沒有辦法住院我們不希望再發生這樣的事情不是立刻上路耶 |
| transcript.whisperx[189].start |
5701.519 |
| transcript.whisperx[189].end |
5719.563 |
| transcript.whisperx[189].text |
你弄清楚那個時間序我們現在是幾年我們現在是115年5月要上路的時間我說過護理事公會他們的訴求並沒有很誇張他不是叫你今年年底實施他們當時在會議上提出的是明年年底實施坦白講就一個緩衝期就一個日出條款來講 |
| transcript.whisperx[190].start |
5725.506 |
| transcript.whisperx[190].end |
5751.903 |
| transcript.whisperx[190].text |
這個是合理的時間你口中所謂四個月的落差我覺得真的沒有那麼的困難一年半的時間要努力綽綽有餘現在是你跟醫界的溝通我當然知道醫界的反彈很大你也來自醫界你那個壓力我可以理解但是很多事情是要互相的護理界長期的血汗大家也看到了他要求一個工作職場上合理的護病比這個有點過分嗎 |
| transcript.whisperx[191].start |
5753.785 |
| transcript.whisperx[191].end |
5780.363 |
| transcript.whisperx[191].text |
所以我們絕對支持這個所以我們應該要全力以赴啦我希望部長不要因為這件事情讓護理師公會去監察院去什麼法院也好告你我也不贊成這樣子啦但是我希望你可以用你的職權跟你的能力就是把他們的訴求跟目標全力以赴也不用鐵板一塊我認為這件事情只要大家願意做其實是做得到的這個是我的訴求 |
| transcript.whisperx[192].start |
5781.644 |
| transcript.whisperx[192].end |
5804.975 |
| transcript.whisperx[192].text |
接下來是我要問一下你們開放農藥這件事情農藥的開放分普寧大幅開放六倍這件事情你們衛福部對來說跟ART一點關係都沒有但是我發現就好巧美國輸進去台灣主要水果第一名就是蘋果 |
| transcript.whisperx[193].start |
5806.115 |
| transcript.whisperx[193].end |
5823.975 |
| transcript.whisperx[193].text |
那分譜您主要就是用在蘋果上面就是這麼的巧那我要請教衛福部的就是如果我們今天沒有美國的壓力也不是因為二手的關係食安標準不是越嚴格越好嗎我們現在守住的 |
| transcript.whisperx[194].start |
5824.575 |
| transcript.whisperx[194].end |
5847.864 |
| transcript.whisperx[194].text |
這一個的食安標準為什麼我們的分譜您有需要去放寬嗎為什麼要放寬是誰要求放寬既然沒有美方的壓力你就更沒有要去放寬的理由啊不是嗎跟委員說明我們這個關於農藥的殘留標準其實我們每年都在調整一年大概都修個二到三次那這一次的調整是一月份所做的預告 |
| transcript.whisperx[195].start |
5848.504 |
| transcript.whisperx[195].end |
5874.995 |
| transcript.whisperx[195].text |
然後完了之後我們現在做事業分證我現在在問你為什麼要調整那這個調整都是有國內的業者也提出一些需求國內業者種蘋果的嗎蘋果農嗎我們的來源有很多啦有的是那我就直接問你囉分譜您直接要求這個要調高到現在3ppm是哪一個單位提出來的要求我跟委員簡單的報告因為看到蘋果 |
| transcript.whisperx[196].start |
5876.758 |
| transcript.whisperx[196].end |
5895.707 |
| transcript.whisperx[196].text |
成類 還有一個櫻桃其實櫻桃是調降的為什麼是調降 我現在就問你蘋果我的意思是說它裡面其實是用科學我們風險有分析有評估我現在直接問你蘋果蘋果為什麼要放大六倍那裡面本身呢我們是風險評估底下在整體的 |
| transcript.whisperx[197].start |
5897.403 |
| transcript.whisperx[197].end |
5900.546 |
| transcript.whisperx[197].text |
是誰的需求總是要有人提出來你如果說農藥放寬是我們國內的農民他說你們現在標準太高了我們達不到我們希望可以適度放寬國內的農民提出來我可以理解你們對外說也沒有美國的壓力那你幹嘛去放寬 |
| transcript.whisperx[198].start |
5916.603 |
| transcript.whisperx[198].end |
5936.962 |
| transcript.whisperx[198].text |
跟委員說明我們在訂這些標準的時候呢都有兩個程序第一個呢它會根據這個所謂的GAP就是優良的農業操作它的施作這個是農業部所訂的然後再搭配國人的這個食用的習慣用這個ADI就是可接受的 |
| transcript.whisperx[199].start |
5937.802 |
| transcript.whisperx[199].end |
5954.135 |
| transcript.whisperx[199].text |
每日攝取量去換算出來的那個安全所以然後再經過專家委員會討論之後才修訂所以它的程序上呢都是前面有科學評估後面呢有專家的會議之後才修訂那要有人提出來啊是誰啊 |
| transcript.whisperx[200].start |
5955.235 |
| transcript.whisperx[200].end |
5972.169 |
| transcript.whisperx[200].text |
這個提出的來源很多啊我們這個所謂農藥標準的評估理念其實是分兩大部分我不要跟你講那麼多我只問蘋果這件事情兩大部分一部分是從國外的進口的部分一部分是國內的需求那國外進口誰有要求你要提高那個 |
| transcript.whisperx[201].start |
5973.19 |
| transcript.whisperx[201].end |
5986.994 |
| transcript.whisperx[201].text |
進口的其實有包括我們的進口商包括我們的各國的政府他們這一間貿易上面的其實我們所以還是有貿易上的你們幹嘛否認說跟ART一點關係都沒有沒有關係因為食品的部分進口我們70%都是 |
| transcript.whisperx[202].start |
5988.815 |
| transcript.whisperx[202].end |
6005.29 |
| transcript.whisperx[202].text |
仰賴進口的我們要讓所有國人能夠有飯吃能夠吃得飽水果等等的其實在平衡之下呢其實提出來我們都是被認為受理我們水果現在蘋果進口也很多啊還有紐西蘭的啊還有智利的啊我同意受理之後我們就進入評估 |
| transcript.whisperx[203].start |
6006.531 |
| transcript.whisperx[203].end |
6035.834 |
| transcript.whisperx[203].text |
所以我們現在沒有量不足的問題啊我現在不懂的是邏輯上面完全講不通我們蘋果的進口量一直非常的大然後在這樣的情況底下為什麼需要去放寬它的農藥標準完全沒有道理如果說你今天是台灣我們現在進口很稀缺沒有稍微放寬我們這個本身食品供應不足所以必須適度放寬這個才有標準另外一個我要告訴你的是歐盟的標準你知道歐盟對於蘋果它的標準是多少 |
| transcript.whisperx[204].start |
6036.334 |
| transcript.whisperx[204].end |
6053.637 |
| transcript.whisperx[204].text |
報告委員0.01這件事情只能告訴一件整個國家對於農藥的需求不同他沒有定標準就用減料標準0.01因為不能用簡單的處法不能用處法去算這個簡單的基本就是這個國家沒有用他的需求沒有 |
| transcript.whisperx[205].start |
6053.797 |
| transcript.whisperx[205].end |
6078.835 |
| transcript.whisperx[205].text |
他們就是覺得分布你能不用就不要用我覺得我們基於科學的基礎之下評估是安全的所以這個安全的評估是整個農藥所協助的你們要放寬總要有一個理由不要對外又不肯承認如果歐盟他採取的標準他也沒有去放寬今天台灣大幅放寬我們一定有一個理由嘛有理由就講出來或是美國的壓力也可以講出來他們叫做不使用 |
| transcript.whisperx[206].start |
6079.355 |
| transcript.whisperx[206].end |
6092.229 |
| transcript.whisperx[206].text |
不使用不代表是也有歐盟使用的我們沒有使用一樣每個國家按照他的需求做需求去調整那蘋果我們國有吃得很大進口量也很大那這一塊正是你們需要把關的啊 |
| transcript.whisperx[207].start |
6093.26 |
| transcript.whisperx[207].end |
6115.095 |
| transcript.whisperx[207].text |
把關沒有必要放寬它是我經過完整的數據的分析算出來的結果絕對小於ADI攝氏量如果是超過我們絕對不會允許的這是科學的基礎不能在科學基礎上我就沒有辦法算了我沒辦法計算的前提之下所有農藥在管理上都會出了問題只有是越嚴格越好 |
| transcript.whisperx[208].start |
6115.655 |
| transcript.whisperx[208].end |
6136.586 |
| transcript.whisperx[208].text |
而不是你講的越寬鬆越好越安全可以安全的基礎才是如果我們的安全基礎是沒有辦法溝通的話我覺得是對國人的農藥的管理是不好的如果我們今天對於進口的水果我們可以管制它的農藥標準我們到底是越嚴格越好還是越寬鬆越好你去問國人就知道我只是要提醒你們如果你們有壓力 |
| transcript.whisperx[209].start |
6139.327 |
| transcript.whisperx[209].end |
6164.2 |
| transcript.whisperx[209].text |
你們有貿易上面的壓力我都可以理解但是不要對外說一套但實質上面你這個放寬就是沒有理由的你如果說是美國的壓力我們可以理解是貿易的壓力但是在沒有貿易壓力的情況底下進行放寬這個就是食藥署包括委員這個根本就還沒有提出連談判之前都還沒有之前就已經提出那你幹嘛放寬 |
| transcript.whisperx[210].start |
6165.181 |
| transcript.whisperx[210].end |
6174.16 |
| transcript.whisperx[210].text |
所以我們評估完整體整個GAP底下我們看到的結果按照國人的使用標準去問國人沒有道理情況底下為什麼要放寬六倍 |
| transcript.whisperx[211].start |
6176.269 |
| transcript.whisperx[211].end |
6193.1 |
| transcript.whisperx[211].text |
為什麼作為一個食藥署的署長作為衛福部應該是這樣子嗎不是你的原則應該採得很清楚嗎能減少用農藥就減少用農藥嗎怎麼會是越放寬越好呢我覺得這件事情我希望衛福部不要推給委員會這件事情不需要放寬本來就不應該放寬我認為在食安的標準上面只有更嚴格不是更寬鬆 |
| transcript.whisperx[212].start |
6205.86 |
| transcript.whisperx[212].end |
6225.561 |
| transcript.whisperx[212].text |
對 跟委員說 我們都是這個保障國人的使用安全請委員放心 這個都有科學的證據去做的評估好 謝謝王月明委員的諮詢待會在廖偉祥委員訓導完畢後休息10分鐘現在請廖委員 委員諮詢廖偉祥委員 |
| transcript.whisperx[213].start |
6235.041 |
| transcript.whisperx[213].end |
6259.466 |
| transcript.whisperx[213].text |
謝謝主席有請石部長有請石崇良部長好 六人好部長好部長我想要先請教一下賴清德總統上任後大動作成立的健康台灣推動委員會那研議五項主題其中一項是強化癌症防治策略擴大篩檢那這個部分有哪些 |
| transcript.whisperx[214].start |
6261.238 |
| transcript.whisperx[214].end |
6289.444 |
| transcript.whisperx[214].text |
我們從過去是傳統的4癌然後到5癌篩檢就是前年開始的這個肺癌的Low Dose CT的篩檢然後到今年全面性對胃癌的前區就是那個對 也加了胃癌那個幽門螺旋菌的全面篩檢大概目前這個是6癌篩檢好 那我想要請教一下部長你們癌症防治工作計畫去年也就是114年的國建署公務預算 |
| transcript.whisperx[215].start |
6290.064 |
| transcript.whisperx[215].end |
6304.232 |
| transcript.whisperx[215].text |
還有煙害防治及保健基金投入癌症的防治工作的經費是多少合計多少如果是癌篩的部分是68億我們編列的預算去年是68億 |
| transcript.whisperx[216].start |
6308.766 |
| transcript.whisperx[216].end |
6322.973 |
| transcript.whisperx[216].text |
68億我這裡我會說包含基金預算包含還有加上公務預算加起來我這裡算到是82億5000多萬我剛好說有公務預算加上宴愛房子加上這個保健基金投入這個部分加起來 |
| transcript.whisperx[217].start |
6323.793 |
| transcript.whisperx[217].end |
6334.605 |
| transcript.whisperx[217].text |
對 因為公務預算是68億啦那另外還有那個那個 嚴謹那個今晚114年公務預算應該是36億8千多萬喔基金預算45億合計是82億5千多這個 這個 |
| transcript.whisperx[218].start |
6342.603 |
| transcript.whisperx[218].end |
6359.461 |
| transcript.whisperx[218].text |
那你們的這個癌症防治工作計畫115年也就是今年的國健署的公務預算跟冤害防治跟保健基金投入癌症防治工作的經費合計又是多少 |
| transcript.whisperx[219].start |
6364.395 |
| transcript.whisperx[219].end |
6368.176 |
| transcript.whisperx[219].text |
我算給你看啦我已經算完了啦是71億71億900萬左右加起來是71億900萬對不對好那我就開頭我就問了嘛你們現在的這個擴大篩檢的這麼多你剛也說從這個4癌變5癌現在變6癌了那你們115年的業務比114年暴增的這麼多說擴大篩檢規模那 |
| transcript.whisperx[220].start |
6392.93 |
| transcript.whisperx[220].end |
6403.923 |
| transcript.whisperx[220].text |
這個包含各項的補助結果到最後擴大了推動我們的相關的防癌的項目跟提高工作經費但是為什麼整體癌篩的預算卻減少了11億5000萬左右 |
| transcript.whisperx[221].start |
6407.34 |
| transcript.whisperx[221].end |
6433.528 |
| transcript.whisperx[221].text |
部長可以講一下是為什麼嗎大概跟我們在執行的對象我們之前的執行率上我們做了一點調整就是說執行的實際上因為我們去年是比前年大幅增加我們大幅增加然後真正執行之後又做了一點調整這樣 |
| transcript.whisperx[222].start |
6434.642 |
| transcript.whisperx[222].end |
6445.067 |
| transcript.whisperx[222].text |
那我就想要因為我就看了一下你們因為今天在講預算吧所以今天也看了一下你們實施內容裡面他是直接說少14億的原因是是改為由公務預算辦理 |
| transcript.whisperx[223].start |
6447.27 |
| transcript.whisperx[223].end |
6476.196 |
| transcript.whisperx[223].text |
你裡面是這樣寫啦但是你們的公務預算其實也只增加3億多啊當然這不是一個小數字但是剛剛跟剛剛我們算出來11億差距還是蠻大的所以你沒有講清楚說為什麼你少編了這麼多啊到底理由是什麼這就會讓我們在想說會不會是113年執行成效是有問題的所以才要自行去縮編這個預算但是因為我不理解的是這應該是一個很重要的預防工作的一環那為什麼會是這樣所以我才要問這個問題 |
| transcript.whisperx[224].start |
6477.378 |
| transcript.whisperx[224].end |
6494.329 |
| transcript.whisperx[224].text |
所以這部分可以解釋一下嗎報告委員那個時候就是希望因為經濟基金這幾年越來越少那那個時候希望能夠藉由爭取公務預算來把基金的部分就是我剛剛有講了所以你公務預算有多了3億多可是整體的這個項目少了11億多 |
| transcript.whisperx[225].start |
6496.491 |
| transcript.whisperx[225].end |
6517.521 |
| transcript.whisperx[225].text |
當初在爭取的時候其實是不止三億多可是後來合下來只有三億多所以才會看起來整體是變少的但是當初在規劃的時候其實希望是在公務預算把整個這個變少總是會有一些理由啦所以我是希望部長是不是可以回去瞭解一下給本席辦公室呢第一個短小11億的根本原因跟檢討報告 |
| transcript.whisperx[226].start |
6518.561 |
| transcript.whisperx[226].end |
6539.791 |
| transcript.whisperx[226].text |
是因為你們第一線的這個篩檢量能啊或是哪裡到底出了問題為什麼會差這麼多那如果差這麼多那不就代表你們以前的評估是有問題的好那這次到底短少的原因是什麼好然後第一個是這個然後第二個是114年的具體最終執行篩檢補助的人員酬金給了多少人次 |
| transcript.whisperx[227].start |
6540.885 |
| transcript.whisperx[227].end |
6558.373 |
| transcript.whisperx[227].text |
然後各種癌症篩檢分別受理了多少件那最終執行調的預算又是多少還有你們預估今年人員的酬金要給多少人次預計處理多少件的具體數字可不可以給本席因為我要查這些資料我覺得蠻黑箱的看不到我不知道你們執行的狀況到底是什麼 |
| transcript.whisperx[228].start |
6559.313 |
| transcript.whisperx[228].end |
6585.448 |
| transcript.whisperx[228].text |
所以我希望這兩點可不可以這個詳細的執行情形我們在另外整理之後給委員參考對因為這個是有關國人的篩檢的健康的問題所以這數字相差太多了我希望你可以給本席一個具體的說明不然我也會覺得你們到底怎麼編的好對然後另外就是之前加問一下部長之前你有說這個有關於攝護腺癌公費篩檢的進度現在是怎麼樣 |
| transcript.whisperx[229].start |
6587.334 |
| transcript.whisperx[229].end |
6610.395 |
| transcript.whisperx[229].text |
目前是委託這個國衛院也在進行這個整個那個癌所國衛院的癌所在進行整個這個攝護腺癌的防治政策的研究那什麼時候會有具體的具體的這個因為你之前有說現在的技術是可以準也越來越準了應該是可以做的因為我們在第一線之前也講過數據了我就不在這裡再展開講這個主題那請問具體是什麼 |
| transcript.whisperx[230].start |
6613.117 |
| transcript.whisperx[230].end |
6617.243 |
| transcript.whisperx[230].text |
我是不是請我們國務院司徒院長來說明一下目前的進度 |
| transcript.whisperx[231].start |
6619.738 |
| transcript.whisperx[231].end |
6646.576 |
| transcript.whisperx[231].text |
好 報告委員目前是由我們國衛院的國家癌症研究所的扎所長那他本身也是泌尿科醫學會的醫事長先跟我講具體的時間就好因為我時間有限那現在他們在學會裡面五月底五月底是好 這個有關於這個攝護腺癌的監討這個推動的報告是五月底會出來是好 那到時候我們就等這個希望可以盡速那再來所以剛剛都在講癌篩所以 |
| transcript.whisperx[232].start |
6649.116 |
| transcript.whisperx[232].end |
6676.838 |
| transcript.whisperx[232].text |
這是剛剛的數字少了14億那再來就是我想要提到的是剛剛的講到癌篩那癌篩裡面呢我相信這些錢也要來用來提升他們相關的待遇啦更新設備啦增設獎金等等的都很重要但最重要也要改善這個人力荒所以不只是護理師現在醫檢師放射師的職業率也面臨很大的挑戰也崩潰了邊緣那他們都是癌篩的重要夥伴 |
| transcript.whisperx[233].start |
6677.677 |
| transcript.whisperx[233].end |
6700.2 |
| transcript.whisperx[233].text |
尤其是這個六癌篩檢主要很多都是醫檢師還有放射師在處理的這個業務啊所以現在的這個人力足夠嗎 部長因為我之前其實也質詢過相關的議題啊之前還有這個報 媒體也大大面積的去報導這個醫事人員的不足的問題所以想要請教一下部長這部分是不是也應該趕快去檢討 |
| transcript.whisperx[234].start |
6703.015 |
| transcript.whisperx[234].end |
6717.722 |
| transcript.whisperx[234].text |
有關於這個篩檢所需要的人力的影響我們也一併做一些評估啦那因為這個每一種篩檢所需要的這個人力是不太一樣譬如說你肺癌那個主要是E方式那個是Low dose CT的篩檢 |
| transcript.whisperx[235].start |
6719.022 |
| transcript.whisperx[235].end |
6744.551 |
| transcript.whisperx[235].text |
那有些是做這個Smear那這個可能跟這個Pathologist跟病理方面的檢驗又比較有關係那跟那個乳塞又是另外一種所以部長我知道所以我現在要講說這些人力也都有面臨短缺的問題甚至現在在醫院要排這個相關的檢查也都要排很久所以我想要先請教一下 |
| transcript.whisperx[236].start |
6745.629 |
| transcript.whisperx[236].end |
6765.825 |
| transcript.whisperx[236].text |
部長你知道醫檢師的人力評鑑竟然只看病床數嗎忽略了門診跟急診的檢驗量另外呼吸治療師也只評估加護病房完全忽視了急診跟一般病房的插管需求所以你們之前有承諾過就評鑑的部分要召開 |
| transcript.whisperx[237].start |
6766.607 |
| transcript.whisperx[237].end |
6776.705 |
| transcript.whisperx[237].text |
基準的延伸會議對不對你們有沒有答應你們之前有說過嗎有嘛對不對就是在那個醫院評鑑的基準裡面會去討論那請問你們目前開個幾場這個會議都還沒開 |
| transcript.whisperx[238].start |
6780.983 |
| transcript.whisperx[238].end |
6798.857 |
| transcript.whisperx[238].text |
因為評鑑本來從四年變六年的時候中間有一些需要確定的東西又在做重新的演繹所以預計最快召開人力的一個相關的一個會議的時候會在明年年初因為今年會把一些東西定案之後你才能夠 |
| transcript.whisperx[239].start |
6799.637 |
| transcript.whisperx[239].end |
6826.716 |
| transcript.whisperx[239].text |
因為你應該要趕快開始召開相關的討論吧兩件事情一個是能力的一個改善一個是評鑑基準然後能力的改善所以我剛問的是基準研商會議對基準研商會議預計拉到明年然後能力的改善的整體規劃的部分的話就成如剛剛部長講我們會有改革小組從那個地方做一個整體政策的分數部長對現在相關的薪資缺乏彈性也過度勞累齁 |
| transcript.whisperx[240].start |
6827.757 |
| transcript.whisperx[240].end |
6853.829 |
| transcript.whisperx[240].text |
所以也導致除了我們上個禮拜的護理師的部分其他的醫事人員也是人才有短缺的問題也大量的外流所以這個部分想要請衛福部趕快研議好針對這些醫事人員上次你也答應過本席你們會全面檢討那究竟什麼時候可以給本席一些相關的我想健保也相關的這個支付制度的調整也在努力在規劃中所以一方面也會有這個支付制度的這個 |
| transcript.whisperx[241].start |
6855.91 |
| transcript.whisperx[241].end |
6870.886 |
| transcript.whisperx[241].text |
這個挹注來調來改善這個醫檢醫放人員的薪資那另外在這個人力的這個規劃包含評鑑標準的這個修訂的也會下半年就會讓他們開始來討論 |
| transcript.whisperx[242].start |
6872.83 |
| transcript.whisperx[242].end |
6897.701 |
| transcript.whisperx[242].text |
部長所以你下半年才要開始討論不可以早一點嗎現在已經五月了就是接下來所以你六月開始會這是重點項目對會去成立因為健康台灣政策最重要的一個環節剛剛講了從開頭就說是這個癌篩的部分癌篩的工作所以經費不足然後人力短缺其實我們就擔心你就像在沙灘上面蓋大樓沒有好的基礎然後只看這個又要這些KPI達標 |
| transcript.whisperx[243].start |
6898.741 |
| transcript.whisperx[243].end |
6910.487 |
| transcript.whisperx[243].text |
那你最後就是逼迫這些第一線的醫事人員做功德所以這部分要請部長盡速去改善那你可不可以一個月內給本席辦公室一個檢討的報告好 我們會規劃進行的這個報告再給委員參考好 謝謝好 謝謝廖宇祥委員的諮詢現在休息十分鐘 |
| transcript.whisperx[244].start |
6942.56 |
| transcript.whisperx[244].end |
6942.58 |
| transcript.whisperx[244].text |
動不動 |
| transcript.whisperx[245].start |
7517.759 |
| transcript.whisperx[245].end |
7519.26 |
| transcript.whisperx[245].text |
現在繼續開會接下來請陳金輝委員質詢 |
| transcript.whisperx[246].start |
7556.514 |
| transcript.whisperx[246].end |
7572.588 |
| transcript.whisperx[246].text |
主席好 謝謝主席 謝謝各位官員還有委員會出席 請石部長請石崇良部長石部長 這位早我聽了早上您許多的回覆這個是2023年9月我們賴清德總統給大家的承諾 我先播給大家聽三班無病痞要入伙 |
| transcript.whisperx[247].start |
7583.101 |
| transcript.whisperx[247].end |
7591.046 |
| transcript.whisperx[247].text |
是嗎?是!大家沒什麼要求,這樣就對了好,我們再播一次三班無病痞要入伙是嗎?是!大家沒什麼要求,這樣就對了 |
| transcript.whisperx[248].start |
7609.206 |
| transcript.whisperx[248].end |
7636.505 |
| transcript.whisperx[248].text |
我覺得現在上次我們聽到總統這麼爽朗的笑聲我對你做的質詢是因為他說他很羨慕醫生他想要回來當醫生你幫他講了好多話你說你那天有去他實際上不是這樣子的但是眼看這幾天這個週末在網路上看了很多你們禮拜五下午跟眾多團體一起開的會議2023年9月開出來的支票 |
| transcript.whisperx[249].start |
7637.469 |
| transcript.whisperx[249].end |
7651.785 |
| transcript.whisperx[249].text |
而且他是說就這樣喔 和你乾單喔就這樣子要入法就這樣喔旁邊還有人跟他補充說還有要加薪結果呢現在實際要上路的時間你們是把他押到117年5月1號也就是2028年5月 |
| transcript.whisperx[250].start |
7656.67 |
| transcript.whisperx[250].end |
7670.6 |
| transcript.whisperx[250].text |
這個上任禮物競選支票最後變成卸任禮包請問你要怎麼解釋這件事情當時說的是多麼的簡單啊現在就做起來是有多麼的困難好 跟委員說明當時候的政見主要是兩年入法啦那任期內完成配套啦所以我們也推估了要這個能夠 |
| transcript.whisperx[251].start |
7685.028 |
| transcript.whisperx[251].end |
7695.551 |
| transcript.whisperx[251].text |
這個很穩健的推動三班顧病比入法那麼跟落地實施這個我們有做個詳細的人力的推估兩年內入法這個是2023年9月的政見今年是2026年你大概是秋會入委員來然後你們才開始講出說你們要做設置辦法 |
| transcript.whisperx[252].start |
7707.475 |
| transcript.whisperx[252].end |
7713.222 |
| transcript.whisperx[252].text |
你們才說要做設置辦法然後突然卓榮泰還在另外一個護理師的場合說要讓考試變簡單還跟考試院院長講兩次 |
| transcript.whisperx[253].start |
7717.984 |
| transcript.whisperx[253].end |
7746.013 |
| transcript.whisperx[253].text |
你如果2023年9月開的支票怎麼會是2026年才開始做這些事情呢不會 我們113年就開始討論三半戶比法的標準嘛113年就開始討論嘛那設定了標準之後就導入114年的三半戶比比獎勵計畫跟12項的改革策略開始挹注資源那人力呢我們現在才看到已經開始回流嘛然後再搭配我們未來所需要 |
| transcript.whisperx[254].start |
7747.013 |
| transcript.whisperx[254].end |
7775.612 |
| transcript.whisperx[254].text |
這個床如果要全開那麼不關床的情形是要所需要的人力缺口去推估所以希望能夠降低婦理人員的負擔但是又保障這個民眾就醫的權益的情形之下很精準的負責任的去推動我等一下舉別的例子給你看 你看一下你們108年其實也有修過那個是全日的護病你看喔 你看你的最後三行 這你自己寫的喔 衛福部自己寫的 他說 |
| transcript.whisperx[255].start |
7776.813 |
| transcript.whisperx[255].end |
7795.985 |
| transcript.whisperx[255].text |
以維護病人安全與提升醫療品質令考量醫院聘僱足夠的護產人員尚需10日但是你要兼顧護理團體期盼早日施行所以108年的時候你是列三個月的緩衝期 |
| transcript.whisperx[256].start |
7797.446 |
| transcript.whisperx[256].end |
7814.124 |
| transcript.whisperx[256].text |
妳那個時候就說 我知道啊 跟妳剛講的話一樣嘛我要維持病人安全 我要提升醫療品質 我要讓醫院有時間去做但是我也要兼顧護理團體的期盼 所以我要早日實行那個時候妳的緩衝期是三個月 |
| transcript.whisperx[257].start |
7815.957 |
| transcript.whisperx[257].end |
7844.143 |
| transcript.whisperx[257].text |
現在你的緩衝期是兩年我想問你你上禮拜五傍晚的時候去跟護理很多團體不只護理眾多團體溝通的時候這個是他們的期盼嗎你講這是他們的期盼嗎當年的108年的時候當時候每年的護理人力都是增加超過5000到5500自從我們COVID疫情之後這中間有一年增加到醫院增加的300多位 |
| transcript.whisperx[258].start |
7845.403 |
| transcript.whisperx[258].end |
7861.415 |
| transcript.whisperx[258].text |
然後到前年呢都還是增加1000多位而已是直到去年才慢慢所以這兩個時空背景是不一樣的那第二個呢那麼在我們上個禮拜五跟護理界討論的時候當然他們的期待是希望在116年12月或117年1月1號去實施那麼 |
| transcript.whisperx[259].start |
7868.72 |
| transcript.whisperx[259].end |
7888.906 |
| transcript.whisperx[259].text |
因為這個時間剛好就是我們冬季就是流感季來的時候各種的肺炎重症會增加再加上過年的長假那麼另外過完年之後又有一批的離職都有轉職潮所以需要有一點點緩衝的時間所以我才提出的是5月1號這差4個月讓這個過年不要重現這個精神優適的局勢護理師講得好清楚 |
| transcript.whisperx[260].start |
7893.667 |
| transcript.whisperx[260].end |
7906.491 |
| transcript.whisperx[260].text |
講得有夠白話的在舞台上在這個競選舞台上他直接說第一他們要入法第二他們要加薪他們就是要改善他們的工作環境嘛然後提高他們的薪水就這兩個那麼簡單你說你說現在齁 |
| transcript.whisperx[261].start |
7912.353 |
| transcript.whisperx[261].end |
7939.12 |
| transcript.whisperx[261].text |
有護理師執照人有30萬願意投入的19萬什麼原因很清楚護理師也告訴你結果你的解方居然是把考試變簡單跟考試院說把考試變簡單我跟你說錄取率已經八成了其實你只要去考八成人都會過他只是不想要留在這個環境裡面沒有那麼高啦跟委員說明那個錄取率沒有那麼高七成我早上才查的只希望說讓這個題目能夠 |
| transcript.whisperx[262].start |
7941.861 |
| transcript.whisperx[262].end |
7947.886 |
| transcript.whisperx[262].text |
符合我們的專業的核心職能那麼不要過於刁鑽就是這樣而已 |
| transcript.whisperx[263].start |
7949.087 |
| transcript.whisperx[263].end |
7972.243 |
| transcript.whisperx[263].text |
他們沒有考不過他們是不願意留在這個職場我從頭到尾就是跟你講這件事情所以白班今天白班今天已經從我上任講到現在白班今天從我第一次人生第一次總質詢講到現在白班今天也還沒發他就在舞台上跟你講他的需求就是護病筆錄法跟加薪就這樣還聽不懂 |
| transcript.whisperx[264].start |
7973.644 |
| transcript.whisperx[264].end |
7979.648 |
| transcript.whisperx[264].text |
真的很奇怪然後呢很多護理師說上禮拜五我剛有聽到我剛有聽到你回答別人說你沒有這樣講不過呢在現場的人說他聽到多次你說可以來告我可以來告我請問你有這樣子說嗎因為你沒有回應他們的需求他已經告訴你這有錄音啊這不是我說話的風格啦我不會這樣說 |
| transcript.whisperx[265].start |
8000.74 |
| transcript.whisperx[265].end |
8026.481 |
| transcript.whisperx[265].text |
那你會去因為我只是跟您說這是一個非常多護理人員追蹤的粉專大概2.6萬追蹤那如果他嚴重影響他嚴重影響你的生育你要不要做一點動作你有沒有提到我不會去告人啦我不會去告他啦你不會去告人但是這個粉專講的是假的你要在這裡跟鏡頭說你沒有講你沒有講你有一天沒有講在的澄清我沒有這樣子的說法 |
| transcript.whisperx[266].start |
8026.681 |
| transcript.whisperx[266].end |
8052.56 |
| transcript.whisperx[266].text |
我不會去嗆告任何人這都是理性政策的討論那麼希望呢在所有的政策的推動當中能夠平順減少衝突跟衝擊到這個大多數民眾的利益只是這樣子的政策討論那不需要用過於情緒的語言那為什麼會有這樣子的說法流出你不知道搞不清楚不知道為什麼 |
| transcript.whisperx[267].start |
8053.54 |
| transcript.whisperx[267].end |
8077.511 |
| transcript.whisperx[267].text |
這個不是我在意的不是你在意的因為明天你還要參加護理師大會的活動對我是覺得以你目前以你目前的態度好像沒有回應他們的需求如果他已經告訴你他2023年9月開給他們的支票然後很希望求你116年年底或是117年1月可以做到你要不要嘗試拉近這個 |
| transcript.whisperx[268].start |
8078.351 |
| transcript.whisperx[268].end |
8095.329 |
| transcript.whisperx[268].text |
跟護理師之間的改良在5月5號我們的對話當中啊那麼三項訴求那第一個呢就是希望按照113年3月1號的標準來入法這個我們做到了那麼第二個呢希望能夠在是在野黨做到了 |
| transcript.whisperx[269].start |
8097.492 |
| transcript.whisperx[269].end |
8102.096 |
| transcript.whisperx[269].text |
我們就是朝這個標準去推動的我們在過去這兩年你覺得我們有辦法上個禮拜五來表決嗎我們的開會通知是在上個禮拜一就已經發出在 |
| transcript.whisperx[270].start |
8115.062 |
| transcript.whisperx[270].end |
8129.966 |
| transcript.whisperx[270].text |
這個立法院開會之前就會議通知就出去我們的會議資料上的這個三班護病比的標準就是113年的那個有會議資料可以查證這個遠在之前就已經通過了我在說入法我們的醫療機構設置標準裡面我們去修的 |
| transcript.whisperx[271].start |
8133.507 |
| transcript.whisperx[271].end |
8156.29 |
| transcript.whisperx[271].text |
上面寫的標準就是113人 這個我們也去推動了明天我們就來看你在護理師表揚大會上面會講出你跟賴清德總統的哪些分工偉業我們明天都會收看你們把一個2023年9月的支票搞到2028年5月才要上路5月1號的卸任禮物 |
| transcript.whisperx[272].start |
8157.071 |
| transcript.whisperx[272].end |
8165.036 |
| transcript.whisperx[272].text |
太離譜了明天我們就來看你們是不是要上台講這個不要抹滅了過去這兩年的努力不要抹滅了過去我們這兩年的努力這個我們投入在戶裡的預算一年超過100億以上 |
| transcript.whisperx[273].start |
8174.262 |
| transcript.whisperx[273].end |
8189.067 |
| transcript.whisperx[273].text |
所以請委員我們會逐一的給你報告我覺得你就像108年你自己發的公文你正面的看待而且要回應護理團體的訴求所以你希望儘早實行你108年可以寫出這樣子的話現在卻講不出這樣子的話人家要2026年2027年年底你硬要弄到2028年5月我們下一個議題 |
| transcript.whisperx[274].start |
8200.851 |
| transcript.whisperx[274].end |
8230.571 |
| transcript.whisperx[274].text |
最近我有聽到你也對健康幣做了很多發言我幫你回憶一下這個是今年3月10號我在總諮詢上面說的問您的情景我想問一下你現在覺得會跳票嗎整個規劃接近完成在我們跟行政院跟院長報告完畢之後就會對外來宣布是業會跳票嗎我問那麼簡單的問題因為我們還是要跟這個院裡面報告還有現在最後的這個手續正在做最後的確認當中這些這個基礎的因為它是兩個APP一個是健康存摺的部分已經ready了另外是這個health code的部分現在正在改版還沒有完成 |
| transcript.whisperx[275].start |
8230.811 |
| transcript.whisperx[275].end |
8247.603 |
| transcript.whisperx[275].text |
那你四月到底會不會跳票?我們朝這個目標來努力所以你跳票了嘛我們現在五月十一才在問你這個對吧?我很謝謝你這麼關心這個議題啦我們就朝這個目標來努力嘛現在已經五月十一欸繼續努力啊努力到幾月?我想問一下 |
| transcript.whisperx[276].start |
8249.772 |
| transcript.whisperx[276].end |
8271.401 |
| transcript.whisperx[276].text |
這邊我們看一下羅一鈞署長出來受訪的時候沒關係羅一鈞署長出來受訪的時候他說拼下半年上路但是你3月10號的時候是說你會朝4月來讀你今年年初是大張旗鼓的跟所有的媒體說你4月就要上路現在5月11號沒有辦法上路羅一鈞說下半年上路請問 |
| transcript.whisperx[277].start |
8273.542 |
| transcript.whisperx[277].end |
8301.277 |
| transcript.whisperx[277].text |
你3月的時候答詢說大部分都已經規劃好了那你是公然在欺騙大家嗎那你要等到今年年底的什麼時候我很謝謝委員對我們這個健康幣這麼熱衷那麼也那麼重視我沒有熱衷是因為你一直講不一樣的話我們把它做好讓大家都很enjoy這個健康幣變成大家的區域的運動你現在不想壓月份了不壓了下半年 |
| transcript.whisperx[278].start |
8302.595 |
| transcript.whisperx[278].end |
8326.858 |
| transcript.whisperx[278].text |
現在講不出來了一定會上路那我們再看這個到底你有沒有用你那個健習生你上次批評蠻多的健習生我們播一下影片這個APP花了900萬開發900萬然後我幫你統計了一下下載量只有500次每天下載的次數是5次操作你操作過了嗎我們講的健康幣不是這個APP這個是你在媒體上講的不是這個APP |
| transcript.whisperx[279].start |
8328.306 |
| transcript.whisperx[279].end |
8354.499 |
| transcript.whisperx[279].text |
3月10號質詢你說不會用這個APP3月15的新聞稿你又跟記者說你要用這個APP請問這5天又發生什麼事情這是我們在既有的基礎上面不要再多更多的預算因為委員也提到了之前這個Health Code是有這個預算去開發出來那我們也不希望說已經開發的東西就把它捨棄所以是我們把它做改版 |
| transcript.whisperx[280].start |
8355.495 |
| transcript.whisperx[280].end |
8379.531 |
| transcript.whisperx[280].text |
在這個經費節省的期間那你3月總值期你就說改版就好啦你說不是用這個APP過五天又說要用這個APP就是不是用這個原來的這個所謂的見習生這個名稱就會改掉了就不叫做見習生了改版 改名字但是是同一個APP不是 就是它的功能已經不同了 |
| transcript.whisperx[281].start |
8380.66 |
| transcript.whisperx[281].end |
8385.223 |
| transcript.whisperx[281].text |
當天你說花了九百萬做這個健喜生APP我已經跟你講了平均一天下載人次總共五百人下載喔 |
| transcript.whisperx[282].start |
8405.291 |
| transcript.whisperx[282].end |
8419.207 |
| transcript.whisperx[282].text |
這個錢是丟到水裡 因為他做出一個電子機事部我們現在請有在看國會直播全國的資訊系 資工系的學生你們做出見習生這個APP你們需要多少錢但是我想跟大家講的是 |
| transcript.whisperx[283].start |
8420.789 |
| transcript.whisperx[283].end |
8423.091 |
| transcript.whisperx[283].text |
這個APP你自己在國會殿堂說你很不滿意結果你另外編了1900萬的預算找另外一家公司改版就你剛剛講的改名改版又找了同一家公司去做專業行銷跟專案管理 |
| transcript.whisperx[284].start |
8440.45 |
| transcript.whisperx[284].end |
8453.355 |
| transcript.whisperx[284].text |
又是1900萬全國的資工系資訊系的學生我請大家要不要來參加衛福部的這個標案你花900萬做出一個連衛福部部長都說爛的APP你可以再獲得1900萬的機會參加會的行銷跟專案管理 |
| transcript.whisperx[285].start |
8463.087 |
| transcript.whisperx[285].end |
8472.533 |
| transcript.whisperx[285].text |
這個健習生的APP其實因為後來還要再跟健康準則對接也要再去跟這些大B像是超商的對接所以他其實還有一些功能必須再優化必須再開發 |
| transcript.whisperx[286].start |
8490.865 |
| transcript.whisperx[286].end |
8517.908 |
| transcript.whisperx[286].text |
會不會這樣子一般來說所有的所有的公司如果你找來一家廠商做了一個900萬你很不滿意的東西你還會再找他你又找他了你又找他了我們所有的這個採購都是根據公開招標的採購程序啦所以並沒有預設的立場那麼至於現在接下來因為他要轉型他不是做原本這樣的功能他要跟 |
| transcript.whisperx[287].start |
8518.488 |
| transcript.whisperx[287].end |
8525.015 |
| transcript.whisperx[287].text |
民間去對接就是PPP的概念有先問你上次他花了我們的民脂民膏900萬做了一個衛福部長說很爛的東西你有跟他開檢討報告嗎你們有開檢討會議嗎所以我們在做優化把這個APP要做優化不是啊你們有開檢討報告嗎 |
| transcript.whisperx[288].start |
8538.929 |
| transcript.whisperx[288].end |
8551.075 |
| transcript.whisperx[288].text |
這個每一個都會有都會有這個期末的報告他先領你們900萬做了一個你說很爛的APP最後你還不得不把它下架用的人實在是太少了然後現在他又獲得1900萬的標案這個是怎麼樣 |
| transcript.whisperx[289].start |
8553.919 |
| transcript.whisperx[289].end |
8583.711 |
| transcript.whisperx[289].text |
所以我們現在在做優化我們要做新的新的功能進去然後強化它跟我們健康必要推動的連結有這麼多人可以找你找一個你這個都是公開招標的結果我們也不是特定去指定沒關係我們就讓大家看一看全國的資訊系資工系的學生我相信你們的能力更好我相信你們的能力更好你們做出那個健習生900萬那個說不定十分之一的錢就做到了我們就讓大家來公平 |
| transcript.whisperx[290].start |
8583.931 |
| transcript.whisperx[290].end |
8601.424 |
| transcript.whisperx[290].text |
我們來看看對我想跟你要幾樣東西第一你到底有沒有跟這個900萬丟到水裡的廠商做檢討報告會議報告我想要索取第二一週內你提供所有目前健康幣的進度跟完整的說明包括你未來的規劃細節一週內來得及嗎 |
| transcript.whisperx[291].start |
8605.108 |
| transcript.whisperx[291].end |
8630.028 |
| transcript.whisperx[291].text |
這個檢討報告那個都是每這個所有的計畫都會有期末的報告我們會把那個期末的報告那大概多久可以跟你要到那這個一個禮拜一個禮拜可以拿到檢討報告那未來你健康幣的規劃因為剛剛只有講下半年你什麼都沒講好多個這個這個會議都已經差不多都是ready我們可以整理一下大概一個月可以可以可以整理一下給委員參考好謝謝部長謝謝署長謝謝主席好謝謝好謝謝委員 |
| transcript.whisperx[292].start |
8647.583 |
| transcript.whisperx[292].end |
8654.769 |
| transcript.whisperx[292].text |
好 謝謝主席那部長先休息一下 先請一下我們食藥署的江署長請食藥署江之鋼署長 |
| transcript.whisperx[293].start |
8663.413 |
| transcript.whisperx[293].end |
8681.826 |
| transcript.whisperx[293].text |
我請問一下 最近有一個週刊在爆料就是有關於一歲幼兒他吃的果乾後來他自行送驗之後發現有超標的情形那我想請問一下我們是不是針對嬰幼兒的食品應該也會比一般食品標準來得嚴格對不對 |
| transcript.whisperx[294].start |
8684.175 |
| transcript.whisperx[294].end |
8702.268 |
| transcript.whisperx[294].text |
跟委員報告我們對嬰幼兒食品它的標準我們基於對幼兒保障嬰幼兒分為我們3歲以下嘛0到1歲 1到3歲所以對幼兒的部分 嬰幼兒的部分我們都有特定的那對特定的話我們對直接使用的一個概念 |
| transcript.whisperx[295].start |
8703.309 |
| transcript.whisperx[295].end |
8721.515 |
| transcript.whisperx[295].text |
真的啊 標準應該是會比一般市民會比較嚴格那針對呢 我們知道這一個個案我們有去 我特別去查過那查完之後 它我們發現呢 它進來的時候它並不是用嬰兒而是平台很像把它叫嬰幼兒所以我有跟同仁們講如果是這樣子會比較偏從嚴來辦理從嚴來考量 |
| transcript.whisperx[296].start |
8725.716 |
| transcript.whisperx[296].end |
8747.199 |
| transcript.whisperx[296].text |
如果它沒有的話 它是一般的食品那我們從後面的查驗登記裡面 它這裡登錄的部分其實比較偏向是一般食品所以它 另外標的不好的不適當我現在針對 那像我們果乾這一類的加工品它在農藥殘留管理的部分它這個容許量的標準有訂定嗎 |
| transcript.whisperx[297].start |
8748.792 |
| transcript.whisperx[297].end |
8777.603 |
| transcript.whisperx[297].text |
對於這個水果它製成果乾其實是一個製成這製成的過程中大部分來自於水分會被被乾燥化所以水會變少會濃縮所以它農藥的農藥不會變但是水變了所以總重量是變了所以分母的部分其實會變成是變小了所以分子的部分假如是農藥其實沒有變一除起來就會變大但是分母變小啊對分母變小所以變成你去 |
| transcript.whisperx[298].start |
8778.283 |
| transcript.whisperx[298].end |
8788.171 |
| transcript.whisperx[298].text |
去測它這個農藥殘留的標準就測起來因為它分母變小就變體高了嘛是的所以在這一項裡面齁如果它是一般的食品 |
| transcript.whisperx[299].start |
8789.042 |
| transcript.whisperx[299].end |
8807.015 |
| transcript.whisperx[299].text |
那我們會回歸到它所謂先時種所以先時種就是我們舉個例子它是用草莓那草莓濃縮之後的草莓乾跟原來的草莓我們會以它原來的原料端當作是我們最重要的評估的基準所以一般食品我們從這個觀點來去進行 |
| transcript.whisperx[300].start |
8809.377 |
| transcript.whisperx[300].end |
8830.789 |
| transcript.whisperx[300].text |
那我們現在針對一歲以上跟一歲以下應用的這個食品我們在商品包裝或者廣告內衛福部會去要求他去做特別的標示嗎對 因為今年年初的時候也遇到海苔相關的事件那海苔事件我們也系統性的也查了 |
| transcript.whisperx[301].start |
8831.329 |
| transcript.whisperx[301].end |
8849.45 |
| transcript.whisperx[301].text |
所以對於它是直接標定在嬰幼兒使用我們就用嬰幼兒使用的標準來去做那嬰幼兒標準裡面特別是重金屬重金屬的標準跟我們一般重金屬好像環境背景的標準跟我們現在適用的農藥的標準的採收的概念是不一樣 |
| transcript.whisperx[302].start |
8849.85 |
| transcript.whisperx[302].end |
8877.876 |
| transcript.whisperx[302].text |
不是我們在商品包裝跟廣告內容我們會要求他去特別標示嗎不然我今天是家長我要去買這個食品我怎麼知道它適不適合我們嬰兒使用所以在一歲以上或一歲以下這個食品應該要有一個明確的標章不然我們去買的時候我根本不知道說這適不適合嬰兒使用啊謝謝委員的指導就是因為我們從一月份一路走下來我們看到的 |
| transcript.whisperx[303].start |
8878.576 |
| transcript.whisperx[303].end |
8893.312 |
| transcript.whisperx[303].text |
整個去做國際的調和我們去發現韓國也是今年海苔大廠韓國也是今年1月份開始做了對於嬰幼兒的標示你如果是宣稱嬰幼兒一定要標示而且一定有更嚴格的標準 |
| transcript.whisperx[304].start |
8893.812 |
| transcript.whisperx[304].end |
8911.514 |
| transcript.whisperx[304].text |
所以我們現在呢是針對這個快速把我們草案擬定接下來就會跟徵求大家的意見那跟委員也報告一下我們我本來以為說海苔這件事情呢幾乎是海洋等等會就很困難因而使用後來發現進出口關我們現在是逐批檢驗一驗 |
| transcript.whisperx[305].start |
8913.676 |
| transcript.whisperx[305].end |
8943.079 |
| transcript.whisperx[305].text |
進口的海苔還是可以符合嬰幼兒標準表示整個污染的背景是不一樣的所以也可以找到是安全的但對於農藥這件事情以及我們草莓 舉個草莓的它就是先實類的 然後去乾燥所以我們對於未來我們在思考農藥是我們應外添加進去的所以對於我們嬰幼兒假如要宣稱嬰幼兒的還是要有嚴格的標準為原則這個是我們會去努力的 |
| transcript.whisperx[306].start |
8943.479 |
| transcript.whisperx[306].end |
8965.212 |
| transcript.whisperx[306].text |
所以剛剛署長也有講其實針對這個事件我們就凸顯了希望你當然去檢驗標準嚴格但是我們一定要在商品包裝廣告內容上很明確的讓消費者讓家長可以知道這個是適合一歲以上以下去使用的 |
| transcript.whisperx[307].start |
8965.552 |
| transcript.whisperx[307].end |
8987.867 |
| transcript.whisperx[307].text |
好這部分希望我們趕快來進行特別是這一歲以下的嬰幼兒的配方食品跟骨類輔助食品在直接吃的跟我們這個可能是臨時給小朋友的他們回歸的標準上面會不一樣像這樣子會回歸是先時類的那對於我們的配方是特別是輔助用的食品的時候就是他從 |
| transcript.whisperx[308].start |
8989.008 |
| transcript.whisperx[308].end |
9010.461 |
| transcript.whisperx[308].text |
喝奶然後轉到我們的食品的時候會有些輔助食品那個嚴格如果我們對於國際的農藥標準會採取表嚴格0.01的所以輔助食品的部分我們特別是這其他的產品原則會還是會依照營養原則所以如果是要標示給孩子嬰幼兒使用的我覺得那個特別的標準是用0.01的農藥標準是 |
| transcript.whisperx[309].start |
9012.302 |
| transcript.whisperx[309].end |
9028.069 |
| transcript.whisperx[309].text |
特定的一個概念希望署長針對這部分我們盡量標示清楚是的不要造成類似像家長在選購給嬰兒幼兒使用的時候造成困擾這部分我們再加強一下謝謝委員好 那請我們部長請施部長 |
| transcript.whisperx[310].start |
9033.647 |
| transcript.whisperx[310].end |
9058.548 |
| transcript.whisperx[310].text |
部長好謝謝部長那針對我們目前除了我們社工保證人的地位問題還有社工司法我們這些問題我們都等待衛福部跟業界的社工來共同來討論那現在我們現在面臨一個社工缺口很大的問題光是我們六都社會局我們查了一下社工人數新北市缺了206人 |
| transcript.whisperx[311].start |
9059.929 |
| transcript.whisperx[311].end |
9077.626 |
| transcript.whisperx[311].text |
桃園缺了157人高雄缺了141人其實各地的社會局都跟中央呼籲我們要提升社工的薪資待遇跟留任的誘因那不然你看現在這個社工缺口這麼大 |
| transcript.whisperx[312].start |
9078.587 |
| transcript.whisperx[312].end |
9094.149 |
| transcript.whisperx[312].text |
那不知道部長針對這部分我們有什麼方案來讓我們這些社工能夠流財久用或者延攬新人進來好 而跟我們說明在這個預算的部分我們有編列像要持續的增加這個社工 |
| transcript.whisperx[313].start |
9095.01 |
| transcript.whisperx[313].end |
9109.148 |
| transcript.whisperx[313].text |
對一些專業人力這個在預算我們裡面已經有編列了那至於在他的這個加擠的部分我們現在也在研議因為之前有設了一些加擠那麼是不是要再提高這目前也在研議當中 |
| transcript.whisperx[314].start |
9109.889 |
| transcript.whisperx[314].end |
9133.565 |
| transcript.whisperx[314].text |
因為我看當然我們這部分本來從37765有調整到38898可是看起來這個沒什麼效益那因為我們查了一下各縣市它針對社工這個低薪其實連縣市首長都看不下去後來我們了解之後 |
| transcript.whisperx[315].start |
9134.045 |
| transcript.whisperx[315].end |
9151.517 |
| transcript.whisperx[315].text |
縣市所長說他們想要增加這些社工的薪資待遇可是礙於我們衛福部的法規限制他沒有辦法去增加所以他看到社工缺那麼多他也沒有辦法因為完全是衛福部的規定卡住讓他們沒有辦法去 |
| transcript.whisperx[316].start |
9152.257 |
| transcript.whisperx[316].end |
9171.702 |
| transcript.whisperx[316].text |
去增加待遇來增加這個社工的人力那是不是這一部分部長針對這一部分我們是有改進的空間您的意思是說因為我們這個年資加給的部分把它限制到對 限制所長想要加薪增加社工人數可是他不能加啊他說因為衛福部的規定啊 |
| transcript.whisperx[317].start |
9174.955 |
| transcript.whisperx[317].end |
9187.904 |
| transcript.whisperx[317].text |
他說這個衛福部法規限制他不能增加社工的薪水因為他說這個是你們規定在這邊他限制首長想要增加社工想要調高他的待遇但是他不能做 |
| transcript.whisperx[318].start |
9189.723 |
| transcript.whisperx[318].end |
9217.724 |
| transcript.whisperx[318].text |
來 你來說明一下那謝謝委員關心社工的一個薪資跟福利待遇那委員您現在顯示的這張表是我們補助民間社工的薪資的這個規定那的確就是每年經過考核之後如果他不錯的話就可以進階現在是7級但是在社安網2.0我們也跟行政院爭取我們要延逸把它擴大到10級那另外在民間社工的薪資我們在前兩年也奉行這邊核定 |
| transcript.whisperx[319].start |
9218.244 |
| transcript.whisperx[319].end |
9242.458 |
| transcript.whisperx[319].text |
一旦這個公務人員調薪的話我們的那個基本的薪資也會跟著調這是第一個是民間社工薪資我們所做的一個努力那前面委員有關切到關於社安網的社工那社安網的社工是公部門的約聘的社工那在社安網的2.0我們也做一些努力我們把那個最高的天花板我們又再往上加了一下 |
| transcript.whisperx[320].start |
9244.059 |
| transcript.whisperx[320].end |
9256.343 |
| transcript.whisperx[320].text |
還有就是我們現在也在檢討關於那個風險加急我們也想要來參考其他的專業人員想要來做一些調整我們正在討論當中但是最後的核定要人事總處這邊來就是來核定 |
| transcript.whisperx[321].start |
9259.464 |
| transcript.whisperx[321].end |
9282.194 |
| transcript.whisperx[321].text |
那剛剛有提到我們在回覆桃園縣政府有提到有一些新知的一個規定的確是人種這邊會它有一個統一的規定但是我們也得到一些好消息是人種也提到他們現在也在檢討關於公務人員的專業家籍那這個我們會配合人種來辦理所以我們就是說演藝是不是可以把社工排除在全國軍公教 |
| transcript.whisperx[322].start |
9283.055 |
| transcript.whisperx[322].end |
9294.456 |
| transcript.whisperx[322].text |
員工待遇知己的要點之外或者用特別法可以讓社工的薪資待遇可以讓縣市首長他們自己去調整這個可能就要再來跟人總那邊做一些溝通 |
| transcript.whisperx[323].start |
9295.123 |
| transcript.whisperx[323].end |
9322.774 |
| transcript.whisperx[323].text |
所以我希望部長針對這部分可以幫我們研議一下不然這個社工缺人已經是很長時間的問題那衛福部居然這個規定卡著連縣市地方為了想要增加社工因為我們衛福部法規的限制讓他想要增加薪水增加人都增加不進來所以我覺得針對我們軍公教員工待遇這自己的要點或者用特別法的方式是不是可以提出一個研議的方法 |
| transcript.whisperx[324].start |
9323.294 |
| transcript.whisperx[324].end |
9348.891 |
| transcript.whisperx[324].text |
一個月內可以給我們答案嗎這個大概兩個一個是我們的補助補助的那個要點那麼這個薪資上怎麼來調整這個可能彈性比較大啦但是對於具有公務人員身份者因為這個有全國的一致性這個我們必須還要再跟行政院人事總書這邊來商議那一個月內可以回覆我們這個檢討的方法嗎我們是不是給我們一點時間三個月內我們檢討出來 |
| transcript.whisperx[325].start |
9351.613 |
| transcript.whisperx[325].end |
9377.138 |
| transcript.whisperx[325].text |
三個月因為這個還涉及到跨部會不是只有本部可以解決我們還要跟行政院因為這個缺口真的很大而且很長時間那我們希望那部長說三個月內我們研議如何去做不然法規限制連縣市我們把相關的這個規定都把它釐清那需要去溝通縣市自己想要來解決還被中央的法規限制沒有辦法處理所以希望部長這邊看怎麼研議把這個 |
| transcript.whisperx[326].start |
9379.258 |
| transcript.whisperx[326].end |
9408.382 |
| transcript.whisperx[326].text |
要點還是是不是用特別法來解決這個問題好我們來研議看看好那我這再再迅速來請部長再幫忙一下因為這個我提了很多次我們賴總統講健康台灣因應人口老化那部長本身也具備健保跟醫療的雙背景那我們一直提我們新屋還有觀音沿海老年人口的比例很高那部桃新屋分院 |
| transcript.whisperx[327].start |
9409.022 |
| transcript.whisperx[327].end |
9418.432 |
| transcript.whisperx[327].text |
一月份國發會早就建請行政院盡快核定可是部長一直說要幫忙推動可是到現在五月了好像 |
| transcript.whisperx[328].start |
9419.485 |
| transcript.whisperx[328].end |
9444.275 |
| transcript.whisperx[328].text |
也沒有任何動靜跟委員說明確實這個計畫這個省了4次啦那最後的這個最近的一次就是說我們考量到整個防疫的需要當時候我們這個新屋分院在COVID的時間也擔任了那個專責病房的收治所以這一次我們在做最後的調整把他的防疫任務又加進去那麼 |
| transcript.whisperx[329].start |
9445.255 |
| transcript.whisperx[329].end |
9459.364 |
| transcript.whisperx[329].text |
應該在這個禮拜我們就會把修正後的計畫書再呈報行政院因為很快會有結果這個禮拜我們就會回覆到行政院對啊因為這個我們在總諮詢的時候有提過那院長也特別指示部長要針對我們沿海醫療量能的問題醫療還有長照的需求特別來做個總檢討那而且我們在 |
| transcript.whisperx[330].start |
9468.809 |
| transcript.whisperx[330].end |
9493.696 |
| transcript.whisperx[330].text |
2023年就知道我們部桃新屋分院它這量能都已經滿載那這問題已經非常非常迫切那據我了解部桃醫院好像說一直要求他要自籌款他說這個自籌款他真的沒辦法解決是不是這經費的問題部長真的幫忙一直要求他自籌款他根本都沒辦法處理啊對 新屋分院因為它自營的能力比較低所以我們會去爭取 |
| transcript.whisperx[331].start |
9494.696 |
| transcript.whisperx[331].end |
9508.631 |
| transcript.whisperx[331].text |
那麼希望能夠有比較高的比例的這個用貢獻計畫來補助讓我們的負擔可以減輕所以拜託部長幫我們跟行政院長爭取一下我們補考這個手續的經費這個多幫忙 是不是我們在上半年度有機會競速來通過讓行政院核電 |
| transcript.whisperx[332].start |
9515.478 |
| transcript.whisperx[332].end |
9524.723 |
| transcript.whisperx[332].text |
好我們再說因為這個真的拖了很多年了這個計畫書再送回行政院我們希望看看能不能在下個月就來合併因為這個擴建案從2018年我們蔡總統就已經 |
| transcript.whisperx[333].start |
9527.577 |
| transcript.whisperx[333].end |
9553.293 |
| transcript.whisperx[333].text |
一直進行到現在你看拖了六七年七八年到現在都還沒有核定好部長拜託最後一路我們來努力對這個為我們沿海醫療量能為我們民眾來請命好委員補充我們這個公間計畫當然我們現在就是請增會增加那個額度目前行政院是願意把我們額度增加所以請一定要解決他說這個自首款 |
| transcript.whisperx[334].start |
9554.013 |
| transcript.whisperx[334].end |
9578.373 |
| transcript.whisperx[334].text |
叫他處理他真的沒辦法處理那一直卡在那邊根本沒辦法解決嘛他現在22億的這個建設的經費那我們現在是要申請50%是由公建那11億會由行政院這邊的公建計畫來支援那我說他的問題已經出來如果一直要他自籌款他真的沒辦法解決所以部長跟行政院長多幫忙好謝謝部長謝謝謝謝圖前局委員的質詢接下來請林淑芬委員質詢 |
| transcript.whisperx[335].start |
9595.083 |
| transcript.whisperx[335].end |
9599.279 |
| transcript.whisperx[335].text |
好 谢谢主席是不是继续请我们石部长请石成良部长 |
| transcript.whisperx[336].start |
9602.937 |
| transcript.whisperx[336].end |
9628.617 |
| transcript.whisperx[336].text |
李委好部長這個上個禮拜五對於愛爾利醫美診所爆發的這個真恐偷拍案經營者廠商等等大概都被收押進鑑結果這個事情結果不是只有單一事件結果上個禮拜五同時光澤診所全台北有14家連鎖店的醫美診所光澤診所 |
| transcript.whisperx[337].start |
9630.879 |
| transcript.whisperx[337].end |
9641.303 |
| transcript.whisperx[337].text |
也招人檢舉採用同樣的手法在整間安裝了真孔偽裝成消防器材的真孔錄影設施然後在艾爾利被檢警偵辦以後他們疑似為了規避刑責毀滅證物動員員工拆除店內所有的偽裝真煙型的攝影機所以除此之外在這個週末 |
| transcript.whisperx[338].start |
9660.029 |
| transcript.whisperx[338].end |
9676.935 |
| transcript.whisperx[338].text |
竟然還有這個聖宜診所北中有7家連鎖店台南的閻一鳴診所安裝針孔設備的新聞然後這幾家連鎖大型醫美診所外這個醫美診所啊這個多如牛毛啊 |
| transcript.whisperx[339].start |
9677.415 |
| transcript.whisperx[339].end |
9690.784 |
| transcript.whisperx[339].text |
你們衛福部到底有沒有同步清查到底有多少的比例醫美診所涉及的類似偷拍或違法露營的狀況你們這樣的風險只存在醫美診所嗎那你們到底宣稱說你們要去處理你們行文要求全台的愛爾利分店要求這個地方衛生局要去處理以外你們到底還做了什麼 |
| transcript.whisperx[340].start |
9708.596 |
| transcript.whisperx[340].end |
9727.326 |
| transcript.whisperx[340].text |
跟委員說明大概目前盤查的大概有四個集團北中南四個集團包含除了愛爾麗之外光澤之外還有聖怡跟另外有一個叫做什麼這不就是我們剛剛講新聞露出的嗎叫顏怡名不是啦這個都已經新聞露出了這個是目前 |
| transcript.whisperx[341].start |
9737.452 |
| transcript.whisperx[341].end |
9753.522 |
| transcript.whisperx[341].text |
那各縣市衛生局呢也會優先針對醫美考量也是因為比較會有這個隱私的暴露啦所以從這個醫美這邊先去就醫美界啦我先談醫美界這個是個案還是通案啊都這樣子啊蛤 |
| transcript.whisperx[342].start |
9757.255 |
| transcript.whisperx[342].end |
9767.161 |
| transcript.whisperx[342].text |
這個如果是通案呢 這個是很糟糕啦因為我們過去就一再的有 你剛剛講這幾家加起來連鎖店加起來幾十家啊這個會是個案而已嗎這是不是業界普遍的現象你告訴我全台灣有幾家醫美診所如果我們在統計裡面大概在800家左右啦 |
| transcript.whisperx[343].start |
9784.202 |
| transcript.whisperx[343].end |
9809.048 |
| transcript.whisperx[343].text |
這裡加起來就佔多少了所以我要告訴你說這個你們到底是到底是同步清查以外這個風險真的只存在醫美診所嗎其他科別有沒有可能皮膚科 小兒科其他涉及身體檢查局部裸露要換衣服的或者是侵入性處置的醫療場所的 |
| transcript.whisperx[344].start |
9811.482 |
| transcript.whisperx[344].end |
9830.743 |
| transcript.whisperx[344].text |
都有涉及到病人裸露的高隱私期待的這些情境你們有沒有討論過有沒有清查過你們這個法律上你先告訴我就法規上有什麼樣的規範法律上我們法律的管制工具在哪裡是不是管制工具出問題了才會這麼嚴重 |
| transcript.whisperx[345].start |
9835.911 |
| transcript.whisperx[345].end |
9844.921 |
| transcript.whisperx[345].text |
這個跟委員說明這裡大概有兩個法律一個是在醫療法裡面72條醫療法72條是講可以入罪但是72條是講外漏外洩才有刑責外漏和外洩才有 |
| transcript.whisperx[346].start |
9851.127 |
| transcript.whisperx[346].end |
9866.438 |
| transcript.whisperx[346].text |
那第二個呢是在各資法第六條的各資法規範的是一般普通原則啦對它不能夠這個這些都屬於各種各資不得收集處理利用而各資法是一般普遍性的規範請問你我們對醫療領域裡面的特別法就是醫療法 |
| transcript.whisperx[347].start |
9872.85 |
| transcript.whisperx[347].end |
9899.34 |
| transcript.whisperx[347].text |
只有洩漏才有刑責 才有處分其他都沒有欸你不覺得法律管制工具有問題嗎它是普遍管理的個資法適用各個領域的我在問你就我們的衛福部主管的醫療法除了72條洩漏以外是不是就沒了 |
| transcript.whisperx[348].start |
9901.049 |
| transcript.whisperx[348].end |
9915.729 |
| transcript.whisperx[348].text |
蛤這個根本說明這個個資法第六條就是指的醫療特種個資啊他不是一般的那個是有特別的規定的他是講不得收集處理利用啊所以他有對應的罰則甚至涉及刑事 |
| transcript.whisperx[349].start |
9916.409 |
| transcript.whisperx[349].end |
9921.073 |
| transcript.whisperx[349].text |
現在我們仰賴的是個資法你給整個目的事業主管機關的法令都不用叫你這樣說醫療法72條嘛 不用啦啦你這樣說全台灣所有法律都不用規範只要靠個資法就好了就是說如果沒有特殊個資法當然是普通法啦 |
| transcript.whisperx[350].start |
9936.866 |
| transcript.whisperx[350].end |
9964.639 |
| transcript.whisperx[350].text |
所以特別法如果沒有特別排除的話現在就是告訴你普通法你剛剛講就有普通法一般規範就好了我這裡講特別法難道不用仔細規範嗎我再講清楚一點喔這些醫療場域中病人身體的影像診療的影像健康的資訊要如何被拍攝如何保存如何調閱如何利用和如何刪除這一些不用仔細規範嗎 |
| transcript.whisperx[351].start |
9966.949 |
| transcript.whisperx[351].end |
9973.793 |
| transcript.whisperx[351].text |
這一些你的醫療法 你的所有衛福部的法律你做了哪些規範 有什麼規範蛤 有什麼規範不要講外洩以後 你就剛剛講的啊拍攝保存調閱利用刪除 |
| transcript.whisperx[352].start |
9985.575 |
| transcript.whisperx[352].end |
10001.083 |
| transcript.whisperx[352].text |
合法的和經當事人簽署同意的要怎麼規範啊你的法規是啥如果沒有特別規範當然是回到各支法的要求嘛沒有特別規範就是你們獨指啦各支法 |
| transcript.whisperx[353].start |
10002.063 |
| transcript.whisperx[353].end |
10024.453 |
| transcript.whisperx[353].text |
各執法裡面已經說這個就不可以一定要有我現在就告訴你了不是只有這樣子難道他怎麼處理怎麼攝影怎麼處理怎麼儲存怎麼利用難道不用更細節的規範嗎這個跟各執法有什麼相關你目的事業主管機關獨子就是在這裡我現在要告訴你 |
| transcript.whisperx[354].start |
10025.513 |
| transcript.whisperx[354].end |
10051.213 |
| transcript.whisperx[354].text |
我們不要把這個事情認為只是醫美界的個案而忽略了整個醫療場所可能存在的隱私和影像管理的風險這個不是個案而是法制面處理了也出問題了而執行面更沒有法制面支撐所以根本沒有人在管理 |
| transcript.whisperx[355].start |
10053.813 |
| transcript.whisperx[355].end |
10065.62 |
| transcript.whisperx[355].text |
好剛才我就講醫美要講醫美我就先講醫美好了你知道說你們唯一的規範除了醫療法72條還有哪裡有規範影像處理上的醫療機構隱私的還有什麼規範你都不知道這件事很大條你也不知道有什麼規範這不是在這裡我都很不想跟你做嚴格 |
| transcript.whisperx[356].start |
10081.961 |
| transcript.whisperx[356].end |
10089.853 |
| transcript.whisperx[356].text |
隱私的規範當然我們過去有一個指引在啦那個指引有什麼強制性有什麼強度可以管理違反指引會怎樣那就會回到各自法去處分啊來 |
| transcript.whisperx[357].start |
10094.642 |
| transcript.whisperx[357].end |
10113.127 |
| transcript.whisperx[357].text |
你們的指引就醫療機構醫療隱私維護規範然後第二點第二項病人就診時應確實隔離其他不相關人員在診療過程醫病雙方如需錄音錄影應先徵得對方同意就是這樣子而已這麼粗糙這麼簡單你不覺得這樣子這樣子叫做有規範嗎違反這個會怎麼樣 |
| transcript.whisperx[358].start |
10121.952 |
| transcript.whisperx[358].end |
10130.596 |
| transcript.whisperx[358].text |
違反的程度樣態很多喔不是要說把他們各支法各支法是普通法一般原則啦那我問你醫療的診間說他貼了一個錄影中請微笑這樣等不等於同意等不等於告知了等不等於同意知情了 |
| transcript.whisperx[359].start |
10145.95 |
| transcript.whisperx[359].end |
10158.742 |
| transcript.whisperx[359].text |
等不等於 不等於還是要說明告知啊對不對 醫病關係然後大家都覺得說不對等然後過同意的過程要怎麼樣行使 你們有規範嗎隱私同意 錄影的同意過程要怎麼樣行使同意權 你們有規範嗎 |
| transcript.whisperx[360].start |
10172.782 |
| transcript.whisperx[360].end |
10193.278 |
| transcript.whisperx[360].text |
所以醫療體制上長期的低度規範然後沒有任何規範還在這裡說仰賴各支法這樣就是一種放任所以在這裡說你們這個條文有沒有過於簡略你的隱私維護規範母法從哪裡來母法從哪裡來 |
| transcript.whisperx[361].start |
10198.082 |
| transcript.whisperx[361].end |
10204.708 |
| transcript.whisperx[361].text |
你這一個規範 這個指引的規範的魔法從哪裡來 不知道 看不到更不要講有什麼強制性啦 更不要講有什麼處分的規定啦所以這個條文這麼簡略 而且一開始就講診療過程 診療過程包括哪裡啊包括什麼時候開始叫診療過程 |
| transcript.whisperx[362].start |
10222.503 |
| transcript.whisperx[362].end |
10242.946 |
| transcript.whisperx[362].text |
包括哪些空間 只有整間手術室 治療室嗎還是麻醉恢復室算不算 換藥室 諮詢室 檢查室醫美診所常見的 宿前拍攝 宿後照顧 恢復觀察區這算不算 你們有規範嗎 沒有不對 你們就是沒有 |
| transcript.whisperx[363].start |
10244.431 |
| transcript.whisperx[363].end |
10264.12 |
| transcript.whisperx[363].text |
而現在從醫美你回到一般的醫界普遍的狀況醫界稱診所與工作區設攝影監控設備是業界的常態聽得懂嗎 不是醫美大家怕糾紛嘛 大家可以理解他怕糾紛嘛 |
| transcript.whisperx[364].start |
10265.896 |
| transcript.whisperx[364].end |
10282.442 |
| transcript.whisperx[364].text |
但是因為你們沒有任何的規範所以到底是為了怕糾紛採取錄影系統錄影之後怎麼管理保存怎麼連網都沒有規範耶他的疏失責任怎麼辦所以這個上個禮拜發生這個事情以後呢 |
| transcript.whisperx[365].start |
10290.786 |
| transcript.whisperx[365].end |
10310.446 |
| transcript.whisperx[365].text |
醫界就有人出來講說裝設攝影監控設備是業界常態目的在於自保你自保那我們病人的隱私權你沒有規範然後這裡醫界說過去從沒有任何指引告知該如何設置 |
| transcript.whisperx[366].start |
10312.02 |
| transcript.whisperx[366].end |
10321.288 |
| transcript.whisperx[366].text |
這才是真正的問題所以你們一直很緊張什麼事情都不知道啊關於醫美醫師人的總控都不知道啊然後這種事情也沒有想辦法要規範啊其實這個個案你看一看啊還有可能會連結到什麼 你看 |
| transcript.whisperx[367].start |
10333.145 |
| transcript.whisperx[367].end |
10360.778 |
| transcript.whisperx[367].text |
這個就是人家網路上講的他們經驗多 我覺得網路上真的是很多鄉民很厲害他說 你看這個長廬山這個艾爾利集團艾爾利診所目前在尋找形象好的網紅部落客來店裡體驗免費體驗互惠的課程 包括這一些這一些哪一些是要脫衣服的 你知道嗎 |
| transcript.whisperx[368].start |
10363.043 |
| transcript.whisperx[368].end |
10386.725 |
| transcript.whisperx[368].text |
來 師長 柏定 這一些他免費體驗的 哪些要脫衣服這個我媽做過就看不懂對啊 我們都看不懂啊 人家帶網路的什麼都看不懂啊師長 哪幾種要脫衣服要更衣才能進去診療 診療室有穿衣服啊但更衣室沒有脫衣服啊 沒有穿衣服啊然後針孔在裡面耶 |
| transcript.whisperx[369].start |
10389.278 |
| transcript.whisperx[369].end |
10394.218 |
| transcript.whisperx[369].text |
很多啦雷射體雕立美基數太能潑橘皮槍 |
| transcript.whisperx[370].start |
10397.051 |
| transcript.whisperx[370].end |
10420.449 |
| transcript.whisperx[370].text |
委員我要講的是我們醫療用不會用針孔攝影機所以一旦用針孔攝影機本來就是違法目的你敢有在查你敢有在查違法在違法你敢有在查這件事情劉司長今天整個十天受害人來受害人會跑到哪裡去他的影像會跑去哪裡看右邊 |
| transcript.whisperx[371].start |
10421.766 |
| transcript.whisperx[371].end |
10431.634 |
| transcript.whisperx[371].text |
他們找一網紅以為是流量網紅以為自己是流量接到一枚的業配要請他們去體驗幫他們宣傳有沒有可能按網跟創意私房下了訂單想要看網紅的裸體裸屁股有沒有可能 |
| transcript.whisperx[372].start |
10442.239 |
| transcript.whisperx[372].end |
10452.342 |
| transcript.whisperx[372].text |
不無可能喔我等一下講韓國的例子這一些影像有沒有可能流到創意私房暗網裡面去你可以保證沒有嗎對不對 你說違法違法你敢這樣唸你敢這樣唸你唸一般的規範就沒有了不要再說這樣唸所以在這裡 |
| transcript.whisperx[373].start |
10465.336 |
| transcript.whisperx[373].end |
10492.169 |
| transcript.whisperx[373].text |
好 我今天不是要講這個可能性真的非常可能那我今天要講說這個全聯會 醫師全聯會陳向國理事長表示部分診所會在工作區設置攝影設備是基於醫療糾紛舉證和自我保護的需求但過去醫界對相關法規和界限的認知並不一致因為沒有法規任何規範 合法的也沒有啦 |
| transcript.whisperx[374].start |
10493.169 |
| transcript.whisperx[374].end |
10503.416 |
| transcript.whisperx[374].text |
界限也不知道啦所以他們全聯會自己要找法務案專家研擬一個規範一個月內他們要自己訂出指引給他們全聯會工會的人去遵循啊曾幾何時政府部門沒有法律規範還要靠全聯會自己去訂指引整個國家都沒政府啊要靠醫師全聯會自己訂指引好 |
| transcript.whisperx[375].start |
10522.109 |
| transcript.whisperx[375].end |
10547.811 |
| transcript.whisperx[375].text |
中華民國美容醫學會副秘書長說診所攝影機設在櫃台、後診區等公共空間是為了防範財務遺失、金錢糾紛或暴力事件但涉及隱私的診療和處置空間原則上不應該設置攝影設備也不能拍攝患者如果有錄影的需求應事先明確告知並取得同意對啊 用說的啊 |
| transcript.whisperx[376].start |
10549.011 |
| transcript.whisperx[376].end |
10574.644 |
| transcript.whisperx[376].text |
沒有更詳細的規範所以目前各醫療機構對攝影的目的使用的情境可以露營的空間都沒有明確的規範不要說醫美我剛剛講的皮膚科 小兒科 骨科或者是外科病患要裸露醫療機構若要告知病患正在攝影以及影像的用處按保存期間 |
| transcript.whisperx[377].start |
10576.426 |
| transcript.whisperx[377].end |
10603.22 |
| transcript.whisperx[377].text |
請問一下你們有制式的規範讓人家去遵循嗎跟委員說明我們從兩個地方先開始做檢討改善第一個呢不知道你都很聰明你就不直接回答說其實沒有你直接說未來會改善那我們也很樂意但你真的搞清楚了嗎 |
| transcript.whisperx[378].start |
10603.82 |
| transcript.whisperx[378].end |
10615.65 |
| transcript.whisperx[378].text |
好 你說哪兩個地方第一個因為每年的地方衛生局都會有督導考核所以整夥都要去上面都沒有法規規範的督導怎麼督導怎麼考核的過程當中對於這種非法裝設這個就要把它抓出來所以第一個5月13號就議事會去邀請召集這些衛生局 |
| transcript.whisperx[379].start |
10628.32 |
| transcript.whisperx[379].end |
10655.906 |
| transcript.whisperx[379].text |
督導考核的時候他會裝給你看喔督導考核的時候就會列入這個重要的這個項目那怎麼這個查法督導考核都有安排日期對方都知道的你跟人家說督導考核的時候他會還裝在那裡讓你查那也有這個預考法也有授權這個不預警的查核也是有的對嘛你如果說這樣比較剛好 |
| transcript.whisperx[380].start |
10658.467 |
| transcript.whisperx[380].end |
10683.486 |
| transcript.whisperx[380].text |
第二個機制是什麼那第二個呢那因為有這些第一個先去做你要講是違法的違法的裁量基準在哪裡啦什麼地方可以裝哪個地方是不應該裝裝的是如果像真孔的這個一律就是違法這個是裁量基準上先去討論出來第二個才是說那更正面的那個指引是什麼就是有必要要裝色的時候你聽我說我告訴你聽 |
| transcript.whisperx[381].start |
10686.969 |
| transcript.whisperx[381].end |
10701.543 |
| transcript.whisperx[381].text |
英國的General Medical Council 他們的製作和使用病人視覺及聲音錄製資料指引這個指引不是只問有沒有同意 而是先區分錄製的目的跟使用的情境 |
| transcript.whisperx[382].start |
10703.044 |
| transcript.whisperx[382].end |
10722.502 |
| transcript.whisperx[382].text |
他們的明確指出錄音照片影像等記錄可能是為了病人照護檢查或治療也可能是為了教學訓練評估醫療人員研究或其他醫療相關但不是直接為了該病人利益的次要目的這個是主要目的但不同的目的 |
| transcript.whisperx[383].start |
10723.343 |
| transcript.whisperx[383].end |
10747.163 |
| transcript.whisperx[383].text |
次要目的也可以也可能會可以允許但主要跟次要不同的目的要不同的要求跟管理義務這個就是台灣你完全長期獨持沒有規範然後通通就一句話概括這個是不行的衛福部現在規範就是把所有的錄音錄影都放在同一句話好像徵得同意就可以 |
| transcript.whisperx[384].start |
10747.984 |
| transcript.whisperx[384].end |
10776.033 |
| transcript.whisperx[384].text |
事實上整件案一句錄影中請微笑不管你患者有沒有注意到等同患者已經同意但是英國的GMC的基本原則揭露第一個醫療人員在製作或使用病人影像聲音記錄時要尊重病人的隱私和尊嚴再來病人要參與決定的權利必須告知病人入治的目的而且確保病人沒有受到壓力才可以 |
| transcript.whisperx[385].start |
10776.653 |
| transcript.whisperx[385].end |
10797.576 |
| transcript.whisperx[385].text |
才同意的狀況才可以再來在在可行時病人要求停止錄製醫療人員就該停止那如果錄製的資料用在原本同意範圍以外的目的原則上還必須要重新取得同意好這個都是合法的允許的 |
| transcript.whisperx[386].start |
10798.217 |
| transcript.whisperx[386].end |
10816.348 |
| transcript.whisperx[386].text |
但台灣對合法的允許的規範就已經模糊不清楚了而現在新聞爆發的是不合法的那我們剛剛講你就唯一一個指引那個指引不知道母法從哪裡來那個指引沒有強制性那個指引沒有法則 |
| transcript.whisperx[387].start |
10817.929 |
| transcript.whisperx[387].end |
10846.545 |
| transcript.whisperx[387].text |
完全都不可能做到人家GMC講的病人有沒有被明確告知影像是為了醫療紀錄安全監視教學研究內部訓練還是行銷宣傳病人可不可以拒絕拒絕會不會影響就醫病人在療程當中要求停止拍攝醫療機構是否會必須停止這些沒有清楚規範有一些手術前beforeafter |
| transcript.whisperx[388].start |
10847.265 |
| transcript.whisperx[388].end |
10873.795 |
| transcript.whisperx[388].text |
before after那這種影像然後人家告訴你看這是我的時機before after這種有規範嗎沒有台灣完全沒有更重要人家因果是這樣子對病人照護而錄製和為教學研究訓練等次要目的而錄製規範不一樣如果錄製或治療是治療或檢查的一部分像X光超音波內視鏡副腔鏡 |
| transcript.whisperx[389].start |
10875.916 |
| transcript.whisperx[389].end |
10888.186 |
| transcript.whisperx[389].text |
GMC認為病人對檢查或治療同意可以包含這類紀錄但是如果變成其他會成為病人醫療照護資料一部分的錄製如果你變成這樣的話要向病人說明為什麼你有助於照護會用什麼形式錄製而且安全保存而且這一些紀錄要被視為是病歷的一部分如果視為病歷的一部分那他就會向醫療 |
| transcript.whisperx[390].start |
10906.761 |
| transcript.whisperx[390].end |
10920.558 |
| transcript.whisperx[390].text |
記錄一樣嚴謹的管理如果錄製不是這兩者是為了教學訓練評估醫療人員研究或其他次要的目的那就更需要取得事前的病人的書面同意 |
| transcript.whisperx[391].start |
10921.599 |
| transcript.whisperx[391].end |
10943.49 |
| transcript.whisperx[391].text |
而不得已如果你採取口頭同意的話也應該留下紀錄跟錄製資料一起保存重要的是在取得同意前必須向病人說明錄製的目的如何使用保存多久如何保存以及病人可以拒絕也該在錄製中或錄製後立即撤回同意而且不會影響其照護品質或醫病關係人家是這樣做得這麼細你們還在那邊講各自法有規範不得 |
| transcript.whisperx[392].start |
10953.001 |
| transcript.whisperx[392].end |
10968.292 |
| transcript.whisperx[392].text |
沒有啦 不是這樣管理的啦你們的醫事司司長太好當了 衛福部這種這樣做可以交代 就這幾個個資法可以交代這樣叫官都太好當 叫官員 |
| transcript.whisperx[393].start |
10970.233 |
| transcript.whisperx[393].end |
10997.421 |
| transcript.whisperx[393].text |
當官這麼容易嗎部長現在醫美診所教學醫院手術示範內部教育訓練病歷討論術前術後照片甚至社群行銷素材都可能涉及到病人的身體影像還有聲音記錄如果沒有把醫療必要跟次要的目的分開病人很容易在不清楚用途之下被拍攝甚至影像被拿去做原本沒有同意的使用 |
| transcript.whisperx[394].start |
10999.281 |
| transcript.whisperx[394].end |
11004.905 |
| transcript.whisperx[394].text |
所以這個規範要不要訂保定要不要訂不要再跟我講說你要剛剛那兩點那兩點太粗糙了 |
| transcript.whisperx[395].start |
11009.234 |
| transcript.whisperx[395].end |
11029.599 |
| transcript.whisperx[395].text |
這個不是這樣子做的要細緻 要真的要認真去管理那你未來規範要怎麼去分情境啊你覺得呢 你覺得呢 保定 你說看看這樣還是這樣跟委員說明這個禮拜我們就會先開的就是對於這個裁罰基準上把它釐清 |
| transcript.whisperx[396].start |
11030.519 |
| transcript.whisperx[396].end |
11039.86 |
| transcript.whisperx[396].text |
接下來就會對那個指引去修訂什麼指引 這個指引的母法依據從哪裡來什麼指引 沒有母法拿來的授權啊 |
| transcript.whisperx[397].start |
11041.656 |
| transcript.whisperx[397].end |
11063.485 |
| transcript.whisperx[397].text |
所以才用指引 你沒有魔法拿來的授權你的指引沒有魔法授權的指引沒有辦法有法則這個就是法律保留原則 你不知道嗎你要處罰人家對人民的權利義務需以法律定之這個叫做法律的保留原則 |
| transcript.whisperx[398].start |
11064.745 |
| transcript.whisperx[398].end |
11075.969 |
| transcript.whisperx[398].text |
如果你的指引沒有來自於法律定出來的授權那你這個指引沒有辦法懲罰這個指引就是一個不好的指引這個是我們用行政指導來作為未來在裁罰上的行政指導 那我們人民的隱私權還要上到什麼時候 |
| transcript.whisperx[399].start |
11092.308 |
| transcript.whisperx[399].end |
11114.7 |
| transcript.whisperx[399].text |
這個也不是說現在依照你們的法律德公要取得同意我說合法的不是違法的喔你用一個有沒有同意就帶過人家人家是講說你對主要目的跟次要目的你都要規範為了教學型或者是你把它拿去當行銷before after 數前數後 |
| transcript.whisperx[400].start |
11117.14 |
| transcript.whisperx[400].end |
11142.56 |
| transcript.whisperx[400].text |
這個跟病人當下接受治療沒有直接相關而且可能使病人的身份被辨識造成日後難以控制的外流風險就應該有更高的保障啊結果你還在指引他的流出到暗網裡面到創意私房裡面被看光光你定一個指引沒有任何懲罰的機制這樣敢做 這樣敢做 |
| transcript.whisperx[401].start |
11146.463 |
| transcript.whisperx[401].end |
11163.033 |
| transcript.whisperx[401].text |
為什麼事情很嚴重你都覺得沒有重要呢不是只有醫美呢我想委員這個觸犯違反了我們這些規定就會回到各個現在目前的相對的法規沒有違反的現在沒有違反的你就廣義一句取得同意就帶過了可是我同意什麼我同意什麼 |
| transcript.whisperx[402].start |
11170.237 |
| transcript.whisperx[402].end |
11197.099 |
| transcript.whisperx[402].text |
是你醫療目的的還是說次要目的的你是為了治療我的病的或者為了醫療機構管理設置的這個怕糾紛的跟你教學研究用的還有書前書後被拿去使用被當行銷用的這是不一樣的你怎麼會認為取得同意就可以呢光是合法的這四種情境 |
| transcript.whisperx[403].start |
11198.735 |
| transcript.whisperx[403].end |
11224.908 |
| transcript.whisperx[403].text |
第一種曾經診斷檢查治療第二種情境為了醫療安全或機構管理設置的不要糾紛的公共空間的第三種為了教學研究醫療人員訓練的第四種為了行銷宣傳前後對照這一種的你叫我一句我同意這樣就可以嗎這樣就合法了嗎 |
| transcript.whisperx[404].start |
11226.325 |
| transcript.whisperx[404].end |
11250.483 |
| transcript.whisperx[404].text |
一個我同意當然是不夠的台灣對醫療機構使用病人影像作為廣告案例的分享 數前數後的對照有規範嗎?有規範嗎?有規範嗎?這個廣告的部分我們有規範我在問你數前數後當事人同意你們政府有規範嗎?怎麼同意?他能暴露到哪裡?有規範嗎? |
| transcript.whisperx[405].start |
11252.642 |
| transcript.whisperx[405].end |
11266.213 |
| transcript.whisperx[405].text |
沒有啦 病人簽了一份療程同意書直接就把它解讀成是同意影像日後備用於宣傳嗎病人同意拍攝病歷照片就直接解讀成同意診所拿去當社群媒體的素材嗎 |
| transcript.whisperx[406].start |
11271.089 |
| transcript.whisperx[406].end |
11283.872 |
| transcript.whisperx[406].text |
你們都沒有規範醫療照護的目的教學研究的目的公開宣傳的目的必須分別告知分別同意不得已概括同意書去混同處理 |
| transcript.whisperx[407].start |
11286.428 |
| transcript.whisperx[407].end |
11302.916 |
| transcript.whisperx[407].text |
我們現在最後再講在這裡只討論可不可以錄影可不可以裝監視器這裡不是只有錄影裝監視器錄製收集而已同一拍攝以後的問題才是更大 |
| transcript.whisperx[408].start |
11304.178 |
| transcript.whisperx[408].end |
11312.201 |
| transcript.whisperx[408].text |
影像有影像管理的權限它會連網 它的流向 它的保存這個才是大問題耶 沒錯這個才是大問題 你們有任何規範嗎 |
| transcript.whisperx[409].start |
11321.26 |
| transcript.whisperx[409].end |
11346.807 |
| transcript.whisperx[409].text |
我跟你講韓國首爾在2023年的3月有一間很知名的整形診所閉路電視招駭客入侵很多影片流出去然後這些暗網的人他們用這樣子發布來你看新聞韓國的新聞他們在發布者以胸部整形外科網路閉路電視洩露新作 |
| transcript.whisperx[410].start |
11349.468 |
| transcript.whisperx[410].end |
11361.205 |
| transcript.whisperx[410].text |
你可以去看他們的應診室、更衣室、手術室連藝人脫去上衣檢查的照片、影片都有這個有管理規範嗎?在台灣有嗎? |
| transcript.whisperx[411].start |
11364.807 |
| transcript.whisperx[411].end |
11382.664 |
| transcript.whisperx[411].text |
他這個在韓國的報導裡面包括右邊的那副女生的臉都看得一清二楚我現在講是這個暗網這個暗網直接告訴你我就是外科整形的醫生的照片你怎麼知道台灣的暗網有沒有這一種主題 |
| transcript.whisperx[412].start |
11385.56 |
| transcript.whisperx[412].end |
11409.111 |
| transcript.whisperx[412].text |
保天你告訴我 台灣的暗網現在有沒有類似的主題跟委員說明這裡如果是這個行為在目前台灣都有相關的法規的規定跟法則那麼這個侵入到醫療機構的我們不要講犯罪責我現在問你的是政府對於診所有沒有刻意相當的責任 法律責任 |
| transcript.whisperx[413].start |
11410.191 |
| transcript.whisperx[413].end |
11431.591 |
| transcript.whisperx[413].text |
你在管理他們的時候 你對於他們的管理權限連網流向保存你有對他們克與什麼樣的責任嗎他這個是被害的 被害當然是違法 可是他的診所 他的影像的管理要達到哪一種等級 你有規範嗎 |
| transcript.whisperx[414].start |
11434.12 |
| transcript.whisperx[414].end |
11457.027 |
| transcript.whisperx[414].text |
這個侵入就一定是違法我不是在講駭客我在講診所的責任有規範嗎那現在就是醫療法72條就是不得洩漏啊他沒有洩漏他是被駭的請問駭客現在醫療法也有罰他用一個幾乎非常加重的油管份啊請你先聽我講他如果用一個幾乎 |
| transcript.whisperx[415].start |
11458.868 |
| transcript.whisperx[415].end |
11473.117 |
| transcript.whisperx[415].text |
這個整個網路的安全的等級是最低的然後他沒有防禦能力的他也不違法因為政府沒有規範所以他很容易被害嘛問題在這裡政府沒有對於他們的安全有任何的配套的要求 |
| transcript.whisperx[416].start |
11483.528 |
| transcript.whisperx[416].end |
11505.245 |
| transcript.whisperx[416].text |
現在不要講竊取 我跟你講的焦點 不要轉移焦點從這個事件我是要跟你覺得韓國的案例對台灣的醫療機構有哪些啟發韓國的案例對台灣政府對醫療機構的管理你不覺得有應該要立即馬上檢討的地方嗎 |
| transcript.whisperx[417].start |
11511.878 |
| transcript.whisperx[417].end |
11528.405 |
| transcript.whisperx[417].text |
醫美診所為了防止診療室手術室內部發生依究會徵求患者同意後錄影這個診所就有徵求同意後錄影啊但是在更衣室拍攝影像他沒有見患者同意違法 |
| transcript.whisperx[418].start |
11531.309 |
| transcript.whisperx[418].end |
11545.007 |
| transcript.whisperx[418].text |
這個診所在接受JTBC採訪時他說更衣室有單獨不被攝影的封閉空間也為事前告知女性患者請問台灣的更衣室有規定不可以攝影嗎 |
| transcript.whisperx[419].start |
11547.679 |
| transcript.whisperx[419].end |
11560.916 |
| transcript.whisperx[419].text |
有嗎台灣有任何法規說公益是這個就是侵犯個人隱私啊這個妨礙在刑法裡面就有妨礙秘密跟妨礙隱私那請問在公共區域都可以裝嗎需要取得知情權嗎 |
| transcript.whisperx[420].start |
11563.356 |
| transcript.whisperx[420].end |
11577.165 |
| transcript.whisperx[420].text |
公共區域 這個是公共場所非違特定的的話 那就是規範啊應診室都可以裝嗎 需要取得書面同意嗎應診室的話 我們在我們的規範裡面提到要根據你的哪裡規範 你哪裡的規範 你的規範在哪裡隱私規範就講那個隱私規範如果沒有的話 他有什麼罰則有什麼罰則 沒有啊 |
| transcript.whisperx[421].start |
11586.551 |
| transcript.whisperx[421].end |
11605.851 |
| transcript.whisperx[421].text |
那你就回到個資法嘛 還有刑法嘛 這些都有你自己目的事業主管機關 主導的醫療法就這樣子 大家直接獨職 堂起不作為出事我就跟你說 有個資法 有刑法那我們特別法通通都可以取消了 |
| transcript.whisperx[422].start |
11607.718 |
| transcript.whisperx[422].end |
11633.279 |
| transcript.whisperx[422].text |
委員你提的這些我都相當認同啦所以我們把它分兩段一個是違法的樣態該怎麼罰違法的樣態我已經不爭執我們都知道該怎麼罰就怎麼處理我現在跟你爭執的是說同意拍攝就是收集的起點但是後續有處理保管處理跟保管你不用苛責 |
| transcript.whisperx[423].start |
11635.861 |
| transcript.whisperx[423].end |
11651.553 |
| transcript.whisperx[423].text |
這個應該要診所要負起什麼樣的責任今天病患同意是同意在特定醫療目的特定範圍下被拍不是同意被你上雲端今天我同意了 合法了但是你剛才把我的影像上雲端嗎 |
| transcript.whisperx[424].start |
11652.754 |
| transcript.whisperx[424].end |
11669.159 |
| transcript.whisperx[424].text |
可以讓即時觀看嗎可以讓裝設錄影器材的這一些維修人員也一起看嗎可以被多人調閱嗎可以在資安鬆散沒有任何管理要求下有暴露於外流的風險之中嗎我在講合法的管理 |
| transcript.whisperx[425].start |
11673.662 |
| transcript.whisperx[425].end |
11693.295 |
| transcript.whisperx[425].text |
這個是兩塊啦 確實非法的部分拿得清楚啦那現在要講合法的範圍應該有什麼樣的責任和規範 為什麼叫合法你這裡講 我跟你講叫合法太容易太簡單合法 所謂合法就是因為你們沒有任何的法律規範所以它沒有違法 |
| transcript.whisperx[426].start |
11694.196 |
| transcript.whisperx[426].end |
11720.901 |
| transcript.whisperx[426].text |
他用一個廣泛的授權我同意然後就容易他就外洩了因為你沒有更精緻的規範所以這個就叫合法叫合法太輕鬆了這樣不是叫合法這叫沒有管理毫無規範沒有管理造成濫用連醫界想要遵循要守法也無法可以遵循連家醫界也不見得每個人都是這種惡質啊 |
| transcript.whisperx[427].start |
11723.081 |
| transcript.whisperx[427].end |
11750.968 |
| transcript.whisperx[427].text |
但有人要遵循醫界可以有遵循的規範嗎 沒有所以醫美診所不能把防醫療糾紛當成無限上綱的錄影然後只要取得同意就全部大家通通都可以錄影你還是要回到必要性比例原則而不是所有的療程所有的空間所有的時間都需要攝影而不是只要診所單方認為有需要就可以全面安裝 |
| transcript.whisperx[428].start |
11753.186 |
| transcript.whisperx[428].end |
11769.075 |
| transcript.whisperx[428].text |
那更衣室換衣區麻醉前後裸露區域原則上都視為高隱私近拍區啊這個韓國的案例之所以震撼他不是只有診療影像外露更衣室需要脫衣檢查的空間 |
| transcript.whisperx[429].start |
11770.447 |
| transcript.whisperx[429].end |
11791.409 |
| transcript.whisperx[429].text |
需要脫衣檢查的空間也遭拍攝並外流最容易發生高度羞辱性難以回復的損害而你們現在我問你你們除了更衣室以外你其他診療空間你看這右側就是診療空間給醫生看錄影可以啊合法啊 |
| transcript.whisperx[430].start |
11792.793 |
| transcript.whisperx[430].end |
11801.609 |
| transcript.whisperx[430].text |
合法啊 他也同意啊結果就外流了啊右邊那個圖他們韓國的新聞是連臉都露出來的 |
| transcript.whisperx[431].start |
11803.004 |
| transcript.whisperx[431].end |
11826.353 |
| transcript.whisperx[431].text |
是我給他打馬賽克的所以台灣現行的醫療隱私規範你們說啊這個要不連個別房間維護隱私但是他有錄影他或許也有可能取得同意但是因為你們對於他保存上傳雲端等等的管理都沒有詳細的規範他就被看光了 |
| transcript.whisperx[432].start |
11828.173 |
| transcript.whisperx[432].end |
11852.324 |
| transcript.whisperx[432].text |
你說那個是人家入侵的你怎麼知道這一個硬體的維護人員沒有看到硬體維護人員沒有外露然後他看到了他沒有外露他看到我也不願意讓硬體維護人員看到我也不要啊我為什麼要除了醫生護理人員在那裡以外我為什麼要讓你們上網你對上網不上網 |
| transcript.whisperx[433].start |
11856.806 |
| transcript.whisperx[433].end |
11862.849 |
| transcript.whisperx[433].text |
你有沒有規範他們錄製的影像可以上網嗎為了他們管理方便就可以上網嗎你應該管理核心是資安啦資安才是你們影像錄製最管理的核心而不是只有同意書啦而你們對各個醫界各個診所所有醫界你們對資安的要求在哪裡 |
| transcript.whisperx[434].start |
11887.13 |
| transcript.whisperx[434].end |
11908.485 |
| transcript.whisperx[434].text |
真正的風險不是有沒有鏡頭在拍攝而是你拍攝的內容 鏡頭是否上網是否可以遠端登錄是否有預設密碼是否有開放外部存取是否上傳第三方平台是否留有完整的存取記錄有嗎 有嗎 保定有感覺沒有沒有嘛 |
| transcript.whisperx[435].start |
11916.721 |
| transcript.whisperx[435].end |
11937.193 |
| transcript.whisperx[435].text |
所以叫建戶太好當了所以你們在這裡閉路系統錄影系統跟一般監視系統要分開優先採取不聯網限制存取加密儲存最小權限留存調閱記錄的做法通通都沒有 |
| transcript.whisperx[436].start |
11938.464 |
| transcript.whisperx[436].end |
11959.056 |
| transcript.whisperx[436].text |
所以一旦診療的影像包括合法的合法的你只要可以被遠端調閱風險就流出去了就不是只有診間嘛它延伸到系統的治安全線的管理外部入侵然後病人的身體影像變成被竊取轉售散佈所以這個不是一般個資嘛個資法講這個是特種個資嘛 |
| transcript.whisperx[437].start |
11967.014 |
| transcript.whisperx[437].end |
11980.749 |
| transcript.whisperx[437].text |
所以現在真正的風險是政府沒有規範啦真正的風險不在於病人有沒有簽同意書啦而是診所是否把高度敏感的醫療影像當成一般監視畫面來收集儲存和傳輸 |
| transcript.whisperx[438].start |
11982.985 |
| transcript.whisperx[438].end |
12008.762 |
| transcript.whisperx[438].text |
現在台灣每個診所我可以跟你講100%就是跟一般監視畫面一樣收集儲存跟傳輸因為政府沒有規範那一旦設備可以聯網全線控管鬆散近拍區不明刪除機制不清病人的同意就不再是權益保障病人簽了那個同意書就等於淪為幫醫療機構卸責的工具啦 |
| transcript.whisperx[439].start |
12013.829 |
| transcript.whisperx[439].end |
12017.221 |
| transcript.whisperx[439].text |
所以你叫那個同意書 反而幫他法律背書了 |
| transcript.whisperx[440].start |
12019.795 |
| transcript.whisperx[440].end |
12043.112 |
| transcript.whisperx[440].text |
台灣我們難道不需要建立完整嚴謹的錄音錄影管理規範嗎要包括錄影的必要性的審查 近拍區域的清單設備聯網的管理 調閱的權限 保存的期限 刪除的機制外包維護的責任 以及影像外流後的通報及下架程序 |
| transcript.whisperx[441].start |
12044.783 |
| transcript.whisperx[441].end |
12055.386 |
| transcript.whisperx[441].text |
請問部長 這個東西要不要入法 還是要訂一個指引一個指引就夠了嗎 你可以告訴我嗎沒入法嗎我做一個很清楚的 |
| transcript.whisperx[442].start |
12065.276 |
| transcript.whisperx[442].end |
12089.699 |
| transcript.whisperx[442].text |
在這些個人的隱私空間像更衣室這邊去裝設這個針孔也好攝影機也好那麼甚至部長我就跟你講我們就講這個已經都是違法不管我們有沒有規範它就是違法了那麼至於如何是合法的部分這違法的就不用講了違法就不用講你還一直講那現在是合法的部分如何去強化這個 |
| transcript.whisperx[443].start |
12091.38 |
| transcript.whisperx[443].end |
12119.269 |
| transcript.whisperx[443].text |
管理者的責任讓這些犯罪侵害的可能性降低這個是我們要來努力的對 但他就不能以指引定制這個是兩件事情要以法律定制這個是對管理者他的管理的想法的要求啦要不要修法什麼時候啟動修法多久以內完成我們來完整的評估啦要修法啦您的醫事師喔 師長很好做的大家都不用講話 |
| transcript.whisperx[444].start |
12121.07 |
| transcript.whisperx[444].end |
12123.532 |
| transcript.whisperx[444].text |
什麼事情都做不好都保證就扛著跟醫事室都沒有關係你一個保證有辦法負責這麼多行嗎會啊我們這個會來找專家大家一起討論一下你不覺得遲到很久了嗎今天所有影像如果外流到暗網創意私房 |
| transcript.whisperx[445].start |
12142.54 |
| transcript.whisperx[445].end |
12163.615 |
| transcript.whisperx[445].text |
我覺得政府獨職啊 這個不用國賠嗎某種程度要國賠 違法的不用國賠 因為違法嘛合法的留出去 你們不是幫兇嗎合法的是不能留出去啊 留出去的不是合法他只是說怎麼樣去強化這個管理者的責任 |
| transcript.whisperx[446].start |
12166.957 |
| transcript.whisperx[446].end |
12190.936 |
| transcript.whisperx[446].text |
整個責任太輕鬆了現在的管理者沒有任何法律責任啦現在你對管理者沒有刻意法律責任啦因為規範不明啦人家醫生跟診所也想要遵循規範就毫無規範可遵循啦對不對 好啦這個很清楚啦 我們朝這個方向來做好 謝謝林師傅的質詢 |
| transcript.whisperx[447].start |
12193.158 |
| transcript.whisperx[447].end |
12203.466 |
| transcript.whisperx[447].text |
跟委員會報告我們今天中午繼續開會待全數委員詢答完畢後再行休息現在可以把便當發下去一起一邊用餐現在請王振旭委員質詢好謝謝主席我們還是要麻煩石部長好請石部長 |
| transcript.whisperx[448].start |
12221.036 |
| transcript.whisperx[448].end |
12240.497 |
| transcript.whisperx[448].text |
歐美人好部長好我想今天還是有蠻多議題雖然是從預算的角度來看所有的問題我們這邊有幾個議題跟部長來討論一下有關世界衛生大會跟國際對話的一個行動方案另外就是針對漢娜病毒 |
| transcript.whisperx[449].start |
12241.098 |
| transcript.whisperx[449].end |
12267.935 |
| transcript.whisperx[449].text |
我們在防疫上面還有哪一些措施來加強那另外就是剛剛林書文委員所提到如果訂定監視錄影資料的規範來保障國人就醫的隱私權那在開始之前明天就是5月12號是國際護師節我們還是祝福我們這個所有的護師還有護士的同仁們護師節快樂 |
| transcript.whisperx[450].start |
12270.436 |
| transcript.whisperx[450].end |
12285.402 |
| transcript.whisperx[450].text |
部長我想今天也都討論非常多嘛就是大家都非常關心這個護理的權益那也希望說在護理權益跟醫療服務的品質跟量能之間達成平衡讓民眾就醫的權益跟護理工作權益都能夠 |
| transcript.whisperx[451].start |
12286.062 |
| transcript.whisperx[451].end |
12306.113 |
| transcript.whisperx[451].text |
充分的被保障所以我認為在三班復併筆入法以後接下來配套要怎麼落實才是真正的關鍵想利用這個機會請部長再說明說要在實施的2028年5月1號之前第一個要如何讓這個人力能夠補足 |
| transcript.whisperx[452].start |
12307.213 |
| transcript.whisperx[452].end |
12331.914 |
| transcript.whisperx[452].text |
那第二部分呢就是裁員要如何處理那健保或公務預算是否能夠有足夠的因應準備部長是不是可以再一次再做一些說明好謝謝謝謝委員給我這個機會再更清楚的講得清楚啦其實上半戶病比錄法不是今日才開始這個是在113年那麼總統上任之後就啟動了 |
| transcript.whisperx[453].start |
12333.275 |
| transcript.whisperx[453].end |
12358.072 |
| transcript.whisperx[453].text |
那麼所以我們在114年那麼行政院就已經合併讓我們有一筆預算來做這個護理人力的改革那就是要這個回應到委員所關心的這個人力怎麼樣補足才能夠達到這個113年所討論出來的三班護病比的標準所以當然第一個我們從這個人才培育的部分去強化讓教考 |
| transcript.whisperx[454].start |
12359.372 |
| transcript.whisperx[454].end |
12382.523 |
| transcript.whisperx[454].text |
這邊可以一貫性第二個從改善這個職場的環境做起所以包含我們做了一些夜班的津貼做了一些三班戶並比的獎勵也做新手導師的制度帶領這個新進的護理人員那麼壓力那麼大那麼恐慌那麼也做這個友善職場的典範的表揚 |
| transcript.whisperx[455].start |
12383.523 |
| transcript.whisperx[455].end |
12411.789 |
| transcript.whisperx[455].text |
讓大家互相的做標竿學習共同改善這個護理的環境那麼另外也導入的智慧照顧那麼智慧護理等等去減輕這些paperwork那麼評鑑的改革也同步在進行這些都是在改善整個護理的這個職場的環境另外在薪資的部分也在做提升所以我們在各項的健保的支付標準現在在調整的時候都會 |
| transcript.whisperx[456].start |
12412.709 |
| transcript.whisperx[456].end |
12433.997 |
| transcript.whisperx[456].text |
加入一個要有多少比例要用在第一線人員的上面所以包含我們的護理費的調整各項集中症支付裡面也都有相類似的這些規範那麼另外在公務人員的這個公立醫院的專業家級的部分那麼也提升了這些都是在做加薪的準備 |
| transcript.whisperx[457].start |
12434.777 |
| transcript.whisperx[457].end |
12458.119 |
| transcript.whisperx[457].text |
那另外這幾年的這個健保的挹注也增加那讓醫院有盈餘也是要求他們要對這個人員要做一些第一線人員的加薪所以這些其實都是在做這個配套的準備那只不過這個人力的補足不是一蹴可及啦在前幾年前年的時候一年那麼才增加了一千多位 |
| transcript.whisperx[458].start |
12458.819 |
| transcript.whisperx[458].end |
12475.855 |
| transcript.whisperx[458].text |
那是到去年才增加到差不多4000多位左右那是一整年那還要分配到各種不同的機構所以我們是需要有時間不過我們看到的是已經在進步已經在讓護病比在降低當中了 |
| transcript.whisperx[459].start |
12476.516 |
| transcript.whisperx[459].end |
12491.31 |
| transcript.whisperx[459].text |
好 我們很期待透過這些努力至少我們的護理同仁可以安心的持續在職場招呼我們所謂全體國民當他需要住院的時候能夠得到大家最好的照顧好 再次感謝部長這方面的說明 |
| transcript.whisperx[460].start |
12492.191 |
| transcript.whisperx[460].end |
12506.705 |
| transcript.whisperx[460].text |
那再過來就是有關你這個WHA就是世界衛生大會期間如何向國際社會說明我國的這個公衛成果WHA將在本月的18日在瑞士之內開幕我們當然期待行政部門能夠持續爭取各項實質的參與 |
| transcript.whisperx[461].start |
12508.647 |
| transcript.whisperx[461].end |
12518.574 |
| transcript.whisperx[461].text |
那目前了解包括衛福部外交部下午也會開一個相關的這個說明會來共同辦理跨國智慧醫療實踐與公共體系升級的國際論壇在日內瓦舉行那也會舉辦首屆的這個WHA台灣 |
| transcript.whisperx[462].start |
12525.539 |
| transcript.whisperx[462].end |
12544.518 |
| transcript.whisperx[462].text |
智慧醫療與健康產業展期待共同研討數位醫療的願景並提升臺灣智慧醫療跟醫療外交人員外的成果那請問部長目前在WHA期間問部還有什麼相關的行動法案以及包括雙邊或多邊合作的一些內容各位請部長也稍微做說明 |
| transcript.whisperx[463].start |
12546.059 |
| transcript.whisperx[463].end |
12556.951 |
| transcript.whisperx[463].text |
謝謝委員這個垂詢那麼今年的世衛活動世界衛生大會的活動那麼我們跟外交部共同合作那麼在周邊我們會辦四場的國際論壇那麼包含 |
| transcript.whisperx[464].start |
12562.156 |
| transcript.whisperx[464].end |
12586.975 |
| transcript.whisperx[464].text |
癌症的防治 吸肝的根除還有智慧醫療跟醫療韌性把台灣的經驗也邀請了其他的國家共同參與讓這個經驗可以互相的交流分享第二個在同時舉辦論壇的同一個場所我們也跟外交部合作導入了我們的智慧醫療展 |
| transcript.whisperx[465].start |
12587.836 |
| transcript.whisperx[465].end |
12615.377 |
| transcript.whisperx[465].text |
那麼讓台灣的相關的醫療體系也好或者是業者也好共同到這個日內瓦那麼透過全世界各重要的衛生官員都會籍的這段期間那麼可以讓台灣的智慧醫療包含產業的部分有一個很好的國際的平台那麼讓世界知道那麼讓這個台灣can help這件事情可以真正的去落地落實 |
| transcript.whisperx[466].start |
12616.198 |
| transcript.whisperx[466].end |
12640.809 |
| transcript.whisperx[466].text |
所以這個今年的做法好像跟往年有特別不同是台灣can help的確那台灣也希望能夠被完整的看見WHA這個周邊相關的會議是一個很好的場域也很歡迎邀請委員同行雖然你最近行動比較不方便但是如果能夠有委員的這個加持那麼會更好 |
| transcript.whisperx[467].start |
12641.129 |
| transcript.whisperx[467].end |
12663.061 |
| transcript.whisperx[467].text |
好 我們會持續來努力那我們也了解美國總統川普在去年被已經簽署行政命令令於今年的1月正式啟動這個退出世界衛生組織叫WHO 那美國政府表達的主要原因是因為包含認為說WHO在COVID期間的防疫不力那以及接受特定國家的過度影響等等 那在今年 |
| transcript.whisperx[468].start |
12663.721 |
| transcript.whisperx[468].end |
12687.717 |
| transcript.whisperx[468].text |
出這個美國國務卿跟他們的衛生部長就終止WHO成員資格所發布的一項聯合聲明裡面指出了退出的相關的原因還有以及美國對未來在全球公衛領域所要扮演的角色那其中聲明提及美國未來將透過直接雙邊以結果為導向夥伴關係來引領全球的公共衛生並繼續與各國 |
| transcript.whisperx[469].start |
12689.338 |
| transcript.whisperx[469].end |
12704.492 |
| transcript.whisperx[469].text |
及值得信賴的衛生機構合作分享最佳的因應模式並推動全球的這個衛生安全那請問部長台灣是否有更多空間在未來與美國建立更多官方或學院機構之間的雙邊合作關係夥伴來加強兩邊的這個 |
| transcript.whisperx[470].start |
12709.156 |
| transcript.whisperx[470].end |
12722.728 |
| transcript.whisperx[470].text |
相關的這個合作跟相關的策略因為我們這邊所提到的就是不只是官方其實美國學術界跟醫療界對於美國政府退出WHO的變動也有相當多的討論其實很多人擔心將會面臨資源縮減 |
| transcript.whisperx[471].start |
12725.39 |
| transcript.whisperx[471].end |
12745.961 |
| transcript.whisperx[471].text |
或者是這個研究中斷因為估計許多研究資源是透過WHO相關的機制跟平台來落實到各個學院的機構那現在的變動包括美國政府對於醫療衛生政策的轉向等等醫界跟學界對於資源跟數據可能面臨的雙重的斷念都非常非常的擔心也是很疑慮 |
| transcript.whisperx[472].start |
12746.821 |
| transcript.whisperx[472].end |
12767.582 |
| transcript.whisperx[472].text |
那外務部可以試著評估在這些情形之下台灣跟美國相關的學術的合作上有沒有機會來做更好的突破這部分是部長也可以利用這個機會跟大家說也謝謝這個委員的這個提醒確實這個美國今年已經明確的表態不參加 |
| transcript.whisperx[473].start |
12769.043 |
| transcript.whisperx[473].end |
12784.542 |
| transcript.whisperx[473].text |
這個世衛大會所以這個很可惜那但是因為畢竟這個世界衛生大會還是現在全球在公共衛生醫療上面非常重要的平台所以我們還是不能缺席但是如何去強化跟台美的互動 |
| transcript.whisperx[474].start |
12785.323 |
| transcript.whisperx[474].end |
12809.839 |
| transcript.whisperx[474].text |
特別是在衛生醫療領域那麼我們其實過去就在疫情當中有簽署了台美的MOU所以這個合作備忘錄我們會繼續的推動那現在也正在洽談在續簽這件事情這是一個那第二個我們每年也都專門會邀請美國的現職的最近這幾年都有現職的官員 |
| transcript.whisperx[475].start |
12810.9 |
| transcript.whisperx[475].end |
12837.142 |
| transcript.whisperx[475].text |
來台灣我們舉辦台美這個衛生福利論壇那今年也是在六月會舉辦這個也是一個強化的平台另外在八月間呢也會在美國會有跟他們的這個各州的衛生官員甚至是中央的官員會有這個圓桌論壇的活動那都是透過很多這樣的實質的這個交流跟這個 |
| transcript.whisperx[476].start |
12838.183 |
| transcript.whisperx[476].end |
12855.275 |
| transcript.whisperx[476].text |
互動那麼來深化雙邊的夥伴關係好 太好了至少我們希望能夠不管是學園界或是食物界都能夠跟台美有更多的這個發展那再過來就要麻煩我們羅一鈞署長針對強化漢他病毒的防疫措施 |
| transcript.whisperx[477].start |
12855.775 |
| transcript.whisperx[477].end |
12874.942 |
| transcript.whisperx[477].text |
也讓民眾更安心因為透過集官署羅署長近日對國人的說明我們了解到今年1月到4月期間我國也具有兩例的漢娜病毒的個案包括台北市新北市各一例事實上跟近四年來的同期相比並沒有額外的特別的增加從過去的疫情 |
| transcript.whisperx[478].start |
12875.622 |
| transcript.whisperx[478].end |
12895.146 |
| transcript.whisperx[478].text |
變化趨勢來看,臺灣不容易出現漢娜病毒大規模傳播的情形不過羅書長也有提醒大家5到6月10到12月期間可能是有疫情上升的可能性推測跟老鼠春秋季迎來繁殖高峰是有關係的近期國外有一艘紅底亞4號的郵輪包含漢娜病毒 |
| transcript.whisperx[479].start |
12898.627 |
| transcript.whisperx[479].end |
12917.295 |
| transcript.whisperx[479].text |
這個感染導致山林乘客不幸上升那這一部分經機關署的確認該轉並沒有台灣的公民不過這也顯示郵輪其實是一個這個屬患的這個發生的熱區那我們也知道基隆跟高雄是我國的這個兩大郵輪的母港包括這個MSC就是榮耀號還有這個哥倫達沙倫納號還有挪威奮進號等郵輪都會 |
| transcript.whisperx[480].start |
12924.358 |
| transcript.whisperx[480].end |
12949.988 |
| transcript.whisperx[480].text |
平緩的停靠到這個不管是基隆或者是高雄港所以這部分應該要強化郵輪乘客的衛教宣傳跟因應相關風險的防疫措施這部分就要麻煩我們這個機關署部裡面能夠加強這方面的處理事實上工會等領域的學者進行的研究有報告告訴我們說這個氣候變遷可能加劇這個鼠類族群分布的擴張連帶會 |
| transcript.whisperx[481].start |
12952.269 |
| transcript.whisperx[481].end |
12980.384 |
| transcript.whisperx[481].text |
導致這個特定病毒的地理性的擴張所以未來衛福部機關署應該跟環境部跨部會在研擬相關的對策那這部分可不可以請羅市長跟我們做一些說明報告委員就是在郵輪的部分應該是我們的國際港部我們都有在例行其實已經行之多年都會去監測這個鼠類就是會布鼠籠去抓老鼠然後也會來驗像漢堂病毒在內相關的病毒那過去幾年是沒有看到有明顯的增減 |
| transcript.whisperx[482].start |
12981.945 |
| transcript.whisperx[482].end |
13004.181 |
| transcript.whisperx[482].text |
但是因為現在有南美阿根廷出發郵輪的南美安地斯病毒的事件所以我們也已經成立專案小組就比較少見的漢娜病毒萬一有旅客帶進來要怎麼樣來因應跟處理包括隔離還有接觸者追蹤等等這些會修訂我們的工作手冊 |
| transcript.whisperx[483].start |
13005.041 |
| transcript.whisperx[483].end |
13026.631 |
| transcript.whisperx[483].text |
那至於委員所提醒的這個氣候變遷跟鼠類相關的分布那我想我們會遵照委員的提醒來跟環境部來開會來討論這個後續的一些處理那我們也會在防疫議題這樣的一個架構之下請農業部一起來因為農地這邊的這個老鼠是由農業部主管所以我們就是三個部會會就這個鼠類的一些狀況會在後續再開會討論 |
| transcript.whisperx[484].start |
13028.672 |
| transcript.whisperx[484].end |
13049.462 |
| transcript.whisperx[484].text |
是謝謝因為我們知道現在各大城市好像也鼠患造成一些問題也希望能夠跟各個地方政府共同來合作讓這個鼠患可以減到最低影響到民眾健康的部分好那個謝謝處長好謝謝最後還是要跟部長討論一下保障民眾就醫的隱私權 |
| transcript.whisperx[485].start |
13050.482 |
| transcript.whisperx[485].end |
13067.415 |
| transcript.whisperx[485].text |
部長我們也了解剛剛我們十分危險也跟你用很長的時間討論我們所知道的近日這個IRD連鎖義美集團疑似真恐脫白的事件讓國人感到不寒而慄那我也認為這是非常嚴重也相當惡劣的行為請部長務必要嚴加查辦 |
| transcript.whisperx[486].start |
13068.395 |
| transcript.whisperx[486].end |
13076.98 |
| transcript.whisperx[486].text |
這次事件也讓社會重新審視現有的保障醫療隱私規範的可能缺口事實上在衛福部2015年有訂定了一個醫療機構醫療隱私維護規範在第二點的第二項有規定 |
| transcript.whisperx[487].start |
13087.366 |
| transcript.whisperx[487].end |
13108.182 |
| transcript.whisperx[487].text |
療過程醫病雙方如需錄音或者是錄影應要先徵得對方的同意然而根據過去衛生部的函文裡面所指出該規範所稱的徵得同意並沒有限制他的方式我想大家會很在意到底是口頭就認為同意呢還是需要什麼情形下需要書面同意 |
| transcript.whisperx[488].start |
13108.522 |
| transcript.whisperx[488].end |
13126.831 |
| transcript.whisperx[488].text |
我認為這個對醫療實務現場造成的某些程度的模糊空間那病患根本不清楚到底在何時或者是在何地已經被真的同意只有口頭告知還是有同意書的簽名等等這個對於病患的知情權跟隱私權來講都是保障不足所以在這邊有兩個問題要來請教部長 |
| transcript.whisperx[489].start |
13129.992 |
| transcript.whisperx[489].end |
13152.871 |
| transcript.whisperx[489].text |
第一個就是如果醫療機構所在未經同意又不具正當理由的情形之下那在診間或病房擅自錄影或錄音當事人有否權利要求機構在當下立即刪除相關的影音資料若機構不願意配合當事人應該如何主張維護自身的權益那第二個部分呢就是現行隱私維護規範實在過於粗略 |
| transcript.whisperx[490].start |
13155.333 |
| transcript.whisperx[490].end |
13174.605 |
| transcript.whisperx[490].text |
缺乏相關的作業細節我認為衛福部應該要研議訂定更為完整認為周全的這個監視錄影設備設置及資訊管理辦法來明確規定醫療院所在哪一些區域進行錄音錄影時必須取得書面同意那哪一些情境可使用 |
| transcript.whisperx[491].start |
13175.225 |
| transcript.whisperx[491].end |
13192.285 |
| transcript.whisperx[491].text |
利用口頭告知或者是張貼告知來處理那資料誰能看能夠保存多久讓這個醫療院所對什麼是合理必要的入職情境有所了解跟依循部長可以承諾趕快來研議訂定管理辦法嗎 |
| transcript.whisperx[492].start |
13193.126 |
| transcript.whisperx[492].end |
13218.076 |
| transcript.whisperx[492].text |
好 這個跟委員說明這個第一個要立即刪除影像的部分這個按照個資法的授權就可以所以這個是沒有問題那至於對於剛剛我在回答林淑芬委員的質詢的時候也特別提到那麼對於加強管理者的責任那麼來降低這一些違法使用 |
| transcript.whisperx[493].start |
13218.496 |
| transcript.whisperx[493].end |
13244.383 |
| transcript.whisperx[493].text |
的風險包含被侵入的這些來定義一個管理的辦法那麼像委員所建議的監視錄影與資訊管理辦法這個是我覺得是我們朝這個方向來做那麼至於他的這個授權法規那麼究竟是要用醫療法裡面這裡比較貼近的就是醫療機構電子病例製作及管理辦法 |
| transcript.whisperx[494].start |
13245.223 |
| transcript.whisperx[494].end |
13270.635 |
| transcript.whisperx[494].text |
來修訂還是回到個資法或資通法資安法的授權法規來訂定我們來研究一下法源上我們用哪一個授權會比較合適也對應後面的相對應的法則這個我們來研究一下朝這個方向來訂定一個規範強化這個管理者的責任我想這個是我們可以來 |
| transcript.whisperx[495].start |
13271.095 |
| transcript.whisperx[495].end |
13289.38 |
| transcript.whisperx[495].text |
好 那就把部長建書來處理那這邊還有一個問題沒有之前還沒有討論到就是診所的負責醫師與實質投資人的法律責任的界定跟承擔那現在的我們的這個法規範是否完備因為我們也了解根據醫療法第18條醫療機構應該要置負責醫師一人對其醫療 |
| transcript.whisperx[496].start |
13295.722 |
| transcript.whisperx[496].end |
13317.656 |
| transcript.whisperx[496].text |
機構醫療業務督導的責任過去衛生署曾頒布一項函示指出私立醫療機構對外均由負責醫師負擔法律上的相關責任負責醫師是我與合夥團體兼另有僱傭或委任等其他民事關係均非醫療機構設立時衛生主管機關所需審查或介入的事項 |
| transcript.whisperx[497].start |
13318.576 |
| transcript.whisperx[497].end |
13345.787 |
| transcript.whisperx[497].text |
那現在的現況其實我們也了解很多的大型診所的集團實質的投資人其實可能甚至都不具有醫師的身份各分院診所各有負責的醫師那麼依據近期這個部分診所安裝真空攝影的非法事件投資人與醫療機構負責人過制法律這個責任如何來界定那負責醫師根據知情與否以及參與的程度等相關調查過程跟後續的法律 |
| transcript.whisperx[498].start |
13346.447 |
| transcript.whisperx[498].end |
13364.844 |
| transcript.whisperx[498].text |
輸送過程相信都會慢慢會有比較明確的釐清依據這個醫療法法律責任的承擔相對會比較明確那請問部長有關大型診所及集團這一類的醫療機構是投資人在相關法律責任的承擔層面我們現況的法規這個規範是夠的嗎 |
| transcript.whisperx[499].start |
13369.248 |
| transcript.whisperx[499].end |
13394.584 |
| transcript.whisperx[499].text |
確實跟委員說明目前在醫療機構的樣態那麼大概有法人附設包含這個財團法人跟醫療社團法人另外一個就是公立機構另外一個就是這個私人機構那現在診所呢基本上還沒有法人型態主要都是以這個私人診所也就是有所謂的負責醫師來擔負 |
| transcript.whisperx[500].start |
13396.365 |
| transcript.whisperx[500].end |
13412.263 |
| transcript.whisperx[500].text |
那確實在管理上也出現這樣的狀況就是說即使他出現了什麼問題沒有辦法去問責到背後的真正的擁有者所以我們剛剛我也在跟市長討論我們來研究一下是不是要讓他 |
| transcript.whisperx[501].start |
13413.304 |
| transcript.whisperx[501].end |
13438.535 |
| transcript.whisperx[501].text |
成變成也是一個法人的樣態這樣呢比較能夠對這個背後的出資或管理者具有約束力所以納入我們來來研究一下我想法律就是需要與時俱進是那也希望大家都應該承擔各自該有的法律責任所以最後其實就是把今天跟部長討論的落實三辦互辯比所需要的配套 |
| transcript.whisperx[502].start |
13439.395 |
| transcript.whisperx[502].end |
13463.35 |
| transcript.whisperx[502].text |
持續強化跟各國在公衛領域的合作關係強化和他病毒防疫措施以及最後訂定這個監視錄影設備設置及資訊管理辦法來保障國人的就醫隱私權再麻煩部長跟部裡面共同來努力來給我們一些書面資料好謝謝謝謝委員我們再提供詳細的資料好也謝謝主席謝謝王振旭委員的諮詢 |
| transcript.whisperx[503].start |
13476.887 |
| transcript.whisperx[503].end |
13483.475 |
| transcript.whisperx[503].text |
下一位請盧縣一召委發言謝謝主席有請部長來有請石部長 |
| transcript.whisperx[504].start |
13487.865 |
| transcript.whisperx[504].end |
13513.147 |
| transcript.whisperx[504].text |
吳昭偉好部長辛苦了那我們先第一個先談到三幫護病品的問題那我們就實質的一個層面來看很像三幫護病品在Center比較沒有問題我是說在醫學中心比較沒有問題然後到現在很像看到比較棘手的問題像把病患都積在急診室所以我想說你們這部分有沒有在研議它的配套措施 |
| transcript.whisperx[505].start |
13514.107 |
| transcript.whisperx[505].end |
13532.158 |
| transcript.whisperx[505].text |
對 跟委員說明確實您的觀察很正確啦就是目前達標的情形大概是醫學中心雖然看起來社區醫院的達標率很高但它實際上是因為關床的關係才達到標準的所以這個三班護病的實施對中小 |
| transcript.whisperx[506].start |
13533.238 |
| transcript.whisperx[506].end |
13550.977 |
| transcript.whisperx[506].text |
中小型醫院特別是有一些比較資源不足的偏鄉醫院他們這個搶人的能力也比較低這個醫學中心要螺絲人力比較容易但中小型醫院確實他的競爭力比較低不然就是說在急診室的部分你想是不是也要一個護病病 |
| transcript.whisperx[507].start |
13552.534 |
| transcript.whisperx[507].end |
13572.061 |
| transcript.whisperx[507].text |
是不是對啊因為急診室等於全部的病人都積在急診然後把急診當作病床來使用就等於是關病房可是把急診室無限擴大這個就是一個連鎖的效應當這個因為護病比關病床的時候人就會積在急診 |
| transcript.whisperx[508].start |
13573.502 |
| transcript.whisperx[508].end |
13597.479 |
| transcript.whisperx[508].text |
那如果急診也有護病筆之後那人會在哪裡那病人的生命安危我們就很擔心所以我們應該是要讓各層級醫院都有相當的量的而不是都集中在醫學中心所以才會關切到說我們要逐步的到位讓這個體系都能夠發展不然 |
| transcript.whisperx[509].start |
13598.901 |
| transcript.whisperx[509].end |
13618.88 |
| transcript.whisperx[509].text |
這個對於這個民眾的就醫全醫的衝擊會非常大我們都知道一些草友都認為是護士是最辛苦的因為他們不僅是有專業知識以外那病人的翻身啊餵食啊沐浴啊這些或者是要跟診啊我覺得這些真的是要時間跟勞力的一個付出那我們都知道說可能是不是 |
| transcript.whisperx[510].start |
13620.001 |
| transcript.whisperx[510].end |
13644.406 |
| transcript.whisperx[510].text |
難道只是一個薪水的問題讓他們分分離開這個職場嗎那我們當然除了薪水的問題以外是不是也要考慮到霸凌的問題因為我們知道以前在當兵的時候很像學長學弟制就是常常都是學長在欺負學弟嘛大家都知道然後現在到護理界我在想在霸凌的一個層面我看了一些資料可以發現說他們的霸凌的一個 |
| transcript.whisperx[511].start |
13645.126 |
| transcript.whisperx[511].end |
13662.823 |
| transcript.whisperx[511].text |
比例以上的32到87% 甚至高達到64%無論是言語的啦 無論是同儕之間 或者是異異戶之間所以我覺得這個霸凌的這個現象如果沒有一個很好的申訴或者是改善的話我相信這是他們離子很主要的原因 |
| transcript.whisperx[512].start |
13663.303 |
| transcript.whisperx[512].end |
13688.842 |
| transcript.whisperx[512].text |
所以我想衛福部這邊是不是應該從八零這個部分也要去多所著墨那至於薪水的部分常常我們都是用日本、韓國、新加坡來做比較那是不是我們有沒有一個可能盡量把這個差距縮短因為我們都知道說他們很辛苦可是卻不給他們一個相對的收入的話很像永遠只是原木求雨啦我希望真的能夠實質幫助到他們的一個實際的需求 |
| transcript.whisperx[513].start |
13689.562 |
| transcript.whisperx[513].end |
13697.994 |
| transcript.whisperx[513].text |
那希望部長能不能做一個你現在的想法告訴我們所有護理師你的想法 |
| transcript.whisperx[514].start |
13699.954 |
| transcript.whisperx[514].end |
13721.642 |
| transcript.whisperx[514].text |
跟委員說明那個霸凌這個事情因為我們在這個護理12項的改善策略裡面也包含友善職場那當然這個有些是因為這個過去的文化也好或者是因為工作的壓力也好有時候會有這樣所以我們在成立的部裡面有一個這個護理的這個申訴通報平台 |
| transcript.whisperx[515].start |
13722.442 |
| transcript.whisperx[515].end |
13737.152 |
| transcript.whisperx[515].text |
也有類似的大概在5、6%會有跟職場霸凌相關那我們也都會積極去處理同時也辦理一些教育訓練課程來舒緩像這樣的一個狀況的發生這個我們會繼續來做我不能夠正視這個議題接下來講到這一本我大概翻了一下 |
| transcript.whisperx[516].start |
13746.158 |
| transcript.whisperx[516].end |
13763.844 |
| transcript.whisperx[516].text |
那我想知道在1-14頁這邊有像檢列優化偏鄉醫療精進計畫第二期7億元的部分是檢列是什麼樣的一個項目優化偏鄉醫療精進它檢列7億嘛那我想說偏鄉已經很需要醫療了可是為什麼還會檢列7億元呢 |
| transcript.whisperx[517].start |
13771.999 |
| transcript.whisperx[517].end |
13791.155 |
| transcript.whisperx[517].text |
因為這個計畫本來裡面吼還有包含那個口腔啦包含這個衛生所的這個設備的這個整件啦等等他不是只有那個這個醫療的部分他有其他其他的公共衛生還是之類的 |
| transcript.whisperx[518].start |
13792.431 |
| transcript.whisperx[518].end |
13796.614 |
| transcript.whisperx[518].text |
我們確認一下之後跟委員說明是說比前一年稍微減少對減少7億那我說天下已經很辛苦來減少7億 |
| transcript.whisperx[519].start |
13808.154 |
| transcript.whisperx[519].end |
13828.856 |
| transcript.whisperx[519].text |
那個是沒有那麼多啦對就是那個衛生所剛剛我提到我們這個計畫裡面包含有衛生所那個都是地方有提出來然後我們再去實際編列所以每年那個變動會比較大因為如果已經整建完了就它一次性就結束了它不是持續性計畫所以那個部分會變動 |
| transcript.whisperx[520].start |
13833.84 |
| transcript.whisperx[520].end |
13848.772 |
| transcript.whisperx[520].text |
1-57這邊我看到我們離島地區的急症症轉診後送的計畫你們只有針對金門 連江跟澎湖可是我們卻沒有看到蘭嶼我覺得蘭嶼也是屬於離島所以我想說是不是離島是另外算嗎 是嗎 |
| transcript.whisperx[521].start |
13850.834 |
| transcript.whisperx[521].end |
13864.967 |
| transcript.whisperx[521].text |
不是 要這樣這三個住地的話是住地所以只有三個大離島有住地那麼蘭嶼 綠島它是由我們空勤總隊去後送所以就沒有特別編列預算 |
| transcript.whisperx[522].start |
13865.848 |
| transcript.whisperx[522].end |
13881.325 |
| transcript.whisperx[522].text |
那就是我的疑慮啦好 最後就是針對偏向的部分跟部長來請教就是其實我們也知道我們在原住民地區我們都很希望說能夠跟平地當然是要走的路還很長就一個實際的案例說 |
| transcript.whisperx[523].start |
13883.767 |
| transcript.whisperx[523].end |
13904.609 |
| transcript.whisperx[523].text |
一個部落的青年他跌倒骨折要為了要處理這個傷勢他可能先後轉好幾次醫院先從低級醫院到區域醫院然後再轉到更高級的比如說醫學中心好了可是在都會的民眾他沒有辦法去想像這些他要遇到的這些問題我想說雲霄偏鄉在分級醫療集中症後送中醫科資源 |
| transcript.whisperx[524].start |
13905.39 |
| transcript.whisperx[524].end |
13929.847 |
| transcript.whisperx[524].text |
我覺得是一個很清楚的一個整合機制因為會讓很多病人家屬都不知道他應該往哪裡去尋求幫忙然後現在IDS也要升級到全人整合照護那之前是用秀嶺的一個經驗希望能夠推到全國的幾個地區希望能夠擴到濁西 豐濱 台東 海端這些那我們希望說 |
| transcript.whisperx[525].start |
13930.848 |
| transcript.whisperx[525].end |
13951.16 |
| transcript.whisperx[525].text |
是不是把這套模式制度化、標準化、指標化以後呢是不是有其他元香可以能夠複製那我想說這個複製的經驗是不是可以把地圖裡面是不是比如說有衛生索啦哪裡缺醫師哪裡缺護健那癌症 |
| transcript.whisperx[526].start |
13952.341 |
| transcript.whisperx[526].end |
13974.442 |
| transcript.whisperx[526].text |
一長篩檢到哪裡去追這些長照出院者要怎麼去接上長照集中症者們來來後送我覺得這是一個要我們把偏向地區去落實照顧的一個很清楚的一個地圖因為我覺得常委主委會搞不太清楚這些所有的因果關係所以我希望 |
| transcript.whisperx[527].start |
13975.303 |
| transcript.whisperx[527].end |
13998.294 |
| transcript.whisperx[527].text |
有個更清楚的脈絡讓族人可以去因應所以我想說這邊具體來要求這件事情能不能不在近期內推出全國與偏鄉 原鄉的一個全能照護的支援盤點地圖我講的剛剛包括醫療院所 衛生所 遠距癌症篩檢 長照ABC 文件站居家醫療 護健支援等等 |
| transcript.whisperx[528].start |
13998.934 |
| transcript.whisperx[528].end |
14015.022 |
| transcript.whisperx[528].text |
第二個就是原鄉能不能建立出院後30天的銜接指標人類管病人出院後是否成功接上居家醫療長照服務復健、輔具、交通接送跟家庭照顧者的支持第三個就是請健保署能夠針對IDS前人 |
| transcript.whisperx[529].start |
14017.063 |
| transcript.whisperx[529].end |
14044.713 |
| transcript.whisperx[529].text |
整合照護提出標準化的推動項目包括加護健康地圖高風險名冊30 90 180天的追蹤機制跨團隊的個案會議文件帳合作AI篩檢跟BI成效的儀表版最後就是衛福部提出秀林鄉模式擴散到其他原鄉的年度時程跟成效指標讓我們能夠享受到我們衛福部近年來對原鄉的這些努力 |
| transcript.whisperx[530].start |
14045.293 |
| transcript.whisperx[530].end |
14073.372 |
| transcript.whisperx[530].text |
好 很謝謝委員者提議我覺得都相當具有可行性那第一個就是說當然我們在健保的跨醫通上面都有這個就醫的地圖不過我們來針對這個原鄉的部分做更精細版所以這個原鄉的這個資源地圖包含像衛生所癌篩因為我們一般的這個APP是沒有特別去強調這個 |
| transcript.whisperx[531].start |
14075.513 |
| transcript.whisperx[531].end |
14101.645 |
| transcript.whisperx[531].text |
包含我們可能IDS的特別的站或者是文件站這個平常是健保的資源地圖是沒有的所以我們專門為這個原鄉先來建這個資源地圖所以我想今年我們就把這個納進去至於那個轉嫌服務就是我們的目標這個長照的部分我們本來就在做至於第三個跟第四個IDS跟那個秀林 |
| transcript.whisperx[532].start |
14102.485 |
| transcript.whisperx[532].end |
14127.501 |
| transcript.whisperx[532].text |
鄉的模式因為今年也擴大到八個八個縣那麼是四個鄉鎮嘛所以我們把這一個這個擴準備怎麼往前往前推目前的狀況跟往前推的一個規劃呢我們來做一個整理再提供給委員參考謝謝部長辛苦了謝謝謝謝委員謝謝盧昭偉的發言也謝謝部長的答詢 |
| transcript.whisperx[533].start |
14138.459 |
| transcript.whisperx[533].end |
14147.344 |
| transcript.whisperx[533].text |
繼續請黃秀芳委員咨詢謝謝主席 我們請部長 總理部長 |
| transcript.whisperx[534].start |
14153.933 |
| transcript.whisperx[534].end |
14177.259 |
| transcript.whisperx[534].text |
黃衍好部長好部長我今天想要請教就是有關我們疫苗政策那我看到就是說我們這個兒童的這個疫苗的接種其實從出生然後可能到小學都有這個手冊就是記錄說小朋友他打了什麼疫苗那我看到就是說我們成人 |
| transcript.whisperx[535].start |
14178.3 |
| transcript.whisperx[535].end |
14193.117 |
| transcript.whisperx[535].text |
的或者是65歲以上好的這個長者他打這個流感疫苗其實我看到這個接這個打流感疫苗的這個接種的這個這個比例好像也不是很高超每一年平均超50%左右那像這樣子的話 |
| transcript.whisperx[536].start |
14196.941 |
| transcript.whisperx[536].end |
14223.139 |
| transcript.whisperx[536].text |
部長這邊是不是有想要去推動讓這些長者他可以很清楚或者是他如果就醫的時候醫師就可以看到說他今年到底有沒有打流感疫苗或打其他的疫苗那可以透過他也許去醫院就醫的時候醫師可以再提醒他是不是就去打流感疫苗或其他的疫苗是不是衛福部未來會這樣推動 |
| transcript.whisperx[537].start |
14225.041 |
| transcript.whisperx[537].end |
14247.021 |
| transcript.whisperx[537].text |
跟委員說其實我們已經在這樣做那當然各醫院的HIS系統他們會自己去做提醒但是我們在健保裡面有個大家醫平台那個大家醫平台現在就已經會主動提醒他有哪一些公費篩檢公費疫苗多久做一次這個都會主動提醒只不過目前這個大家醫平台只限於在 |
| transcript.whisperx[538].start |
14247.521 |
| transcript.whisperx[538].end |
14259.606 |
| transcript.whisperx[538].text |
家庭醫師計畫的會員那如何把它擴大到讓所有的診所只要就醫都能提醒我來請健保研議把它擴大目前它只針對參加嘉義的會員有這個提醒 |
| transcript.whisperx[539].start |
14263.087 |
| transcript.whisperx[539].end |
14282.097 |
| transcript.whisperx[539].text |
那看看未來怎麼把這個提醒擴大到所有的這個在因為畢竟在診所就醫比較多所以從那個地方來做那另外在醫院的部分我們也一併來要求醫院也把這個提醒的把它做進來所以這個我覺得這個是我們應該要做的 |
| transcript.whisperx[540].start |
14285.018 |
| transcript.whisperx[540].end |
14310.093 |
| transcript.whisperx[540].text |
我希望這個應該我覺得應該不會太困難吧因為所有你不論是到診所到醫院你有打這個疫苗的話其實就把它註記一下然後也提醒他自己或者是醫師看到之後或譬如說你們十月份開始這個鼓勵長者要打流感疫苗那醫師如果看到的話他還沒有打這個流感疫苗就可以鼓勵他去打嘛 |
| transcript.whisperx[541].start |
14310.373 |
| transcript.whisperx[541].end |
14329.298 |
| transcript.whisperx[541].text |
因為這個應該不是很困難長者打那個流感是在我們的那個大家醫計畫還有那個全人整合照護計畫裡面的KPI只是怎麼把那個沒有納入這個大家醫計畫的也來推基層的部分這個我們來更努力 |
| transcript.whisperx[542].start |
14330.418 |
| transcript.whisperx[542].end |
14345.206 |
| transcript.whisperx[542].text |
那部長我想請教另外一個就是我們在看預算的時候那我看到預算我覺得一個蠻奇怪的就是說你們去年送出來的這個預算書有標準的這個疫苗 |
| transcript.whisperx[543].start |
14345.626 |
| transcript.whisperx[543].end |
14360.813 |
| transcript.whisperx[543].text |
那也有加強型的疫苗那總共加起來是700萬劑那這個一般型的疫苗當時就是去年你們送出來的這個就是原本採購標準型的可能就是335萬劑 |
| transcript.whisperx[544].start |
14364.375 |
| transcript.whisperx[544].end |
14388.968 |
| transcript.whisperx[544].text |
那加強型的是這個要採購365萬劑那加起來就是總共是700萬劑那到最後我看到的你們到最後是這個加強型的剩下20萬劑那一般的就是一般型的就差不多差不多是600 |
| transcript.whisperx[545].start |
14392.27 |
| transcript.whisperx[545].end |
14412.965 |
| transcript.whisperx[545].text |
684萬劑啦那跟你們原本去年送出來的那個預算你們原本要採購是完全不一樣那既然知道就是說這個加強型的這個疫苗對長輩來講是比較好的然後它的保護力也比較好那標準型的這個流感疫苗它的這個保護力聽說是只有 |
| transcript.whisperx[546].start |
14413.966 |
| transcript.whisperx[546].end |
14441.545 |
| transcript.whisperx[546].text |
百分之三十幾嘛保護力是只有百分之三十幾那如果既然知道是這個加強型的保護力是比較好那我們每一年看到得到重症的這個因為流感然後得到重症的長輩真的都是65歲以上會比較嚴重所以如果是真的這樣的那為什麼到最後你們採購的這個疫苗是跟原本去年送出來的這個預算是完全不一樣 |
| transcript.whisperx[547].start |
14442.746 |
| transcript.whisperx[547].end |
14460.576 |
| transcript.whisperx[547].text |
跟委員說明也是這個說來說去還是資源的問題就是到底我們有多少資源能夠做多少事情還要考慮到成本效益所以確實在這個這個家常型疫苗對一些脆弱族群可以降低重症跟住院率 |
| transcript.whisperx[548].start |
14461.116 |
| transcript.whisperx[548].end |
14475.905 |
| transcript.whisperx[548].text |
死亡率是沒有錯但是呢如果能夠打更多的人這個更多的人打也要一併考慮所以我們現在的策略上是說逐步增加啦所以這前面今年會採購20萬劑的加強型會先針對機構的你去年送出來的預算是比一般型的還多然後你竟然是 |
| transcript.whisperx[549].start |
14486.092 |
| transcript.whisperx[549].end |
14494.288 |
| transcript.whisperx[549].text |
對跟我說明這兩種疫苗的價格也差很多啦是所以我們那個價格的差異非常大所以呢我們先從這個機構的 |
| transcript.whisperx[550].start |
14497.046 |
| transcript.whisperx[550].end |
14513.121 |
| transcript.whisperx[550].text |
長者先開始然後再慢慢擴大到明年我們會再增加到這個重大傷病的長者我想請教就是說每一年會打這個流感疫苗的這個長者也差不多差不多一半那個65歲超過480萬人那這個也大約只有一半差不多240萬人會去打這個流感疫苗 |
| transcript.whisperx[551].start |
14520.248 |
| transcript.whisperx[551].end |
14532.856 |
| transcript.whisperx[551].text |
那如果按照這樣子的話其實我覺得既然加強型的這個疫苗它的保護力更好那其實為什麼不去考慮一下而且既然你們去年在預算書上面也有這樣的一個編列 |
| transcript.whisperx[552].start |
14536.609 |
| transcript.whisperx[552].end |
14551.895 |
| transcript.whisperx[552].text |
這個還是回到意願啦就是說打加強型跟非加強型會不會因為打了加強型長者的施打意願會更高這個我們要調查啦但是從我們這個這幾年買的疫苗幾乎都打完啦 |
| transcript.whisperx[553].start |
14552.855 |
| transcript.whisperx[553].end |
14574.486 |
| transcript.whisperx[553].text |
沒有剩的啦當然啦我現在的意思是說65歲以上的長者既然你們知道說這個保護力是比較好的那你們去年的這個預算書上面也有這樣的一個編列那是不是就是說我看到就是說你們這個今年呢是只有採購20萬劑嘛這個落差真的很大欸你們去年編是編預計是要採購365萬劑 |
| transcript.whisperx[554].start |
14579.928 |
| transcript.whisperx[554].end |
14606.717 |
| transcript.whisperx[554].text |
這個差好幾倍捏那如果說有意願其實部長有意願打這個流感疫苗的長者其實他也不會去他只要有糖素他就會去做不會因為就是說當然如果加強那個保護力更好的話我覺得他的意願應該也會更高啦對啊所以所以而且你也要去考慮到後面如果他得到重症的話其實我們的健保的這個支出也許會更大所以 |
| transcript.whisperx[555].start |
14607.778 |
| transcript.whisperx[555].end |
14623.232 |
| transcript.whisperx[555].text |
這個部長我是想要再提醒一下就是說為什麼落差這麼大那你剛剛講的可能是因為會其他的疫苗可能會受到排擠那是什麼樣的疫苗會受到排擠就是我們會來多爭取一些預算因為這個都還是資源的問題 |
| transcript.whisperx[556].start |
14623.772 |
| transcript.whisperx[556].end |
14641.177 |
| transcript.whisperx[556].text |
當然另一方面也得從成本效益去評估到底什麼樣的人打會比較有效益這個我們都會一併考量進來那你們應該也是會覺得說65歲以上的長者打他的效益會更高嗎 |
| transcript.whisperx[557].start |
14642.077 |
| transcript.whisperx[557].end |
14670.393 |
| transcript.whisperx[557].text |
對不對就是說他如果以成本效益來講當然是以65歲裡面的高風險群又會更高這個當然你打越多成本效益就會下降啦越target那個成本效益就會很高因為成本少嘛保護的剛好都是你的目標族群所以就是我們會去平衡啦所以你到最後是因為那個預算預算的關係嗎對預算當然是一個重要的考量 |
| transcript.whisperx[558].start |
14671.153 |
| transcript.whisperx[558].end |
14694.808 |
| transcript.whisperx[558].text |
可是你去年送出來的時候你沒有考慮到說這個預算因為你去年9月份送到立法院的時候需要打那個700萬劑因為今年是打算打700萬劑對啊其實原本的疫苗的價格也是一個你去年就編的出來那為什麼今年會落差這麼大這個是我疑問的一個地方啦 |
| transcript.whisperx[559].start |
14695.663 |
| transcript.whisperx[559].end |
14723.597 |
| transcript.whisperx[559].text |
就是我們是變態支出但是我們的收入要從公務預算來撥補所以那時候公務預算撥補最後合下來的是增加疫苗接種處置費還有這個我們後來也有爭取這個兒童輪狀病毒疫苗所以明年會先從兒童輪狀病毒疫苗這邊開始啦因為兒童疫苗已經10年沒有新增品項了那成人這邊人數當然很多所以價格的關係會波動一下就會影響到整個預算的規模所以我們後續會逐步來擴大 |
| transcript.whisperx[560].start |
14725.459 |
| transcript.whisperx[560].end |
14738.676 |
| transcript.whisperx[560].text |
那當然就是因為可能就預算可能你們要增加其他的這個疫苗所以這個會受到一些排擠嘛所以我是看到這個預算我就覺得說我很不解的是原本編了你們加強型的編的這個 |
| transcript.whisperx[561].start |
14741.299 |
| transcript.whisperx[561].end |
14762.83 |
| transcript.whisperx[561].text |
這個疫苗是比標準型的還要多結果到最後是差落差這麼大那個標準型是685萬劑然後這個剩下20萬劑我覺得這個真的這個落差很大而且如果既然知道它的保護力是好的話其實我覺得你應該你現在20萬劑只能在機構 |
| transcript.whisperx[562].start |
14767.073 |
| transcript.whisperx[562].end |
14778.125 |
| transcript.whisperx[562].text |
20萬劑只能在機構嘛就是機構的這些長輩可以施打那剛剛部長你說的如果在這個65歲以上的這些長者然後他也是高風險不只是在機構 |
| transcript.whisperx[563].start |
14779.773 |
| transcript.whisperx[563].end |
14803.542 |
| transcript.whisperx[563].text |
它也需要這種加強型的疫苗所以我覺得部長針對這部分應該還要再去思考一下既然你在去年的時候你就已經編得出來這個預算編得出來那就表示你們有精算過如果是這樣子的話我覺得應該要去好好的思考一下針對不只是機構 |
| transcript.whisperx[564].start |
14804.722 |
| transcript.whisperx[564].end |
14823.269 |
| transcript.whisperx[564].text |
不只是機構 針對一般高風險的這些長者我覺得應該都是要把這個風險考慮進去然後讓這些長者也可以施打到這種加強型的疫苗好 我們會逐年來爭取增加預算來施打那你去年不是已經編得出來了 為什麼 |
| transcript.whisperx[565].start |
14825.55 |
| transcript.whisperx[565].end |
14831.094 |
| transcript.whisperx[565].text |
就是今年的預算 去年是今年的預算因為要打700萬劑差不多 預算就是這樣你去年就編得出來 怎麼會差不多因為我們一般型的價格比較便宜 |
| transcript.whisperx[566].start |
14847.185 |
| transcript.whisperx[566].end |
14854.896 |
| transcript.whisperx[566].text |
一劑一劑你們編是差不多那個如果打完折之後差不多178元嘛178.5嘛那加強型的是差不多420嘛 |
| transcript.whisperx[567].start |
14860.442 |
| transcript.whisperx[567].end |
14884.253 |
| transcript.whisperx[567].text |
但是實際上沒有那麼多對就是說如果我們真的按照這個預算全去買的話就是要用疫苗基金目前剩餘的那個金額但是因為每年都要買這麼多所以一旦買下去之後每年都要一直花所以必須要先確定有後續足夠的這個疫苗基金的撥補那去年後來的決定是以疫苗接種儲置費優先所以多了8.4億在這個部分而且後面也會一直每年都要8.4億來優先照顧我們低線醫療人員是 |
| transcript.whisperx[568].start |
14888.115 |
| transcript.whisperx[568].end |
14906.927 |
| transcript.whisperx[568].text |
所以是因為這樣子然後又要就是那個小朋友的那個倫狀病毒的疫苗好那當然就是說我希望你們未來如果要編的話你真的要去神聖去思考一下要不然真的編出來之後後來落差這麼大我會覺得說真的還蠻奇怪的啦 |
| transcript.whisperx[569].start |
14909.205 |
| transcript.whisperx[569].end |
14916.917 |
| transcript.whisperx[569].text |
那剛剛講的那個65歲以上這些長者然後是高風險的我覺得應該也要考慮進去會會好謝謝謝謝黃修芳委員的諮詢接下來請陳穎委員諮詢 |
| transcript.whisperx[570].start |
14934.667 |
| transcript.whisperx[570].end |
14948.548 |
| transcript.whisperx[570].text |
謝主席麻煩請石部長還有江署長以及中醫藥師司長請石部長江署長陳委員好部長好大家大家好 |
| transcript.whisperx[571].start |
14949.626 |
| transcript.whisperx[571].end |
14968.384 |
| transcript.whisperx[571].text |
我想在這邊首先要先是這樣子我們這個鑰匙兩用在111年的時候曾經有討論過那後來因為大家意見太分歧了而作罷了那所以我今天本席要在這邊特別肯定這個我們中醫藥師 |
| transcript.whisperx[572].start |
14970.306 |
| transcript.whisperx[572].end |
14995.323 |
| transcript.whisperx[572].text |
蘇司長他非常積極的想要解決這個問題那麼在這個歷經4年之後呢在今年4月14號呢又再次提出這個相關草案那我想我們先來看一下首先呢我要在這邊先請教一下部長海帶、蓮子、山藥還有牡蠣您覺得是食品還是藥品 |
| transcript.whisperx[573].start |
14997.097 |
| transcript.whisperx[573].end |
15017.508 |
| transcript.whisperx[573].text |
這些我了解在我們傳統的中藥材裡面都會有入藥所以應該都是屬於藥食兩用那你覺得這些品項的屬性是食品多還是中藥材多用的多當然是食品用的多 |
| transcript.whisperx[574].start |
15018.689 |
| transcript.whisperx[574].end |
15044.358 |
| transcript.whisperx[574].text |
那好那在上個月14號衛福部有預告訂定了這個德工食品原料使用之中藥材品項及其產品屬性認定基準的草案那本席想請教就是說為什麼不叫德工中藥材原料使用之食品品項及其產品屬性認定標準這個差別在哪裡部長有沒有想過這個問題 |
| transcript.whisperx[575].start |
15047.806 |
| transcript.whisperx[575].end |
15075.565 |
| transcript.whisperx[575].text |
為什麼會反過來我們是可於食品中添加這個是說德公中藥產原料使用因為我們的食品基本上是比較寬鬆啦我們沒有對於這個食品特別去做一些要求那麼除非有這個所謂的這個小綠人標章這些才會有特別的這個就健康食品類我們才會有特別 |
| transcript.whisperx[576].start |
15077.766 |
| transcript.whisperx[576].end |
15096.482 |
| transcript.whisperx[576].text |
做藥品當中的就會有爭議因為做藥的話要求會比較高所以才會有說可以拿來作為中藥材的食品原料所以這樣反過來就不合適是嗎 |
| transcript.whisperx[577].start |
15098.152 |
| transcript.whisperx[577].end |
15126.631 |
| transcript.whisperx[577].text |
因為規範的寬鬆是不一樣的所以有一切的一切我是說按照這個字面上來看我們這個其實中藥材來源原先它的最原始的狀態大概都是天然的凍植物在加工後製之後才變成藥材所以我們才會想說那德工中藥材使用的原料是食品品項我們把它反過來這樣思考我想拋出這樣的議題你們也可以後續好好的想一想 |
| transcript.whisperx[578].start |
15127.532 |
| transcript.whisperx[578].end |
15139.985 |
| transcript.whisperx[578].text |
那我另外要再請教就是說這個基準本身有沒有法律強制力那我們現行有哪一部法律是需要靠這個基準來認定的 |
| transcript.whisperx[579].start |
15142.765 |
| transcript.whisperx[579].end |
15169.863 |
| transcript.whisperx[579].text |
基本上這個是回到這個要事法因為要事法裡面有一些規範就會造成在這個裁罰違法的時候的一個認定上那麼地方這個衛生主管機關在裁罰的時候需要有一個這個行政依據所以我們才會有這個基準來做裁罰的時候的一個衡量標準這樣 |
| transcript.whisperx[580].start |
15170.623 |
| transcript.whisperx[580].end |
15188.104 |
| transcript.whisperx[580].text |
所以在整個這個規規矩辦剛標準的這個參考的法規之下順序那其實其實基準這個基準我們其實他就是一個給行政單位參考對不對好那 |
| transcript.whisperx[581].start |
15188.724 |
| transcript.whisperx[581].end |
15212.426 |
| transcript.whisperx[581].text |
再根據這個中央法規標準法第三條基準它本身它並不是一個行政命令所以它不存在對人民的一個強制效力頂多就是行政機關在行政上的業務參考所以從內容來看 |
| transcript.whisperx[582].start |
15213.627 |
| transcript.whisperx[582].end |
15231.874 |
| transcript.whisperx[582].text |
如果今天這一旦這個基準它通過了對於這個食品跟藥品的認定就直接就是讓這個行政機關來決定對於這個食品產業的發展及民眾的權益它將產生一個非常重大的影響根據這個中央法規標準法第五條規定 |
| transcript.whisperx[583].start |
15240.755 |
| transcript.whisperx[583].end |
15266.661 |
| transcript.whisperx[583].text |
關於人民之權利義務者應以法律定之那有關這個食品跟藥品的認定即將透過這樣不具法律位階的行政認定他等於架空了我們的藥事法那對於這個藥品的定義跟管理的職權也衝擊食品安全衛生管理法以及這個健康食品管理法的適用我想請教衛福部你們的看法是什麼嗯 |
| transcript.whisperx[584].start |
15271.015 |
| transcript.whisperx[584].end |
15288.387 |
| transcript.whisperx[584].text |
對 這個剛剛提到 因為這個裁罰的時候都是地方衛生主管機關那所以呢 在裁罰標準上如果沒有不一致 沒有一個一致性的話就會造成這個人民權益的受損 所以才有 |
| transcript.whisperx[585].start |
15289.447 |
| transcript.whisperx[585].end |
15310.408 |
| transcript.whisperx[585].text |
這個由中央上級機關對於下級機關的指導所以以這個方式來定這個基準意思是提供給地方的衛生主管機關在裁罰的時候有一個標準如果沒有這個標準的話那可能大家各自裁罰那個拿捏就會不一樣要反而變成一個產品在某一個 |
| transcript.whisperx[586].start |
15312.19 |
| transcript.whisperx[586].end |
15333.122 |
| transcript.whisperx[586].text |
這個縣市是合法沒有被罰到另外一個縣市就被罰所以才會有這樣的這個部分本席完全同意也是為什麼我們一直就是說這幾年來一直想要有一個基準省的三不五時我想不只我辦公室很多立委的辦公室都接到陳情 |
| transcript.whisperx[587].start |
15336.204 |
| transcript.whisperx[587].end |
15357.239 |
| transcript.whisperx[587].text |
本席是最支持中醫藥的那當然就是說也最支持中藥師那我要在這邊再一次就是肯定司長要處理這個藥食兩用正義的破例那但行使公權利我們要回歸就是還是必須要建構在這個法律的基礎上 |
| transcript.whisperx[588].start |
15358.66 |
| transcript.whisperx[588].end |
15386.158 |
| transcript.whisperx[588].text |
那所以我們的藥事法第六條針對藥品它是有特別的定義的那也就是說我們所謂的這個所稱的藥品必須是要點國家處方診斷治療減輕預防疾病影響身體結構及身體機能才能夠認定是藥品而不是靠行政的認定來決定它是不是藥品這句話很重要我再重複一次 |
| transcript.whisperx[589].start |
15387.418 |
| transcript.whisperx[589].end |
15401.705 |
| transcript.whisperx[589].text |
就是在所稱的藥品必須是要點國家處方診斷治療減輕預防疾病影響身體結構及身體機能才能認定為藥品而不是靠行政的認定來決定它是不是藥品 |
| transcript.whisperx[590].start |
15403.606 |
| transcript.whisperx[590].end |
15427.417 |
| transcript.whisperx[590].text |
而且我們藥品的管理相較於食品是相對嚴格的行政管理的成本也相當高台灣在過去幾十年來對於食品類的中藥材已經有非常穩健的發展今天我們突然要以行政的手段硬是將具中藥材效用的食品把它原則劃入藥品 |
| transcript.whisperx[591].start |
15429.438 |
| transcript.whisperx[591].end |
15458.302 |
| transcript.whisperx[591].text |
例如說在例外視為食品那沒有考慮一旦說列為藥品就必須適用藥式法那對於這個藥品的規範包括了這個機查檢驗查驗登錄等等那我想要請教衛福部就是說那我們目前就是說在這個時間點上推出這樣的政策的原因是為什麼 |
| transcript.whisperx[592].start |
15459.665 |
| transcript.whisperx[592].end |
15463.739 |
| transcript.whisperx[592].text |
因為已經有業者系屬法院 |
| transcript.whisperx[593].start |
15465.064 |
| transcript.whisperx[593].end |
15489.952 |
| transcript.whisperx[593].text |
已經被細數法院了那所以呢就會發現有這個狀況跟實際上實務上確實有需要把它釐清楚讓這個地方主管機關在移送的時候那麼能夠有比較一致性的標準所以這一個基準我想還是有它的必要性不然現在馬上就觸及到只是說它裡面上可以在我們預告的期間 |
| transcript.whisperx[594].start |
15492.913 |
| transcript.whisperx[594].end |
15507.75 |
| transcript.whisperx[594].text |
再來這個接受大家的意見的表達那再來做最後頒布的時候的調整我想這就是說因為他預告期間當然我也認同其實在我們想要解決就是已經有這麼多的訴訟在 |
| transcript.whisperx[595].start |
15510.333 |
| transcript.whisperx[595].end |
15530.503 |
| transcript.whisperx[595].text |
那當然這過程我們也討論了很多但是我想這樣子的一個基準通過之後呢我可以預言兩件事第一我們的輸送可能更多了然後再來這個中醫藥相關的這個生技產業可能這個倒閉潮就來了 |
| transcript.whisperx[596].start |
15531.567 |
| transcript.whisperx[596].end |
15549.421 |
| transcript.whisperx[596].text |
好這個是我想今天預告期我們很客觀的來點出一些問題那我要在這裡嚴正聲明就是說我們國家已經訂有這個中醫藥發展法對於食品用於中藥材已經有一部上市中藥監測辦法那在對中藥材中藥製劑實施的法定監測也規定了這個中藥查驗登記的辦法 |
| transcript.whisperx[597].start |
15557.227 |
| transcript.whisperx[597].end |
15577.418 |
| transcript.whisperx[597].text |
那今天呢 我們冒然提出說這樣的一個認定標準 認定基準將這個第二類的品項 就是說 則定有每人每日食用的限量那如果說添加了第二類中藥材 且這個總量呢 佔比超過五成 |
| transcript.whisperx[598].start |
15578.658 |
| transcript.whisperx[598].end |
15603.212 |
| transcript.whisperx[598].text |
或者產品中成分第二類中藥材任意產品相好每日食用量超過台灣中藥點最低用量五成就需列為藥品的管理我想要請問部長將來這些被你們認定為藥品的藥材食品你們要不要監測我舉個例子同樣都屬於第二類的中藥材 |
| transcript.whisperx[599].start |
15604.833 |
| transcript.whisperx[599].end |
15622.486 |
| transcript.whisperx[599].text |
我們這個以這個藥膳包去販售就沒有限量的問題嗎那以茶包的方式就不需要管理嗎那其他通路的方式販售就要以藥品來管理那這樣子的邏輯我就問說這樣的邏輯有符合法律原則嗎 |
| transcript.whisperx[600].start |
15624.857 |
| transcript.whisperx[600].end |
15652.766 |
| transcript.whisperx[600].text |
所以是不是說以後的生技廠都要轉型去開五十攔去開清新手搖飲這樣就沒問題啦部長怎麼看法這個有些當作食品添加啦有些他會加進去那過去的話經常涉及到固有成方啦等等這些違法都被判定我想我們跟委員的這個初衷都是一樣想要解決現在在 |
| transcript.whisperx[601].start |
15653.807 |
| transcript.whisperx[601].end |
15665.236 |
| transcript.whisperx[601].text |
這個中藥跟這個藥食兩用在食品發展上面的困境所以我們大家的想法都是一次要解決這個困境那至於說過去討論了很多那目前所 |
| transcript.whisperx[602].start |
15669.655 |
| transcript.whisperx[602].end |
15687.468 |
| transcript.whisperx[602].text |
這篇預告的內容也是經過很多的討論如果中間還有不急之處我想我們可以再趕快來修訂但是要趕快讓它發布不然這些糾紛一直存在無法解決 |
| transcript.whisperx[603].start |
15689.009 |
| transcript.whisperx[603].end |
15715.264 |
| transcript.whisperx[603].text |
我們是不希望後續有更多的糾紛所以我今天提出來你們真的要好好去思考一下那你們的這個食藥署也很明確的就叫做食品及藥物管理署也就是說我們食品跟藥品是要分開管理的不能說根據自己訂立一個行政基準就可以把這個食品當作中藥材甚至說還出現符合你們認定的不以藥品管理的字眼那這種 |
| transcript.whisperx[604].start |
15716.445 |
| transcript.whisperx[604].end |
15729.073 |
| transcript.whisperx[604].text |
就是說食藥不分的態度因為我們今天在講法那當然就是說食物上這個你要怎麼去克服但是我想要建立在法規的基礎上是對這個我說食藥不分那對這個藥事法 |
| transcript.whisperx[605].start |
15731.474 |
| transcript.whisperx[605].end |
15753.132 |
| transcript.whisperx[605].text |
就是說這個是對藥事法的這個架空也是對江署長的架空啦那也可能是這個行政權這個擴權的一個最壞的示範所以今天用這個品項及屬性來認定食品還是藥品以這個行政來霸凌醫藥的專業那就會完全打臉中醫師他下處方的這個專業 |
| transcript.whisperx[606].start |
15755.754 |
| transcript.whisperx[606].end |
15773.194 |
| transcript.whisperx[606].text |
那因為呢沒有在這個第二類的75項的裡面或者是說使用超過你們定定的用量那食品就變成藥品我想這個讓人很多人很難接受那部長就是說一片人身重量多少克你知道嗎 |
| transcript.whisperx[607].start |
15777.28 |
| transcript.whisperx[607].end |
15789.717 |
| transcript.whisperx[607].text |
我們有查過AI啦因為切大 切小 切厚 切薄可能不一樣好 這個是聰明人的回答那我們一般大概可能大概在一到兩克吧 市長 對吧 |
| transcript.whisperx[608].start |
15790.678 |
| transcript.whisperx[608].end |
15813.288 |
| transcript.whisperx[608].text |
好差不多好那你們的基準好假如我們就是看一下就是說一到兩克來為標準那你們的基準定在每人日食用量是1.5克那食用超過限量的五成0.75克就是藥品所以以後含一片人參要當作藥品 |
| transcript.whisperx[609].start |
15814.248 |
| transcript.whisperx[609].end |
15835.88 |
| transcript.whisperx[609].text |
來管理那要符合藥事法的規定要由醫師來下處方才可以含那要認定合格的人參才可以買含半片就是食品那請問市長這樣的管理合適嗎我現在講的是大家一起含我不是說一個人我們這樣解釋是不是正確所以以後也建議這個五十蘭他可以賣人參茶 |
| transcript.whisperx[610].start |
15837.981 |
| transcript.whisperx[610].end |
15863.469 |
| transcript.whisperx[610].text |
又搖頭喔好不好因為它是這個人生如果是像這樣這個是原型啦所以它這個沒有被我們這次納入在特別的規範裡頭所以它因為我們現在所規範的通常它都是經過加工處理之後然後它還會有一些功能的宣稱等等的所以才需要做這一規範磨成粉的也是也是加工啊 |
| transcript.whisperx[611].start |
15865.229 |
| transcript.whisperx[611].end |
15891.899 |
| transcript.whisperx[611].text |
沒關係這個我想食材它就是食材那藥材是藥材人民有權利可以自由去選擇以食品去食用那也可以在醫師的調理之下以藥品來食用那這個用藥安全的核心是在於這個醫師來下處方或者是醫師來調劑那不是說有沒有符合這個 |
| transcript.whisperx[612].start |
15894.08 |
| transcript.whisperx[612].end |
15920.217 |
| transcript.whisperx[612].text |
你們訂定的這個基準那這樣的行政方式將食材變成藥材真的是把一些過去的這個中藥材食品認定為藥品那就是要照藥師法來管理了那光一個這個藥品監測製造生產管理行政負荷就非常大了除非說你們認為食品中藥材的這個廠商會大量 |
| transcript.whisperx[613].start |
15921.638 |
| transcript.whisperx[613].end |
15937.294 |
| transcript.whisperx[613].text |
官場歇業再不然我要請教部長新增這麼多品項的藥品衛福部現在你們有沒有足夠的人力物力可以負荷得了不過跟委員說明如果現在這些都是被列為中藥材 |
| transcript.whisperx[614].start |
15938.12 |
| transcript.whisperx[614].end |
15958.429 |
| transcript.whisperx[614].text |
那如果我們沒有這個基準讓他可以得為食品使用那就通通都以後都是真的要一絲處方這個也會造成人民的不便所以我們才需要做這樣的調和我想是這樣今天的重點當然就是說廠商他本來就可以產生高品質的這個機能性食品來販售 |
| transcript.whisperx[615].start |
15959.83 |
| transcript.whisperx[615].end |
15983.146 |
| transcript.whisperx[615].text |
那過去是這樣那未來也應該是如此那今天呢衛福部你們不能夠說去限制只有通過健康食品認證才能夠以食品去販售嘛對不對那其他的都要當作藥品來管理嘛也不能這樣那這是剝奪人民選擇食物的自由那剝奪我們對於機能性食品的需求的消費的權利嘛因此 |
| transcript.whisperx[616].start |
15985.202 |
| transcript.whisperx[616].end |
16007.91 |
| transcript.whisperx[616].text |
本席是要求目前公告的基準因為藥品的認定與藥施法的定義是有漢格那法律未接它仍然是有存在的疑義而且這個名稱德工食品使用之中藥材它這個是有一個特定的立場所以如果 |
| transcript.whisperx[617].start |
16011.111 |
| transcript.whisperx[617].end |
16038.157 |
| transcript.whisperx[617].text |
就說德工中藥材使用之食品他根據中立與客觀性的話那這個公告跟後續的程序你們應該要很慎重的去考慮那如果說衛福部認為現階段有急迫的需要那以界定中藥材品項及屬性去兼顧國人中藥及用藥安全跟膳食文化那我們也更應該要就是說 |
| transcript.whisperx[618].start |
16039.097 |
| transcript.whisperx[618].end |
16055.384 |
| transcript.whisperx[618].text |
呃要因循一個正式的這個法制作業啦我主要重點要去強調這個那把這個相關基準提升到法律位階所以我並沒有去反對我也肯定中醫藥師好只是說我們 |
| transcript.whisperx[619].start |
16056.184 |
| transcript.whisperx[619].end |
16080.271 |
| transcript.whisperx[619].text |
我們就是說這個法制作業這件事情建構在法的基準上這個是很重要的好那我們把它納入藥師法或這個中醫藥發展法的這個附屬法規好來符合法律保留跟這個明確授權的原則那此外現行預告的基準每日使用量不得超過台灣中藥點最低用量的五成作為規範的依據那其這個 |
| transcript.whisperx[620].start |
16081.511 |
| transcript.whisperx[620].end |
16106.958 |
| transcript.whisperx[620].text |
其中這個科學基礎跟這個食物管理的可行性它確實是有待商榷那第二類的品項雖然從這個37項大幅增加到73項許多品項納入跟排除我相信我們在這個社會中還有很多的討論它還沒有完全達到一個共識那例如說帝皇有納入這個熟帝皇 |
| transcript.whisperx[621].start |
16107.438 |
| transcript.whisperx[621].end |
16124.597 |
| transcript.whisperx[621].text |
沒有納入然後甘草有納入自甘草他沒有納入都可能影響民眾的權益跟產用適用標準的一致性所以基於這個上述爭議尚未釐清那為求這個審慎周延那本席是建議就是說如果未來 |
| transcript.whisperx[622].start |
16125.978 |
| transcript.whisperx[622].end |
16147.75 |
| transcript.whisperx[622].text |
我們想要把這個基準正式法制化來也希望應該來送這個立法院本委員會來進行這個專業的審查跟充分的討論來凝聚社會共識那兼顧這個食安用藥安全跟人民的權益啦我想是做這樣的建議 |
| transcript.whisperx[623].start |
16149.17 |
| transcript.whisperx[623].end |
16173.019 |
| transcript.whisperx[623].text |
我這個跟委員在說明現在目前我們規範的都已經是納入中藥材管理的其實我們是在把中藥材裡面當作藥管的讓它可以當作食品來使用其實是在對人民有利的發展上去走跟大家想像的不是把食品匡入變成藥材現在都是在中華藥點裡面有的 |
| transcript.whisperx[624].start |
16174.76 |
| transcript.whisperx[624].end |
16192.577 |
| transcript.whisperx[624].text |
詳細的我們再找時間跟委員詳細的說明現在的困境就是因為它被寫在中藥點裡面已經是中藥材了所以現在是要把它部分拉出來讓它可以進入食品使用不然目前很多可能違法的樣態會無法解決會更擴大 |
| transcript.whisperx[625].start |
16196.802 |
| transcript.whisperx[625].end |
16205.432 |
| transcript.whisperx[625].text |
這個我理解我們之前也都有討論過那只是說希望在未來我們在行政授權的就是在這個規範我們在 |
| transcript.whisperx[626].start |
16210.558 |
| transcript.whisperx[626].end |
16233.396 |
| transcript.whisperx[626].text |
要判定他是不是藥材藥品這件事情我想應該就是我們讓他更有法治化這樣子因為現在目前我們這一次預告的現在通通是種藥材如果我們這個不走的話那些回來都不能用那個會很麻煩OK那後續我們再找出來謝謝謝謝陳銀偉的質詢現在請李昆城委員質詢 |
| transcript.whisperx[627].start |
16246.906 |
| transcript.whisperx[627].end |
16250.547 |
| transcript.whisperx[627].text |
好 謝謝主席 請施部長請施朝良部長李議員好部長好 辛苦了現在已經12點多了要1點了 1點了 |
| transcript.whisperx[628].start |
16260 |
| transcript.whisperx[628].end |
16272.969 |
| transcript.whisperx[628].text |
先請教一下大家都很關心這個有關艾爾利還有涉嫌偷拍這件事情部長也說這是明知故犯是有目的性的一個行為不可原諒請醫事司處辦依法給予停業的處分我想請問一下現在處理的情況怎麼樣 |
| transcript.whisperx[629].start |
16280.354 |
| transcript.whisperx[629].end |
16305.255 |
| transcript.whisperx[629].text |
我們已經先發函給衛生局那衛生局他就會依照事實去認定那麼裁罰權這個真正的裁罰是在哪裏發函給哪些如果是第一案的話那個艾爾利集團大概涉及到七個縣市但是後面還有另外三個集團可能又有點差異順於我們會繼續往後一直追目前是七個縣市 |
| transcript.whisperx[630].start |
16306.816 |
| transcript.whisperx[630].end |
16329.594 |
| transcript.whisperx[630].text |
這個是愛爾利的部分就對了那其他三個呢?這倒已經這個媒體有揭露的後面還有三個集團嘛包含那個光澤啦還有那個伊延銘還有一個對對對那我們今天也會陸陸續續針對這三個案子那所以說這個採取是由這個地方衛生局來做採取就對了對依法由按照醫療法是由地方主管機關採法 |
| transcript.whisperx[631].start |
16331.115 |
| transcript.whisperx[631].end |
16354.46 |
| transcript.whisperx[631].text |
那罰款呢?我們看它的這個樣態,它有兩種樣態第一個呢,是它這個是涉及到病人隱私的問題會按照醫療法108條第六款來處理那這個部分呢,它可以是五萬到五十萬另外情節重大的話會停業處分,這個是一種 |
| transcript.whisperx[632].start |
16355.26 |
| transcript.whisperx[632].end |
16365.147 |
| transcript.whisperx[632].text |
第二種是費用的超收他預收費用現在也爆發爭議在退款的時候還設了一堆門檻這個就違反到108條的第7款這個罰則是相同的 |
| transcript.whisperx[633].start |
16371.371 |
| transcript.whisperx[633].end |
16397.047 |
| transcript.whisperx[633].text |
那另外如果這些資料還洩漏那又涉及到醫療法的72條那甚至會有刑法的這個妨礙秘密罪隱私的問題那甚至如果還有性影像那又涉及到另外的罰則那也是刑事責任所以就會不同所以還要看他可能他的違法的樣態去實質認定那現在有地方政府有報上來了嗎 |
| transcript.whisperx[634].start |
16398.403 |
| transcript.whisperx[634].end |
16426.975 |
| transcript.whisperx[634].text |
到目前還沒有有關這個停業的這個規定或是說罰款都還沒有報上來就對了那有有說有有請他們說最快哪時候報上來嗎一週內我們都是一週內希望回復我們他的處理情形等於這個禮拜嘛這禮拜就要回復了那再請教一下部長那你也說過要對這個醫療院所要展開這個聯合的普查那請問要哪時候開始進行 |
| transcript.whisperx[635].start |
16428.723 |
| transcript.whisperx[635].end |
16443.921 |
| transcript.whisperx[635].text |
這個禮拜五月十三號呢醫事會邀集這個衛生局來討論如何進行下一步的這個稽查稽查的程序我是說是已經要進行全面普查了然後只是要求邀集這個地方衛生局跟這個 |
| transcript.whisperx[636].start |
16445.042 |
| transcript.whisperx[636].end |
16464.767 |
| transcript.whisperx[636].text |
醫師公會一起來來做處理還是說我們在討論要不要普查應該是這樣子講因為我們每年呢就有這個督導考核對所有的診所本來就要做的那只是說我們把優先順序要調一下哪一些先優先對啊這就涉及這個這個偷拍的部分對對對對那所以普查會做就對了 |
| transcript.whisperx[637].start |
16465.848 |
| transcript.whisperx[637].end |
16477.862 |
| transcript.whisperx[637].text |
因為本來每年就會查的只是說我們現在把順序調整還有查的內容上去強化特別是跟這次事件相關的那所以這樣子的話所謂的針對偷拍的普查大概哪時候會開始進行 |
| transcript.whisperx[638].start |
16484.015 |
| transcript.whisperx[638].end |
16498.772 |
| transcript.whisperx[638].text |
5月13號就會你們只是開會嗎 5月13號是開會嗎對 開會有個共識 怎麼進行這樣對啊 我的意思是說哪時候開始啦我補充一下 因為每一個地方政府他的那個都考會的時間不太一樣 |
| transcript.whisperx[639].start |
16500.253 |
| transcript.whisperx[639].end |
16525.754 |
| transcript.whisperx[639].text |
會從7月到9月甚至到10月都不等所以我們才會5月13號先把一些優先規則預定以後請大家按它的時間應該優先去做處理那到底是7月9月10月這個地方5月13號的時候會再做一次預定不可能到7月9月到11月吧對所以希望提前因為它原本有既定的行程我們需要時間去做相對的溝通 |
| transcript.whisperx[640].start |
16526.294 |
| transcript.whisperx[640].end |
16552.188 |
| transcript.whisperx[640].text |
因為我看那個新聞會提早會優先把這個事件相關的先列出來因為有的這個大縣跟小縣有的縣市沒有幾家有的縣市很多家所以需要有一個priority把這個優先順序會提出來我們會要求對這個案件會提早開始跟這個相關的會因為我看那個媒體報導說新北高雄已經開始做普查了這是他們自己先做就對了 |
| transcript.whisperx[641].start |
16553.949 |
| transcript.whisperx[641].end |
16569.483 |
| transcript.whisperx[641].text |
所以其實我認為六都應該都是有辦法來先做的應該是 因為本來就在查了只是我們把它提早然後優先順位提前這樣好 然後再請教一下部長你剛剛有提到就是說偷拍所以偷拍 |
| transcript.whisperx[642].start |
16570.123 |
| transcript.whisperx[642].end |
16587.126 |
| transcript.whisperx[642].text |
目前有涉及到的這些民刑事的這些法律責任包含刑法剛有提到說妨礙秘密罪那也包含這個妨礙性隱私還有不實性影像的罪然後也有違反到這個個人資料的保護法那請教一下部長那有違反醫療法的哪個規定 |
| transcript.whisperx[643].start |
16588.207 |
| transcript.whisperx[643].end |
16610.44 |
| transcript.whisperx[643].text |
醫療法的話就是目前是醫療法72條跟108條的規定那醫療法72條不是針對偷拍啊它是洩漏嘛對它是洩漏啊然後這個108條的話呢在第六款有這個傷害風化那個部分有明定那對所以我是要跟你討論就是說因為我看你今天在回覆就是說在講說是72條但是72條是洩漏病人的移植血那還有108條 |
| transcript.whisperx[644].start |
16613.862 |
| transcript.whisperx[644].end |
16640.765 |
| transcript.whisperx[644].text |
兩條文但是我們今天是講到偷拍這件事情那我是說在醫療法這部分的話可不可以特別針對偷拍因為你們現在只有一個醫療機構醫療隱私維護的規範是不是只有這個規範在這個規範才四條我去看了一下才四條你們有提到說如果說醫病雙方要進行錄音錄影要先取得對方的同意 |
| transcript.whisperx[645].start |
16641.425 |
| transcript.whisperx[645].end |
16662.023 |
| transcript.whisperx[645].text |
那我們今天不是說要取得對方同意這件事情欸但是等一下還會再提到我們今天講的是偷拍這件事情欸偷拍偷拍我根本不知道說我被拍了啊我怎麼還要去取得這個對方的這個同意呢那我是要問部長說除了我們剛才講的刑法個人資格保護法上有沒有必要在醫療法這部分特別針對這個偷拍這部分來做這個規範 |
| transcript.whisperx[646].start |
16663.409 |
| transcript.whisperx[646].end |
16684.778 |
| transcript.whisperx[646].text |
偷拍本身就是一個違法行為所以沒有什麼規範好定因為他只要偷拍因為你們也有一個規範啊那我們要做的是說我們要做的事情是說在合法的部分如何去強化管理者的責任避免有不孝之徒來偷拍 |
| transcript.whisperx[647].start |
16685.718 |
| transcript.whisperx[647].end |
16711.955 |
| transcript.whisperx[647].text |
應該是這樣因為偷拍本身這個行為就違法所以我們不會去定一個說什麼情況之下可以偷拍不會的不是這個意思啦我今天說因為你目前只有這一個維護的規範那個維護的規範就是去強化這個管理者的責任嘛說你要在你在如果你需要錄影的時候要合法的情形之下那還是要取得告知同意的這個動作嘛 |
| transcript.whisperx[648].start |
16713.536 |
| transcript.whisperx[648].end |
16742.095 |
| transcript.whisperx[648].text |
所以我們會來研究把這個強化這個管理者的責任如何避免有這個不肖這個侵犯隱私的事情發生那包含這個偷拍等等的如果你去防範包含你的這個資訊系統被侵入所以你要強化如何反映我們都有資通法資安法的規定那所以講的這些補修這些措施還是用這種我認為位階比較低的規範來做處理嗎 |
| transcript.whisperx[649].start |
16744.357 |
| transcript.whisperx[649].end |
16765.976 |
| transcript.whisperx[649].text |
還是你們要再根據具有強制性我們回頭來看我們現在相關的這個授權法規來取得我們設這樣的規範之後要依附在哪一個授權法規比較合適比如說我們有醫療機構電子病歷製作及管理辦法這個跟個人隱私也有關係的 |
| transcript.whisperx[650].start |
16766.897 |
| transcript.whisperx[650].end |
16791.893 |
| transcript.whisperx[650].text |
那麼或者是滋通法裡面也有作權違法的強制性是最強那違法那就是有相關的處罰嘛那可是目前我找到的就只有這個規範那規範位階很低啊就是說沒有辦法去處理到說這一個我們這個病人的消費者隱私的這部分的問題啊其實對違法者目前的相對應的罰則都有了您剛剛提到的醫療法沒有 |
| transcript.whisperx[651].start |
16796.156 |
| transcript.whisperx[651].end |
16811.692 |
| transcript.whisperx[651].text |
對我們現在醫療法做的事情只是對於管理者的責任如何強化應該是這樣來預防這個違法樣態的出現這個不見得是就是說你們來討論一下那如果是故意所為的話那現在都已經可以罰了 |
| transcript.whisperx[652].start |
16812.513 |
| transcript.whisperx[652].end |
16833.659 |
| transcript.whisperx[652].text |
對啦 我的意思是說 你講我也知道嘛 有新法有 個人資格保護法有但是這是關係到說我們在醫療機構所遇到的一些問題但是我看一下目前醫療法沒有一個法處理到這部分那早一早就只有一個規範只有一個規範 那我認為說這個規範位階比較低那剛才部長有提到說 |
| transcript.whisperx[653].start |
16834.719 |
| transcript.whisperx[653].end |
16849.796 |
| transcript.whisperx[653].text |
有很多相關問題因為這件事情所引發出來的那你們也要做一些討論跟修正只是說要把這一塊放在哪裡嘛對不對那好那大概你們總是要有個時間出來吧大概多久會把這個這部分你所提到這些問題來做個處理這個這個 |
| transcript.whisperx[654].start |
16854.625 |
| transcript.whisperx[654].end |
16879.42 |
| transcript.whisperx[654].text |
訂這個相關的規範那麼大概也要一點時間違法樣態如何的裁罰這個很快這一兩個禮拜就會把它確定如何裁罰那至於要訂這個規範然後依附在哪一個授權辦法裡面呢可能要我們一點時間可能兩三個月的時間把它擬進來最後我再問 主席不好意思 |
| transcript.whisperx[655].start |
16880.04 |
| transcript.whisperx[655].end |
16893.72 |
| transcript.whisperx[655].text |
就是說現在業者在主張就是說當時候你進來不論是做醫美或是做其他的診療他說你已經簽同意書同意我們錄影可是老實講一般人不會看到這麼細 |
| transcript.whisperx[656].start |
16895.603 |
| transcript.whisperx[656].end |
16912.124 |
| transcript.whisperx[656].text |
那我們也不知道說然後現在業者拿著說你當初你有這個簽字啊這當作你已經同意我們錄影了啊那請問一下我們對於目前的這一種就是說這種定型化契約有沒有做出一些指引的規範定型化沒有沒有那要不要做出一個指引的規範 |
| transcript.whisperx[657].start |
16915.421 |
| transcript.whisperx[657].end |
16930.356 |
| transcript.whisperx[657].text |
定型化契約對我的意思是說每一家可能都不一樣每一家都不一樣那現在很多業者說你應該有簽名了那定型化契約有指出來說哪一些是該寫出來的哪一些是不應該寫出來的這個都要做一些規範好 |
| transcript.whisperx[658].start |
16931.697 |
| transcript.whisperx[658].end |
16952.968 |
| transcript.whisperx[658].text |
因為這個就回到消保法所以這個是不一樣的所以如果剛剛委員提的是要由我們找到跟醫療法相關或者是其他法規授權給主管機關那麼有一個辦法的話就不需要這個契約啦如果其他沒有那當然也可以用消保法的這個定型化契約來處理這個你們來跟這個消保會來做個研究啦好不好因為很多消費者他其實 |
| transcript.whisperx[659].start |
16960.872 |
| transcript.whisperx[659].end |
16978.485 |
| transcript.whisperx[659].text |
當你要簽約的時候根本其實不會看到那麼細而且每一家可能規範寫的內容也不一樣契約內容可能不一樣好不好這部分你們來跟那個消防人我們看有哪一個法規工具比較好好不好來做個處理因為現在大家都很關心這件事情謝謝部長 謝謝主席謝謝李坤臣委員的諮詢接下來請樂園支委員諮詢 |
| transcript.whisperx[660].start |
16993.348 |
| transcript.whisperx[660].end |
16995.921 |
| transcript.whisperx[660].text |
主席好麻煩請衛福部長請施成良部長 |
| transcript.whisperx[661].start |
17000.778 |
| transcript.whisperx[661].end |
17024.096 |
| transcript.whisperx[661].text |
上禮拜五我們通過三班護病比入法其實是想要解決醫院護理師缺乏的問題希望能夠改善他們的環境這個東西其實是賴總統在選舉的時候的壯言承諾兩年內要入法賴總統沒有做新政院也沒版本在黨推了之後衛福部又說要延緩執行等一下我再來跟你討論 |
| transcript.whisperx[662].start |
17025.077 |
| transcript.whisperx[662].end |
17042.611 |
| transcript.whisperx[662].text |
那我想要提另外一個也是一樣想要解決醫院醫護人力不足的問題的另外一個議題今天我才聽說有大醫院也有兩個組織醫師要離開為什麼因為診所的待遇就是比較好還有一個很重要原因其實衛福部也知道 |
| transcript.whisperx[663].start |
17043.251 |
| transcript.whisperx[663].end |
17063.103 |
| transcript.whisperx[663].text |
就是診所醫師他們的所得實際上可以扣掉大概接近80%的部分當作是他的執行業務的成本他大概要報稅只有20%左右但是如果是在醫院的話當醫院的主治醫師他不是用勞基法然後他的所有的所得通通都要報稅 |
| transcript.whisperx[664].start |
17064.224 |
| transcript.whisperx[664].end |
17092.859 |
| transcript.whisperx[664].text |
那我是有看到之前應該也是賴總統吧他在2025年的5月也有注意到這個問題然後開了一個健康台灣的論壇就是說希望醫院的主治醫師加班費可以免繳所得稅注意只有加班費免繳所得稅不是所得免繳所得稅是加班費免繳所得稅那這個我完全贊成為什麼因為他也不會負擔也不會增加任何衛福部的成本 |
| transcript.whisperx[665].start |
17094.255 |
| transcript.whisperx[665].end |
17108.067 |
| transcript.whisperx[665].text |
他只是少繳稅那問題是這個事情已經拖多久了呢2025年的5月份就講囉今天已經是2026年的5月份我是不知道說做這樣的一個事情為什麼要拖到一年這麼久 |
| transcript.whisperx[666].start |
17109.554 |
| transcript.whisperx[666].end |
17137.884 |
| transcript.whisperx[666].text |
你說三班戶必比你的理由是講說要給醫院要讓醫院準備什麼之類的那這個問題等一下再跟你討論但是醫生這個東西是為什麼要拖這麼久包括部長你本人你本人自己在今年的過年前也都講說你們已經會很積極的去跟財政部跟人事行政總督去說而且會發函你自己講的說最快的話今年五月份報稅 |
| transcript.whisperx[667].start |
17139.364 |
| transcript.whisperx[667].end |
17156.366 |
| transcript.whisperx[667].text |
那些醫生就可以試用那今天現在已經在報稅了吧那請問一下部長他們今天可以試用嗎好 跟委員說明其實我們的想法是一樣的啦這個是一個付稅公平因為根據所得稅法14條的規定加班費的部分就是可以免稅 |
| transcript.whisperx[668].start |
17157.728 |
| transcript.whisperx[668].end |
17172.044 |
| transcript.whisperx[668].text |
不過在這個推動過程當中我們也低估了它的複雜性因為它有各種不同的樣態那麼舉例而言呢這個在這個公立醫院就有公立醫院的規定那麼退府會醫院有退府會醫院的規定 |
| transcript.whisperx[669].start |
17172.625 |
| transcript.whisperx[669].end |
17197.623 |
| transcript.whisperx[669].text |
那麼在軍醫院有軍醫院的規定所以加班費的資理這個就是對於加班費免稅這件事情大家有共識但是各自有還受到一些法規的限制所以我們目前也還需要再調整這個行政院有關於部長你這樣我跟你講做任何的改變都會有複雜性對不過看你花多少時間跟心力處理而已所以目前也到了最後一步沒有啦部長因為 |
| transcript.whisperx[670].start |
17199.904 |
| transcript.whisperx[670].end |
17216.393 |
| transcript.whisperx[670].text |
去年五月的事情嘛那你今年年初過年前有講嘛說最快希望今年五月可以實施嘛換言之從去年五月總統承諾到今年年初過年前你的承諾應該已經大概八九個月了 |
| transcript.whisperx[671].start |
17217.347 |
| transcript.whisperx[671].end |
17242.718 |
| transcript.whisperx[671].text |
你這八九個月你都不知道事情的複雜性一直在解決結果你過年前其實一件一件在解決如果說你過年前就知道這個複雜性你會講出今年五月份可以最快可以實施的這樣一個承諾嗎現在我們不能接受的是每一個都是你們自己的承諾一個個跳票然後問你為什麼跳票你說因為我低估了事情的複雜性那你當初為什麼要講總統為什麼2024年選舉前他要承諾三班戶必必入法 |
| transcript.whisperx[672].start |
17247.199 |
| transcript.whisperx[672].end |
17257.13 |
| transcript.whisperx[672].text |
那他那時候是隨便講講嗎部長你今年年初承諾醫生說今年就可以報稅就可以實施那你也是隨便講講嗎 |
| transcript.whisperx[673].start |
17258.706 |
| transcript.whisperx[673].end |
17280.477 |
| transcript.whisperx[673].text |
大家不能接受為什麼我們每一個政務官包括總統在內講出來的承諾都可以隨便講講然後再問就是不好意思我們低估了複雜性那以後你們講的話哪一句話大家可以相信都在進行當中當然在進行當中但是問題是要進行到什麼時候嘛大約在冬季嗎還是牛年馬月每個事情都在進行當中嘛關鍵是什麼時候處理好嘛 |
| transcript.whisperx[674].start |
17281.497 |
| transcript.whisperx[674].end |
17298.575 |
| transcript.whisperx[674].text |
請大家放心啦好那你什麼時候你再給一個承諾什麼時候明年是不是又要兩年後這個最後啊最後的這個裁定當然在財政部是不是又要兩年後因為這個稅賦的主管機關是財政部那我們做盡今天不管什麼部啦因為這個事情如果是總統講的 |
| transcript.whisperx[675].start |
17301.038 |
| transcript.whisperx[675].end |
17311.029 |
| transcript.whisperx[675].text |
總統講的那什麼部都不是問題啦如果今天是衛福部講的你說那我要問財政部那我想因為你平息機關你要溝通但如果是總統講的總統搞不定財政部嗎所以這個這個 |
| transcript.whisperx[676].start |
17315.334 |
| transcript.whisperx[676].end |
17343.836 |
| transcript.whisperx[676].text |
說不過去啦而且部長我跟你講因為今年可以嗎今年一定會確定不是 今年的五月報稅報稅可能來不及來不及那你之前說要趕今年啊去年五月總統說總統去年五月就講了啊然後今年過年前你也說要趕今年現在你又等下再準備報稅部長你看喔發布都是隔年實施啦你看喔沒有啦你今天發布隔年實施你自己講說這個我幫你畫出來的好不好你自己念一下 |
| transcript.whisperx[677].start |
17345.111 |
| transcript.whisperx[677].end |
17370.074 |
| transcript.whisperx[677].text |
你念一下好不好紅線部分你念一下好不好紅線你念一下石崇良說石崇良是你本人嘛你念一下你念一下紅線部分嘛你念一下紅線部分你一個字一個字念出來好不好你不敢念我念石崇良說如果醫院已請醫師打卡記錄清楚符合規定者今年就可以試用 |
| transcript.whisperx[678].start |
17371.435 |
| transcript.whisperx[678].end |
17392.164 |
| transcript.whisperx[678].text |
這個是我們的規劃是希望這樣那但是因為希望全國的一致性你有講嗎你有講嗎好那你的承諾已經造成什麼狀況了因為網路上大家已經在講了因為你不行今年又來不及了然後網友說結果醫師上班都要趕著打卡是在打心酸的嗎 |
| transcript.whisperx[679].start |
17393.325 |
| transcript.whisperx[679].end |
17416.588 |
| transcript.whisperx[679].text |
然後因為部長的 等一下部長等一下部長等一下然後網友說因為這個消息各家醫院開始管制主治醫師上班打卡然後有人講說衛福部的話就信食都可以吃了吧看看三班護病名就知道了這是網友講的人家已經開始管制打卡跟大家講因為主治醫師是本來是不用打卡 |
| transcript.whisperx[680].start |
17417.256 |
| transcript.whisperx[680].end |
17433.743 |
| transcript.whisperx[680].text |
為了配合衛福部說今年有可能加班費免稅現在已經開始管制打卡了結果部長講說因為我們低估了事情的複雜性所以呢不好意思喔我們在進行當中但什麼時候我就不敢講了那你這段時間醫師就一個一個離開醫院 |
| transcript.whisperx[681].start |
17436.844 |
| transcript.whisperx[681].end |
17451.858 |
| transcript.whisperx[681].text |
不會我今天就已經拼到了啊把這個制度建立好什麼時候嘛明年報稅來得及嗎對明年報稅來得及一定來得及那會不會明年的時候又再講說對不起我們又低估了事情的複雜性但是要現在開始準備 |
| transcript.whisperx[682].start |
17452.699 |
| transcript.whisperx[682].end |
17468.769 |
| transcript.whisperx[682].text |
早就該準備了嗎不是部長這個是去年五月總統講的東西嘛你現在才說要開提早準備過了一年你說我要提早準備我是說各醫院要準備醫院本來就準備可是你看那個醫生說現在都趕著打卡了你那個技術問題 |
| transcript.whisperx[683].start |
17470.35 |
| transcript.whisperx[683].end |
17497.792 |
| transcript.whisperx[683].text |
有的醫院已經配合了嘛對我們需要大家都配合會比較好那大家配合你去講啊人家沒有不配合啊我問了幾間醫院大家沒有不配合這是幫助醫院留住醫生誰會不配合現在的問題是你的問題嘛你的問題嘛這個要積極一點啊護理師留師不要沒關係院長講說要把叫那個考試院簡單一點我看網路上看護理師在酸那個總統太院長 |
| transcript.whisperx[684].start |
17499.392 |
| transcript.whisperx[684].end |
17520.266 |
| transcript.whisperx[684].text |
有一個護理師講說他那時候因為疫情期間沒有學習怎麼抽痰他是到了醫院才開始學抽痰結果讓學姐還花很多時間教他們所以你現在不考那些技術的東西到時候資深護理師還要花很多時間去教學弟妹又加重他們的負擔那個是在實習當中要去完備的那個也不是用考 |
| transcript.whisperx[685].start |
17520.526 |
| transcript.whisperx[685].end |
17533.472 |
| transcript.whisperx[685].text |
比試考出來的那些都是要看實習那你不考也很奇怪嘛所以院長本人也沒有對症下藥嘛有些是要實習的部分然後三班互遇比入法你又說兩年那你確定兩年之後就OK你現在擔心問題就OK喔 |
| transcript.whisperx[686].start |
17536.641 |
| transcript.whisperx[686].end |
17547.669 |
| transcript.whisperx[686].text |
我們做人力的評估之後所以兩年之後護理師就會夠了就可以實施三萬護必比了你承諾是這樣子兩年後就會夠了你講的兩年後就會夠了最後問一個問題現在很多人反應 |
| transcript.whisperx[687].start |
17558.103 |
| transcript.whisperx[687].end |
17565.529 |
| transcript.whisperx[687].text |
因為美伊戰爭的關係啦有很多醫材都缺乏有人講說包括那個器械用的 |
| transcript.whisperx[688].start |
17566.812 |
| transcript.whisperx[688].end |
17589.362 |
| transcript.whisperx[688].text |
臭攤管然後跟去很多輔具商就買不到然後講說要去大型的輔具店買然後打了幾家也都買不到我是知道說現在藥局很多塑膠類的東西都漲了都有漲 酒精因為他有用到塑膠瓶子然後還有什麼乳膠手套有的是漲 |
| transcript.whisperx[689].start |
17590.589 |
| transcript.whisperx[689].end |
17619.252 |
| transcript.whisperx[689].text |
但缺貨更麻煩缺貨就更麻煩那缺貨其中有一個原因是因為上游廠商可能顧慮到是不是之後價格波動太大所以暫時不出貨這也是個原因那請問一下為什麼會出現市面上會這種買不到器械用抽痰管的問題應該沒有買不到那就買不到就民眾講的第一個部長為什麼跟你反映事情你都是先否認的那是民眾在亂講嗎他無緣無故要亂講這是幹嘛不會啦就買不到啊我們在這個 |
| transcript.whisperx[690].start |
17620.673 |
| transcript.whisperx[690].end |
17637.239 |
| transcript.whisperx[690].text |
這個行政院的平台呢那麼經濟部有協調對於這個聚乙烯的供應醫療的部分是優先的所以醫材的製造會被優先所以如果部長不好意思打斷你一下這個就是民眾反映他就是買不到 |
| transcript.whisperx[691].start |
17637.839 |
| transcript.whisperx[691].end |
17652.572 |
| transcript.whisperx[691].text |
那你覺得買得到人家說買不到那問題是出在哪裡除非這個民眾這麼無聊故意去講說買不到我想去應該沒有人這麼無聊一定是很急的情況之下才會反應那你知道這個訊息你應該去了解一下你的想法跟 |
| transcript.whisperx[692].start |
17652.952 |
| transcript.whisperx[692].end |
17680.085 |
| transcript.whisperx[692].text |
跟實務上有什麼落差而不是你一直在解釋說不可能那一定是有問題嘛就像以前我一直反應缺藥問題你們就講說不會啊我們一個缺藥平台有缺藥一定會上去登錄但是問題是很多藥局是連懶的連登錄都懶得登錄因為登錄也沒有用所以你應該是要去了解問題在哪裡不是一味的否定民眾的建議的問題因為確實我們沒有接受到那我現在告訴你了我現在告訴你了現在就是說 |
| transcript.whisperx[693].start |
17682.586 |
| transcript.whisperx[693].end |
17700.243 |
| transcript.whisperx[693].text |
很多民眾有民眾的反應買不到器械用的抽痰管一般輔具店買不到然後小的輔具店說你去問大型的連鎖的那他問了大型的連鎖也是買很多家裡面只有幾家有跟委員報告一下針對這件事情大概是10天前左右 |
| transcript.whisperx[694].start |
17700.763 |
| transcript.whisperx[694].end |
17724.131 |
| transcript.whisperx[694].text |
我們就去為了這件事情去確立所有的供應商供應商給我們的答案是供應是都可以滿足的但供應的所有頻率稍微有拉長一點我說那你一定要讓民眾可以用得到所以我們希望他的調控能夠做一些修正所以他也協助了我們做這件事情那我們會持續對這個我得到的是今天的那我會持續再去講的有問題就解決 |
| transcript.whisperx[695].start |
17727.192 |
| transcript.whisperx[695].end |
17751.71 |
| transcript.whisperx[695].text |
謝謝 要說當不知道這樣 就是說沒問題這樣那民眾是不是在亂講嗎好 謝謝好 謝謝委員謝謝葉元志委員的質詢接下來請張雅琳委員質詢好 謝謝主席 我們有請部長有請石崇良部長 |
| transcript.whisperx[696].start |
17758.954 |
| transcript.whisperx[696].end |
17779.325 |
| transcript.whisperx[696].text |
前陣子我們把兒少性剝削也把他上線打開就是他成年之後才可以去追溯我認為這是對於我們的兒少一個很重要的保障因為黃子嬌這個案件在上禮拜四公佈之後我想大家也都知道民情沸然大家認為說 |
| transcript.whisperx[697].start |
17780.505 |
| transcript.whisperx[697].end |
17795.814 |
| transcript.whisperx[697].text |
似乎只要他有錢他可以搞到和解基本上他就可以被判緩刑那當然我也知道這是因為我們現在的刑法基本上就是說在如果他可以跟被害人達成和解的話的確是他法官可以裁量是這個緩刑 |
| transcript.whisperx[698].start |
17796.835 |
| transcript.whisperx[698].end |
17817.326 |
| transcript.whisperx[698].text |
但是因為大家也會認為說就像我剛剛如同我講的今天只要我有錢我好像就沒有事的問題所以我今天想要跟部長再討論我認為還是要去積極的保障我們的兒少因為我覺得像現在的兒少呢因為這個兒少性剝削它基本上是一個就算我這次和解了對不對可是我的影像還是持續的在網路上面 |
| transcript.whisperx[699].start |
17818.386 |
| transcript.whisperx[699].end |
17845.6 |
| transcript.whisperx[699].text |
曝光可能還是在網路上面流通所以我想要問一下是說我們是不是也可以來修這個兒少性剝削條例新增重大持有或加重持有的罪那第二個是否來限制重大兒少性影像犯罪輕易使用緩刑第三是否應建立影像數量被害人數等等來確立一個新的量刑標準那所以我想針對第一個部分 |
| transcript.whisperx[700].start |
17846.841 |
| transcript.whisperx[700].end |
17872.907 |
| transcript.whisperx[700].text |
我想請教部長的想法就是說我們對於修這個耳哨性剝削條例第39條把下列的事項更明確為加重事由第一就是接付對價購買或取得第二個透過會員制論壇私密群組非法平台取得第三持有數量非常龐大第四涉及多名耳哨第五反覆下載分類備份雲端同步或建立資料夾 |
| transcript.whisperx[701].start |
17874.267 |
| transcript.whisperx[701].end |
17890.876 |
| transcript.whisperx[701].text |
收藏第六就是未滿24歲兒少而且影像內具有高度侵害性不曉得部長您的看法是什麼對 跟文說明對於這個剛剛提到那個追溯目前是預告中所以我們的追溯期從成年之後開始計算 |
| transcript.whisperx[702].start |
17891.696 |
| transcript.whisperx[702].end |
17911.621 |
| transcript.whisperx[702].text |
那另外在這個刑度的部分呢那麼也做了修正只不過是剛好那個是113年才修所以適用的時候不同那現在您提出的是在某一些的樣態在給予加重這個我支持好 那我需要是說我們是不是可以來驗因為其實我就給部長一個參考的 |
| transcript.whisperx[703].start |
17912.541 |
| transcript.whisperx[703].end |
17933.653 |
| transcript.whisperx[703].text |
其實這樣子的量刑參考呢其實在英國跟美國都有類似的概念因為你可以看到在左邊的英國量刑指引是有分到影像的類型喔也就是分他的嚴重性最嚴重就插入式性行為限虐待第二個等級是非插入式性影像第三個是違憲然後他會除了影像類型之外他會再加重因素也就是我剛剛講的那些 |
| transcript.whisperx[704].start |
17934.353 |
| transcript.whisperx[704].end |
17953.036 |
| transcript.whisperx[704].text |
那些狀態這是英國的所以基本上內容越嚴重行為越系統化刑度就會越重那美國呢基本上就看他持有多少張數如果說他影像是如果是影像不是照片一部影像就換算成75張照片所以呢 |
| transcript.whisperx[705].start |
17953.776 |
| transcript.whisperx[705].end |
17970.416 |
| transcript.whisperx[705].text |
這樣子我們才能夠去確保說他不是只是一個單純的犯罪行為而已我們還要去看他的情節有多重大那這個部分如果部長也都支持的話是不是也可以給我們一個規劃就是例如說大概多久之後我們會推出相關的修法 |
| transcript.whisperx[706].start |
17974.461 |
| transcript.whisperx[706].end |
17997.315 |
| transcript.whisperx[706].text |
這可能要花一點時間啦 我們花一點時間大概多久的時間呢 那個修法的規劃因為我看到就是這次兒少性剝削這個預告這個部分進行的非常非常快那我也認為這件事情非常重要因為很多的兒少在這一次的事件裡他們雖然和解了但是很多都是被害人的法定代理人來和解 |
| transcript.whisperx[707].start |
17998.115 |
| transcript.whisperx[707].end |
18015.073 |
| transcript.whisperx[707].text |
那因為這個法這樣子修過就讓這些兒少在長大的時候他還能夠去求行我覺得這件事情非常重要但是我認為在現行的話我們還是要加強我們的這個法則才能夠去嚇阻啦所以部長大概認為何時大概多久的時間我們可以有一個修法的規劃就是 |
| transcript.whisperx[708].start |
18020.441 |
| transcript.whisperx[708].end |
18049.557 |
| transcript.whisperx[708].text |
因為我們現在一個預告大概就是要60天那我們現在預告裡面再新增這一些 那就會延長它的那個等於這一次修的時候再往後延我們來研究一下不一定要 你不一定要你可以在前面那部分我看你前面那個你要加速吧 對不對你前面那個要預告上限20年的這個是要加速嘛我這個部分我百分之百支持你可以先修啊 但是這部分那就等於是下一次 |
| transcript.whisperx[709].start |
18050.217 |
| transcript.whisperx[709].end |
18073.696 |
| transcript.whisperx[709].text |
對 但是我覺得這件事情要加速因為我可以 大家也可以看到嘛這幾天這個艾爾利各種我們都不曉得那些影像而且其中有涉及到未成年的兒少性影像它會流傳到哪裡我們完全不曉得但是我們必須要在我們的法制上面再強化這個嚇阻力對好對 好 部長那大概多久呢我們的規劃可以多久半年 |
| transcript.whisperx[710].start |
18075.965 |
| transcript.whisperx[710].end |
18097.833 |
| transcript.whisperx[710].text |
因為以前我們這個單純持有是一年以下後來1130修法之後已經變1到7年所以最高期其實可以已經判到7年所以如果是但是因為如果他是在那個現在的人如果他全部受和解的話他還是有可能嘛對不對因為在刑事訴訟法的狀況之下那這部分我們也有跟司法院跟法務部今天早上質詢都有 |
| transcript.whisperx[711].start |
18098.813 |
| transcript.whisperx[711].end |
18120.455 |
| transcript.whisperx[711].text |
有徵詢他們的意見那他們基本上就是尊重衛福部的一個看法所以我想這個部分如果你們也覺得OK的話是不是可以一起來討論這件事情我們是不是容我們找那個衛福部找那個法務部跟司法院一起來討論因為它還會涉及到一個量刑的很平性我們再跟他們一起研究沒問題可以的那我現在只想要知道說大概什麼時候我們可以來了解一個後續的進度呢半年 |
| transcript.whisperx[712].start |
18127.227 |
| transcript.whisperx[712].end |
18138.32 |
| transcript.whisperx[712].text |
那再來就是第二個問題就是有關於我們的兒校現在因為他們缺乏時間休息就是我之前跟部長提到就是說他們現在根本沒有休息時間然後呢這個功課量 |
| transcript.whisperx[713].start |
18139.621 |
| transcript.whisperx[713].end |
18155.662 |
| transcript.whisperx[713].text |
還有太多的學業呢導致他們現在喝能量飲料這已經不是單一事件了包含我問我本來從我小孩那邊聽到一個國中生國二的時候就告訴我說他們有同學在喝這個能量飲料喝魔爪後來有一次我在跟兒少代表 |
| transcript.whisperx[714].start |
18156.243 |
| transcript.whisperx[714].end |
18170.021 |
| transcript.whisperx[714].text |
在講休息時間的時候他就說這個是他們班上高中生每個人的櫃子裡面都會放所以這已經是非常普遍的現象可是這個兒少能量飲其實是非常不適合兒少飲用的在國際上面其實都有講到這會對兒少的身體 |
| transcript.whisperx[715].start |
18172.564 |
| transcript.whisperx[715].end |
18188.071 |
| transcript.whisperx[715].text |
產生健康上面的影響那其實在歐盟加拿大英國美國都有會一些警示語的內容標示但是我們現在對於這些能量飲料是毫無標示的這部分是不是可以說明一下標示的問題對我想 |
| transcript.whisperx[716].start |
18190.712 |
| transcript.whisperx[716].end |
18212.526 |
| transcript.whisperx[716].text |
的確在目前對於我們的飲料的標示裡面上面沒有特別強調是嬰幼兒或者是兒少使用它只是標示上面的一般它裡面要有標示含量熱量蛋白質糖類等等那這部分可以標示嗎因為這個會直接影響到兒少的健康 |
| transcript.whisperx[717].start |
18213.246 |
| transcript.whisperx[717].end |
18236.02 |
| transcript.whisperx[717].text |
我想這個標示我們一直以來有一個標準的標示的模式那也大概它的規範那在審法第22條向下我們按照這樣的標準標示所以裡面的內容我們其實可以來爭取大家的意見對於是不是對於特定的一個族群裡面我想是另外一個部分讓我們可以做一點點研議只是說標示的部分的確是沒有特別針對而是 |
| transcript.whisperx[718].start |
18237.521 |
| transcript.whisperx[718].end |
18260.896 |
| transcript.whisperx[718].text |
或者我們面對一個老人家說這個不適合使用那個不適合使用那個對於整體的用其他的方式來去協助讓民眾可以知道它的合適性我覺得會是更好的但是因為這個東西已經算是蠻普遍兒少其實都在飲用了啦所以我覺得就是說我希望你們去研議大概什麼時候我們可以用什麼樣子的方式來讓更多的兒少不要使用這樣子的飲料可以嗎 |
| transcript.whisperx[719].start |
18261.596 |
| transcript.whisperx[719].end |
18287.45 |
| transcript.whisperx[719].text |
我們可能要盡量在各方面的宣導我覺得是要跟很多學校一起來共同來演習我想飲料上面還是要強化啦 好不好可以嗎 好 謝謝那最後一題就是說我們現在有托育津貼跟育兒補助但是我想釐清一件事情托育津貼跟育兒補助原本的功能其實是不一樣的 對嗎托育津貼跟育兒補助 |
| transcript.whisperx[720].start |
18290.183 |
| transcript.whisperx[720].end |
18313.4 |
| transcript.whisperx[720].text |
我們托育是為了我們現在是二折一啦我們現在是二折一嘛可是問題是托育今天原本就是希望讓家長可以把小孩送去托育中心嘛對不對我們讓小孩得到托育中心的照顧也釋放女性的勞動力嘛這應該是原本的政策目標嘛那育兒補助就是說今天只要你有生小孩我們都理解生小孩多餘的可能會需要一些成本 |
| transcript.whisperx[721].start |
18313.88 |
| transcript.whisperx[721].end |
18341.443 |
| transcript.whisperx[721].text |
那政府來支持你一些成本嗎所以這兩件事情其實是不應該二選一啊部長你的看法是什麼對我了解這個委員的切入點啊那當時候這一個補助的時候他把它視為是同一件事情就自己帶跟托別人帶的成本那麼去給的啦就是說你自己帶我們就給你津貼那你托給別人帶那我們就有用補助所以才會有二折一啦 |
| transcript.whisperx[722].start |
18342.123 |
| transcript.whisperx[722].end |
18366.257 |
| transcript.whisperx[722].text |
現在是說這個委員的看法就是另外一個就是我只要是有這個孩子我的成本就會提高所以我需要大家都有一致大家都補啦那這個概念是這樣這個現在因為整個行政院也在討論對於這個津貼或補助啊怎麼去強化對這些育兒家庭的支持那麼未來應該會有一個新的版本出來 |
| transcript.whisperx[723].start |
18366.917 |
| transcript.whisperx[723].end |
18391.652 |
| transcript.whisperx[723].text |
所以我希望就是說我們可以考量托育津貼跟育兒補助不應該是二則因為這是兩個完全不一樣因為即便是我托育了我還是育兒成本還是會增加嘛對不對我只是少了托育的費用但是我平常的尿布奶粉什麼我都還是要買嘛對不對那所以這個部分我希望就是在我們新的現在正在討論的這個版本要把這件事情一起納進去那這樣子才是對一個家庭最全面的支持好嗎謝謝好好謝謝謝謝委員 |
| transcript.whisperx[724].start |
18394.133 |
| transcript.whisperx[724].end |
18421.485 |
| transcript.whisperx[724].text |
好 謝謝張雅琳委員的諮詢現在處理開會時間報告委員會我們今天上午開會時間是否延長到詢答結束沒有意見我們就延長開會時間現在請洪孟凱委員諮詢好 主席謝謝麻煩請石部長有請石崇良部長 |
| transcript.whisperx[725].start |
18425.505 |
| transcript.whisperx[725].end |
18451.623 |
| transcript.whisperx[725].text |
好 宏偉也好 徐部長我想很多委員都在關心上個禮拜我們通過三班互併筆的正式三讀通過但居然傳出說衛福部還要兩年之後才能實施那我必須很嚴正的利用今天的機會再一次的跟部長以及我們所有的衛福部的同仁來說明跟報告三班互併筆並不是現在才在談 |
| transcript.whisperx[726].start |
18453.143 |
| transcript.whisperx[726].end |
18463.552 |
| transcript.whisperx[726].text |
最早2019年2019年的時候其實就已經有談了當時就已經有講是說要往這個方向做賴清德總統2023年9月9號去醫護所謂的後援會的時候承諾說兩年入法當時給大家講是說兩年內要實施 |
| transcript.whisperx[727].start |
18472.871 |
| transcript.whisperx[727].end |
18495.636 |
| transcript.whisperx[727].text |
結果現在兩年快到的時間你沒有辦法沒有行政院沒有衛福部的版本而我們上個禮拜三讀通過你竟然自己來認定是說還要再兩年覺得這會不會太荒謬了一點不會我們是很負責任你會變成是說在這一個任期賴清德總統這個任期自始至終那就變成是從頭到尾沒有打算在這個任期裡面來做 |
| transcript.whisperx[728].start |
18497.018 |
| transcript.whisperx[728].end |
18518.094 |
| transcript.whisperx[728].text |
因為你這個任期裡面是做不到的會做得到你2024年2026年2028年對你如果說你要在兩年的話你2028年你在這個任期是做不到如果說有任何意願違反的話你也沒有辦法有任何的處罰工具會跟委員說明啦所以來部長我只是想請教啊 |
| transcript.whisperx[729].start |
18518.294 |
| transcript.whisperx[729].end |
18540.812 |
| transcript.whisperx[729].text |
因為你上禮 上午還回答我們委員的時候還在那邊我不知道說那個情境是怎麼樣那點 嬉皮笑臉還是怎麼樣還講說這次做不到再給他一次機會啊再投他都開拔蠟票了還要我們再投給你不是好意思嗎 我說任期是到520啊來啦 我們是5月1號4次還在任期內啊所以 對啊所以就兩年兩年是不會動的 |
| transcript.whisperx[730].start |
18541.713 |
| transcript.whisperx[730].end |
18554.304 |
| transcript.whisperx[730].text |
你現在公告給所有我們醫護同仁來明白就是即便是2026年的5月8號三讀通過就是還要再給衛福部兩年的時間 |
| transcript.whisperx[731].start |
18555.919 |
| transcript.whisperx[731].end |
18561.942 |
| transcript.whisperx[731].text |
就是沒有辦法再提早這個兩年的時間是怎麼來的這個兩年時間怎麼來的我已經說了所以我已經說了從一開始我們就講了這不是現在才討論啦不是現在才討論啦2019年就開始討論啦如果說當時你還要兩年的時間的話 |
| transcript.whisperx[732].start |
18577.748 |
| transcript.whisperx[732].end |
18584.311 |
| transcript.whisperx[732].text |
一個邏輯問題啊雖然當時你不是副長但是當時你也在衛福部裡面服務2023年的9月9號賴金德總統賴金德副總統總統候選人用什麼樣的基礎下去跟醫護承諾如果你要講是說要有兩年的時間的話那你用什麼基礎去承諾當時的承諾是任內完成這不就是騙票嗎 |
| transcript.whisperx[733].start |
18601.67 |
| transcript.whisperx[733].end |
18625.076 |
| transcript.whisperx[733].text |
不會啊 這個就是在任內一定的事實沒關係沒關係我們今天就事論事把它說清楚因為部長過去到現在本席在這邊都很就事論事很理性但在這件事情上面我覺得是大是大非的問題2024年的第一會期本席在第11屆第一會期擔任書記長當時對於我們的邱太元部長的時候我們在很多次的朝野協商我們都有提 |
| transcript.whisperx[734].start |
18626.076 |
| transcript.whisperx[734].end |
18639.828 |
| transcript.whisperx[734].text |
三班戶並不要入法但當時我們為什麼沒有在第一會期我們就來做二三讀就是因為我們當時也聽到邱太元部長講是說需要時間溝通也因此我們才會先做什麼事情我們先做健保點子1.0.95 |
| transcript.whisperx[735].start |
18643.231 |
| transcript.whisperx[735].end |
18661.598 |
| transcript.whisperx[735].text |
從一點點0.81開始我們認為我們也要給衛福部多一些裁員多一些能夠讓醫院去溝通醫院的點子能夠提高變成醫院的裁員有的時候我們才要請他們照顧到我們的醫師照顧到我們的護理人員所以我們先做的第一個會期是先做健保點子一點點0.95做到了 |
| transcript.whisperx[736].start |
18663.479 |
| transcript.whisperx[736].end |
18684.561 |
| transcript.whisperx[736].text |
做到完畢之後在第二年我們才來講說那三幫互併比你要做但是你們沒有拿出版本也因此才會在我們上個禮拜到最後二三讀事情把它講清楚就很明確如果說到現在你還要跟我們講說還要再兩年那說真的2023年的9月9號賴清德總統候選人他就是在台上騙票 |
| transcript.whisperx[737].start |
18685.956 |
| transcript.whisperx[737].end |
18697.907 |
| transcript.whisperx[737].text |
我們一直的規劃都是照這樣子在進行當中所以我們一直規劃就是反正你現在規劃還要在兩年嘛還要在兩年是不是就是確定還要在兩年 有沒有辦法提早沒有辦法提早還是就是兩年 才死 |
| transcript.whisperx[738].start |
18705.874 |
| transcript.whisperx[738].end |
18735.174 |
| transcript.whisperx[738].text |
就是我們希望衝擊是最低的衝擊要當它最低不要影響到民眾的就醫來 部長 那另外另外一個議題我想很多委員都關心這個醫療院所的一個部分這個偷拍的一個事件那其實我們也看到但是本席現在想要提到另外一個我也做了很多研究跟很多的瞭解日本跟韓國他們其實有很多積極的做法來 我們看一下部長 這本席幫您整理出來的 |
| transcript.whisperx[739].start |
18735.834 |
| transcript.whisperx[739].end |
18760.891 |
| transcript.whisperx[739].text |
日本跟韓國其實他們對於隱藏式的攝影器他們是有很嚴格的規範譬如像日本他們在電商平台上面是限制隱藏式的攝影器包括說偽裝插頭掛鉤時鐘等不能販售或者說這些商品需要下架韓國他們也針對偽裝的時鐘插座等等就是必須要全面的清查跟 |
| transcript.whisperx[740].start |
18761.872 |
| transcript.whisperx[740].end |
18787.88 |
| transcript.whisperx[740].text |
下架這是日本韓國的做法那我也知道因為這個議題他會涉及到跨部會衛福部管理的是這次的醫療院所所以醫療院所相關場域是衛福部管但是這個產品出現在醫療院所到底是醫療院所要去限制還是說從經濟部源頭管理或是內政部警政署來要求因為這可能會有治安疑慮或者是NCC |
| transcript.whisperx[741].start |
18788.32 |
| transcript.whisperx[741].end |
18811.061 |
| transcript.whisperx[741].text |
因為它有涉及到Wi-Fi的傳輸所以NCC可能有角色但本席現在還是就事論事在這一個艾爾利事件上面我覺得既然已經發生了過去也許我們還沒有做到這一步但我們希望是衛福部能夠更積極能不能衛福部參考一下日本跟韓國的做法找相關單位過來討論也許我們可以先針對醫療院所 |
| transcript.whisperx[742].start |
18813.322 |
| transcript.whisperx[742].end |
18840.05 |
| transcript.whisperx[742].text |
也規範就醫療院所禁止出現這樣的一個器材或是禁止出現這樣的一個設備或者是說因為這樣的一個事件來找經濟部來找內政部相關部會我們針對這一些偽裝式的攝影器不要讓一般的民眾或是有心人那麼容易取得因為本席有看啊你到現在你隨便查偽裝式攝影器網路上部長 |
| transcript.whisperx[743].start |
18842.779 |
| transcript.whisperx[743].end |
18861.754 |
| transcript.whisperx[743].text |
您知道像這一個最近愛爾利這個事件或者是說一般那種掛鉤式的攝影器一個多少錢這個我沒買過沒有概念我相信你不會買一般正常人不會去買我沒有什麼樣特殊目的你很難去買那些東西但是你知道一個多少錢嗎 |
| transcript.whisperx[744].start |
18863.16 |
| transcript.whisperx[744].end |
18880.991 |
| transcript.whisperx[744].text |
最便宜啊700塊台幣買得到掛勾式的攝影器還現在標榜什麼1080P啊標榜畫素高啊那如果說再貴一點有Wi-Fi傳輸可以直接那個你用APP來傳輸那個影像的話兩三千塊其實就有 |
| transcript.whisperx[745].start |
18882.202 |
| transcript.whisperx[745].end |
18910.258 |
| transcript.whisperx[745].text |
所以換言之這個門檻低到如果你真的有心人士想要犯罪或是想要用這一些東西去偷拍還是說做一些這種隱藏式的攝影的話其實防不勝防也才會爆發這次愛爾麗事件那愛爾麗是唯一嗎我想現在可能連環報啊我看衛福部也不敢講是說只有愛爾麗一家嗎可能現在我們也請各縣市政府的衛生局都去稽查相關但美容院所以外 |
| transcript.whisperx[746].start |
18911.277 |
| transcript.whisperx[746].end |
18929.563 |
| transcript.whisperx[746].text |
你說其他的診所有沒有你說其他的娛樂場所有沒有可能都有可是那就變成是跨很多部會所以我現在還是就叫衛福部長針對我們這個部分能不能先找相關部會來討論來做這樣子的一個限制或是做這樣子的一個要求下架 |
| transcript.whisperx[747].start |
18930.414 |
| transcript.whisperx[747].end |
18957.498 |
| transcript.whisperx[747].text |
應該是先跟我們說明就我們的主管範圍有兩件事情會做第一個呢這個禮拜就會找各地方政府衛生局來討論如何做盤查跟裁罰它的基準在哪裡然後全面性的展開這是第一個第二個呢對於如何強化管理者的責任就是說這一些診所的這個負責人或者是擁有者 |
| transcript.whisperx[748].start |
18958.038 |
| transcript.whisperx[748].end |
18980.554 |
| transcript.whisperx[748].text |
那在對於這一些所謂的攝入領基的設置或者是必須遵守的規範上我們來討論出一些這個這個辦法也好來強化要求管理那這個就是我們在醫療院所但還需要這個禮拜才開會啊那你這樣子不就是讓一些有心人士要現在趕快拆 |
| transcript.whisperx[749].start |
18981.354 |
| transcript.whisperx[749].end |
18996.752 |
| transcript.whisperx[749].text |
不會這個馬上就已經在採訪了不是已經開始啦已經開始了有的衛生局都已經開始了現在我們只是在講說你那個採訪的時候應該要怎麼個採訪所以應該是同步進行吧各縣市有衛生局已經要再做稽查了譬如說我們採訪的時候為什麼我說要這個 |
| transcript.whisperx[750].start |
18999.955 |
| transcript.whisperx[750].end |
19015.26 |
| transcript.whisperx[750].text |
停業處分依據是什麼讓衛生局能夠掌握不要大家有的只開開罰單就算了這種情節重大的就是要停業處分好像類似像這樣的這個這個跟衛生局的裁罰的因為我覺得這件事情 |
| transcript.whisperx[751].start |
19016.52 |
| transcript.whisperx[751].end |
19032.736 |
| transcript.whisperx[751].text |
艾爾利集團啊我說實在話我們跟他沒有非親非故啦可是他畢竟就我們一般的認知他算是醫美的數一數二的品牌啊對不對如果連一個數一數二品牌都會這樣做的話那真的很難讓人家放心說還有其他的一個 |
| transcript.whisperx[752].start |
19034.077 |
| transcript.whisperx[752].end |
19056.403 |
| transcript.whisperx[752].text |
診所的一個狀況也因此本席還是強調就是說你該開罰以及如果說勒令停業不要有上限也不要因為人家是集團就害怕或說我們就手軟可是另外一個部分本席還是強調的是利用這一次的機會是不是衛福部也跟相關單位能夠來做一個研究至少本席的這一個建議我覺得要看一下日本跟韓國怎麼做 |
| transcript.whisperx[753].start |
19057.463 |
| transcript.whisperx[753].end |
19083.359 |
| transcript.whisperx[753].text |
那也請部長這邊能夠請同仁在開會的時候互相大家來討論一下當然本席也會要求不管是經濟部不管是內政部因為這真的跨部會可是政府是一體的既然這件事情已經爆發出來了我認為隱藏式的攝影器確實這樣亂象有必要要去規範跟管理部長你同意嗎同意同意這個需要我們繼續努力好不好謝謝好謝謝謝謝委員謝謝黃孟愷委員的諮詢 |
| transcript.whisperx[754].start |
19089.554 |
| transcript.whisperx[754].end |
19099.067 |
| transcript.whisperx[754].text |
林倩琦 林倩琦 林倩琦委員不在林思明 林思明 林思明委員不在顏匡恆 顏匡恆 顏匡恆委員不在這個請張嘉斌委員質詢 |
| transcript.whisperx[755].start |
19112.146 |
| transcript.whisperx[755].end |
19125.236 |
| transcript.whisperx[755].text |
主席在場的委員先進如果還有的話在場的學會官員那個面題資訊女士先生工作夥伴大家午安那有請我們辛苦的石部長餓著肚子的石部長石部長我可能是今天的最後一位啦不曉得在看主席但是所以一開始輕鬆一點在上個月的月底啊是台電公司80週年的紀念活動 |
| transcript.whisperx[756].start |
19141.38 |
| transcript.whisperx[756].end |
19161.987 |
| transcript.whisperx[756].text |
賴總統跟我和集會委員也受邀前往其中有兩位很特別一個是前工研院的劉文雄院長一位是高雄市議會的康玉成議長他們都剛好是台電的員工眷屬他們都不約同提到一件事情我也有這個經驗小時候在家裡如果沒有隨手關燈會被爸爸敲腦袋 |
| transcript.whisperx[757].start |
19164.848 |
| transcript.whisperx[757].end |
19191.342 |
| transcript.whisperx[757].text |
電不是台電生產的嗎你覺得為什麼台電的員工會特別要求自己的子女要求節約用電為什麼因為他們知道這個電的來源是不易是的所以台電的員工其實過去有一個政策台電員工電價家裡的電是半價但是台電好像不覺得這樣子會被浪費電你有搭過高鐵嗎部長有你知道高鐵的員工搭高鐵是怎麼算錢 |
| transcript.whisperx[758].start |
19192.438 |
| transcript.whisperx[758].end |
19209.372 |
| transcript.whisperx[758].text |
這個不行大家猜猜看高鐵的員工搭高鐵要不要收費要不要買票要合理嘛但是航空公司的空服員如果這班班機只要有空位他其實是可以在一定額度內免費搭乘你覺得可以接受嗎 |
| transcript.whisperx[759].start |
19211.069 |
| transcript.whisperx[759].end |
19235.527 |
| transcript.whisperx[759].text |
可不合理他是用現有的空位去那邊未停其實這兩個來講如果是台電的員工電費半價對台電的股東跟其他的用家有一點點不太公平因為電你把它用掉別人就用不到但是如果是空位搭乘航空公司或高鐵空位搭乘本來就沒有人搭所以不用算錢可以接受所以一個 |
| transcript.whisperx[760].start |
19237.249 |
| transcript.whisperx[760].end |
19250.603 |
| transcript.whisperx[760].text |
服務體系在運作的時候他必然的會對這個體系提供服務者一些優惠所以我們的健保體系很多人有貢獻我覺得最近大家最引起注目的就是護理人員 |
| transcript.whisperx[761].start |
19251.741 |
| transcript.whisperx[761].end |
19280.919 |
| transcript.whisperx[761].text |
很辛苦而且很辛苦看得到感受最直接對不對很多人啊在台灣這個年代比我早一點的在家裡生的是那個住產式接生的像我這個是在醫院生的其實大部分第一個張開眼睛看到的是什麼是護理人員是不是所以如果你覺得我們的健保系統我們國民的滿意度這麼高對這些人員給予一些在健保使用上的優惠你覺得可以考慮嗎 |
| transcript.whisperx[762].start |
19283.952 |
| transcript.whisperx[762].end |
19299.192 |
| transcript.whisperx[762].text |
使用上來 使用有很多種嘛對不對譬如說我曾經長年捐血那我得到的是什麼如果未來我本人或我的至親親屬需要用血的時候捐血中心說我可以優先使用你覺得合理嗎 |
| transcript.whisperx[763].start |
19302.15 |
| transcript.whisperx[763].end |
19314.418 |
| transcript.whisperx[763].text |
我覺得這個規定可不合理我們還是按照那個使用的規定我先說我捐血的話如果我有捐血我的止息金屬需要用我本人所以捐血中心說我可以優先使用你覺得這樣的一個規定合人情吧 |
| transcript.whisperx[764].start |
19318.992 |
| transcript.whisperx[764].end |
19343.31 |
| transcript.whisperx[764].text |
這個優先我不是想捐血我不是問你健保因為我們還是從這個生命上的使用的優先順序去看這個對部長來講這可能是個哲學的問題但我覺得你值得去思考其實我們今天在看健保的滿意度其實我們都忽略了一點其實健保我們其實是得到的遠比我們付出的多我想平心而論雖然我已經很久沒有使用健保卡了 |
| transcript.whisperx[765].start |
19344.502 |
| transcript.whisperx[765].end |
19359.935 |
| transcript.whisperx[765].text |
但是呢我覺得在台灣社會要讓健保的品質維持服務部團也很用心嘛之前你也提出怎麼樣增加健保收入嘛對不對你說健保的補充保費那後來什麼原因你覺得要重新考慮健保的補充保費 |
| transcript.whisperx[766].start |
19361.833 |
| transcript.whisperx[766].end |
19389.611 |
| transcript.whisperx[766].text |
這一點不堪回首主要還是希望減少大家的衝擊啦就是讓有能者多付一些是的你說得很好有能者我們健保的收費有點跟稅很像其實我們的補充保費呢你知道吧兩萬元以上的利息才會要扣補充保費嘛那如果我不想付我就讓我那個帳戶不要超過兩萬塊的利息嘛那你知道利息要不要繳綜合所得稅 |
| transcript.whisperx[767].start |
19391.032 |
| transcript.whisperx[767].end |
19419.69 |
| transcript.whisperx[767].text |
要嘛股票大漲我分配到的股利要不要繳中和所的稅要但是要不要繳補充保費要看情況所以我覺得目前啊股市一片大火的情況之下對於這些一般的退休的人他靠著銀行存款的利息靠著投資幾張股票的股息在過日子的我覺得不需要跟他計較補充保費但是如果是我有好幾百張台積電的股票我可以很高的配息 |
| transcript.whisperx[768].start |
19420.35 |
| transcript.whisperx[768].end |
19440.313 |
| transcript.whisperx[768].text |
你覺得我有沒有能力多付他一點補充保費應該有應該有所以兩個方向如果未來我們有機會透過這個方式讓更有能力的人多付一些補充保費就是利息收入300萬的人跟利息收入3萬塊的人他付的補充保費的費率不一樣 |
| transcript.whisperx[769].start |
19442.154 |
| transcript.whisperx[769].end |
19463.202 |
| transcript.whisperx[769].text |
費率是一樣對可是年所得三千萬的人跟年所得三百萬的人他的所得稅稅率不一樣不一樣不一樣那您了解了我想部長很聰明我覺得站在目前大家關注包括整個健保體系付出很多心力像我們現場的護理人員我們社會都是感恩跟肯定 |
| transcript.whisperx[770].start |
19463.942 |
| transcript.whisperx[770].end |
19485.288 |
| transcript.whisperx[770].text |
那我們希望他的所得能夠提高 給付能夠增加可是部長想到健保要永續發展我的收入也要增加你就不得不從補充保費去著手對不對可是補充保費要看對象所以我剛剛講了如果利息收入高達三百萬的跟利息收入三萬塊的是不是補充保費應該不太一樣的手法 |
| transcript.whisperx[771].start |
19486.823 |
| transcript.whisperx[771].end |
19501.898 |
| transcript.whisperx[771].text |
我們當然現在有一個補充保費的天花板那費率是相同啦對 費率都一樣嘛那天花板是1000萬啦所以我是覺得費率可以不同天花板可以提高要不然往這方面去思考一下後面的署長一點頭眼睛都快掉下來了 |
| transcript.whisperx[772].start |
19504.219 |
| transcript.whisperx[772].end |
19531.989 |
| transcript.whisperx[772].text |
所以我是這樣的一個思考希望部長往這兩個方向就是我們的健保要永續經營一定要提高它的收入收入的可以找有能力的人比較好能力的人來提取好不好就差別取價不是差別 差別取費率但是如果我們健保的收入既然提高了那怎麼樣回饋到支撐健保體系的這些人的身上這樣就有空間了嘛 |
| transcript.whisperx[773].start |
19533.206 |
| transcript.whisperx[773].end |
19554.153 |
| transcript.whisperx[773].text |
那我就剛剛拋出來嘛那如果是護理人員就像我說我過去我們是台電的員工子弟我們的家庭過去電費是半價那有沒有可能為我們來思考一下給予這些支撐健保體系非常辛苦的人縱使我不能夠幫他加薪我可以減輕他的負擔部長這樣可以思考一下嗎 |
| transcript.whisperx[774].start |
19555.553 |
| transcript.whisperx[774].end |
19579.078 |
| transcript.whisperx[774].text |
這個需要很慎重的討論當然我覺得您的討論您的推出來的政策都是要很慎重的因為遷移法動全身所以我今天只提供這兩個你的健保保費從哪裡來增加你得到的增加的這個健保的收入用在誰身上這兩個方向部長願意待會去思考嗎好我們來思考我希望說今天是會議的最後一位發言者我就簡單輕鬆的這樣請問也謝謝主席的容忍謝謝好謝謝委員謝謝 |
| transcript.whisperx[775].start |
19584.499 |
| transcript.whisperx[775].end |
19593.523 |
| transcript.whisperx[775].text |
謝謝曾嘉斌委員的質詢羅明才 羅明才 羅明才委員不在鄭振淺 鄭振淺 鄭振淺委員不在劉建國劉建國委員質詢 |
| transcript.whisperx[776].start |
19616.205 |
| transcript.whisperx[776].end |
19637.657 |
| transcript.whisperx[776].text |
謝謝主席有連接的 等一下請部長有請施部長部長現在兩點半有重要的會記者會有重要的會那我等一下問你就即時回答然後該承諾的該答應的就簡單扼要我們就時間以前讓你離開如果不承諾不答應那你就 |
| transcript.whisperx[777].start |
19644.075 |
| transcript.whisperx[777].end |
19671.032 |
| transcript.whisperx[777].text |
3點以後才離開這個全台到底有多少醫美診所裝設真孔攝影有掌握了嗎目前沒有,還是有在查那在這一家叫艾爾利嘛,爆發裝設這個真孔攝影在這個天花板的煙霧偵測器裡面嘛對不對後續又入區有爆出三家醫美診所對不對都有裝設 |
| transcript.whisperx[778].start |
19672.172 |
| transcript.whisperx[778].end |
19694.338 |
| transcript.whisperx[778].text |
那到10日前已經有4家機構又被查到都沒有錯嘛好那昨天又傳出知名的產後護理師家發現有疑似的這個針孔攝影器雖然初步這個調查是說可能是錄音的設備限裁但偷錄音也算是侵害隱私的行為嘛這個不容許嘛那這件事有掌握嗎 |
| transcript.whisperx[779].start |
19695.833 |
| transcript.whisperx[779].end |
19714.62 |
| transcript.whisperx[779].text |
這個要全面的盤查下去不是先針對這一家你們有掌握嗎我們是台北市政府已經去查了那目前找到的不是那個錄影機但是還是持續在確認不是錄影機啊當然有錄影機吧錄影也不行啊 |
| transcript.whisperx[780].start |
19716.251 |
| transcript.whisperx[780].end |
19744.745 |
| transcript.whisperx[780].text |
它不是針孔錄影那是一個消防安全的煙霧不過現在還在釐清中還沒有完全掌握所以還沒有掌握到就對了還沒有完全掌握那這個報導已經出來了嘛我也想說大家會想問的是這個全國到底有全國到底有多少家醫美診所做這種事情嗎包含這護理師家我想在病患服務的對象家屬都不清不楚的情況之下這些被偽裝成為天花板這煙霧偵測器的針孔攝影器材 |
| transcript.whisperx[781].start |
19745.425 |
| transcript.whisperx[781].end |
19772.513 |
| transcript.whisperx[781].text |
或是錄影或是錄音那剛剛市長又講那個不是天花板的那種偵測映入器可能又另外一種另外一種形式上的器材嘛對不對這可能會我覺得會蠻多的啦然後9日的時候媒體是這麼報導他說偷拍移運進到這個醫美圈外部出手5月13號開會不排除全台普查沒有錯嗎對 |
| transcript.whisperx[782].start |
19775.217 |
| transcript.whisperx[782].end |
19799.95 |
| transcript.whisperx[782].text |
你現在是為什麼做這樣的決定應該是這樣講就是說每年本來地方衛生局就會對醫療機構做督導考核那個其實也是一種普查啦只是過去沒有特別著重在這一些所裝設的攝影機它的那個集合所以這一次會特別現在13號要先開會真的沒有針對特別的攝影機去集合嗎 |
| transcript.whisperx[783].start |
19803.892 |
| transcript.whisperx[783].end |
19811.931 |
| transcript.whisperx[783].text |
他藏在那個天花板的煙露偵測器裡面你到底查不到嘛對不對那你糟糕5月13號你是叫做落日條款 |
| transcript.whisperx[784].start |
19812.554 |
| transcript.whisperx[784].end |
19832.222 |
| transcript.whisperx[784].text |
不是落日啦,這是跟衛生局大家討論完之後就開始你會討論完之後,我們台南市政府也不用等到你討論完之後人家切皮就開始展開啊我們現在是全國一致性開始來做對嘛,你全國一致性,你是公告全國的醫美診所來喔,我當時要開始喔,要照你附近照喔 |
| transcript.whisperx[785].start |
19835.68 |
| transcript.whisperx[785].end |
19860.993 |
| transcript.whisperx[785].text |
沒有啦沒有啦你就是這樣說沒有這新聞就是這樣不定不定我們誠實以對好不好你就是例行性的一個集合的過程裡面就是沒有查到嘛今天這個人家是投訴的又不是你們查到的對啊那你現在又5月13號要召開全國的這個地方衛生局然後說我們要開這個會然後我們就要來不排除全國補查嘛 |
| transcript.whisperx[786].start |
19861.909 |
| transcript.whisperx[786].end |
19865.472 |
| transcript.whisperx[786].text |
所以五十三個月後,這個會開啥?還有一個禮拜時間給你們?我鼓勵你,你覺得台無利,你說我聽你如果覺得我沒利,我現在下去了,你去問你的事情但是沒開齁?你不用開,台南市衛生局,我們就在你面前啊南北省九零一你是發現一家裝有 |
| transcript.whisperx[787].start |
19887.469 |
| transcript.whisperx[787].end |
19906.424 |
| transcript.whisperx[787].text |
真空攝影一樣在天花板的煙霧偵測器上的陰影的偵測啊我們就查到了啊我們不用等到你照啊 不用等到你開花啊我們就處理啊你現在人家每天七點鐘你做給你看結果你到五十三點才開啊那就是不對啊那就是不對啊你這麼說你現在應該是國慶統領會你等一下國慶去查嘛 |
| transcript.whisperx[788].start |
19915.253 |
| transcript.whisperx[788].end |
19936.498 |
| transcript.whisperx[788].text |
你有什麼理由不可以查 你有什麼自然人性嘛你要馬上去掌握嘛哪來等你到5月13號才召開這個會所以我說我用多的時間跟你講基本上不過分啦 也不會過啊我們今天就去發文啦沒有 我覺得補充你的經驗跟你的個性不會去做這些事情除非 |
| transcript.whisperx[789].start |
19937.617 |
| transcript.whisperx[789].end |
19961.744 |
| transcript.whisperx[789].text |
除非有陰謀沒有啦沒什麼陰謀啦你這有陰謀你這樣做嘛沒什麼陰謀啊不然是市長要限你不義啊沒有啦不然我就跟你講地方政府在8號就走了就開始查了隔天就查到了你的過去例行事物就查不到嘛人家現在查就查得到嘛那你還有5月13日要召開這個會的意義目的是什麼嘛 |
| transcript.whisperx[790].start |
19963.773 |
| transcript.whisperx[790].end |
19990.276 |
| transcript.whisperx[790].text |
跟委員說明 上個禮拜我們就已經發文了是針對這幾個縣市 也有集團在那個縣市有 不見得還沒查 還沒查到啦但是就一定先叫人去查啦所以這個是先針對這個醫美集團所在它有在那個縣市有分店的 有一些集團我們就開始了 所以全面性當然各縣市衛生局隨時可以開始 沒有問題 |
| transcript.whisperx[791].start |
19992.057 |
| transcript.whisperx[791].end |
20015.666 |
| transcript.whisperx[791].text |
那麼我們現在這個意思是預計安排5月13號是對這個裁罰的基準 要發什麼東西根據哪些條文 應該要重罰這要有一個要求部長 我真的是善意建議啦你如果很沒用 你把副品牌的事我其實剛才不是副品牌的你再問下去 你也真的要給我回應我是要跟你說這件事你如果這樣處理 其實是我覺得有點有點不智啦 |
| transcript.whisperx[792].start |
20023.203 |
| transcript.whisperx[792].end |
20038.288 |
| transcript.whisperx[792].text |
如果今天地方政府沒有走我不會引用這個例子來提醒你人家已經走了啊今天是511啊人家5月9日就查到了啊你還到5月13日你還不是要馬上查所以你趕快通令下去嘛市長做得到吧 |
| transcript.whisperx[793].start |
20039.178 |
| transcript.whisperx[793].end |
20056.956 |
| transcript.whisperx[793].text |
可以啦 你們開放開會嘛你通常都在我們茶間查嘛我們又不可以支援你們啊委員5月8號我們就已經發文請衛生局去查可是在查的過程中大家是依據哪個法條查的違法的那個法條依據你們只有查到這而已啦沒有沒有 |
| transcript.whisperx[794].start |
20058.516 |
| transcript.whisperx[794].end |
20076.257 |
| transcript.whisperx[794].text |
公文今天才發嘛公文是今天發另外三個集團5月8號艾爾利就已經發下去了你要全國補償怎麼只有那三家而已那三家跟你們編長就是互通不是很良好首先優先處理這三家你也很奇怪還是跟那三家互不合 |
| transcript.whisperx[795].start |
20080.36 |
| transcript.whisperx[795].end |
20091.989 |
| transcript.whisperx[795].text |
你這個邏輯講不夠,不然你是做邏輯的人,我這樣給你提倡,你覺得這個邏輯通嗎?這個處理的程序上這樣通嗎?底下各司的各署的都在嗎?你如果覺得你回答的那些是覺得做生活程序的,我就跟他說你不要問,你怎麼會離開啊?因為你兩點半嘛,十三分,你用早還過早啦 |
| transcript.whisperx[796].start |
20106.772 |
| transcript.whisperx[796].end |
20135.562 |
| transcript.whisperx[796].text |
這個就這個我們完全同意我們開始發文全部都開始今天就發文通一下去的嘛好不好地方政府如果不做那是地方政府的問題嘛地方政府如果自然而然請求你們協助那你當然要協助嘛好第二個題目啦齁這個AI已經成為社會的新潮流白宮白夜搭AI的輔助也是一個趨勢那醫療產業也是在一馬當先但是部長你是領導社政跟這個議政嘛那議政已經走了已經飛起來了那社政勒 |
| transcript.whisperx[797].start |
20137.153 |
| transcript.whisperx[797].end |
20163.466 |
| transcript.whisperx[797].text |
設置AI的運用對啊我們也是有在長照3.0裡頭有導入AI輔助的科技來提升長照的服務那針對社工這一塊社工是這一塊社工主要是派案的部分社工師也有在導入應該是保護服務師吧他好用嗎 |
| transcript.whisperx[798].start |
20165.754 |
| transcript.whisperx[798].end |
20176.214 |
| transcript.whisperx[798].text |
我跟妳提醒一下,不好用,不好用還在用人家AI是AI,妳的AI是不AI,不AI就沒救了 |
| transcript.whisperx[799].start |
20177.492 |
| transcript.whisperx[799].end |
20199.681 |
| transcript.whisperx[799].text |
連一個清大研發一個AI系統來輔助社工完全免費喔然後兼顧隱私資源現場還兼顧隱私喔然後去年8月上線以來累計已經超過36000產生超過8000筆的社工紀錄每天穩定的處理近百筆的資料那這個中間他不只如此啦也在整個這一個 |
| transcript.whisperx[800].start |
20201.762 |
| transcript.whisperx[800].end |
20215.111 |
| transcript.whisperx[800].text |
整個這個仿似的錄音轉組織稿等五項的這個AI的輔助的這個功能然後等於是民間自發的來協助社工減輕壓力我不曉得我們衛福部主管機關 |
| transcript.whisperx[801].start |
20216.365 |
| transcript.whisperx[801].end |
20239.042 |
| transcript.whisperx[801].text |
有這套系統嗎?如果民間系統可以做到讓大家覺得可以隨心的運手然後公佈我們為什麼沒有更好的系統來協助他們你看那個每天的爆量、案件寫不完的紀錄跟報告有時候會把社工的熱情整個消磨殆盡那最後每一個個案都成為流於刑事上的紓論文件 |
| transcript.whisperx[802].start |
20240.545 |
| transcript.whisperx[802].end |
20261.719 |
| transcript.whisperx[802].text |
你看凱凱案那個出現社工造假的記錄然後文化被譴責而且這個系統是完全純協助他不記錄個案資訊不進行數據分析照理講官方應該是有更好的一個便利好用的AI系統來協助社工好好去輔導這樣的一個個案 |
| transcript.whisperx[803].start |
20265.035 |
| transcript.whisperx[803].end |
20281.523 |
| transcript.whisperx[803].text |
是不是讓我們市長補充一下 好像他們對這個系統有進行了解那跟委員報告 也謝謝委員的關心首先本部在兩三年前我們就已經委託了國網中心進行社工智慧決策平台的開發 |
| transcript.whisperx[804].start |
20282.563 |
| transcript.whisperx[804].end |
20310.865 |
| transcript.whisperx[804].text |
那其中就有包括協助語音轉文字來協助社工作進入還有行動加息圖這樣的一個功能那至於我們也從平台上就是其他的一個平台有看到清大的老師有開發這個平台那我們也跟我們的研究團隊有做了一些討論那初步我們會覺得他可能在一些資安的一些狀況情形下可能還有一些疑慮那我們會再進一步來做一些討論 |
| transcript.whisperx[805].start |
20311.926 |
| transcript.whisperx[805].end |
20334.633 |
| transcript.whisperx[805].text |
你現在針對清大這個系統,你覺得他有治安上的疑慮?是他去年就開始了,你的疑慮也有點久了我們是最近才發覺他們有這個系統你要質疑他有治安疑慮,他開始動的時候你就開始要查了,要了解了怎麼可能去年辦案到現在 |
| transcript.whisperx[806].start |
20336.893 |
| transcript.whisperx[806].end |
20356.323 |
| transcript.whisperx[806].text |
你現在跟人家講說你這個資安有疑慮人家覺得很老用你說他資安有疑慮那你現在還沒幫我確定到底是疑慮還是確定有資安問題因為這個AI的運用主管機關是我們數位部它有一些相關的規範所以你那回答人家的話發條尾音話那是說大家是實施實施不要再犯罪不犯罪 |
| transcript.whisperx[807].start |
20364.312 |
| transcript.whisperx[807].end |
20389.217 |
| transcript.whisperx[807].text |
現在顧問律師還是補丁的頭要抹什麼抹的,越來越有抹,我可以講真的。我是要拿這個補丁,我想社工跟醫療一樣,要去做很重要的事情嘛。你做醫生,拿手術的話,那些手術可以幫你培養,是那個醫生講的為準嘛。現在社工說,請大家這個OK,很好用,你現在說治安有利,南北方開始用你現在說治安有利,到底有利沒利,市長你現在怎麼可以這樣。 |
| transcript.whisperx[808].start |
20391.927 |
| transcript.whisperx[808].end |
20419.697 |
| transcript.whisperx[808].text |
講這種話然後我們你講的那套系統叫做社會工作人員智慧決策行動平台嘛對不對2024開始啟用嘛給社工使用這個系統齁我們中央覺得是好像是超前部署啦創新啦但我接受到第一線的社工的反應一點都不好用徒增工作量然後他們拿來跟清大車道系統對比社工認為齁不然你聽啦市長你也聽社工認為清大用的是第一線的角度在看事情 |
| transcript.whisperx[809].start |
20420.946 |
| transcript.whisperx[809].end |
20425.148 |
| transcript.whisperx[809].text |
衛務部的APP是用管理社工的思維在增加他們的負擔沒有你給我調整沒有你給我調整這個我們再進一步去了解啦 看看有什麼地方既然大家都覺得好用 那當然我們看看能不能把它導入啦不是啦 應該我們公務員應該用個 |
| transcript.whisperx[810].start |
20448.377 |
| transcript.whisperx[810].end |
20464.072 |
| transcript.whisperx[810].text |
要比清道路去還要更好用才對也更沒有資安的問題才對啊我們還需要的還是有一些管理的功能還是需要因為從主管機關的角度他還是需要有一些管理的功能看看這兩個因為我沒有用過這個系統我們再來瞭解一下 |
| transcript.whisperx[811].start |
20465.03 |
| transcript.whisperx[811].end |
20480.48 |
| transcript.whisperx[811].text |
對,你一定沒有用過,你也不可能會用嘛那市長應該會很清楚嘛所以他剛剛市長這樣打我,我也覺得這個已經不是有什麼治安疑慮了所以我們內部有疑慮吧兩個禮拜好不好好,我再請資訊處也協助評估一下這個系統怎麼樣好啊,人好我們那邊比較好啊對啊,兩個禮拜可以啦齁 |
| transcript.whisperx[812].start |
20490.166 |
| transcript.whisperx[812].end |
20490.567 |
| transcript.whisperx[812].text |
最後三萬戶併比 |
| transcript.whisperx[813].start |
20505.074 |
| transcript.whisperx[813].end |
20523.96 |
| transcript.whisperx[813].text |
我還是覺得在執行面的問題我個人感覺我想部長的經驗還有市長的經驗這個事情會引起宣傳大波我還是請兩位展智慧我覺得是執行面的問題有確確去執行 |
| transcript.whisperx[814].start |
20527.302 |
| transcript.whisperx[814].end |
20539.781 |
| transcript.whisperx[814].text |
有時候當然是必須要有法律的一個依據跟規範但是有時候法律訂出來你自己面還是有那種心態的情況之下 |
| transcript.whisperx[815].start |
20542.075 |
| transcript.whisperx[815].end |
20566.709 |
| transcript.whisperx[815].text |
也不盡然可以達到大家想要追求的到那個理想嘛但是可能在當你有行政權的時候執行面很多事情是不只你這邊跟市長這邊你們可以可以去很有智慧去做處理我個人感覺是這樣啦給你們最後一個建議啦好不好好謝謝好謝謝主席謝謝好謝謝劉建國委員的諮詢 |
| transcript.whisperx[816].start |
20571.317 |
| transcript.whisperx[816].end |
20598.099 |
| transcript.whisperx[816].text |
賴仕寶 賴仕寶 賴仕寶委員不在本日會議詢答全部結束委員楊耀 徐欣穎所提順便質詢落入紀錄刊登公報現在作以下決議說明及詢答完畢委員質詢未及答覆或請補充資料者請相關金管理兩周內以順便答覆委員另要求期限者從期鎖定中華民國一百一十五年度中央總預算 |
| transcript.whisperx[817].start |
20600.14 |
| transcript.whisperx[817].end |
20623.091 |
| transcript.whisperx[817].text |
政府總預算案關於衛生福利部主管公務及基金預算及直轄市及縣市政府一般補助款衛生福利部主管部分預算案令則其繼續審查本日會議到此結束 現在散會今天下午2點30分召開空氣污染防治法公聽會 |
| transcript.whisperx[818].start |
20627.5 |
| transcript.whisperx[818].end |
20631.021 |
| transcript.whisperx[818].text |
我休息一下吧,我饭饭饭饭饭饭饭 |