{"id":149964,"url":"https://ivod.ly.gov.tw/Play/Clip/1M/149964","video_url":"https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/14550b3f67fe733a3a3f561913138d8e25cd79889bed64eaf8ba9b0039caa7a615f377d25edfc7d75ea18f28b6918d91.mp4/playlist.m3u8","委員名稱":"陳菁徽","委員發言時間":"10:10:47 - 10:28:32","影片長度":"00:17:45","會議時間":"2024-03-18T09:00:00+08:00","會議名稱":"立法院第11屆第1會期社會福利及衛生環境委員會第6次全體委員會議（事由：邀請衛生福利部部長、教育部、法務部、內政部警政署就「社會安全網推動情形及策進作為」進行專題報告，並備質詢。）","meet":{"tmpMeeting":null,"title":"第11屆第1會期社會福利及衛生環境委員會第6次全體委員會議","term":11,"type":"委員會","sessionPeriod":1,"sessionTimes":6,"committees":[26],"id":"委員會-11-1-26-6"},"date":"2024-03-18","duration":1065,"end_time":"2024-03-18T10:28:32+08:00","start_time":"2024-03-18T10:10:47+08:00","features":["ai-transcript","gazette"],"type":"Clip","gazette":{"lineno":855,"blocks":[["陳委員菁徽：（10時10分）主席、各位委員同事、各位官員還有各位媒體朋友，大家早安，大家好，有請部長。"],["主席：好，請薛部長。"],["薛部長瑞元：委員早。"],["陳委員菁徽：早安。這段話是2020年蔡總統宣布第二期社安網所說的，就職典禮的發言稿，他提到我們要讓第一線的社工能量提升，改善他們的工作環境，讓社工能夠深入最基層，把過去社會安全網沒有接住的人都找回來，我們也不應該把責任全部推給醫療部門、個別法官，司法和行政部門應該要檢討制度。結果，我們很遺憾地發現，到今天過了4年，我們的社工能量還是沒有提升，到處缺社工，結果這件事事發後，大家是獵巫啊！醫師啊、社工師啊等等。剛剛部長有增加了非常多的篇幅，本席也非常感動，但是昨天列出來的檢討報告居然800字出現了11次地方，看到的時候真的很難過，但剛才部長已經跟全國民眾還有剴剴的家屬道歉了，我在這邊有一個小小的提議，因為我也身為三個小孩的媽媽，不知道部長如果在沒有媒體關注的狀況下，你是否願意親自跟這位小男童的家屬道歉並且安慰他，還有提供後續的安置，還有你後續的作法呢？"],["薛部長瑞元：這個沒有問題。"],["陳委員菁徽：是，謝謝部長今天願意道歉，因為現在網路上已經有幾萬人連署，馬上就破幾萬連署虐童致死，可見人民對這件事有多麼生氣，全國各地都有民眾主動要送花跟剴剴致哀，所以我們今天委員會召開最重要的意義就是我們應該要一起協助部長把這個社會安全網補起來，因為您才是把每一絲、每一絲的線補起來的人，我們醫生、社工單位、所有的地方政府都是這個網的一條線而已啊！您才是最重要的角色。"],["薛部長瑞元：是。"],["陳委員菁徽：您在14號說我們要同步制定托育專法，盼本會期能送入立法院，但這個會期剩下2個月，我想問您在這個會期真的可以送入立法院嗎？"],["薛部長瑞元：比較精確來講應該是送到行政院，因為經過專家會議討論之後，由我們的法規會再考慮法律的文字，最後定案了才送行政院，所以應該這個會期之內我們會把它送到……"],["陳委員菁徽：我們的人工生殖法已經搞2年了，還沒完成，你現在說要做這個托育專法，我不知道是不是就你法律專業的立場有什麼特別的考量。我們現在的兒權法已經包含托嬰中心、育兒機構還有保母的規範都在裡面了，提出專法的意思是說你要把現在相關的條文、子法全部刪掉，然後另立一個托育專法，這是一個大工程，但我們的洞現在都還沒補好，週末又有新的案件發生耶！"],["薛部長瑞元：新案件部分，如果委員詢問我們再回答。這個部分就托育專法跟兒權法的修正，我們已經討論2年了，所以已經差不多快要收尾。"],["陳委員菁徽：所以你很有信心在這個會期送出？"],["薛部長瑞元：對，能夠把它送到行政院去做審查。"],["陳委員菁徽：好，我們會緊盯您的進度。另外，我也獲得本黨二十幾位委員共同連署，我們要即刻提出兒少權法修正草案，還有保母定期評鑑制度化，本席在這邊希望衛福部可以在1個月內提出相關的研究報告、預計實施的辦法，以及你們對於托育專法大概的修法方向和預計進度。"],["薛部長瑞元：兒少權法這次修正很重要的是要符合CRC兒權公約的部分，對於托育，尤其是像保母還有托育機構管理的部分，如果仍然放在兒權法裡面可能會非常膨脹，變成整個兒權法的重點都會被壓縮到。"],["陳委員菁徽：我想關心這件事的大眾還有委員真的非常多，所以我們一定會密切在這個會期觀察大家的進度，好嗎？"],["薛部長瑞元：好。"],["陳委員菁徽：再來，109年衛福部曾經提出一個優化兒童醫療照護計畫，當時連行政院院長都說我們5歲以下兒童死亡率的數字讓他感到非常丟臉，他自己公開在媒體上承認我們跟其他OECD國家比起來，別人是1.7%、2.4%，我們是4.7%、4.6%。你提出這個兒童醫療照護計畫時幫自己定了KPI，你希望110年、111年、112年、113年是逐年下降，結果我們發現實際的數據在110年、111年是4.8%、5.1%，你的這個照護計畫是出了什麼事情？"],["薛部長瑞元：報告委員，這有兩個部分，像委員這一張slide顯示的右下方那邊，新生兒的死亡率有兩種算法，一種是把22週以下的也算進來，所以現在講的4.8%、5.1%是包括在裡面的，但如果把這部分扣掉就會稍微減少一點，不過我們國內還是……"],["陳委員菁徽：但還是沒有達到你的KPI啊！"],["薛部長瑞元：對，所以我們有檢討這個部分，第一個，我們已經在著手所謂的新生兒及嬰兒的死因回溯計畫，我們想要找出可避免的死亡原因。"],["陳委員菁徽：所以我們今天討論到的這個案例，你看上面寫期待降低死亡率，減少兒童可預防、可避免的死亡，我們這個案例算不算你提到的可預防、可避免的死亡？"],["薛部長瑞元：是，這個是。"],["陳委員菁徽：深切檢討？"],["薛部長瑞元：對，這個優化兒童醫療照護計畫裡面有一部分叫幼兒專責醫師，所以如果這個小孩子有被納入幼兒專責醫師的話，可能就可以多一個機會阻止死亡機率的發生。"],["陳委員菁徽：好，我們來看表格，你把其他的策略目標分成兒童重難罕症疾病、培訓兒童重症運送專業團隊、未滿3歲之兒童有專責醫師的照護、推展脆弱家庭育兒指導服務，你列了這四項，我們看到實際有達到的KPI就是未滿3歲之兒童有專責醫師的照護，其他要建立重難罕症疾病的平臺在113年想要18個，實際只有8個；培訓兒童重症運送專業團隊，113年想要4個，實際只有3個。你會把自己的KPI設成30%表示你深深地發現醫療資源有限、醫療資源不均，這個全國覆蓋率你自己也知道資源配置不太合理，你希望這些脆家的育兒都可以有專責醫師，那你為什麼要把第三項跟第四項分開？你應該是推展脆弱家庭育兒指導服務加上專責醫師的照護，不是嗎？"],["薛部長瑞元：現在這個幼兒專責醫師的照護，我們希望每一位小孩子都有這樣的專責醫師，不管他的背景是什麼，所以我們設定的KPI 30%實際上已經超過了。但是脆家的部分是在裡面的另外一小塊，因為這一些可能會缺乏所謂的家屬參與，所以這個部分要特別去做處理。"],["陳委員菁徽：沒錯，我們看這個表，部長都知道了。一個一般的幼兒要加入專責醫師，家長要先上網查詢，還要再帶手冊去填寫家長同意書來媒合，基本上可以做到這件事情的家長就是不會在我們社會安全網之外，所以我們來看你的表，你說109年就開始把社政還有衛政拉在一起，結果你自己剛剛也在口頭報告承認宣導不力，對不對？社會局跟衛生局都對這件事情不太清楚，雖然你說109年有做，可是你根本沒有制度化，也沒有系統化，我去問基層的社工、兒科醫師，他們都說這半年來才知道，而且經過這個新聞，他們的壓力超大，因為每個案主都去問他們說我的專責醫師呢？你都還沒幫我找專責醫師！所以如果沒有制度化跟系統化，而只有宣導，這件事情我們怎麼把脆家的人納進來？我覺得這個立意非常好，因為兒科醫師現在已經不夠了、全國都已經不夠了，可是我們不是應該要先從接不住的人開始注意到他們一定要被照顧到嗎？"],["薛部長瑞元：其實我們算過，如果一位兒科醫師平均有200個個案，事實上我們大概只需要3,000名兒科醫師。"],["陳委員菁徽：對，我們現在3,777位兒科醫師。"],["薛部長瑞元：所以人數是夠的。"],["陳委員菁徽：可是我們的城鄉分布非常不均喔！"],["薛部長瑞元：對，所以在兒科醫師比較缺乏的地方，我們會交給衛生所，由衛生所的醫師處理，不論他是哪一個專科都可以來做這件事情。"],["陳委員菁徽：好，我等一下跟你說基層醫師在反映什麼。我們看一下你自己畫的圖，現在這個圖的問題出在哪裡？你只有把一般幼童、一般新生兒還有高風險孕產婦所生的新生兒列到幼兒專責醫師，最後你發現脆家的因子還是醫生自己要發現或是衛生局自己要發現，而不是從源頭就把他們找出來嘛！所以我們這個案例就從這個破洞掉下來啦！"],["薛部長瑞元：對，所以這一次我們深刻檢討後，這一點一定是未來要去改善的。"],["陳委員菁徽：就是這個圖，我幫你畫好了。"],["薛部長瑞元：社政跟衛政之間的聯繫是不夠的。"],["陳委員菁徽：對，但你要把它制度化。"],["薛部長瑞元：對。"],["陳委員菁徽：比如說通報以後多久以內、誰要去訪查等等，包括兒科醫師要怎麼訪查嘛！"],["薛部長瑞元：兒科醫師要做什麼，這些SOP是有的，現在只是社政單位沒有把這一個個案的名冊交給衛生單位。"],["陳委員菁徽：好，我們仔細的比較了一下，15號、上個禮拜五你跟雙北市政府開完共識會議，還有你給我們衛環委員會的書面報告，你說要指定專責醫師，但這二個族群居然有一點小小的落差，你剛才說你要落實社政跟衛政，而你跟雙北的共識會議是說政府安置之3歲以下兒童，結果你給我們的報告範圍更大，脆弱家庭也把它納入了。"],["薛部長瑞元：這一個部分講的是不需要家長的同意書，因為他的家屬已經是支持系統薄弱，你還要找他的家長的話，恐怕會有一點困難。"],["陳委員菁徽：所以你的意思是說，政府安置的不用家長同意書，但很多脆弱家庭找不到家長，你不把它列進來喔？"],["薛部長瑞元：所以就是直接列進來，不必經過他的同意了。"],["陳委員菁徽：是。我這邊也要反映一下基層的聲音，我很多同學是小兒科醫生，他們說，第一，本來一般幼兒1年是500點，你把它調到1,000點，很好！可是現在發生了這麼重大的事件，這些脆家的小孩都要交給他們照顧，他們當然只是其中、裡面的一條線，所以點數的部分不用提升嗎？不用比一般兒童更多嗎？不是應該要3倍、5倍嗎？"],["薛部長瑞元：脆家的部分是1,500，是比那個高。委員，這個事情是這樣子的，第一個，我們把脆家的兒童放進來，只是要讓他被identify出來，他手上有這樣一個小孩子，如果沒有被identify出來，這些小孩子到他的診所去看病的時候，沒有被他發現這可能是兒虐的話，畢竟醫師本來就是所謂的義務通報人員，他還是有一定的責任啦！"],["陳委員菁徽：他如果是被指定的話，他還要加上一年訪視兩次。"],["薛部長瑞元：他有個案管理師啊！而且並不是每一個案子都需要去做家訪，他可以通知他把小孩子帶到他的診所去。"],["陳委員菁徽：我希望您還是可以關懷這些基層醫師，因為他們願意納入你的分級醫療，現在就是看您是不是考慮也把大型的醫療機構納入？"],["薛部長瑞元：目前已經要把他們納入了。"],["陳委員菁徽：很好，因為對他們來說，這也是多餘的行政負擔，因為他們在訪視等等之後，還是要提交報告。"],["薛部長瑞元：目前參與這個計畫的，醫院的部分是118家，然後基層的是916家；其中醫師的部分，醫院的醫師有395位，基層是1,481位，所以醫院的部分也有。"],["陳委員菁徽：關於這些特殊家庭的點數，我們之後再來講。"],["薛部長瑞元：好。"],["陳委員菁徽：剛剛口頭報告時也有花很多篇幅去討論我們的保母平臺，這個是你們的保母平臺，也請你們有空的時候自己用用看，如果我是一個家長，我要看看目前我找的這個保母到底是合法還是違法，好，我們從左邊進去，但出現的這些資訊並不是很統一，有人放照片，有人不放照片，但出現的資料代表我今天搜尋到的保母是合法保母；另外，我今天想要知道我這個保母是不是違法，結果居然是連到「違反兒少法專區」，叫我們自己慢慢撈，我在撈的時候嚇死了，只要是有做過未成年犯罪、性侵、性行為等等，全部都列在那裡面，全部都跟保母混在一起。現在家長最關心的是什麼？家長最關心的是我這個保母有沒有過一些負評等等的，而你就是把它跟這些「違反兒少法專區」全部混在一起，這根本不是家長想看的資訊啊！"],["薛部長瑞元：報告委員，這一個部分依法律規定是我們必須要公告的項目。至於委員提到對於保母相關搜尋的平臺，這我們會來努力。"],["陳委員菁徽：對，而且你也應該把它自己獨立成為一項啊！"],["薛部長瑞元：對，就是要分開啦！"],["陳委員菁徽：好。我希望今天大家從各個層面來努力，可以把這個網子再補得更好一點，這也是我最後想要提出來的建議，好嗎？謝謝部長。"],["薛部長瑞元：建議應該不會越來越大洞，應該是越來越完密。"],["陳委員菁徽：因為這件事情，所以我們今天許多委員都會提出各種建議。好，謝謝部長。"],["薛部長瑞元：謝謝。"],["主席：我們謝謝陳菁徽委員的質詢。等一下盧縣一委員質詢結束，我們休息5分鐘。","接下來我們請盧縣一委員進行質詢。"]],"agenda":{"page_end":206,"meet_id":"委員會-11-1-26-6","speakers":["王育敏","黃秀芳","蘇清泉","吳思瑤","洪孟楷","林月琴","廖偉翔","陳昭姿","陳菁徽","盧縣一","邱鎮軍","王正旭","李彥秀","徐巧芯","涂權吉","羅廷瑋","陳玉珍","柯建銘","傅崐萁","劉建國","伍麗華Saidhai‧Tahovecahe","楊曜","陳瑩","林淑芬","陳培瑜","賴士葆","郭昱晴","范雲","黃國昌","牛煦庭","吳春城","顏寬恒","沈伯洋","林德福","陳冠廷","張雅琳","葉元之","羅智強"],"page_start":61,"meetingDate":["2024-03-18"],"gazette_id":"1131501","agenda_lcidc_ids":["1131501_00003"],"meet_name":"立法院第11屆第1會期社會福利及衛生環境委員會第6次全體委員會議紀錄","content":"邀請衛生福利部部長、教育部、法務部、內政部警政署就「社會安全網推動情形及策進作為」進\n行專題報告，並備質詢","agenda_id":"1131501_00002"}},"transcript":{"id":"149964","pyannote":{"name":"ronny","tool":"pyannote","data":{"url":"https://ivod.ly.gov.tw/Play/Clip/1M/149964","tool":"pyannote","id":"149964-pyannote"},"job_id":"0TS6KYIoNcbc5l12","queued_at":"2024-06-02 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598.369, \"end\": 598.61, \"score\": 0.991}, {\"word\": \"嘛\", \"start\": 598.61, \"end\": 599.13, \"score\": 0.961}, {\"word\": \"所\", \"start\": 599.13, \"end\": 599.23, \"score\": 0.997}, {\"word\": \"以\", \"start\": 599.23, \"end\": 599.31, \"score\": 0.746}, {\"word\": \"我\", \"start\": 599.31, \"end\": 599.73, \"score\": 0.808}, {\"word\": \"們\"}, {\"word\": \"來\"}, {\"word\": \"看\", \"start\": 599.73, \"end\": 599.91, \"score\": 0.967}, {\"word\": \"你\", \"start\": 599.91, \"end\": 600.03, \"score\": 0.746}, {\"word\": \"的\", \"start\": 600.03, \"end\": 600.191, \"score\": 0.96}, {\"word\": \"表\", \"start\": 600.191, \"end\": 600.211, \"score\": 0.995}]}, {\"start\": 602.028, \"end\": 629.535, \"text\": \"你說109年你就開始把社政還有衛政拉在一起結果你剛剛自己也在你的口頭報告承認說宣導不利嘛 對不對結果社會局跟衛生局他們都對於這件事情不太清楚你雖然109年你說你109年有做可是你根本沒有制度化也沒有系統化啊我去問基層的社工、兒科醫師他們都說\", \"words\": [{\"word\": \"你\", \"start\": 602.028, \"end\": 604.589, \"score\": 0.799}, {\"word\": \"說\"}, {\"word\": \"1\"}, {\"word\": \"0\"}, {\"word\": 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876.621, \"end\": 876.821, \"score\": 0.992}, {\"word\": \"看\", \"start\": 876.821, \"end\": 877.061, \"score\": 1.0}, {\"word\": \"病\", \"start\": 877.061, \"end\": 877.221, \"score\": 0.911}, {\"word\": \"的\", \"start\": 877.221, \"end\": 877.381, \"score\": 0.875}, {\"word\": \"時\"}, {\"word\": \"候\", \"start\": 877.381, \"end\": 877.982, \"score\": 0.966}, {\"word\": \"你\", \"start\": 877.982, \"end\": 878.122, \"score\": 0.958}, {\"word\": \"沒\", \"start\": 878.122, \"end\": 878.282, \"score\": 0.875}, {\"word\": \"有\", \"start\": 878.282, \"end\": 878.582, \"score\": 0.933}, {\"word\": \"給\"}, {\"word\": \"他\", \"start\": 878.582, \"end\": 880.423, \"score\": 0.932}, {\"word\": \"發\"}, {\"word\": \"現\"}, {\"word\": \"說\"}, {\"word\": \"這\"}, {\"word\": \"個\"}, {\"word\": \"有\", \"start\": 880.423, \"end\": 880.803, \"score\": 1.0}, {\"word\": \"有\", \"start\": 880.803, \"end\": 881.223, \"score\": 0.952}, {\"word\": \"這\"}, {\"word\": \"一\", \"start\": 881.223, \"end\": 882.203, 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\"score\": 0.912}, {\"word\": \"開\"}, {\"word\": \"陳\"}, {\"word\": \"菁\", \"start\": 1040.084, \"end\": 1040.204, \"score\": 0.832}, {\"word\": \"徽\", \"start\": 1040.204, \"end\": 1040.224, \"score\": 0.0}, {\"word\": \"委\", \"start\": 1040.224, \"end\": 1040.244, \"score\": 0.0}, {\"word\": \"員\"}], \"language\": \"zh\"}","srt":"1\n00:00:05,735 --> 00:00:14,604\n主席、各位委員同事、各位官員、還有各位媒體朋友,大家早安、大家好。有請部長。好,請薛部長。\n\n2\n00:00:21,952 --> 00:00:38,843\n這段話是2020年蔡總統宣布第二期社安網所說的就職典禮的發言稿他提到我們要讓第一線的社工能量提升改善他們的工作環境讓社工能夠深入最基層\n\n3\n00:00:39,844 --> 00:01:09,255\n把過去社會安全網沒有接觸的人都找回來我們也不應該把責任全部推給醫療部門、個別法官、司法和行政部門應該要檢討制度結果我們很遺憾的發現到今天過了4年我們的社工能量還是沒有提升到處缺社工結果這件事事發大家是獵巫啊、醫師啊、社工師啊等等\n\n4\n00:01:11,988 --> 00:01:25,561\n這個剛剛部長有增加了非常多的篇幅本席也非常感動但是昨天列出來的檢討報告居然800字出現了11次地方\n\n5\n00:01:27,964 --> 00:01:55,592\n看到的時候真的很難過但剛才部長已經跟全國民眾還有凱凱的家屬道歉了我在這邊有一個小小的提議因為我也身為三個小孩的媽媽不知道部長如果在沒有媒體關注的狀況下你是否願意親自跟這位小男童的家屬道歉並且安慰他還有提供後續的安置還有你後續的做法呢\n\n6\n00:01:56,685 --> 00:02:17,239\n這沒有問題是謝謝部長謝謝部長今天願意道歉因為現在網路上已經有幾萬人聯署馬上破幾萬要聯署滅同致死可見人民對這件事有多麼生氣全國更是各地有民眾主動想要送花\n\n7\n00:02:18,291 --> 00:02:43,055\n跟這個凱凱致哀所以我們今天委員會召開最重要的意義就是我們應該要一起協助部長把這個社會安全網補起來因為您才是把每一絲每一絲的線補起來的人我們醫生、社工單位所有的地方政府都是這個網的一條線而已啊所以您才是最重要的角色\n\n8\n00:02:44,144 --> 00:02:57,044\n你有講到說14號說我們要同步制定托育專法盼本會期能送入立法院我想問這個會期剩下兩個月啦\n\n9\n00:02:58,747 --> 00:03:09,871\n您在這個會期真的可以送入立法院嗎?比較精確來講的話應該是送到行政院因為經過了這個專家會議討論之後的話我們會必須要我們的法規會再考慮這個法律的這個文字\n\n10\n00:03:19,355 --> 00:03:41,101\n那最後定案了才送那個行政院所以應該這個會期之內我們會我們人工生殖法已經搞兩年了還沒完成你現在說要做這個托育專法我不知道是不是就你法律專業的立場有什麼特別的考量您覺得現在我們的兒權法已經包含托嬰中心育兒機構還有保姆的規範都在裡面了\n\n11\n00:03:43,482 --> 00:04:08,822\n提出專法的意思是說你要把現在相關的條文、執法全部刪掉然後另立一個托育專法這是一個大工程欸我們的棟現在都還沒補好週末又有新的案件發生欸新的案件那個如果委員詢問我們再回答那這一個部分其實這個托育專法跟兒權法的修正我們已經討論兩年了所以已經差不多所以你很有信心這個會期\n\n12\n00:04:10,043 --> 00:04:10,603\n本席也在這邊希望\n\n13\n00:04:34,799 --> 00:04:44,294\n衛福部可以在一個月內提出相關的研究報告還有預計實施的辦法還有你們大概修改這個托育專法修法的方向還有預計的進度\n\n14\n00:04:50,748 --> 00:05:10,782\n這一個部分的話,因為兒少權法這一次的修正很重要一個是要符合這個CRC的一些就兒權公約的這一個部分那對於這一個做托育,尤其是像保姆還有托育的機構的管理的這部分因為如果仍然放在兒權法裡面的話,那他可能就會\n\n15\n00:05:11,883 --> 00:05:11,943\n主席\n\n16\n00:05:28,559 --> 00:05:51,457\n好我們再來看109年衛福部曾經提出一個優化兒童醫療照護計畫當時呢這個連行政院院長都說我們5歲以下兒童的死亡率這個數字讓他感到非常的丟臉他自己公開在媒體上承認我們跟其他的OECD國家比起來\n\n17\n00:05:54,127 --> 00:05:58,349\n別人是1.7、2.4然後我們來看我們4.7、4.6當時你提出這個兒童醫療照護計畫幫自己訂了KPI你希望110、111、112、113是逐年下降結果呢我們發現實際的數據110、111是\n\n18\n00:06:24,099 --> 00:06:43,324\n4.8、5.1你的這個照護計畫是出了什麼事情?報告委員,這裡有兩個部分像委員這一張slide所顯示的右下方那邊新生兒的死亡率這部分的話有兩種算法一種是把22週裡面的也算進來所以現在再講4.8、5.1是這一個包括在裡面的\n\n19\n00:06:47,105 --> 00:06:47,225\n陳菁徽\n\n20\n00:07:05,232 --> 00:07:31,907\n新生兒及嬰兒的這個死因的回溯的這個計畫我們想要找出可避免的這個死亡的原因所以這個案例我們今天討論的這個案例你看你上面寫說期待降低死亡率減少兒童可預防可避免的死亡我們這個案例算不算你提到的可預防可避免的死亡是這個是深切檢討對\n\n21\n00:07:33,148 --> 00:07:33,628\n我們來看明別的表格\n\n22\n00:07:55,626 --> 00:08:23,387\n你把其他的策略目標還分成比如說兒童重難罕症疾病培訓兒童重症運送專業團隊未滿3歲而有專責醫師的照護推展脆弱家庭育兒指導服務好你列了這四項來我們看實際有達到你的KPI就是未滿3歲這兒童有專責醫師的照護其他你想要重難罕症疾病的這個\n\n23\n00:08:24,508 --> 00:08:49,745\n平台想要113年18個實際只有8個兒童重症運送專業團隊想要113年4個實際只有3個好你會把自己的KPI設成30%表示你深深的有發現其實醫療資源有限醫療資源不均你這個全國復開率你自己也知道資源配置不太合理好\n\n24\n00:08:50,425 --> 00:08:56,971\n你說你希望這些翠家的育兒都可以有專責醫師那你為什麼要把第三項跟第四項分開\n\n25\n00:08:59,537 --> 00:09:16,810\n你應該是推廣催弱家庭育兒指導服務加上有專責醫師的照顧啊不是嗎現在這個育兒專責醫師的照顧的話我們希望是每一位不管他的背景是怎樣每一位小孩子都有這樣子一個專責醫師所以我們這個設定的KPI30%那實際上是已經有超過了\n\n26\n00:09:22,894 --> 00:09:37,334\n但是對於退家的這個部分的話那是在裡面的另外一小塊因為這一些的話可能就會缺乏所謂的這個家屬那他的參與所以這個部分有特別要去做處理沒錯來我們可以看這個表\n\n27\n00:09:39,597 --> 00:10:00,211\n這個你都知道了部長也都知道了我們一個一般的幼兒需要加入專責醫師家長要上網先查詢還要再帶著手冊去填寫家長同意書來媒合基本上可以做到這件事情的家長就是不會在我們社會安全網之外嘛所以我們來看你的表\n\n28\n00:10:02,028 --> 00:10:29,535\n你說109年你就開始把社政還有衛政拉在一起結果你剛剛自己也在你的口頭報告承認說宣導不利嘛對不對結果社會局跟衛生局他們都對於這件事情不太清楚你雖然109年你說你109年有做可是你根本沒有制度化也沒有系統化啊我去問基層的社工、兒科醫師他們都說\n\n29\n00:10:31,535 --> 00:10:49,255\n這半年來才知道而且經過這個新聞他們壓力超大因為每一個案主都去問他們說我的專責醫師呢你都還沒幫我找專責醫師所以你如果沒有制度化跟系統化你只有宣導這件事情我們怎麼把這個退家的人納進來嘛\n\n30\n00:10:51,097 --> 00:11:17,968\n我覺得這個利益非常好因為兒科醫師現在都已經不夠了全國都已經不夠了可是我們不是應該要先從接不住的人開始一定要注意他們都有被照顧到嗎這一個其實我們算過那如果說一位兒科醫師平均來照顧這一個有200個個案的話事實上我們大概只需要大概3000名的兒科醫師\n\n31\n00:11:18,368 --> 00:11:23,611\n我等一下跟你說基層醫師在反映什麼我們看一下你自己畫的圖我們現在這個圖的問題出在哪裡你看\n\n32\n00:11:46,072 --> 00:12:06,768\n你只有把一般幼兒一般新生兒還有高風險孕產婦所生的新生兒列到幼兒專責醫師最後呢你發現翠家的因子還是醫生自己要發現或是衛生局自己要發現而不是從源頭就把他們找出來嘛所以你就從這個破洞我們這個案例就從這個破洞掉下來啦\n\n33\n00:12:11,375 --> 00:12:38,708\n對所以這一次我們的深刻檢討就是這一點一定是未來要去改善的就這個圖我幫你畫好了社政跟那個衛生之間的聯繫是不夠的但你要把它制度化你要把它制度化比如說你這通報以後多久以內誰去訪查兒科醫師要怎麼訪查嗎這個兒科醫師要做什麼這些SOP是有的現在只是說社政單位沒有把這個個案的名冊交給這個衛生單位\n\n34\n00:12:40,929 --> 00:13:03,375\n我們仔細的比較了一下15號上個禮拜五你跟雙北市政府開完共識會議還有給我們衛環委員會的書面報告你說要指定專責醫師的這兩個族群居然有一點小小的落差你跟雙北的共識會議你剛才說你要落實衛政跟社政你跟雙北的共識會議說是\n\n35\n00:13:05,336 --> 00:13:13,038\n政府安置的3歲以下兒童結果你給我們的報告範圍更大是脆弱家庭也把他納入\n\n36\n00:13:15,213 --> 00:13:34,466\n這個部分的話講的是說不需要家長同意書因為他的家屬是已經這個支持系統薄弱你還要找他的家長的話有一點困難所以你的意思是說政府安置的不用家長同意書很多脆弱家庭找不到家長你不把他列進來喔\n\n37\n00:13:35,587 --> 00:13:56,644\n所以要直接就列進來,不必去經過他的同意的啦是,是,好這邊基層的聲音,我這邊也要反映一下基層的聲音我很多同學是小兒科嘛,他說第一你本來一班幼兒一年是500點嘛,你把他調到1000點很好\n\n38\n00:13:57,694 --> 00:14:11,677\n可是你現在你看發生這麼大的重大事件這些脆家的小孩都要交給他們照顧他們當然只是其中裡面的一條線第一你點數不用提升嗎他不用比一般兒童更多嗎有啊不是應該三倍五倍嗎是比那個高\n\n39\n00:14:21,535 --> 00:14:43,924\n這件事情是這樣子的第一個就是說我們把崔家這一個兒童放進來只是讓他identify出來說他手上有這樣子的一個小孩子如果沒有identify出來這些小孩子到他的診所去看病的時候你沒有給他發現說這個有有這一個這一個可能是額虐的話這個也\n\n40\n00:14:45,825 --> 00:14:55,862\n本來就是醫師本來就是所謂的義務通報人員對他還是有一定的責任的啦是他如果是被指定的話他還要加上一年訪視兩次欸\n\n41\n00:14:58,028 --> 00:15:02,309\n我希望您還是可以關懷這些基層醫師因為他們願意納入你的分級醫療看你是不是考慮也把大型的醫療機構也納入這目前已經要把他們納入了\n\n42\n00:15:23,775 --> 00:15:24,355\n關於這些特殊家庭的點數我們之後再來講\n\n43\n00:15:52,568 --> 00:15:53,609\n我今天搜尋到的保姆是合法保姆\n\n44\n00:16:22,830 --> 00:16:46,653\n我今天想要知道我這個保姆是不是違法居然是連到違反而效法專區叫我們自己慢慢撈我在撈的時候嚇死了只要是有做過這個未成年犯罪等等性侵性行為全部都列在那裡面跟保姆全部混在一起\n\n45\n00:16:48,034 --> 00:17:01,349\n那現在家長其實最關心的是什麼?家長最關心的是我這個保姆有沒有過一些賦品嘛等等的嘛而你就是把他跟這些違反兒校法專區全部混在一起這根本不是家長想看的資訊啊\n\n46\n00:17:03,465 --> 00:17:18,482\n包委員這一個部分是依在法律規定我們必須要公告的項目那至於委員說到說對於保姆那他的一個搜尋的平台這我們會來努力對而且你也應該把他自己獨立成一項對啦就是要分開\n\n47\n00:17:20,084 --> 00:17:20,244\n陳菁徽委員\n\n","tsv":"start\tend\ttext\n5735\t14604\t主席、各位委員同事、各位官員、還有各位媒體朋友,大家早安、大家好。有請部長。好,請薛部長。\n21952\t38843\t這段話是2020年蔡總統宣布第二期社安網所說的就職典禮的發言稿他提到我們要讓第一線的社工能量提升改善他們的工作環境讓社工能夠深入最基層\n39844\t69255\t把過去社會安全網沒有接觸的人都找回來我們也不應該把責任全部推給醫療部門、個別法官、司法和行政部門應該要檢討制度結果我們很遺憾的發現到今天過了4年我們的社工能量還是沒有提升到處缺社工結果這件事事發大家是獵巫啊、醫師啊、社工師啊等等\n71988\t85561\t這個剛剛部長有增加了非常多的篇幅本席也非常感動但是昨天列出來的檢討報告居然800字出現了11次地方\n87964\t115592\t看到的時候真的很難過但剛才部長已經跟全國民眾還有凱凱的家屬道歉了我在這邊有一個小小的提議因為我也身為三個小孩的媽媽不知道部長如果在沒有媒體關注的狀況下你是否願意親自跟這位小男童的家屬道歉並且安慰他還有提供後續的安置還有你後續的做法呢\n116685\t137239\t這沒有問題是 謝謝部長 謝謝部長今天願意道歉因為現在網路上已經有幾萬人聯署馬上破幾萬要聯署滅同致死可見人民對這件事有多麼生氣全國更是各地有民眾主動想要送花\n138291\t163055\t跟這個凱凱致哀所以我們今天委員會召開最重要的意義就是我們應該要一起協助部長把這個社會安全網補起來因為您才是把每一絲每一絲的線補起來的人我們醫生、社工單位所有的地方政府都是這個網的一條線而已啊所以您才是最重要的角色\n164144\t177044\t你有講到說14號說我們要同步制定托育專法盼本會期能送入立法院我想問這個會期剩下兩個月啦\n178747\t189871\t您在這個會期真的可以送入立法院嗎?比較精確來講的話應該是送到行政院因為經過了這個專家會議討論之後的話我們會必須要我們的法規會再考慮這個法律的這個文字\n199355\t221101\t那最後定案了才送那個行政院所以應該這個會期之內我們會我們人工生殖法已經搞兩年了還沒完成你現在說要做這個托育專法我不知道是不是就你法律專業的立場有什麼特別的考量您覺得現在我們的兒權法已經包含托嬰中心育兒機構還有保姆的規範都在裡面了\n223482\t248822\t提出專法的意思是說你要把現在相關的條文、執法全部刪掉然後另立一個托育專法這是一個大工程欸我們的棟現在都還沒補好週末又有新的案件發生欸新的案件那個如果委員詢問我們再回答那這一個部分其實這個托育專法跟兒權法的修正我們已經討論兩年了所以已經差不多所以你很有信心這個會期\n250043\t250603\t本席也在這邊希望\n274799\t284294\t衛福部可以在一個月內提出相關的研究報告還有預計實施的辦法還有你們大概修改這個托育專法修法的方向還有預計的進度\n290748\t310782\t這一個部分的話,因為兒少權法這一次的修正很重要一個是要符合這個CRC的一些就兒權公約的這一個部分那對於這一個做托育,尤其是像保姆還有托育的機構的管理的這部分因為如果仍然放在兒權法裡面的話,那他可能就會\n311883\t311943\t主席\n328559\t351457\t好 我們再來看109年衛福部曾經提出一個優化兒童醫療照護計畫當時呢這個連行政院院長都說我們5歲以下兒童的死亡率這個數字讓他感到非常的丟臉他自己公開在媒體上承認我們跟其他的OECD國家比起來\n354127\t358349\t別人是1.7、2.4然後我們來看我們4.7、4.6當時你提出這個兒童醫療照護計畫幫自己訂了KPI你希望110、111、112、113是逐年下降結果呢我們發現實際的數據110、111是\n384099\t403324\t4.8、5.1你的這個照護計畫是出了什麼事情?報告委員,這裡有兩個部分像委員這一張slide所顯示的右下方那邊新生兒的死亡率這部分的話有兩種算法一種是把22週裡面的也算進來所以現在再講4.8、5.1是這一個包括在裡面的\n407105\t407225\t陳菁徽\n425232\t451907\t新生兒及嬰兒的這個死因的回溯的這個計畫我們想要找出可避免的這個死亡的原因所以這個案例我們今天討論的這個案例你看你上面寫說期待降低死亡率減少兒童可預防可避免的死亡我們這個案例算不算你提到的可預防可避免的死亡是這個是深切檢討對\n453148\t453628\t我們來看明別的表格\n475626\t503387\t你把其他的策略目標還分成比如說兒童重難罕症疾病培訓兒童重症運送專業團隊未滿3歲而有專責醫師的照護推展脆弱家庭育兒指導服務好你列了這四項來我們看實際有達到你的KPI就是未滿3歲這兒童有專責醫師的照護其他你想要重難罕症疾病的這個\n504508\t529745\t平台想要113年18個實際只有8個兒童重症運送專業團隊想要113年4個實際只有3個好你會把自己的KPI設成30%表示你深深的有發現其實醫療資源有限醫療資源不均你這個全國復開率你自己也知道資源配置不太合理好\n530425\t536971\t你說你希望這些翠家的育兒都可以有專責醫師那你為什麼要把第三項跟第四項分開\n539537\t556810\t你應該是推廣催弱家庭育兒指導服務加上有專責醫師的照顧啊不是嗎現在這個育兒專責醫師的照顧的話我們希望是每一位不管他的背景是怎樣每一位小孩子都有這樣子一個專責醫師所以我們這個設定的KPI30%那實際上是已經有超過了\n562894\t577334\t但是對於退家的這個部分的話那是在裡面的另外一小塊因為這一些的話可能就會缺乏所謂的這個家屬那他的參與所以這個部分有特別要去做處理沒錯來我們可以看這個表\n579597\t600211\t這個你都知道了部長也都知道了我們一個一般的幼兒需要加入專責醫師家長要上網先查詢還要再帶著手冊去填寫家長同意書來媒合基本上可以做到這件事情的家長就是不會在我們社會安全網之外嘛所以我們來看你的表\n602028\t629535\t你說109年你就開始把社政還有衛政拉在一起結果你剛剛自己也在你的口頭報告承認說宣導不利嘛 對不對結果社會局跟衛生局他們都對於這件事情不太清楚你雖然109年你說你109年有做可是你根本沒有制度化也沒有系統化啊我去問基層的社工、兒科醫師他們都說\n631535\t649255\t這半年來才知道而且經過這個新聞他們壓力超大因為每一個案主都去問他們說我的專責醫師呢你都還沒幫我找專責醫師所以你如果沒有制度化跟系統化你只有宣導這件事情我們怎麼把這個退家的人納進來嘛\n651097\t677968\t我覺得這個利益非常好因為兒科醫師現在都已經不夠了全國都已經不夠了可是我們不是應該要先從接不住的人開始一定要注意他們都有被照顧到嗎這一個其實我們算過那如果說一位兒科醫師平均來照顧這一個有200個個案的話事實上我們大概只需要大概3000名的兒科醫師\n678368\t683611\t我等一下跟你說基層醫師在反映什麼我們看一下你自己畫的圖我們現在這個圖的問題出在哪裡你看\n706072\t726768\t你只有把一般幼兒一般新生兒還有高風險孕產婦所生的新生兒列到幼兒專責醫師最後呢你發現翠家的因子還是醫生自己要發現或是衛生局自己要發現而不是從源頭就把他們找出來嘛所以你就從這個破洞我們這個案例就從這個破洞掉下來啦\n731375\t758708\t對 所以這一次我們的深刻檢討就是這一點一定是未來要去改善的就這個圖我幫你畫好了社政跟那個衛生之間的聯繫是不夠的但你要把它制度化你要把它制度化比如說你這通報以後多久以內誰去訪查兒科醫師要怎麼訪查嗎這個兒科醫師要做什麼這些SOP是有的現在只是說社政單位沒有把這個個案的名冊交給這個衛生單位\n760929\t783375\t我們仔細的比較了一下15號上個禮拜五你跟雙北市政府開完共識會議還有給我們衛環委員會的書面報告你說要指定專責醫師的這兩個族群居然有一點小小的落差你跟雙北的共識會議你剛才說你要落實衛政跟社政你跟雙北的共識會議說是\n785336\t793038\t政府安置的3歲以下兒童結果你給我們的報告範圍更大是脆弱家庭也把他納入\n795213\t814466\t這個部分的話講的是說不需要家長同意書因為他的家屬是已經這個支持系統薄弱你還要找他的家長的話有一點困難所以你的意思是說政府安置的不用家長同意書很多脆弱家庭找不到家長你不把他列進來喔\n815587\t836644\t所以要直接就列進來,不必去經過他的同意的啦是,是,好這邊基層的聲音,我這邊也要反映一下基層的聲音我很多同學是小兒科嘛,他說第一你本來一班幼兒一年是500點嘛,你把他調到1000點很好\n837694\t851677\t可是你現在你看發生這麼大的重大事件這些脆家的小孩都要交給他們照顧他們當然只是其中裡面的一條線第一你點數不用提升嗎他不用比一般兒童更多嗎有啊不是應該三倍五倍嗎是比那個高\n861535\t883924\t這件事情是這樣子的第一個就是說我們把崔家這一個兒童放進來只是讓他identify出來說他手上有這樣子的一個小孩子如果沒有identify出來這些小孩子到他的診所去看病的時候你沒有給他發現說這個有有這一個這一個可能是額虐的話這個也\n885825\t895862\t本來就是醫師本來就是所謂的義務通報人員對他還是有一定的責任的啦是他如果是被指定的話他還要加上一年訪視兩次欸\n898028\t902309\t我希望您還是可以關懷這些基層醫師因為他們願意納入你的分級醫療看你是不是考慮也把大型的醫療機構也納入這目前已經要把他們納入了\n923775\t924355\t關於這些特殊家庭的點數我們之後再來講\n952568\t953609\t我今天搜尋到的保姆是合法保姆\n982830\t1006653\t我今天想要知道我這個保姆是不是違法居然是連到違反而效法專區叫我們自己慢慢撈我在撈的時候嚇死了只要是有做過這個未成年犯罪等等性侵性行為全部都列在那裡面跟保姆全部混在一起\n1008034\t1021349\t那現在家長其實最關心的是什麼?家長最關心的是我這個保姆有沒有過一些賦品嘛等等的嘛而你就是把他跟這些違反兒校法專區全部混在一起這根本不是家長想看的資訊啊\n1023465\t1038482\t包委員這一個部分是依在法律規定我們必須要公告的項目那至於委員說到說對於保姆那他的一個搜尋的平台這我們會來努力對而且你也應該把他自己獨立成一項對啦就是要分開\n1040084\t1040244\t陳菁徽委員\n","txt":"主席、各位委員同事、各位官員、還有各位媒體朋友,大家早安、大家好。有請部長。好,請薛部長。\n這段話是2020年蔡總統宣布第二期社安網所說的就職典禮的發言稿他提到我們要讓第一線的社工能量提升改善他們的工作環境讓社工能夠深入最基層\n把過去社會安全網沒有接觸的人都找回來我們也不應該把責任全部推給醫療部門、個別法官、司法和行政部門應該要檢討制度結果我們很遺憾的發現到今天過了4年我們的社工能量還是沒有提升到處缺社工結果這件事事發大家是獵巫啊、醫師啊、社工師啊等等\n這個剛剛部長有增加了非常多的篇幅本席也非常感動但是昨天列出來的檢討報告居然800字出現了11次地方\n看到的時候真的很難過但剛才部長已經跟全國民眾還有凱凱的家屬道歉了我在這邊有一個小小的提議因為我也身為三個小孩的媽媽不知道部長如果在沒有媒體關注的狀況下你是否願意親自跟這位小男童的家屬道歉並且安慰他還有提供後續的安置還有你後續的做法呢\n這沒有問題是 謝謝部長 謝謝部長今天願意道歉因為現在網路上已經有幾萬人聯署馬上破幾萬要聯署滅同致死可見人民對這件事有多麼生氣全國更是各地有民眾主動想要送花\n跟這個凱凱致哀所以我們今天委員會召開最重要的意義就是我們應該要一起協助部長把這個社會安全網補起來因為您才是把每一絲每一絲的線補起來的人我們醫生、社工單位所有的地方政府都是這個網的一條線而已啊所以您才是最重要的角色\n你有講到說14號說我們要同步制定托育專法盼本會期能送入立法院我想問這個會期剩下兩個月啦\n您在這個會期真的可以送入立法院嗎?比較精確來講的話應該是送到行政院因為經過了這個專家會議討論之後的話我們會必須要我們的法規會再考慮這個法律的這個文字\n那最後定案了才送那個行政院所以應該這個會期之內我們會我們人工生殖法已經搞兩年了還沒完成你現在說要做這個托育專法我不知道是不是就你法律專業的立場有什麼特別的考量您覺得現在我們的兒權法已經包含托嬰中心育兒機構還有保姆的規範都在裡面了\n提出專法的意思是說你要把現在相關的條文、執法全部刪掉然後另立一個托育專法這是一個大工程欸我們的棟現在都還沒補好週末又有新的案件發生欸新的案件那個如果委員詢問我們再回答那這一個部分其實這個托育專法跟兒權法的修正我們已經討論兩年了所以已經差不多所以你很有信心這個會期\n本席也在這邊希望\n衛福部可以在一個月內提出相關的研究報告還有預計實施的辦法還有你們大概修改這個托育專法修法的方向還有預計的進度\n這一個部分的話,因為兒少權法這一次的修正很重要一個是要符合這個CRC的一些就兒權公約的這一個部分那對於這一個做托育,尤其是像保姆還有托育的機構的管理的這部分因為如果仍然放在兒權法裡面的話,那他可能就會\n主席\n好 我們再來看109年衛福部曾經提出一個優化兒童醫療照護計畫當時呢這個連行政院院長都說我們5歲以下兒童的死亡率這個數字讓他感到非常的丟臉他自己公開在媒體上承認我們跟其他的OECD國家比起來\n別人是1.7、2.4然後我們來看我們4.7、4.6當時你提出這個兒童醫療照護計畫幫自己訂了KPI你希望110、111、112、113是逐年下降結果呢我們發現實際的數據110、111是\n4.8、5.1你的這個照護計畫是出了什麼事情?報告委員,這裡有兩個部分像委員這一張slide所顯示的右下方那邊新生兒的死亡率這部分的話有兩種算法一種是把22週裡面的也算進來所以現在再講4.8、5.1是這一個包括在裡面的\n陳菁徽\n新生兒及嬰兒的這個死因的回溯的這個計畫我們想要找出可避免的這個死亡的原因所以這個案例我們今天討論的這個案例你看你上面寫說期待降低死亡率減少兒童可預防可避免的死亡我們這個案例算不算你提到的可預防可避免的死亡是這個是深切檢討對\n我們來看明別的表格\n你把其他的策略目標還分成比如說兒童重難罕症疾病培訓兒童重症運送專業團隊未滿3歲而有專責醫師的照護推展脆弱家庭育兒指導服務好你列了這四項來我們看實際有達到你的KPI就是未滿3歲這兒童有專責醫師的照護其他你想要重難罕症疾病的這個\n平台想要113年18個實際只有8個兒童重症運送專業團隊想要113年4個實際只有3個好你會把自己的KPI設成30%表示你深深的有發現其實醫療資源有限醫療資源不均你這個全國復開率你自己也知道資源配置不太合理好\n你說你希望這些翠家的育兒都可以有專責醫師那你為什麼要把第三項跟第四項分開\n你應該是推廣催弱家庭育兒指導服務加上有專責醫師的照顧啊不是嗎現在這個育兒專責醫師的照顧的話我們希望是每一位不管他的背景是怎樣每一位小孩子都有這樣子一個專責醫師所以我們這個設定的KPI30%那實際上是已經有超過了\n但是對於退家的這個部分的話那是在裡面的另外一小塊因為這一些的話可能就會缺乏所謂的這個家屬那他的參與所以這個部分有特別要去做處理沒錯來我們可以看這個表\n這個你都知道了部長也都知道了我們一個一般的幼兒需要加入專責醫師家長要上網先查詢還要再帶著手冊去填寫家長同意書來媒合基本上可以做到這件事情的家長就是不會在我們社會安全網之外嘛所以我們來看你的表\n你說109年你就開始把社政還有衛政拉在一起結果你剛剛自己也在你的口頭報告承認說宣導不利嘛 對不對結果社會局跟衛生局他們都對於這件事情不太清楚你雖然109年你說你109年有做可是你根本沒有制度化也沒有系統化啊我去問基層的社工、兒科醫師他們都說\n這半年來才知道而且經過這個新聞他們壓力超大因為每一個案主都去問他們說我的專責醫師呢你都還沒幫我找專責醫師所以你如果沒有制度化跟系統化你只有宣導這件事情我們怎麼把這個退家的人納進來嘛\n我覺得這個利益非常好因為兒科醫師現在都已經不夠了全國都已經不夠了可是我們不是應該要先從接不住的人開始一定要注意他們都有被照顧到嗎這一個其實我們算過那如果說一位兒科醫師平均來照顧這一個有200個個案的話事實上我們大概只需要大概3000名的兒科醫師\n我等一下跟你說基層醫師在反映什麼我們看一下你自己畫的圖我們現在這個圖的問題出在哪裡你看\n你只有把一般幼兒一般新生兒還有高風險孕產婦所生的新生兒列到幼兒專責醫師最後呢你發現翠家的因子還是醫生自己要發現或是衛生局自己要發現而不是從源頭就把他們找出來嘛所以你就從這個破洞我們這個案例就從這個破洞掉下來啦\n對 所以這一次我們的深刻檢討就是這一點一定是未來要去改善的就這個圖我幫你畫好了社政跟那個衛生之間的聯繫是不夠的但你要把它制度化你要把它制度化比如說你這通報以後多久以內誰去訪查兒科醫師要怎麼訪查嗎這個兒科醫師要做什麼這些SOP是有的現在只是說社政單位沒有把這個個案的名冊交給這個衛生單位\n我們仔細的比較了一下15號上個禮拜五你跟雙北市政府開完共識會議還有給我們衛環委員會的書面報告你說要指定專責醫師的這兩個族群居然有一點小小的落差你跟雙北的共識會議你剛才說你要落實衛政跟社政你跟雙北的共識會議說是\n政府安置的3歲以下兒童結果你給我們的報告範圍更大是脆弱家庭也把他納入\n這個部分的話講的是說不需要家長同意書因為他的家屬是已經這個支持系統薄弱你還要找他的家長的話有一點困難所以你的意思是說政府安置的不用家長同意書很多脆弱家庭找不到家長你不把他列進來喔\n所以要直接就列進來,不必去經過他的同意的啦是,是,好這邊基層的聲音,我這邊也要反映一下基層的聲音我很多同學是小兒科嘛,他說第一你本來一班幼兒一年是500點嘛,你把他調到1000點很好\n可是你現在你看發生這麼大的重大事件這些脆家的小孩都要交給他們照顧他們當然只是其中裡面的一條線第一你點數不用提升嗎他不用比一般兒童更多嗎有啊不是應該三倍五倍嗎是比那個高\n這件事情是這樣子的第一個就是說我們把崔家這一個兒童放進來只是讓他identify出來說他手上有這樣子的一個小孩子如果沒有identify出來這些小孩子到他的診所去看病的時候你沒有給他發現說這個有有這一個這一個可能是額虐的話這個也\n本來就是醫師本來就是所謂的義務通報人員對他還是有一定的責任的啦是他如果是被指定的話他還要加上一年訪視兩次欸\n我希望您還是可以關懷這些基層醫師因為他們願意納入你的分級醫療看你是不是考慮也把大型的醫療機構也納入這目前已經要把他們納入了\n關於這些特殊家庭的點數我們之後再來講\n我今天搜尋到的保姆是合法保姆\n我今天想要知道我這個保姆是不是違法居然是連到違反而效法專區叫我們自己慢慢撈我在撈的時候嚇死了只要是有做過這個未成年犯罪等等性侵性行為全部都列在那裡面跟保姆全部混在一起\n那現在家長其實最關心的是什麼?家長最關心的是我這個保姆有沒有過一些賦品嘛等等的嘛而你就是把他跟這些違反兒校法專區全部混在一起這根本不是家長想看的資訊啊\n包委員這一個部分是依在法律規定我們必須要公告的項目那至於委員說到說對於保姆那他的一個搜尋的平台這我們會來努力對而且你也應該把他自己獨立成一項對啦就是要分開\n陳菁徽委員\n","vtt":"WEBVTT\n\n00:05.735 --> 00:14.604\n主席、各位委員同事、各位官員、還有各位媒體朋友,大家早安、大家好。有請部長。好,請薛部長。\n\n00:21.952 --> 00:38.843\n這段話是2020年蔡總統宣布第二期社安網所說的就職典禮的發言稿他提到我們要讓第一線的社工能量提升改善他們的工作環境讓社工能夠深入最基層\n\n00:39.844 --> 01:09.255\n把過去社會安全網沒有接觸的人都找回來我們也不應該把責任全部推給醫療部門、個別法官、司法和行政部門應該要檢討制度結果我們很遺憾的發現到今天過了4年我們的社工能量還是沒有提升到處缺社工結果這件事事發大家是獵巫啊、醫師啊、社工師啊等等\n\n01:11.988 --> 01:25.561\n這個剛剛部長有增加了非常多的篇幅本席也非常感動但是昨天列出來的檢討報告居然800字出現了11次地方\n\n01:27.964 --> 01:55.592\n看到的時候真的很難過但剛才部長已經跟全國民眾還有凱凱的家屬道歉了我在這邊有一個小小的提議因為我也身為三個小孩的媽媽不知道部長如果在沒有媒體關注的狀況下你是否願意親自跟這位小男童的家屬道歉並且安慰他還有提供後續的安置還有你後續的做法呢\n\n01:56.685 --> 02:17.239\n這沒有問題是謝謝部長謝謝部長今天願意道歉因為現在網路上已經有幾萬人聯署馬上破幾萬要聯署滅同致死可見人民對這件事有多麼生氣全國更是各地有民眾主動想要送花\n\n02:18.291 --> 02:43.055\n跟這個凱凱致哀所以我們今天委員會召開最重要的意義就是我們應該要一起協助部長把這個社會安全網補起來因為您才是把每一絲每一絲的線補起來的人我們醫生、社工單位所有的地方政府都是這個網的一條線而已啊所以您才是最重要的角色\n\n02:44.144 --> 02:57.044\n你有講到說14號說我們要同步制定托育專法盼本會期能送入立法院我想問這個會期剩下兩個月啦\n\n02:58.747 --> 03:09.871\n您在這個會期真的可以送入立法院嗎?比較精確來講的話應該是送到行政院因為經過了這個專家會議討論之後的話我們會必須要我們的法規會再考慮這個法律的這個文字\n\n03:19.355 --> 03:41.101\n那最後定案了才送那個行政院所以應該這個會期之內我們會我們人工生殖法已經搞兩年了還沒完成你現在說要做這個托育專法我不知道是不是就你法律專業的立場有什麼特別的考量您覺得現在我們的兒權法已經包含托嬰中心育兒機構還有保姆的規範都在裡面了\n\n03:43.482 --> 04:08.822\n提出專法的意思是說你要把現在相關的條文、執法全部刪掉然後另立一個托育專法這是一個大工程欸我們的棟現在都還沒補好週末又有新的案件發生欸新的案件那個如果委員詢問我們再回答那這一個部分其實這個托育專法跟兒權法的修正我們已經討論兩年了所以已經差不多所以你很有信心這個會期\n\n04:10.043 --> 04:10.603\n本席也在這邊希望\n\n04:34.799 --> 04:44.294\n衛福部可以在一個月內提出相關的研究報告還有預計實施的辦法還有你們大概修改這個托育專法修法的方向還有預計的進度\n\n04:50.748 --> 05:10.782\n這一個部分的話,因為兒少權法這一次的修正很重要一個是要符合這個CRC的一些就兒權公約的這一個部分那對於這一個做托育,尤其是像保姆還有托育的機構的管理的這部分因為如果仍然放在兒權法裡面的話,那他可能就會\n\n05:11.883 --> 05:11.943\n主席\n\n05:28.559 --> 05:51.457\n好我們再來看109年衛福部曾經提出一個優化兒童醫療照護計畫當時呢這個連行政院院長都說我們5歲以下兒童的死亡率這個數字讓他感到非常的丟臉他自己公開在媒體上承認我們跟其他的OECD國家比起來\n\n05:54.127 --> 05:58.349\n別人是1.7、2.4然後我們來看我們4.7、4.6當時你提出這個兒童醫療照護計畫幫自己訂了KPI你希望110、111、112、113是逐年下降結果呢我們發現實際的數據110、111是\n\n06:24.099 --> 06:43.324\n4.8、5.1你的這個照護計畫是出了什麼事情?報告委員,這裡有兩個部分像委員這一張slide所顯示的右下方那邊新生兒的死亡率這部分的話有兩種算法一種是把22週裡面的也算進來所以現在再講4.8、5.1是這一個包括在裡面的\n\n06:47.105 --> 06:47.225\n陳菁徽\n\n07:05.232 --> 07:31.907\n新生兒及嬰兒的這個死因的回溯的這個計畫我們想要找出可避免的這個死亡的原因所以這個案例我們今天討論的這個案例你看你上面寫說期待降低死亡率減少兒童可預防可避免的死亡我們這個案例算不算你提到的可預防可避免的死亡是這個是深切檢討對\n\n07:33.148 --> 07:33.628\n我們來看明別的表格\n\n07:55.626 --> 08:23.387\n你把其他的策略目標還分成比如說兒童重難罕症疾病培訓兒童重症運送專業團隊未滿3歲而有專責醫師的照護推展脆弱家庭育兒指導服務好你列了這四項來我們看實際有達到你的KPI就是未滿3歲這兒童有專責醫師的照護其他你想要重難罕症疾病的這個\n\n08:24.508 --> 08:49.745\n平台想要113年18個實際只有8個兒童重症運送專業團隊想要113年4個實際只有3個好你會把自己的KPI設成30%表示你深深的有發現其實醫療資源有限醫療資源不均你這個全國復開率你自己也知道資源配置不太合理好\n\n08:50.425 --> 08:56.971\n你說你希望這些翠家的育兒都可以有專責醫師那你為什麼要把第三項跟第四項分開\n\n08:59.537 --> 09:16.810\n你應該是推廣催弱家庭育兒指導服務加上有專責醫師的照顧啊不是嗎現在這個育兒專責醫師的照顧的話我們希望是每一位不管他的背景是怎樣每一位小孩子都有這樣子一個專責醫師所以我們這個設定的KPI30%那實際上是已經有超過了\n\n09:22.894 --> 09:37.334\n但是對於退家的這個部分的話那是在裡面的另外一小塊因為這一些的話可能就會缺乏所謂的這個家屬那他的參與所以這個部分有特別要去做處理沒錯來我們可以看這個表\n\n09:39.597 --> 10:00.211\n這個你都知道了部長也都知道了我們一個一般的幼兒需要加入專責醫師家長要上網先查詢還要再帶著手冊去填寫家長同意書來媒合基本上可以做到這件事情的家長就是不會在我們社會安全網之外嘛所以我們來看你的表\n\n10:02.028 --> 10:29.535\n你說109年你就開始把社政還有衛政拉在一起結果你剛剛自己也在你的口頭報告承認說宣導不利嘛對不對結果社會局跟衛生局他們都對於這件事情不太清楚你雖然109年你說你109年有做可是你根本沒有制度化也沒有系統化啊我去問基層的社工、兒科醫師他們都說\n\n10:31.535 --> 10:49.255\n這半年來才知道而且經過這個新聞他們壓力超大因為每一個案主都去問他們說我的專責醫師呢你都還沒幫我找專責醫師所以你如果沒有制度化跟系統化你只有宣導這件事情我們怎麼把這個退家的人納進來嘛\n\n10:51.097 --> 11:17.968\n我覺得這個利益非常好因為兒科醫師現在都已經不夠了全國都已經不夠了可是我們不是應該要先從接不住的人開始一定要注意他們都有被照顧到嗎這一個其實我們算過那如果說一位兒科醫師平均來照顧這一個有200個個案的話事實上我們大概只需要大概3000名的兒科醫師\n\n11:18.368 --> 11:23.611\n我等一下跟你說基層醫師在反映什麼我們看一下你自己畫的圖我們現在這個圖的問題出在哪裡你看\n\n11:46.072 --> 12:06.768\n你只有把一般幼兒一般新生兒還有高風險孕產婦所生的新生兒列到幼兒專責醫師最後呢你發現翠家的因子還是醫生自己要發現或是衛生局自己要發現而不是從源頭就把他們找出來嘛所以你就從這個破洞我們這個案例就從這個破洞掉下來啦\n\n12:11.375 --> 12:38.708\n對所以這一次我們的深刻檢討就是這一點一定是未來要去改善的就這個圖我幫你畫好了社政跟那個衛生之間的聯繫是不夠的但你要把它制度化你要把它制度化比如說你這通報以後多久以內誰去訪查兒科醫師要怎麼訪查嗎這個兒科醫師要做什麼這些SOP是有的現在只是說社政單位沒有把這個個案的名冊交給這個衛生單位\n\n12:40.929 --> 13:03.375\n我們仔細的比較了一下15號上個禮拜五你跟雙北市政府開完共識會議還有給我們衛環委員會的書面報告你說要指定專責醫師的這兩個族群居然有一點小小的落差你跟雙北的共識會議你剛才說你要落實衛政跟社政你跟雙北的共識會議說是\n\n13:05.336 --> 13:13.038\n政府安置的3歲以下兒童結果你給我們的報告範圍更大是脆弱家庭也把他納入\n\n13:15.213 --> 13:34.466\n這個部分的話講的是說不需要家長同意書因為他的家屬是已經這個支持系統薄弱你還要找他的家長的話有一點困難所以你的意思是說政府安置的不用家長同意書很多脆弱家庭找不到家長你不把他列進來喔\n\n13:35.587 --> 13:56.644\n所以要直接就列進來,不必去經過他的同意的啦是,是,好這邊基層的聲音,我這邊也要反映一下基層的聲音我很多同學是小兒科嘛,他說第一你本來一班幼兒一年是500點嘛,你把他調到1000點很好\n\n13:57.694 --> 14:11.677\n可是你現在你看發生這麼大的重大事件這些脆家的小孩都要交給他們照顧他們當然只是其中裡面的一條線第一你點數不用提升嗎他不用比一般兒童更多嗎有啊不是應該三倍五倍嗎是比那個高\n\n14:21.535 --> 14:43.924\n這件事情是這樣子的第一個就是說我們把崔家這一個兒童放進來只是讓他identify出來說他手上有這樣子的一個小孩子如果沒有identify出來這些小孩子到他的診所去看病的時候你沒有給他發現說這個有有這一個這一個可能是額虐的話這個也\n\n14:45.825 --> 14:55.862\n本來就是醫師本來就是所謂的義務通報人員對他還是有一定的責任的啦是他如果是被指定的話他還要加上一年訪視兩次欸\n\n14:58.028 --> 15:02.309\n我希望您還是可以關懷這些基層醫師因為他們願意納入你的分級醫療看你是不是考慮也把大型的醫療機構也納入這目前已經要把他們納入了\n\n15:23.775 --> 15:24.355\n關於這些特殊家庭的點數我們之後再來講\n\n15:52.568 --> 15:53.609\n我今天搜尋到的保姆是合法保姆\n\n16:22.830 --> 16:46.653\n我今天想要知道我這個保姆是不是違法居然是連到違反而效法專區叫我們自己慢慢撈我在撈的時候嚇死了只要是有做過這個未成年犯罪等等性侵性行為全部都列在那裡面跟保姆全部混在一起\n\n16:48.034 --> 17:01.349\n那現在家長其實最關心的是什麼?家長最關心的是我這個保姆有沒有過一些賦品嘛等等的嘛而你就是把他跟這些違反兒校法專區全部混在一起這根本不是家長想看的資訊啊\n\n17:03.465 --> 17:18.482\n包委員這一個部分是依在法律規定我們必須要公告的項目那至於委員說到說對於保姆那他的一個搜尋的平台這我們會來努力對而且你也應該把他自己獨立成一項對啦就是要分開\n\n17:20.084 --> 17:20.244\n陳菁徽委員\n\n","segments":[{"start":5.735,"end":14.604,"text":"主席、各位委員同事、各位官員、還有各位媒體朋友,大家早安、大家好。有請部長。好,請薛部長。"},{"start":21.952,"end":38.843,"text":"這段話是2020年蔡總統宣布第二期社安網所說的就職典禮的發言稿他提到我們要讓第一線的社工能量提升改善他們的工作環境讓社工能夠深入最基層"},{"start":39.844,"end":69.255,"text":"把過去社會安全網沒有接觸的人都找回來我們也不應該把責任全部推給醫療部門、個別法官、司法和行政部門應該要檢討制度結果我們很遺憾的發現到今天過了4年我們的社工能量還是沒有提升到處缺社工結果這件事事發大家是獵巫啊、醫師啊、社工師啊等等"},{"start":71.988,"end":85.561,"text":"這個剛剛部長有增加了非常多的篇幅本席也非常感動但是昨天列出來的檢討報告居然800字出現了11次地方"},{"start":87.964,"end":115.592,"text":"看到的時候真的很難過但剛才部長已經跟全國民眾還有凱凱的家屬道歉了我在這邊有一個小小的提議因為我也身為三個小孩的媽媽不知道部長如果在沒有媒體關注的狀況下你是否願意親自跟這位小男童的家屬道歉並且安慰他還有提供後續的安置還有你後續的做法呢"},{"start":116.685,"end":137.239,"text":"這沒有問題是 謝謝部長 謝謝部長今天願意道歉因為現在網路上已經有幾萬人聯署馬上破幾萬要聯署滅同致死可見人民對這件事有多麼生氣全國更是各地有民眾主動想要送花"},{"start":138.291,"end":163.055,"text":"跟這個凱凱致哀所以我們今天委員會召開最重要的意義就是我們應該要一起協助部長把這個社會安全網補起來因為您才是把每一絲每一絲的線補起來的人我們醫生、社工單位所有的地方政府都是這個網的一條線而已啊所以您才是最重要的角色"},{"start":164.144,"end":177.044,"text":"你有講到說14號說我們要同步制定托育專法盼本會期能送入立法院我想問這個會期剩下兩個月啦"},{"start":178.747,"end":189.871,"text":"您在這個會期真的可以送入立法院嗎?比較精確來講的話應該是送到行政院因為經過了這個專家會議討論之後的話我們會必須要我們的法規會再考慮這個法律的這個文字"},{"start":199.355,"end":221.101,"text":"那最後定案了才送那個行政院所以應該這個會期之內我們會我們人工生殖法已經搞兩年了還沒完成你現在說要做這個托育專法我不知道是不是就你法律專業的立場有什麼特別的考量您覺得現在我們的兒權法已經包含托嬰中心育兒機構還有保姆的規範都在裡面了"},{"start":223.482,"end":248.822,"text":"提出專法的意思是說你要把現在相關的條文、執法全部刪掉然後另立一個托育專法這是一個大工程欸我們的棟現在都還沒補好週末又有新的案件發生欸新的案件那個如果委員詢問我們再回答那這一個部分其實這個托育專法跟兒權法的修正我們已經討論兩年了所以已經差不多所以你很有信心這個會期"},{"start":250.043,"end":250.603,"text":"本席也在這邊希望"},{"start":274.799,"end":284.294,"text":"衛福部可以在一個月內提出相關的研究報告還有預計實施的辦法還有你們大概修改這個托育專法修法的方向還有預計的進度"},{"start":290.748,"end":310.782,"text":"這一個部分的話,因為兒少權法這一次的修正很重要一個是要符合這個CRC的一些就兒權公約的這一個部分那對於這一個做托育,尤其是像保姆還有托育的機構的管理的這部分因為如果仍然放在兒權法裡面的話,那他可能就會"},{"start":311.883,"end":311.943,"text":"主席"},{"start":328.559,"end":351.457,"text":"好 我們再來看109年衛福部曾經提出一個優化兒童醫療照護計畫當時呢這個連行政院院長都說我們5歲以下兒童的死亡率這個數字讓他感到非常的丟臉他自己公開在媒體上承認我們跟其他的OECD國家比起來"},{"start":354.127,"end":358.349,"text":"別人是1.7、2.4然後我們來看我們4.7、4.6當時你提出這個兒童醫療照護計畫幫自己訂了KPI你希望110、111、112、113是逐年下降結果呢我們發現實際的數據110、111是"},{"start":384.099,"end":403.324,"text":"4.8、5.1你的這個照護計畫是出了什麼事情?報告委員,這裡有兩個部分像委員這一張slide所顯示的右下方那邊新生兒的死亡率這部分的話有兩種算法一種是把22週裡面的也算進來所以現在再講4.8、5.1是這一個包括在裡面的"},{"start":407.105,"end":407.225,"text":"陳菁徽"},{"start":425.232,"end":451.907,"text":"新生兒及嬰兒的這個死因的回溯的這個計畫我們想要找出可避免的這個死亡的原因所以這個案例我們今天討論的這個案例你看你上面寫說期待降低死亡率減少兒童可預防可避免的死亡我們這個案例算不算你提到的可預防可避免的死亡是這個是深切檢討對"},{"start":453.148,"end":453.628,"text":"我們來看明別的表格"},{"start":475.626,"end":503.387,"text":"你把其他的策略目標還分成比如說兒童重難罕症疾病培訓兒童重症運送專業團隊未滿3歲而有專責醫師的照護推展脆弱家庭育兒指導服務好你列了這四項來我們看實際有達到你的KPI就是未滿3歲這兒童有專責醫師的照護其他你想要重難罕症疾病的這個"},{"start":504.508,"end":529.745,"text":"平台想要113年18個實際只有8個兒童重症運送專業團隊想要113年4個實際只有3個好你會把自己的KPI設成30%表示你深深的有發現其實醫療資源有限醫療資源不均你這個全國復開率你自己也知道資源配置不太合理好"},{"start":530.425,"end":536.971,"text":"你說你希望這些翠家的育兒都可以有專責醫師那你為什麼要把第三項跟第四項分開"},{"start":539.537,"end":556.81,"text":"你應該是推廣催弱家庭育兒指導服務加上有專責醫師的照顧啊不是嗎現在這個育兒專責醫師的照顧的話我們希望是每一位不管他的背景是怎樣每一位小孩子都有這樣子一個專責醫師所以我們這個設定的KPI30%那實際上是已經有超過了"},{"start":562.894,"end":577.334,"text":"但是對於退家的這個部分的話那是在裡面的另外一小塊因為這一些的話可能就會缺乏所謂的這個家屬那他的參與所以這個部分有特別要去做處理沒錯來我們可以看這個表"},{"start":579.597,"end":600.211,"text":"這個你都知道了部長也都知道了我們一個一般的幼兒需要加入專責醫師家長要上網先查詢還要再帶著手冊去填寫家長同意書來媒合基本上可以做到這件事情的家長就是不會在我們社會安全網之外嘛所以我們來看你的表"},{"start":602.028,"end":629.535,"text":"你說109年你就開始把社政還有衛政拉在一起結果你剛剛自己也在你的口頭報告承認說宣導不利嘛 對不對結果社會局跟衛生局他們都對於這件事情不太清楚你雖然109年你說你109年有做可是你根本沒有制度化也沒有系統化啊我去問基層的社工、兒科醫師他們都說"},{"start":631.535,"end":649.255,"text":"這半年來才知道而且經過這個新聞他們壓力超大因為每一個案主都去問他們說我的專責醫師呢你都還沒幫我找專責醫師所以你如果沒有制度化跟系統化你只有宣導這件事情我們怎麼把這個退家的人納進來嘛"},{"start":651.097,"end":677.968,"text":"我覺得這個利益非常好因為兒科醫師現在都已經不夠了全國都已經不夠了可是我們不是應該要先從接不住的人開始一定要注意他們都有被照顧到嗎這一個其實我們算過那如果說一位兒科醫師平均來照顧這一個有200個個案的話事實上我們大概只需要大概3000名的兒科醫師"},{"start":678.368,"end":683.611,"text":"我等一下跟你說基層醫師在反映什麼我們看一下你自己畫的圖我們現在這個圖的問題出在哪裡你看"},{"start":706.072,"end":726.768,"text":"你只有把一般幼兒一般新生兒還有高風險孕產婦所生的新生兒列到幼兒專責醫師最後呢你發現翠家的因子還是醫生自己要發現或是衛生局自己要發現而不是從源頭就把他們找出來嘛所以你就從這個破洞我們這個案例就從這個破洞掉下來啦"},{"start":731.375,"end":758.708,"text":"對 所以這一次我們的深刻檢討就是這一點一定是未來要去改善的就這個圖我幫你畫好了社政跟那個衛生之間的聯繫是不夠的但你要把它制度化你要把它制度化比如說你這通報以後多久以內誰去訪查兒科醫師要怎麼訪查嗎這個兒科醫師要做什麼這些SOP是有的現在只是說社政單位沒有把這個個案的名冊交給這個衛生單位"},{"start":760.929,"end":783.375,"text":"我們仔細的比較了一下15號上個禮拜五你跟雙北市政府開完共識會議還有給我們衛環委員會的書面報告你說要指定專責醫師的這兩個族群居然有一點小小的落差你跟雙北的共識會議你剛才說你要落實衛政跟社政你跟雙北的共識會議說是"},{"start":785.336,"end":793.038,"text":"政府安置的3歲以下兒童結果你給我們的報告範圍更大是脆弱家庭也把他納入"},{"start":795.213,"end":814.466,"text":"這個部分的話講的是說不需要家長同意書因為他的家屬是已經這個支持系統薄弱你還要找他的家長的話有一點困難所以你的意思是說政府安置的不用家長同意書很多脆弱家庭找不到家長你不把他列進來喔"},{"start":815.587,"end":836.644,"text":"所以要直接就列進來,不必去經過他的同意的啦是,是,好這邊基層的聲音,我這邊也要反映一下基層的聲音我很多同學是小兒科嘛,他說第一你本來一班幼兒一年是500點嘛,你把他調到1000點很好"},{"start":837.694,"end":851.677,"text":"可是你現在你看發生這麼大的重大事件這些脆家的小孩都要交給他們照顧他們當然只是其中裡面的一條線第一你點數不用提升嗎他不用比一般兒童更多嗎有啊不是應該三倍五倍嗎是比那個高"},{"start":861.535,"end":883.924,"text":"這件事情是這樣子的第一個就是說我們把崔家這一個兒童放進來只是讓他identify出來說他手上有這樣子的一個小孩子如果沒有identify出來這些小孩子到他的診所去看病的時候你沒有給他發現說這個有有這一個這一個可能是額虐的話這個也"},{"start":885.825,"end":895.862,"text":"本來就是醫師本來就是所謂的義務通報人員對他還是有一定的責任的啦是他如果是被指定的話他還要加上一年訪視兩次欸"},{"start":898.028,"end":902.309,"text":"我希望您還是可以關懷這些基層醫師因為他們願意納入你的分級醫療看你是不是考慮也把大型的醫療機構也納入這目前已經要把他們納入了"},{"start":923.775,"end":924.355,"text":"關於這些特殊家庭的點數我們之後再來講"},{"start":952.568,"end":953.609,"text":"我今天搜尋到的保姆是合法保姆"},{"start":982.83,"end":1006.653,"text":"我今天想要知道我這個保姆是不是違法居然是連到違反而效法專區叫我們自己慢慢撈我在撈的時候嚇死了只要是有做過這個未成年犯罪等等性侵性行為全部都列在那裡面跟保姆全部混在一起"},{"start":1008.034,"end":1021.349,"text":"那現在家長其實最關心的是什麼?家長最關心的是我這個保姆有沒有過一些賦品嘛等等的嘛而你就是把他跟這些違反兒校法專區全部混在一起這根本不是家長想看的資訊啊"},{"start":1023.465,"end":1038.482,"text":"包委員這一個部分是依在法律規定我們必須要公告的項目那至於委員說到說對於保姆那他的一個搜尋的平台這我們會來努力對而且你也應該把他自己獨立成一項對啦就是要分開"},{"start":1040.084,"end":1040.244,"text":"陳菁徽委員"}]}}}}