{"id":154409,"url":"https://ivod.ly.gov.tw/Play/Clip/1M/154409","video_url":"https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/1f04b26fe05fa65a6bde47235cc2e4e0fe28e669f0977b51f868a9bd827740ca1983f8fde3002dc55ea18f28b6918d91.mp4/playlist.m3u8","委員名稱":"王正旭","委員發言時間":"11:19:14 - 11:35:38","影片長度":"00:16:24","會議時間":"2024-07-01T09:00:00+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23次全體委員會議（事由：邀請衛生福利部部長就「有關健保合理支付、保障醫護人員收入、設置百億癌症基金及健康投資等事項」進行專題報告，並備質詢。）","type":"Clip","date":"2024-07-01","start_time":"2024-07-01T11:19:14+08:00","end_time":"2024-07-01T11:35:38+08:00","duration":984,"meet":{"tmpMeeting":null,"title":"第11屆第1會期社會福利及衛生環境委員會第23次全體委員會議","term":11,"type":"委員會","sessionPeriod":1,"sessionTimes":23,"committees":[26],"id":"委員會-11-1-26-23"},"features":["ai-transcript","gazette"],"gazette":{"lineno":604,"blocks":[["王委員正旭：（11時19分）謝謝主席，有請邱部長。"],["主席：請邱部長。"],["王委員正旭：部長好。"],["邱部長泰源：委員好。"],["王委員正旭：剛剛蘇清泉委員說，今天至少會有3位醫療相關的醫師委員跟你請教問題，很謝謝召委今天特別安排這個專題報告，讓所有的委員更清楚地知道目前衛福部針對這些重大議題做了哪些努力，也期待未來能夠迅速地回應民眾的需求，針對落實「健康台灣」能夠有更多好的發展方向。","我們先看一下目前這些挑戰，透過今天的報告我們到底能夠做哪些延伸跟進步。不管是護理師、急診，最近好多急診量能滿載的現象，部分藥品供應不足，還有在護理人力不足的相關因素之下，開床的病床數也無法滿足醫療需求。另外一個比較少被提到的藥師人力不足，這部分希望透過今天的詢答，請教你們有如何因應的對策。我們再往下看就會發現，醫療院所缺藥師是一個進行式，已經不是未來才會面臨的問題。我們也發現醫院、生技藥廠或診所都很需要藥師的幫忙，尤其在COVID-19那一段時間，藥師協助發放口罩等提供幫助，針對COVID-19造成的影響，真的很感謝藥師能夠提供非常多協助，讓民眾各方面得到很大的安慰跟好的服務。越來越多藥師前往社區藥局發展是可以理解的，如果我是藥師或者是我家人有藥師的話，我相信做這樣的選擇是非常自然的事情。可是我們也擔心，因為我們發現藥師目前的狀況讓基層診所面臨醫療的時候，尤其是兒科的處方、調劑出現一些困難或者是困擾。不知道未來如何因應它造成的相關影響？部長有沒有什麼好的策略或方式？"],["邱部長泰源：藥師方面嗎？"],["王委員正旭：是，藥師人力的部分。"],["邱部長泰源：好，我先提你現在放的這一張，既然要慢慢朝向醫藥分業，社區藥局所有的藥物都要能夠儘量備齊，儘量符合民眾的需要，特別是小孩子，尤其是急性病跟兒童處方真的會比較費時，所以拜託社區藥局能夠多多幫忙。至於藥師方面，如果工作條件不一樣，包括薪水、壓力，當然會跟護理人員一樣我們醫生也是一樣，大家一定會找一個……像當兵就要離家近。當然我們的醫學教育很用心，百年來臺灣醫護能夠駐守在第一線去守護偏鄉、肯在加護病房面對瀕死的病人、肯在安寧病房面對即將過世的病人，握著他的手、照顧他，都沒有避開這樣一個非常困難的照顧環境，這也是我們醫學教育核心價值的發揮，我相信所有醫事人員的教育都是這樣子。至於怎麼樣營造一個更好的環境，可能有些考試的及格率我認為也都應該要考量，因為有的人很認真讀書，但就不是很會考試。"],["王委員正旭：部長，我請教你，針對偏鄉醫師人力需要做適度的補充，或者是需要去解決這樣的問題，不知道藥師未來在這方面有沒有相關的問題也要同步去克服？最近像慈濟，他們在花蓮偏鄉，經過努力的爭取，他們的藥學系就有增設的機會，那未來在偏鄉如果藥師短缺怎麼辦？會不會像公費醫學生一樣，將來會有公費藥學生類似的因應措施？因為未來不管要如何落實醫藥分業單軌制，萬一出現人力不足的情況，我們不希望像今天一樣，問題出現以後才開始思考一些解決方案。"],["邱部長泰源：我想這部分可以分全國性跟區域性，全國性就是量大，合理的情況是讀得不錯的就讓他出來社會服務，每一個唸大學相關科系的都是父母的寶貝，如果能夠多多輔導，讓他能夠有工作做，而且是能夠做他專業的工作，不管哪一個醫事人員，我覺得我們都要去協助，這個部分就要考選部跟各專科團體能夠站在國家的立場來思考。我覺得如果把整個國家的量充實起來，然後再開始鼓勵偏鄉的醫事人力，不只醫生，都要鼓勵，而且也要像花蓮慈濟這樣培養在地的醫生。我個人過去幾年來是非常支持原鄉自己培養醫師人力，因為那個留任率可能可以到七成，如果用公費學生去，時間一到都跑得像飛一樣，留任的可能不到30%。"],["王委員正旭：謝謝部長。"],["邱部長泰源：而且我也提過一個意見，就是老鮭魚下鄉，臺北市的醫療資源非常豐富，臺北市以前的專家現在看病看很少，是不是我們也可以鼓勵他夫妻一起下鄉？反正小孩也不理他了，空巢期了嘛，夫妻兩個可以一起去臺東、花蓮，可以服務還可以延年益壽，當然不要去跟當地的基層醫師衝突，不要去做基層醫師可以做的事情，而要去充實急重症的醫療。像我們石崇良醫師，以後退休也許會恢復他急診的專業，老鮭魚到鄉下服務，這也是花蓮之福、臺東之福，我覺得這些大家都可以思考。"],["王委員正旭：大家可以一起做好的事情，我們也知道護理師的部分，剛剛部長也說明了非常多，我們也希望醫療院所有更好的彈性工時的安排，讓我們的護理師能夠回流。"],["邱部長泰源：我講一句公平話，據我瞭解，醫療院所都講一句話，你只要跟我說這個要給護理人員，他們怎麼會跟你拿去呢？所以將來只要說是要給護理人員的，我覺得醫院一毛錢都不會跟你拿，不要誤解醫院會去拿這些錢，我個人瞭解過，很多醫療院所領導人的意見是這樣子。"],["王委員正旭：好，再來看瑞士洛桑管理學院最近公布了國家競爭力的部分，跟醫療相關的基礎建設部分，我們的成績非常好，名列前三名，這個部分就是醫療保健基礎設施符合社會需要，意思就是我們的硬體設備其實是很有競爭力的，這也反映出在已經很充分的硬體設施包括醫院的設置之下，萬一新增人口需要床數增加的時候，在分布上要怎麼樣讓需求能夠在這麼好的基礎上去做特別的處理？另外，我們也看到醫療保健支出占GDP的比例，相對來講就差很多，才占第41名，這一部分其實反映出我們真的很需要有更多的醫療資源投入，這一部分也需要邱部長繼續努力來做相關的處理。"],["邱部長泰源：是。"],["王委員正旭：有關於公共衛生支出的項目，剛才你也已經說明得很清楚，如果有辦法把這些相關的項目做適當的盤整以後，讓它回歸到醫療需求，如果這樣對GDP的占比會有效提升到多少百分比？有沒有這樣的預估或盤算？"],["邱部長泰源：好，我想這個部分應該是王委員長期在關注的，而且你才是專家，我們衛福部應該也必須要來盤算，因為現在都還在盤算當中，但是我相信只要公務預算都投入到公共衛生、傳染病防治、預防保健的話，我們的GDP應該就自然而然會提升到相當不錯的水準。"],["王委員正旭：好，我們期待能夠看到這個數字的具體呈現。那還有兩個問題想要請部長幫忙確認，就是通訊診療其實今天就要正式實施，基層醫療院所可能會有一些擔心的部分，能不能夠更有效的提供相關的誘因，協助基層醫療院所知道怎麼去配合，讓受惠的民眾可以到達274萬人，在這個過程當中，基層醫療院所可以扮演重要的角色。"],["邱部長泰源：王委員提到的這個部分，我必須要感謝基層醫療院所其實是用通訊診察用得最多的，在我們COVID疫情最困難的時候，以臺北市為例，一天最高曾經到達一萬個infected COVID，新北市兩萬個，這時候只要有其中一小部分的人因為擔心他的小孩子發燒或自己不舒服就衝到急診，只要有1%，每一個急診都會爆掉，但是我們政府的政策是推動通訊診療，用視訊就可以看他家裡小孩子的發燒狀況、生病狀況，有什麼問題可以隨時來解決。這個也植基於過去二十年來我們臺灣推動社區醫療群家庭醫師制度，大家都有一個合作，我鼓勵你、你鼓勵我，診所才肯來做相關的居家甚至居家通訊診療，穩住了國家的疫情，所以基層你不必擔心，他們做最多了，現在的通訊診療辦法，我想醫事司很清楚，都會以病人為中心，協助基層醫療院所能夠很方便的來照顧病人；而醫院方面，原來用的通訊設備會比較屬於照顧它原來的病人，或者是離島、外島等等偏鄉特殊任務的，大致上不至於影響到基層醫療院所就近看病人，這也是我們臺灣醫療體系必須要堅持的。基層醫療原則上就是要face to face，就是要去瞭解你社區的狀況，甚至他們家有養幾隻貓、幾隻狗，你都知道，才能夠知道他的疾病，這是基層醫療的價值所在。如果能夠配合讓有些高齡化的社會或機構也給基層醫療來做，也可以因應像COVID那個時候的狀況。我覺得這是進步的，我們把這樣的一個辦法弄到更進步、更符合人民的需要。"],["王委員正旭：好，謝謝部長與時俱進。","最後是一個有關公費克流感使用的部分，因為6月26日突然宣布又可以回歸到公費使用，讓很多基層診所措手不及。這次流感或類流感在夏天還這麼猖獗，的確令人無法預估，不過依照我們所看到的，因為重症數並沒有緩和下來，疾管署把公費克流感第八類對象的適用期間從6月26日一直延長到7月31日，我們期待的是，如果用公費持續來支應這個需求，到7月31日截止之前，萬一疫情沒有真的緩和下來的話，要公布延續或取消是不是能提前一個禮拜就事先做個預告之類的？否則不管醫療機構或者是醫師，當面對這個可能性的時候，將無法去適應或者是無法去掌握，這個部分再麻煩邱部長或者是疾管署能有一個好的準備。"],["邱部長泰源：疾管署要不要簡單說明一下？"],["曾副署長淑慧：跟委員報告，我們這次因應疫情，所以把擴大克流感的用藥從6月26日延長到7月底，主要的原因是我們認為這次流感疫情大概是7月中左右會到尖峰，後面可能會逐漸下降。不過我們仍然會持續評估，如果到了7月底仍然有需要擴大，我們仍然會持續擴大，我們也會遵照委員的指示，下次要再擴大之前，會提早讓基層醫療院所知道相關的訊息，讓他們能夠有所因應。謝謝委員的指導，謝謝。"],["王委員正旭：好，謝謝。"],["邱部長泰源：謝謝委員。"],["主席：我先作一下宣告：等一下在鄭天財委員質詢結束後處理臨時提案。","現在請鄭天財委員發言。"]],"agenda":{"page_end":118,"meet_id":"委員會-11-1-26-23","speakers":["黃秀芳","陳昭姿","林月琴","陳菁徽","邱鎮軍","王育敏","涂權吉","廖偉翔","蘇清泉","王正旭","鄭天財Sra 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\"那這次的這個流感或類流感它的在夏天還這麼樣的猖獗的確是令人無法去預估不過依照我們所看到的這個重症數並沒有緩和下來我們最後一張可以看到的就是\", \"words\": [{\"word\": \"那\", \"start\": 869.156, \"end\": 870.177, \"score\": 0.98}, {\"word\": \"這\"}, {\"word\": \"次\", \"start\": 870.177, \"end\": 870.397, \"score\": 0.911}, {\"word\": \"的\", \"start\": 870.397, \"end\": 871.337, \"score\": 0.94}, {\"word\": \"這\"}, {\"word\": \"個\"}, {\"word\": \"流\", \"start\": 871.337, \"end\": 871.537, \"score\": 0.9}, {\"word\": \"感\", \"start\": 871.537, \"end\": 871.697, \"score\": 0.995}, {\"word\": \"或\", \"start\": 871.697, \"end\": 871.937, \"score\": 0.834}, {\"word\": \"類\"}, {\"word\": \"流\", \"start\": 871.937, \"end\": 872.158, \"score\": 0.963}, {\"word\": \"感\", \"start\": 872.158, \"end\": 872.598, \"score\": 0.988}, {\"word\": \"它\", \"start\": 872.598, \"end\": 872.838, \"score\": 0.938}, {\"word\": \"的\", \"start\": 872.838, \"end\": 873.058, \"score\": 0.999}, {\"word\": \"在\", \"start\": 873.058, \"end\": 873.898, \"score\": 1.0}, {\"word\": \"夏\", 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\"start\": 941.28, \"end\": 941.48, \"score\": 0.77}, {\"word\": \"的\", \"start\": 941.48, \"end\": 941.78, \"score\": 0.811}, {\"word\": \"用\", \"start\": 941.78, \"end\": 942.461, \"score\": 0.86}, {\"word\": \"藥\"}, {\"word\": \",\"}, {\"word\": \"把\", \"start\": 942.461, \"end\": 942.601, \"score\": 0.908}, {\"word\": \"它\", \"start\": 942.601, \"end\": 943.502, \"score\": 0.825}, {\"word\": \"從\"}, {\"word\": \"6\"}, {\"word\": \"月\", \"start\": 943.502, \"end\": 944.283, \"score\": 0.735}, {\"word\": \"2\"}, {\"word\": \"6\"}, {\"word\": \"號\"}, {\"word\": \"延\", \"start\": 944.283, \"end\": 944.643, \"score\": 0.779}, {\"word\": \"長\"}, {\"word\": \"到\", \"start\": 944.643, \"end\": 945.064, \"score\": 0.799}, {\"word\": \"7\"}, {\"word\": \"月\", \"start\": 945.064, \"end\": 945.304, \"score\": 0.858}, {\"word\": \"底\", \"start\": 945.304, \"end\": 946.065, \"score\": 0.897}, {\"word\": \"。\"}, {\"word\": \"主\", \"start\": 946.065, \"end\": 946.225, \"score\": 0.958}, {\"word\": 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\"end\": 954.313, \"score\": 0.806}, {\"word\": \"面\", \"start\": 954.313, \"end\": 954.674, \"score\": 0.824}, {\"word\": \"可\", \"start\": 954.674, \"end\": 954.774, \"score\": 0.779}, {\"word\": \"能\", \"start\": 954.774, \"end\": 955.054, \"score\": 0.754}, {\"word\": \"會\"}, {\"word\": \"逐\", \"start\": 955.054, \"end\": 955.194, \"score\": 0.902}, {\"word\": \"漸\"}, {\"word\": \"下\", \"start\": 955.194, \"end\": 955.214, \"score\": 0.0}, {\"word\": \"降\", \"start\": 955.214, \"end\": 955.234, \"score\": 0.0}, {\"word\": \"。\"}], \"language\": \"zh\"}","srt":"1\n00:00:00,349 --> 00:00:26,518\n好謝謝主席有請邱部長請邱部長部長好委員好是剛剛我們事情前委員說目前今天至少會有三位醫療相關醫師的委員來跟你請教相關的問題那也很謝謝趙偉今天特別安排這個專題報告\n\n2\n00:00:29,059 --> 00:00:50,395\n讓所有委員也更清楚的知道目前衛福部針對這些重大的議題做了哪一些的努力那也期待未來能夠迅速的回應民眾的需求能夠針對於作實這個健康台灣有更多好的發展的方向那我們先看一下到底目前這些挑戰\n\n3\n00:00:51,616 --> 00:01:05,103\n透過今天的報告我們能夠做哪一些的延伸跟進步的機會包括不管是護理師的急診的最近好多好多急診這些量的滿載部分\n\n4\n00:01:07,084 --> 00:01:29,301\n藥品供應不足還有因為護理人力不足相關因素之下這個病床數的開床無法滿足這些醫療需求那另外一個比較少被提到的就是藥師人力的不足的部分那這部分希望透過今天的詢問來請教我們有如何因應的對策我們再往下看就會發現其實這個醫療院所缺藥師\n\n5\n00:01:33,824 --> 00:02:01,054\n是一個進行式他已經不是未來才會面臨的問題那我們也發現不管這個醫院或者是生技藥廠診所都很需要藥師的幫忙那藥師尤其在COVID-19那段時間協助發放口罩或等等的幫助針對於我們對於COVID-19造成的影響真的很感謝藥師能夠提供非常多的協助讓民眾\n\n6\n00:02:02,194 --> 00:02:24,420\n這方面得到很大的安慰跟好的服務可是越來越多的藥師前往社區藥局發展這個是可以理解的因為如果我是藥師或者是我家人有藥師的話我相信做這樣的選擇是非常自然的事情可是我們也擔心往下看我們發現說藥師這種目前的狀況\n\n7\n00:02:29,961 --> 00:02:31,102\n在藥師方面嗎是藥師人力的部分\n\n8\n00:02:58,575 --> 00:03:17,635\n我先提這個剛剛你現在放這一張我們很期待既然慢慢的要朝向醫藥分裂那社區的藥局大概所有的藥物都能夠盡量備齊那也盡量符合民眾的需要那特別是小孩子的尤其急性病\n\n9\n00:03:18,696 --> 00:03:21,118\n那當然大家會shift,跟護理人員一樣嘛\n\n10\n00:03:40,470 --> 00:04:08,893\n我們醫生也是一樣,大家一定要找一個,那時候我們做病就要離家近,緊張到那個。當然我們的醫學教育,我們很用心,百年來台灣今天能夠駐守到第一線,去守護偏鄉,能夠肯在加護病房面對病死的病人,肯在安寧病房面對即將過世的病人,\n\n11\n00:04:10,294 --> 00:04:36,033\n摸著他的手照顧他這樣子都沒有避開這樣一個非常困難的一個照顧環境這也是我們醫學教育的也是一個核心價值的一個發揮我相信所有的醫事人員的教育都是這樣子那至於說怎麼樣改善一個更好的環境或者是說讓可能有一些考試的及格率\n\n12\n00:04:37,952 --> 00:04:56,158\n我認為也都應該要考量,因為有的人很忙,就不一定考試就不說很難考。部長我請教你,就是說如果針對於偏鄉的醫師人力需要做適度的補充,或者是需要去解決這樣的問題,\n\n13\n00:04:57,378 --> 00:05:18,530\n那不知道藥師未來在這方面有沒有相關的問題也要同步去克服最近像慈濟慈濟他們在花蓮偏鄉所以就經過努力的爭取以後他們就這個要學習這個他的偵測的機會那未來在偏鄉的部分如果藥師短缺怎麼辦\n\n14\n00:05:19,631 --> 00:05:42,455\n有沒有像工會醫學生一樣將來會有工會藥學生類似的這些要因應的措施因為未來不管是要如何去處理醫藥分業單軌制的情形要落實的話那萬一這個人力不足的時候我們不希望看到像今天一樣好像問題出現以後才開始解決的一些方案\n\n15\n00:05:43,427 --> 00:06:01,027\n我想這個部分可以分全國性跟地區域性啦齁全國性你就是要有這個量大嘛阿合理的學到不錯的你就讓他出來來社會服務沒一個去念大學科相關科系的都是父母的寶貝阿齁你能讓\n\n16\n00:06:02,188 --> 00:06:20,039\n如果能夠多多輔導他能夠有工作做而且是能夠工作他的專業不管哪一個醫事人員我覺得我們都真的要去協助這個部分就會在考選部跟各位專科的團體能夠去重新站在國家的立場來思考\n\n17\n00:06:21,039 --> 00:06:33,406\n那我覺得把量,整個國家的量充實起來以後,然後再開始鼓勵偏鄉的一個醫事人力,包括民間的醫生,都要鼓勵。藝生也能夠培養成花蓮慈濟,培養在地的醫生。我個人過去幾年來是非常支持\n\n18\n00:06:44,867 --> 00:07:04,932\n自己原鄉培養的一個自己培養醫師人力因為那個留任率可能可以到七成那你用光輝的去齁那如果時間夠都照那背的啦可能就沒30%啦所以我覺得這些都要...而且我還要提一個意見就是說老歸於下鄉啦齁\n\n19\n00:07:12,472 --> 00:07:28,370\n臺北企業醫療資源非常豐富,臺北市那些以前的專家,現在看病看得很少,是不是我們也可以安排說那個給他鼓勵,反正孩子也不要理他,空巢期嘛,你兩個帶他去台東、去花蓮去做,\n\n20\n00:07:30,172 --> 00:07:31,372\n衛生福利部長\n\n21\n00:07:48,544 --> 00:07:49,365\n大家可以做好事\n\n22\n00:08:08,880 --> 00:08:31,140\n那我們也知道護理師的部分剛剛部長也說明了非常多我們也希望醫療院所有更好的彈線工時的安排等等讓我們的護理師們可以有一點話我自我了解醫療院所包括都講一句話你只要跟我講說這個要給護理他們怎麼會去跟你要拿去呢所以將來只要說要給護理的\n\n23\n00:08:34,161 --> 00:09:01,256\n我覺得醫院一毛錢都不會跟你拿不要誤解到醫院會去拿這些錢我個人是從很多醫療院所的領導人他們的意見是這樣子那再來看這個瑞士洛杉磯管理學院他在2024年最近公佈的這個國家競爭力的部分那和醫療相關的就是有一個基礎建設基礎建設部分其實我們的成績非常好\n\n24\n00:09:02,416 --> 00:09:25,051\n其實名列前三這個部分就是醫療保健基礎設施符合社會需要意思就是說我們的硬體設備其實是很有競爭力的那這個也剛剛反映出萬一對於這些在已經很充分的硬體設施包括醫院的設置之下新增人口需要床數增加的時候\n\n25\n00:09:25,851 --> 00:09:41,660\n那個分布上要怎麼樣去讓這些需求能夠在已經這麼好的基礎之上去做特別的處理另外我們也看到這個醫療保健支出佔GDP的比例相對來講就是差很多才佔了41名\n\n26\n00:09:43,061 --> 00:10:05,252\n那這一部分其實反映出來就是我們真的很需要有更多的醫療資源的投入那這一部分也需要請邱部長繼續努力的來做相關的處理那其實我們也看到下一張就是有關於這些公共衛生支出的項目那剛才你也已經說明得很清楚\n\n27\n00:10:06,372 --> 00:10:26,529\n再來,如果有辦法把這個相關的項目做適當的盤整以後讓它回歸到這個醫療需求你想想看,剛才這樣算對GDP的占比會有效提升到多少百分比有沒有這樣的一個預估或者是盤算\n\n28\n00:10:28,805 --> 00:10:57,865\n我想我們這個部分應該是王委員長期在關注而且你才是專家我們衛務部應該也必須要來盤算因為現在都還在盤算當中但是我相信只要公務預算都投入到公共衛生、傳染病防治、預防保健的話我們相信我們的LDP應該就自然而然就會提升到相當不錯的水準\n\n29\n00:10:58,885 --> 00:11:22,133\n好,很期待能夠看到這個數字的具體呈現那還有兩個問題想要請部長這邊幫忙確認就是通訊診療其實今天就要正式實施那對於這個基層機構診所可能會有一些擔心的部分那能不能夠更有效的去提供相關的誘因協助\n\n30\n00:11:23,053 --> 00:11:49,198\n讓我們的基層診所也比較安心的去知道怎麼去配合這個需要讓這個社會的民眾可以到達274萬人的過程當中醫療診所是可以扮演重要的角色這個部分王委員提到這個部分我必須要感謝我們基層醫療其實你們是大家用通訊診察用的最多的\n\n31\n00:11:50,495 --> 00:12:01,895\n在我們最困難的疫情COVID的疫情最困難的時候即台北市一天最高曾經到達1萬個infectedCOVID新北市2萬個\n\n32\n00:12:04,085 --> 00:12:28,741\n這是如果只要有其中一少部分的人因為他擔心他的小孩子發燒或者自己不舒服就衝到急診只要百分之一每一個急診都爆掉但是我們政府這個時候的政策應該是從兩個當時也是推動這個通訊診療用視訊就會來看他家裡的這個小孩子的發燒狀況生病狀況\n\n33\n00:12:31,062 --> 00:12:57,864\n那有什麼問題可以隨時來解決那這個也直擊以過去我們20年來臺灣推動社區醫療群、家庭醫師制度就大家都有一個合作所以我鼓勵你,你鼓勵我今宵才肯來做相關的一個居家甚至到居家通訊的診療穩住了國家的一個疫情所以其實你不用煩惱,你做多少\n\n34\n00:13:00,427 --> 00:13:05,275\n現在通信的整條辦法那個我想意思是很清楚都是會站在\n\n35\n00:13:06,328 --> 00:13:34,257\n以病人為中心然後協助讓基層醫療能夠很方便的來照顧他原來的病人而醫院方面他只是在照顧他原來他用的通訊設備會比較屬於照顧他原來的病人或者是比較離島、外島等等的偏鄉特殊任務的大致上不至於影響到基層他就近在看病人\n\n36\n00:13:34,837 --> 00:13:48,893\n這也是我們臺灣醫療體系必須要堅持的基層醫療就是要原則上要facetoface你就是要去瞭解你社區的狀況你就是瞭解甚至他們家有幾隻貓幾隻狗你都知道\n\n37\n00:13:49,554 --> 00:14:10,858\n你才能夠知道他的疾病嘛這是基層醫療的價值所在那如果能夠配合有些為高齡化的社會或機構那也給基層醫療來做那也可以應應剛剛COVID的那個時候的狀況我覺得這是這是這一個進步的我們把這樣的一個辦法弄到更進步更符合人民的需要\n\n38\n00:14:12,680 --> 00:14:28,536\n最後就是一個有關於公費流感、客流感使用的這個部分因為在6月26號突然就宣布說又可以回歸到這個公費使用所以讓很多基層診所挫折不及\n\n39\n00:14:29,156 --> 00:14:46,245\n那這次的這個流感或類流感它的在夏天還這麼樣的猖獗的確是令人無法去預估不過依照我們所看到的這個重症數並沒有緩和下來我們最後一張可以看到的就是\n\n40\n00:14:49,046 --> 00:15:15,654\n接管署把這個試用期間從6月26號一直延伸到7月31號那我們期待的是說如果是這樣公費持續來適應這個需求的話那到7月31號截止之前萬一這個疫情沒有真的緩和下來的時候那要公佈這樣的延續或者是要取消是不是能夠再提前一個禮拜就能夠事先一個預告之類的否則的話\n\n41\n00:15:17,294 --> 00:15:31,383\n不管是醫療機構或者是醫師或者是我們的面對這樣的可能性的時候無法去試驗或者是無法去掌握這部分再麻煩邱部長或者是有一個好的準備\n\n42\n00:15:34,993 --> 00:15:55,234\n各位委員報告,我們這次因應疫情,所以把擴大客流感的用藥,把它從6月26號延長到7月底。主要的原因是我們認為說,這次流感的疫情大概是7月中左右會到尖峰,可是後面可能會逐漸下降。\n\n","tsv":"start\tend\ttext\n349\t26518\t好 謝謝主席 有請邱部長請邱部長部長好委員好是 剛剛我們事情前委員說目前今天至少會有三位醫療相關醫師的委員來跟你請教相關的問題那也很謝謝趙偉今天特別安排這個專題報告\n29059\t50395\t讓所有委員也更清楚的知道目前衛福部針對這些重大的議題做了哪一些的努力那也期待未來能夠迅速的回應民眾的需求能夠針對於作實這個健康台灣有更多好的發展的方向那我們先看一下到底目前這些挑戰\n51616\t65103\t透過今天的報告我們能夠做哪一些的延伸跟進步的機會包括不管是護理師的急診的最近好多好多急診這些量的滿載部分\n67084\t89301\t藥品供應不足還有因為護理人力不足相關因素之下這個病床數的開床無法滿足這些醫療需求那另外一個比較少被提到的就是藥師人力的不足的部分那這部分希望透過今天的詢問來請教我們有如何因應的對策我們再往下看就會發現其實這個醫療院所缺藥師\n93824\t121054\t是一個進行式他已經不是未來才會面臨的問題那我們也發現不管這個醫院或者是生技藥廠診所都很需要藥師的幫忙那藥師尤其在COVID-19那段時間協助發放口罩或等等的幫助針對於我們對於COVID-19造成的影響真的很感謝藥師能夠提供非常多的協助讓民眾\n122194\t144420\t這方面得到很大的安慰跟好的服務可是越來越多的藥師前往社區藥局發展這個是可以理解的因為如果我是藥師或者是我家人有藥師的話我相信做這樣的選擇是非常自然的事情可是我們也擔心往下看我們發現說藥師這種目前的狀況\n149961\t151102\t在藥師方面嗎是藥師人力的部分\n178575\t197635\t我先提這個剛剛你現在放這一張我們很期待既然慢慢的要朝向醫藥分裂那社區的藥局大概所有的藥物都能夠盡量備齊那也盡量符合民眾的需要那特別是小孩子的尤其急性病\n198696\t201118\t那當然大家會shift,跟護理人員一樣嘛\n220470\t248893\t我們醫生也是一樣,大家一定要找一個,那時候我們做病就要離家近,緊張到那個。當然我們的醫學教育,我們很用心,百年來台灣今天能夠駐守到第一線,去守護偏鄉,能夠肯在加護病房面對病死的病人,肯在安寧病房面對即將過世的病人,\n250294\t276033\t摸著他的手照顧他這樣子都沒有避開這樣一個非常困難的一個照顧環境這也是我們醫學教育的也是一個核心價值的一個發揮我相信所有的醫事人員的教育都是這樣子那至於說怎麼樣改善一個更好的環境或者是說讓可能有一些考試的及格率\n277952\t296158\t我認為也都應該要考量,因為有的人很忙,就不一定考試就不說很難考。部長我請教你,就是說如果針對於偏鄉的醫師人力需要做適度的補充,或者是需要去解決這樣的問題,\n297378\t318530\t那不知道藥師未來在這方面有沒有相關的問題也要同步去克服最近像慈濟慈濟他們在花蓮偏鄉所以就經過努力的爭取以後他們就這個要學習這個他的偵測的機會那未來在偏鄉的部分如果藥師短缺怎麼辦\n319631\t342455\t有沒有像工會醫學生一樣將來會有工會藥學生類似的這些要因應的措施因為未來不管是要如何去處理醫藥分業單軌制的情形要落實的話那萬一這個人力不足的時候我們不希望看到像今天一樣好像問題出現以後才開始解決的一些方案\n343427\t361027\t我想這個部分可以分全國性跟地區域性啦齁全國性你就是要有這個量大嘛阿合理的 學到不錯的你就讓他出來來社會服務沒一個去念大學科 相關科系的都是父母的寶貝阿齁你能讓\n362188\t380039\t如果能夠多多輔導他能夠有工作做而且是能夠工作他的專業不管哪一個醫事人員我覺得我們都真的要去協助這個部分就會在考選部跟各位專科的團體能夠去重新站在國家的立場來思考\n381039\t393406\t那我覺得把量,整個國家的量充實起來以後,然後再開始鼓勵偏鄉的一個醫事人力,包括民間的醫生,都要鼓勵。藝生也能夠培養成花蓮慈濟,培養在地的醫生。我個人過去幾年來是非常支持\n404867\t424932\t自己原鄉培養的一個自己培養醫師人力因為那個留任率可能可以到七成那你用光輝的去齁那如果時間夠都照那背的啦可能就沒30%啦所以我覺得這些都要...而且我還要提一個意見就是說老歸於下鄉啦齁\n432472\t448370\t臺北企業醫療資源非常豐富,臺北市那些以前的專家,現在看病看得很少,是不是我們也可以安排說那個給他鼓勵,反正孩子也不要理他,空巢期嘛,你兩個帶他去台東、去花蓮去做,\n450172\t451372\t衛生福利部長\n468544\t469365\t大家可以做好事\n488880\t511140\t那我們也知道護理師的部分剛剛部長也說明了非常多我們也希望醫療院所有更好的彈線工時的安排等等讓我們的護理師們可以有一點話我自我了解醫療院所包括都講一句話你只要跟我講說這個要給護理他們怎麼會去跟你要拿去呢所以將來只要說要給護理的\n514161\t541256\t我覺得醫院一毛錢都不會跟你拿不要誤解到醫院會去拿這些錢我個人是從很多醫療院所的領導人他們的意見是這樣子那再來看這個瑞士洛杉磯管理學院他在2024年最近公佈的這個國家競爭力的部分那和醫療相關的就是有一個基礎建設基礎建設部分其實我們的成績非常好\n542416\t565051\t其實名列前三這個部分就是醫療保健基礎設施符合社會需要意思就是說我們的硬體設備其實是很有競爭力的那這個也剛剛反映出萬一對於這些在已經很充分的硬體設施包括醫院的設置之下新增人口需要床數增加的時候\n565851\t581660\t那個分布上要怎麼樣去讓這些需求能夠在已經這麼好的基礎之上去做特別的處理另外我們也看到這個醫療保健支出佔GDP的比例相對來講就是差很多才佔了41名\n583061\t605252\t那這一部分其實反映出來就是我們真的很需要有更多的醫療資源的投入那這一部分也需要請邱部長繼續努力的來做相關的處理那其實我們也看到下一張就是有關於這些公共衛生支出的項目那剛才你也已經說明得很清楚\n606372\t626529\t再來,如果有辦法把這個相關的項目做適當的盤整以後讓它回歸到這個醫療需求你想想看,剛才這樣算對GDP的占比會有效提升到多少百分比有沒有這樣的一個預估或者是盤算\n628805\t657865\t我想我們這個部分應該是王委員長期在關注而且你才是專家我們衛務部應該也必須要來盤算因為現在都還在盤算當中但是我相信只要公務預算都投入到公共衛生、傳染病防治、預防保健的話我們相信我們的LDP應該就自然而然就會提升到相當不錯的水準\n658885\t682133\t好,很期待能夠看到這個數字的具體呈現那還有兩個問題想要請部長這邊幫忙確認就是通訊診療其實今天就要正式實施那對於這個基層機構診所可能會有一些擔心的部分那能不能夠更有效的去提供相關的誘因協助\n683053\t709198\t讓我們的基層診所也比較安心的去知道怎麼去配合這個需要讓這個社會的民眾可以到達274萬人的過程當中醫療診所是可以扮演重要的角色這個部分王委員提到這個部分我必須要感謝我們基層醫療其實你們是大家用通訊診察用的最多的\n710495\t721895\t在我們最困難的疫情COVID的疫情最困難的時候即台北市一天最高曾經到達1萬個infected COVID新北市2萬個\n724085\t748741\t這是如果只要有其中一少部分的人因為他擔心他的小孩子發燒或者自己不舒服就衝到急診只要百分之一每一個急診都爆掉但是我們政府這個時候的政策應該是從兩個當時也是推動這個通訊診療用視訊就會來看他家裡的這個小孩子的發燒狀況生病狀況\n751062\t777864\t那有什麼問題可以隨時來解決那這個也直擊以過去我們20年來臺灣推動社區醫療群、家庭醫師制度就大家都有一個合作所以我鼓勵你,你鼓勵我今宵才肯來做相關的一個居家甚至到居家通訊的診療穩住了國家的一個疫情所以其實你不用煩惱,你做多少\n780427\t785275\t現在通信的整條辦法那個我想意思是很清楚都是會站在\n786328\t814257\t以病人為中心然後協助讓基層醫療能夠很方便的來照顧他原來的病人而醫院方面他只是在照顧他原來他用的通訊設備會比較屬於照顧他原來的病人或者是比較離島、外島等等的偏鄉特殊任務的大致上不至於影響到基層他就近在看病人\n814837\t828893\t這也是我們臺灣醫療體系必須要堅持的基層醫療就是要原則上要face to face你就是要去瞭解你社區的狀況你就是瞭解甚至他們家有幾隻貓幾隻狗你都知道\n829554\t850858\t你才能夠知道他的疾病嘛這是基層醫療的價值所在那如果能夠配合有些為高齡化的社會或機構那也給基層醫療來做那也可以應應剛剛COVID的那個時候的狀況我覺得這是這是這一個進步的我們把這樣的一個辦法弄到更進步更符合人民的需要\n852680\t868536\t最後就是一個有關於公費流感、客流感使用的這個部分因為在6月26號突然就宣布說又可以回歸到這個公費使用所以讓很多基層診所挫折不及\n869156\t886245\t那這次的這個流感或類流感它的在夏天還這麼樣的猖獗的確是令人無法去預估不過依照我們所看到的這個重症數並沒有緩和下來我們最後一張可以看到的就是\n889046\t915654\t接管署把這個試用期間從6月26號一直延伸到7月31號那我們期待的是說如果是這樣公費持續來適應這個需求的話那到7月31號截止之前萬一這個疫情沒有真的緩和下來的時候那要公佈這樣的延續或者是要取消是不是能夠再提前一個禮拜就能夠事先一個預告之類的否則的話\n917294\t931383\t不管是醫療機構或者是醫師或者是我們的面對這樣的可能性的時候無法去試驗或者是無法去掌握這部分再麻煩邱部長或者是有一個好的準備\n934993\t955234\t各位委員報告,我們這次因應疫情,所以把擴大客流感的用藥,把它從6月26號延長到7月底。主要的原因是我們認為說,這次流感的疫情大概是7月中左右會到尖峰,可是後面可能會逐漸下降。\n956015\t984360\t響鐘\n","txt":"好 謝謝主席 有請邱部長請邱部長部長好委員好是 剛剛我們事情前委員說目前今天至少會有三位醫療相關醫師的委員來跟你請教相關的問題那也很謝謝趙偉今天特別安排這個專題報告\n讓所有委員也更清楚的知道目前衛福部針對這些重大的議題做了哪一些的努力那也期待未來能夠迅速的回應民眾的需求能夠針對於作實這個健康台灣有更多好的發展的方向那我們先看一下到底目前這些挑戰\n透過今天的報告我們能夠做哪一些的延伸跟進步的機會包括不管是護理師的急診的最近好多好多急診這些量的滿載部分\n藥品供應不足還有因為護理人力不足相關因素之下這個病床數的開床無法滿足這些醫療需求那另外一個比較少被提到的就是藥師人力的不足的部分那這部分希望透過今天的詢問來請教我們有如何因應的對策我們再往下看就會發現其實這個醫療院所缺藥師\n是一個進行式他已經不是未來才會面臨的問題那我們也發現不管這個醫院或者是生技藥廠診所都很需要藥師的幫忙那藥師尤其在COVID-19那段時間協助發放口罩或等等的幫助針對於我們對於COVID-19造成的影響真的很感謝藥師能夠提供非常多的協助讓民眾\n這方面得到很大的安慰跟好的服務可是越來越多的藥師前往社區藥局發展這個是可以理解的因為如果我是藥師或者是我家人有藥師的話我相信做這樣的選擇是非常自然的事情可是我們也擔心往下看我們發現說藥師這種目前的狀況\n在藥師方面嗎是藥師人力的部分\n我先提這個剛剛你現在放這一張我們很期待既然慢慢的要朝向醫藥分裂那社區的藥局大概所有的藥物都能夠盡量備齊那也盡量符合民眾的需要那特別是小孩子的尤其急性病\n那當然大家會shift,跟護理人員一樣嘛\n我們醫生也是一樣,大家一定要找一個,那時候我們做病就要離家近,緊張到那個。當然我們的醫學教育,我們很用心,百年來台灣今天能夠駐守到第一線,去守護偏鄉,能夠肯在加護病房面對病死的病人,肯在安寧病房面對即將過世的病人,\n摸著他的手照顧他這樣子都沒有避開這樣一個非常困難的一個照顧環境這也是我們醫學教育的也是一個核心價值的一個發揮我相信所有的醫事人員的教育都是這樣子那至於說怎麼樣改善一個更好的環境或者是說讓可能有一些考試的及格率\n我認為也都應該要考量,因為有的人很忙,就不一定考試就不說很難考。部長我請教你,就是說如果針對於偏鄉的醫師人力需要做適度的補充,或者是需要去解決這樣的問題,\n那不知道藥師未來在這方面有沒有相關的問題也要同步去克服最近像慈濟慈濟他們在花蓮偏鄉所以就經過努力的爭取以後他們就這個要學習這個他的偵測的機會那未來在偏鄉的部分如果藥師短缺怎麼辦\n有沒有像工會醫學生一樣將來會有工會藥學生類似的這些要因應的措施因為未來不管是要如何去處理醫藥分業單軌制的情形要落實的話那萬一這個人力不足的時候我們不希望看到像今天一樣好像問題出現以後才開始解決的一些方案\n我想這個部分可以分全國性跟地區域性啦齁全國性你就是要有這個量大嘛阿合理的 學到不錯的你就讓他出來來社會服務沒一個去念大學科 相關科系的都是父母的寶貝阿齁你能讓\n如果能夠多多輔導他能夠有工作做而且是能夠工作他的專業不管哪一個醫事人員我覺得我們都真的要去協助這個部分就會在考選部跟各位專科的團體能夠去重新站在國家的立場來思考\n那我覺得把量,整個國家的量充實起來以後,然後再開始鼓勵偏鄉的一個醫事人力,包括民間的醫生,都要鼓勵。藝生也能夠培養成花蓮慈濟,培養在地的醫生。我個人過去幾年來是非常支持\n自己原鄉培養的一個自己培養醫師人力因為那個留任率可能可以到七成那你用光輝的去齁那如果時間夠都照那背的啦可能就沒30%啦所以我覺得這些都要...而且我還要提一個意見就是說老歸於下鄉啦齁\n臺北企業醫療資源非常豐富,臺北市那些以前的專家,現在看病看得很少,是不是我們也可以安排說那個給他鼓勵,反正孩子也不要理他,空巢期嘛,你兩個帶他去台東、去花蓮去做,\n衛生福利部長\n大家可以做好事\n那我們也知道護理師的部分剛剛部長也說明了非常多我們也希望醫療院所有更好的彈線工時的安排等等讓我們的護理師們可以有一點話我自我了解醫療院所包括都講一句話你只要跟我講說這個要給護理他們怎麼會去跟你要拿去呢所以將來只要說要給護理的\n我覺得醫院一毛錢都不會跟你拿不要誤解到醫院會去拿這些錢我個人是從很多醫療院所的領導人他們的意見是這樣子那再來看這個瑞士洛杉磯管理學院他在2024年最近公佈的這個國家競爭力的部分那和醫療相關的就是有一個基礎建設基礎建設部分其實我們的成績非常好\n其實名列前三這個部分就是醫療保健基礎設施符合社會需要意思就是說我們的硬體設備其實是很有競爭力的那這個也剛剛反映出萬一對於這些在已經很充分的硬體設施包括醫院的設置之下新增人口需要床數增加的時候\n那個分布上要怎麼樣去讓這些需求能夠在已經這麼好的基礎之上去做特別的處理另外我們也看到這個醫療保健支出佔GDP的比例相對來講就是差很多才佔了41名\n那這一部分其實反映出來就是我們真的很需要有更多的醫療資源的投入那這一部分也需要請邱部長繼續努力的來做相關的處理那其實我們也看到下一張就是有關於這些公共衛生支出的項目那剛才你也已經說明得很清楚\n再來,如果有辦法把這個相關的項目做適當的盤整以後讓它回歸到這個醫療需求你想想看,剛才這樣算對GDP的占比會有效提升到多少百分比有沒有這樣的一個預估或者是盤算\n我想我們這個部分應該是王委員長期在關注而且你才是專家我們衛務部應該也必須要來盤算因為現在都還在盤算當中但是我相信只要公務預算都投入到公共衛生、傳染病防治、預防保健的話我們相信我們的LDP應該就自然而然就會提升到相當不錯的水準\n好,很期待能夠看到這個數字的具體呈現那還有兩個問題想要請部長這邊幫忙確認就是通訊診療其實今天就要正式實施那對於這個基層機構診所可能會有一些擔心的部分那能不能夠更有效的去提供相關的誘因協助\n讓我們的基層診所也比較安心的去知道怎麼去配合這個需要讓這個社會的民眾可以到達274萬人的過程當中醫療診所是可以扮演重要的角色這個部分王委員提到這個部分我必須要感謝我們基層醫療其實你們是大家用通訊診察用的最多的\n在我們最困難的疫情COVID的疫情最困難的時候即台北市一天最高曾經到達1萬個infected COVID新北市2萬個\n這是如果只要有其中一少部分的人因為他擔心他的小孩子發燒或者自己不舒服就衝到急診只要百分之一每一個急診都爆掉但是我們政府這個時候的政策應該是從兩個當時也是推動這個通訊診療用視訊就會來看他家裡的這個小孩子的發燒狀況生病狀況\n那有什麼問題可以隨時來解決那這個也直擊以過去我們20年來臺灣推動社區醫療群、家庭醫師制度就大家都有一個合作所以我鼓勵你,你鼓勵我今宵才肯來做相關的一個居家甚至到居家通訊的診療穩住了國家的一個疫情所以其實你不用煩惱,你做多少\n現在通信的整條辦法那個我想意思是很清楚都是會站在\n以病人為中心然後協助讓基層醫療能夠很方便的來照顧他原來的病人而醫院方面他只是在照顧他原來他用的通訊設備會比較屬於照顧他原來的病人或者是比較離島、外島等等的偏鄉特殊任務的大致上不至於影響到基層他就近在看病人\n這也是我們臺灣醫療體系必須要堅持的基層醫療就是要原則上要face to face你就是要去瞭解你社區的狀況你就是瞭解甚至他們家有幾隻貓幾隻狗你都知道\n你才能夠知道他的疾病嘛這是基層醫療的價值所在那如果能夠配合有些為高齡化的社會或機構那也給基層醫療來做那也可以應應剛剛COVID的那個時候的狀況我覺得這是這是這一個進步的我們把這樣的一個辦法弄到更進步更符合人民的需要\n最後就是一個有關於公費流感、客流感使用的這個部分因為在6月26號突然就宣布說又可以回歸到這個公費使用所以讓很多基層診所挫折不及\n那這次的這個流感或類流感它的在夏天還這麼樣的猖獗的確是令人無法去預估不過依照我們所看到的這個重症數並沒有緩和下來我們最後一張可以看到的就是\n接管署把這個試用期間從6月26號一直延伸到7月31號那我們期待的是說如果是這樣公費持續來適應這個需求的話那到7月31號截止之前萬一這個疫情沒有真的緩和下來的時候那要公佈這樣的延續或者是要取消是不是能夠再提前一個禮拜就能夠事先一個預告之類的否則的話\n不管是醫療機構或者是醫師或者是我們的面對這樣的可能性的時候無法去試驗或者是無法去掌握這部分再麻煩邱部長或者是有一個好的準備\n各位委員報告,我們這次因應疫情,所以把擴大客流感的用藥,把它從6月26號延長到7月底。主要的原因是我們認為說,這次流感的疫情大概是7月中左右會到尖峰,可是後面可能會逐漸下降。\n響鐘\n","vtt":"WEBVTT\n\n00:00.349 --> 00:26.518\n好謝謝主席有請邱部長請邱部長部長好委員好是剛剛我們事情前委員說目前今天至少會有三位醫療相關醫師的委員來跟你請教相關的問題那也很謝謝趙偉今天特別安排這個專題報告\n\n00:29.059 --> 00:50.395\n讓所有委員也更清楚的知道目前衛福部針對這些重大的議題做了哪一些的努力那也期待未來能夠迅速的回應民眾的需求能夠針對於作實這個健康台灣有更多好的發展的方向那我們先看一下到底目前這些挑戰\n\n00:51.616 --> 01:05.103\n透過今天的報告我們能夠做哪一些的延伸跟進步的機會包括不管是護理師的急診的最近好多好多急診這些量的滿載部分\n\n01:07.084 --> 01:29.301\n藥品供應不足還有因為護理人力不足相關因素之下這個病床數的開床無法滿足這些醫療需求那另外一個比較少被提到的就是藥師人力的不足的部分那這部分希望透過今天的詢問來請教我們有如何因應的對策我們再往下看就會發現其實這個醫療院所缺藥師\n\n01:33.824 --> 02:01.054\n是一個進行式他已經不是未來才會面臨的問題那我們也發現不管這個醫院或者是生技藥廠診所都很需要藥師的幫忙那藥師尤其在COVID-19那段時間協助發放口罩或等等的幫助針對於我們對於COVID-19造成的影響真的很感謝藥師能夠提供非常多的協助讓民眾\n\n02:02.194 --> 02:24.420\n這方面得到很大的安慰跟好的服務可是越來越多的藥師前往社區藥局發展這個是可以理解的因為如果我是藥師或者是我家人有藥師的話我相信做這樣的選擇是非常自然的事情可是我們也擔心往下看我們發現說藥師這種目前的狀況\n\n02:29.961 --> 02:31.102\n在藥師方面嗎是藥師人力的部分\n\n02:58.575 --> 03:17.635\n我先提這個剛剛你現在放這一張我們很期待既然慢慢的要朝向醫藥分裂那社區的藥局大概所有的藥物都能夠盡量備齊那也盡量符合民眾的需要那特別是小孩子的尤其急性病\n\n03:18.696 --> 03:21.118\n那當然大家會shift,跟護理人員一樣嘛\n\n03:40.470 --> 04:08.893\n我們醫生也是一樣,大家一定要找一個,那時候我們做病就要離家近,緊張到那個。當然我們的醫學教育,我們很用心,百年來台灣今天能夠駐守到第一線,去守護偏鄉,能夠肯在加護病房面對病死的病人,肯在安寧病房面對即將過世的病人,\n\n04:10.294 --> 04:36.033\n摸著他的手照顧他這樣子都沒有避開這樣一個非常困難的一個照顧環境這也是我們醫學教育的也是一個核心價值的一個發揮我相信所有的醫事人員的教育都是這樣子那至於說怎麼樣改善一個更好的環境或者是說讓可能有一些考試的及格率\n\n04:37.952 --> 04:56.158\n我認為也都應該要考量,因為有的人很忙,就不一定考試就不說很難考。部長我請教你,就是說如果針對於偏鄉的醫師人力需要做適度的補充,或者是需要去解決這樣的問題,\n\n04:57.378 --> 05:18.530\n那不知道藥師未來在這方面有沒有相關的問題也要同步去克服最近像慈濟慈濟他們在花蓮偏鄉所以就經過努力的爭取以後他們就這個要學習這個他的偵測的機會那未來在偏鄉的部分如果藥師短缺怎麼辦\n\n05:19.631 --> 05:42.455\n有沒有像工會醫學生一樣將來會有工會藥學生類似的這些要因應的措施因為未來不管是要如何去處理醫藥分業單軌制的情形要落實的話那萬一這個人力不足的時候我們不希望看到像今天一樣好像問題出現以後才開始解決的一些方案\n\n05:43.427 --> 06:01.027\n我想這個部分可以分全國性跟地區域性啦齁全國性你就是要有這個量大嘛阿合理的學到不錯的你就讓他出來來社會服務沒一個去念大學科相關科系的都是父母的寶貝阿齁你能讓\n\n06:02.188 --> 06:20.039\n如果能夠多多輔導他能夠有工作做而且是能夠工作他的專業不管哪一個醫事人員我覺得我們都真的要去協助這個部分就會在考選部跟各位專科的團體能夠去重新站在國家的立場來思考\n\n06:21.039 --> 06:33.406\n那我覺得把量,整個國家的量充實起來以後,然後再開始鼓勵偏鄉的一個醫事人力,包括民間的醫生,都要鼓勵。藝生也能夠培養成花蓮慈濟,培養在地的醫生。我個人過去幾年來是非常支持\n\n06:44.867 --> 07:04.932\n自己原鄉培養的一個自己培養醫師人力因為那個留任率可能可以到七成那你用光輝的去齁那如果時間夠都照那背的啦可能就沒30%啦所以我覺得這些都要...而且我還要提一個意見就是說老歸於下鄉啦齁\n\n07:12.472 --> 07:28.370\n臺北企業醫療資源非常豐富,臺北市那些以前的專家,現在看病看得很少,是不是我們也可以安排說那個給他鼓勵,反正孩子也不要理他,空巢期嘛,你兩個帶他去台東、去花蓮去做,\n\n07:30.172 --> 07:31.372\n衛生福利部長\n\n07:48.544 --> 07:49.365\n大家可以做好事\n\n08:08.880 --> 08:31.140\n那我們也知道護理師的部分剛剛部長也說明了非常多我們也希望醫療院所有更好的彈線工時的安排等等讓我們的護理師們可以有一點話我自我了解醫療院所包括都講一句話你只要跟我講說這個要給護理他們怎麼會去跟你要拿去呢所以將來只要說要給護理的\n\n08:34.161 --> 09:01.256\n我覺得醫院一毛錢都不會跟你拿不要誤解到醫院會去拿這些錢我個人是從很多醫療院所的領導人他們的意見是這樣子那再來看這個瑞士洛杉磯管理學院他在2024年最近公佈的這個國家競爭力的部分那和醫療相關的就是有一個基礎建設基礎建設部分其實我們的成績非常好\n\n09:02.416 --> 09:25.051\n其實名列前三這個部分就是醫療保健基礎設施符合社會需要意思就是說我們的硬體設備其實是很有競爭力的那這個也剛剛反映出萬一對於這些在已經很充分的硬體設施包括醫院的設置之下新增人口需要床數增加的時候\n\n09:25.851 --> 09:41.660\n那個分布上要怎麼樣去讓這些需求能夠在已經這麼好的基礎之上去做特別的處理另外我們也看到這個醫療保健支出佔GDP的比例相對來講就是差很多才佔了41名\n\n09:43.061 --> 10:05.252\n那這一部分其實反映出來就是我們真的很需要有更多的醫療資源的投入那這一部分也需要請邱部長繼續努力的來做相關的處理那其實我們也看到下一張就是有關於這些公共衛生支出的項目那剛才你也已經說明得很清楚\n\n10:06.372 --> 10:26.529\n再來,如果有辦法把這個相關的項目做適當的盤整以後讓它回歸到這個醫療需求你想想看,剛才這樣算對GDP的占比會有效提升到多少百分比有沒有這樣的一個預估或者是盤算\n\n10:28.805 --> 10:57.865\n我想我們這個部分應該是王委員長期在關注而且你才是專家我們衛務部應該也必須要來盤算因為現在都還在盤算當中但是我相信只要公務預算都投入到公共衛生、傳染病防治、預防保健的話我們相信我們的LDP應該就自然而然就會提升到相當不錯的水準\n\n10:58.885 --> 11:22.133\n好,很期待能夠看到這個數字的具體呈現那還有兩個問題想要請部長這邊幫忙確認就是通訊診療其實今天就要正式實施那對於這個基層機構診所可能會有一些擔心的部分那能不能夠更有效的去提供相關的誘因協助\n\n11:23.053 --> 11:49.198\n讓我們的基層診所也比較安心的去知道怎麼去配合這個需要讓這個社會的民眾可以到達274萬人的過程當中醫療診所是可以扮演重要的角色這個部分王委員提到這個部分我必須要感謝我們基層醫療其實你們是大家用通訊診察用的最多的\n\n11:50.495 --> 12:01.895\n在我們最困難的疫情COVID的疫情最困難的時候即台北市一天最高曾經到達1萬個infectedCOVID新北市2萬個\n\n12:04.085 --> 12:28.741\n這是如果只要有其中一少部分的人因為他擔心他的小孩子發燒或者自己不舒服就衝到急診只要百分之一每一個急診都爆掉但是我們政府這個時候的政策應該是從兩個當時也是推動這個通訊診療用視訊就會來看他家裡的這個小孩子的發燒狀況生病狀況\n\n12:31.062 --> 12:57.864\n那有什麼問題可以隨時來解決那這個也直擊以過去我們20年來臺灣推動社區醫療群、家庭醫師制度就大家都有一個合作所以我鼓勵你,你鼓勵我今宵才肯來做相關的一個居家甚至到居家通訊的診療穩住了國家的一個疫情所以其實你不用煩惱,你做多少\n\n13:00.427 --> 13:05.275\n現在通信的整條辦法那個我想意思是很清楚都是會站在\n\n13:06.328 --> 13:34.257\n以病人為中心然後協助讓基層醫療能夠很方便的來照顧他原來的病人而醫院方面他只是在照顧他原來他用的通訊設備會比較屬於照顧他原來的病人或者是比較離島、外島等等的偏鄉特殊任務的大致上不至於影響到基層他就近在看病人\n\n13:34.837 --> 13:48.893\n這也是我們臺灣醫療體系必須要堅持的基層醫療就是要原則上要facetoface你就是要去瞭解你社區的狀況你就是瞭解甚至他們家有幾隻貓幾隻狗你都知道\n\n13:49.554 --> 14:10.858\n你才能夠知道他的疾病嘛這是基層醫療的價值所在那如果能夠配合有些為高齡化的社會或機構那也給基層醫療來做那也可以應應剛剛COVID的那個時候的狀況我覺得這是這是這一個進步的我們把這樣的一個辦法弄到更進步更符合人民的需要\n\n14:12.680 --> 14:28.536\n最後就是一個有關於公費流感、客流感使用的這個部分因為在6月26號突然就宣布說又可以回歸到這個公費使用所以讓很多基層診所挫折不及\n\n14:29.156 --> 14:46.245\n那這次的這個流感或類流感它的在夏天還這麼樣的猖獗的確是令人無法去預估不過依照我們所看到的這個重症數並沒有緩和下來我們最後一張可以看到的就是\n\n14:49.046 --> 15:15.654\n接管署把這個試用期間從6月26號一直延伸到7月31號那我們期待的是說如果是這樣公費持續來適應這個需求的話那到7月31號截止之前萬一這個疫情沒有真的緩和下來的時候那要公佈這樣的延續或者是要取消是不是能夠再提前一個禮拜就能夠事先一個預告之類的否則的話\n\n15:17.294 --> 15:31.383\n不管是醫療機構或者是醫師或者是我們的面對這樣的可能性的時候無法去試驗或者是無法去掌握這部分再麻煩邱部長或者是有一個好的準備\n\n15:34.993 --> 15:55.234\n各位委員報告,我們這次因應疫情,所以把擴大客流感的用藥,把它從6月26號延長到7月底。主要的原因是我們認為說,這次流感的疫情大概是7月中左右會到尖峰,可是後面可能會逐漸下降。\n\n","segments":[{"start":0.349,"end":26.518,"text":"好 謝謝主席 有請邱部長請邱部長部長好委員好是 剛剛我們事情前委員說目前今天至少會有三位醫療相關醫師的委員來跟你請教相關的問題那也很謝謝趙偉今天特別安排這個專題報告"},{"start":29.059,"end":50.395,"text":"讓所有委員也更清楚的知道目前衛福部針對這些重大的議題做了哪一些的努力那也期待未來能夠迅速的回應民眾的需求能夠針對於作實這個健康台灣有更多好的發展的方向那我們先看一下到底目前這些挑戰"},{"start":51.616,"end":65.103,"text":"透過今天的報告我們能夠做哪一些的延伸跟進步的機會包括不管是護理師的急診的最近好多好多急診這些量的滿載部分"},{"start":67.084,"end":89.301,"text":"藥品供應不足還有因為護理人力不足相關因素之下這個病床數的開床無法滿足這些醫療需求那另外一個比較少被提到的就是藥師人力的不足的部分那這部分希望透過今天的詢問來請教我們有如何因應的對策我們再往下看就會發現其實這個醫療院所缺藥師"},{"start":93.824,"end":121.054,"text":"是一個進行式他已經不是未來才會面臨的問題那我們也發現不管這個醫院或者是生技藥廠診所都很需要藥師的幫忙那藥師尤其在COVID-19那段時間協助發放口罩或等等的幫助針對於我們對於COVID-19造成的影響真的很感謝藥師能夠提供非常多的協助讓民眾"},{"start":122.194,"end":144.42,"text":"這方面得到很大的安慰跟好的服務可是越來越多的藥師前往社區藥局發展這個是可以理解的因為如果我是藥師或者是我家人有藥師的話我相信做這樣的選擇是非常自然的事情可是我們也擔心往下看我們發現說藥師這種目前的狀況"},{"start":149.961,"end":151.102,"text":"在藥師方面嗎是藥師人力的部分"},{"start":178.575,"end":197.635,"text":"我先提這個剛剛你現在放這一張我們很期待既然慢慢的要朝向醫藥分裂那社區的藥局大概所有的藥物都能夠盡量備齊那也盡量符合民眾的需要那特別是小孩子的尤其急性病"},{"start":198.696,"end":201.118,"text":"那當然大家會shift,跟護理人員一樣嘛"},{"start":220.47,"end":248.893,"text":"我們醫生也是一樣,大家一定要找一個,那時候我們做病就要離家近,緊張到那個。當然我們的醫學教育,我們很用心,百年來台灣今天能夠駐守到第一線,去守護偏鄉,能夠肯在加護病房面對病死的病人,肯在安寧病房面對即將過世的病人,"},{"start":250.294,"end":276.033,"text":"摸著他的手照顧他這樣子都沒有避開這樣一個非常困難的一個照顧環境這也是我們醫學教育的也是一個核心價值的一個發揮我相信所有的醫事人員的教育都是這樣子那至於說怎麼樣改善一個更好的環境或者是說讓可能有一些考試的及格率"},{"start":277.952,"end":296.158,"text":"我認為也都應該要考量,因為有的人很忙,就不一定考試就不說很難考。部長我請教你,就是說如果針對於偏鄉的醫師人力需要做適度的補充,或者是需要去解決這樣的問題,"},{"start":297.378,"end":318.53,"text":"那不知道藥師未來在這方面有沒有相關的問題也要同步去克服最近像慈濟慈濟他們在花蓮偏鄉所以就經過努力的爭取以後他們就這個要學習這個他的偵測的機會那未來在偏鄉的部分如果藥師短缺怎麼辦"},{"start":319.631,"end":342.455,"text":"有沒有像工會醫學生一樣將來會有工會藥學生類似的這些要因應的措施因為未來不管是要如何去處理醫藥分業單軌制的情形要落實的話那萬一這個人力不足的時候我們不希望看到像今天一樣好像問題出現以後才開始解決的一些方案"},{"start":343.427,"end":361.027,"text":"我想這個部分可以分全國性跟地區域性啦齁全國性你就是要有這個量大嘛阿合理的 學到不錯的你就讓他出來來社會服務沒一個去念大學科 相關科系的都是父母的寶貝阿齁你能讓"},{"start":362.188,"end":380.039,"text":"如果能夠多多輔導他能夠有工作做而且是能夠工作他的專業不管哪一個醫事人員我覺得我們都真的要去協助這個部分就會在考選部跟各位專科的團體能夠去重新站在國家的立場來思考"},{"start":381.039,"end":393.406,"text":"那我覺得把量,整個國家的量充實起來以後,然後再開始鼓勵偏鄉的一個醫事人力,包括民間的醫生,都要鼓勵。藝生也能夠培養成花蓮慈濟,培養在地的醫生。我個人過去幾年來是非常支持"},{"start":404.867,"end":424.932,"text":"自己原鄉培養的一個自己培養醫師人力因為那個留任率可能可以到七成那你用光輝的去齁那如果時間夠都照那背的啦可能就沒30%啦所以我覺得這些都要...而且我還要提一個意見就是說老歸於下鄉啦齁"},{"start":432.472,"end":448.37,"text":"臺北企業醫療資源非常豐富,臺北市那些以前的專家,現在看病看得很少,是不是我們也可以安排說那個給他鼓勵,反正孩子也不要理他,空巢期嘛,你兩個帶他去台東、去花蓮去做,"},{"start":450.172,"end":451.372,"text":"衛生福利部長"},{"start":468.544,"end":469.365,"text":"大家可以做好事"},{"start":488.88,"end":511.14,"text":"那我們也知道護理師的部分剛剛部長也說明了非常多我們也希望醫療院所有更好的彈線工時的安排等等讓我們的護理師們可以有一點話我自我了解醫療院所包括都講一句話你只要跟我講說這個要給護理他們怎麼會去跟你要拿去呢所以將來只要說要給護理的"},{"start":514.161,"end":541.256,"text":"我覺得醫院一毛錢都不會跟你拿不要誤解到醫院會去拿這些錢我個人是從很多醫療院所的領導人他們的意見是這樣子那再來看這個瑞士洛杉磯管理學院他在2024年最近公佈的這個國家競爭力的部分那和醫療相關的就是有一個基礎建設基礎建設部分其實我們的成績非常好"},{"start":542.416,"end":565.051,"text":"其實名列前三這個部分就是醫療保健基礎設施符合社會需要意思就是說我們的硬體設備其實是很有競爭力的那這個也剛剛反映出萬一對於這些在已經很充分的硬體設施包括醫院的設置之下新增人口需要床數增加的時候"},{"start":565.851,"end":581.66,"text":"那個分布上要怎麼樣去讓這些需求能夠在已經這麼好的基礎之上去做特別的處理另外我們也看到這個醫療保健支出佔GDP的比例相對來講就是差很多才佔了41名"},{"start":583.061,"end":605.252,"text":"那這一部分其實反映出來就是我們真的很需要有更多的醫療資源的投入那這一部分也需要請邱部長繼續努力的來做相關的處理那其實我們也看到下一張就是有關於這些公共衛生支出的項目那剛才你也已經說明得很清楚"},{"start":606.372,"end":626.529,"text":"再來,如果有辦法把這個相關的項目做適當的盤整以後讓它回歸到這個醫療需求你想想看,剛才這樣算對GDP的占比會有效提升到多少百分比有沒有這樣的一個預估或者是盤算"},{"start":628.805,"end":657.865,"text":"我想我們這個部分應該是王委員長期在關注而且你才是專家我們衛務部應該也必須要來盤算因為現在都還在盤算當中但是我相信只要公務預算都投入到公共衛生、傳染病防治、預防保健的話我們相信我們的LDP應該就自然而然就會提升到相當不錯的水準"},{"start":658.885,"end":682.133,"text":"好,很期待能夠看到這個數字的具體呈現那還有兩個問題想要請部長這邊幫忙確認就是通訊診療其實今天就要正式實施那對於這個基層機構診所可能會有一些擔心的部分那能不能夠更有效的去提供相關的誘因協助"},{"start":683.053,"end":709.198,"text":"讓我們的基層診所也比較安心的去知道怎麼去配合這個需要讓這個社會的民眾可以到達274萬人的過程當中醫療診所是可以扮演重要的角色這個部分王委員提到這個部分我必須要感謝我們基層醫療其實你們是大家用通訊診察用的最多的"},{"start":710.495,"end":721.895,"text":"在我們最困難的疫情COVID的疫情最困難的時候即台北市一天最高曾經到達1萬個infected COVID新北市2萬個"},{"start":724.085,"end":748.741,"text":"這是如果只要有其中一少部分的人因為他擔心他的小孩子發燒或者自己不舒服就衝到急診只要百分之一每一個急診都爆掉但是我們政府這個時候的政策應該是從兩個當時也是推動這個通訊診療用視訊就會來看他家裡的這個小孩子的發燒狀況生病狀況"},{"start":751.062,"end":777.864,"text":"那有什麼問題可以隨時來解決那這個也直擊以過去我們20年來臺灣推動社區醫療群、家庭醫師制度就大家都有一個合作所以我鼓勵你,你鼓勵我今宵才肯來做相關的一個居家甚至到居家通訊的診療穩住了國家的一個疫情所以其實你不用煩惱,你做多少"},{"start":780.427,"end":785.275,"text":"現在通信的整條辦法那個我想意思是很清楚都是會站在"},{"start":786.328,"end":814.257,"text":"以病人為中心然後協助讓基層醫療能夠很方便的來照顧他原來的病人而醫院方面他只是在照顧他原來他用的通訊設備會比較屬於照顧他原來的病人或者是比較離島、外島等等的偏鄉特殊任務的大致上不至於影響到基層他就近在看病人"},{"start":814.837,"end":828.893,"text":"這也是我們臺灣醫療體系必須要堅持的基層醫療就是要原則上要face to face你就是要去瞭解你社區的狀況你就是瞭解甚至他們家有幾隻貓幾隻狗你都知道"},{"start":829.554,"end":850.858,"text":"你才能夠知道他的疾病嘛這是基層醫療的價值所在那如果能夠配合有些為高齡化的社會或機構那也給基層醫療來做那也可以應應剛剛COVID的那個時候的狀況我覺得這是這是這一個進步的我們把這樣的一個辦法弄到更進步更符合人民的需要"},{"start":852.68,"end":868.536,"text":"最後就是一個有關於公費流感、客流感使用的這個部分因為在6月26號突然就宣布說又可以回歸到這個公費使用所以讓很多基層診所挫折不及"},{"start":869.156,"end":886.245,"text":"那這次的這個流感或類流感它的在夏天還這麼樣的猖獗的確是令人無法去預估不過依照我們所看到的這個重症數並沒有緩和下來我們最後一張可以看到的就是"},{"start":889.046,"end":915.654,"text":"接管署把這個試用期間從6月26號一直延伸到7月31號那我們期待的是說如果是這樣公費持續來適應這個需求的話那到7月31號截止之前萬一這個疫情沒有真的緩和下來的時候那要公佈這樣的延續或者是要取消是不是能夠再提前一個禮拜就能夠事先一個預告之類的否則的話"},{"start":917.294,"end":931.383,"text":"不管是醫療機構或者是醫師或者是我們的面對這樣的可能性的時候無法去試驗或者是無法去掌握這部分再麻煩邱部長或者是有一個好的準備"},{"start":934.993,"end":955.234,"text":"各位委員報告,我們這次因應疫情,所以把擴大客流感的用藥,把它從6月26號延長到7月底。主要的原因是我們認為說,這次流感的疫情大概是7月中左右會到尖峰,可是後面可能會逐漸下降。"},{"start":956.015,"end":984.36,"text":"響鐘"}]}}}}