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{\"word\": \"量\", \"start\": 641.728, \"end\": 641.748, \"score\": 0.0}, {\"word\": \"項\"}, {\"word\": \"目\", \"start\": 641.748, \"end\": 641.928, \"score\": 0.704}, {\"word\": \"我\", \"start\": 641.928, \"end\": 641.948, \"score\": 0.001}, {\"word\": \"關\"}, {\"word\": \"起\", \"start\": 641.948, \"end\": 641.968, \"score\": 0.0}, {\"word\": \"來\"}, {\"word\": \"我\", \"start\": 641.968, \"end\": 642.128, \"score\": 0.961}, {\"word\": \"們\"}, {\"word\": \"看\", \"start\": 642.128, \"end\": 642.148, \"score\": 0.0}, {\"word\": \"6\"}, {\"word\": \"7\"}, {\"word\": \"8\"}, {\"word\": \"9\"}, {\"word\": \"點\"}]}, {\"start\": 656.936, \"end\": 671.167, \"text\": \"醫院應設防火管理人等6、7、8、9因依準診療環境建築病人及第一線應變人員特色規劃符合所需的檢災預防準備設施第6、7病人不亦疏散以採取就地避難的診療部門\", \"words\": [{\"word\": \"醫\"}, {\"word\": \"院\", \"start\": 656.936, \"end\": 657.696, \"score\": 0.706}, {\"word\": \"應\"}, {\"word\": \"設\"}, {\"word\": \"防\", \"start\": 657.696, \"end\": 657.816, \"score\": 0.844}, {\"word\": \"火\", \"start\": 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\"採\"}, {\"word\": \"取\", \"start\": 669.526, \"end\": 669.546, \"score\": 0.0}, {\"word\": \"就\", \"start\": 669.546, \"end\": 670.127, \"score\": 0.911}, {\"word\": \"地\", \"start\": 670.127, \"end\": 670.727, \"score\": 0.958}, {\"word\": \"避\", \"start\": 670.727, \"end\": 671.087, \"score\": 0.942}, {\"word\": \"難\"}, {\"word\": \"的\", \"start\": 671.087, \"end\": 671.147, \"score\": 0.596}, {\"word\": \"診\"}, {\"word\": \"療\"}, {\"word\": \"部\", \"start\": 671.147, \"end\": 671.167, \"score\": 0.0}, {\"word\": \"門\"}]}, {\"start\": 676.852, \"end\": 691.883, \"text\": \"然後具有適當的防火區劃及病人持續的照顧的備援計畫然後每年定期檢查火災災害的檢災預防和等等這樣子這些以上的評鑑都很棒很棒但是備註不要看備註第一點\", \"words\": [{\"word\": \"然\", \"start\": 676.852, \"end\": 677.032, \"score\": 0.734}, {\"word\": \"後\", \"start\": 677.032, \"end\": 677.052, \"score\": 0.0}, {\"word\": \"具\", \"start\": 677.052, \"end\": 677.192, \"score\": 0.863}, {\"word\": \"有\", \"start\": 677.192, \"end\": 677.613, \"score\": 0.768}, {\"word\": \"適\"}, {\"word\": 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680.655, \"end\": 680.675, \"score\": 0.0}, {\"word\": \"後\", \"start\": 680.675, \"end\": 681.896, \"score\": 0.879}, {\"word\": \"每\", \"start\": 681.896, \"end\": 682.036, \"score\": 0.681}, {\"word\": \"年\", \"start\": 682.036, \"end\": 682.276, \"score\": 0.871}, {\"word\": \"定\", \"start\": 682.276, \"end\": 682.656, \"score\": 0.937}, {\"word\": \"期\", \"start\": 682.656, \"end\": 683.097, \"score\": 0.719}, {\"word\": \"檢\"}, {\"word\": \"查\", \"start\": 683.097, \"end\": 683.377, \"score\": 0.892}, {\"word\": \"火\", \"start\": 683.377, \"end\": 683.917, \"score\": 0.86}, {\"word\": \"災\"}, {\"word\": \"災\"}, {\"word\": \"害\", \"start\": 683.917, \"end\": 684.057, \"score\": 0.611}, {\"word\": \"的\", \"start\": 684.057, \"end\": 684.778, \"score\": 0.8}, {\"word\": \"檢\"}, {\"word\": \"災\"}, {\"word\": \"預\"}, {\"word\": \"防\", \"start\": 684.778, \"end\": 684.958, \"score\": 0.825}, {\"word\": \"和\", \"start\": 684.958, \"end\": 685.499, \"score\": 0.961}, {\"word\": \"等\", 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{\"word\": \"出\", \"start\": 735.418, \"end\": 736.339, \"score\": 0.886}, {\"word\": \"來\"}, {\"word\": \"都\", \"start\": 736.339, \"end\": 736.559, \"score\": 0.833}, {\"word\": \"沒\", \"start\": 736.559, \"end\": 737.619, \"score\": 0.843}, {\"word\": \"關\"}, {\"word\": \"係\"}, {\"word\": \"因\", \"start\": 737.619, \"end\": 738.859, \"score\": 0.855}, {\"word\": \"為\"}, {\"word\": \"這\"}, {\"word\": \"個\"}, {\"word\": \"叫\", \"start\": 738.859, \"end\": 739.08, \"score\": 0.967}, {\"word\": \"做\", \"start\": 739.08, \"end\": 739.1, \"score\": 0.748}, {\"word\": \"視\"}, {\"word\": \"頻\"}]}, {\"start\": 740.76, \"end\": 740.92, \"text\": \"所以：\", \"words\": [{\"word\": \"所\", \"start\": 740.76, \"end\": 740.9, \"score\": 0.852}, {\"word\": \"以\", \"start\": 740.9, \"end\": 740.92, \"score\": 0.0}, {\"word\": \"：\"}]}, {\"start\": 759.076, \"end\": 759.256, \"text\": \"報告委員 我們所有的\", \"words\": [{\"word\": \"報\"}, {\"word\": \"告\", \"start\": 759.076, \"end\": 759.156, \"score\": 0.75}, 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\"有\", \"start\": 843.958, \"end\": 843.978, \"score\": 0.0}, {\"word\": \"4\"}, {\"word\": \"1\"}, {\"word\": \"7\"}, {\"word\": \"家\", \"start\": 843.978, \"end\": 843.998, \"score\": 0.0}, {\"word\": \"那\", \"start\": 843.998, \"end\": 844.118, \"score\": 0.827}, {\"word\": \"醫\"}, {\"word\": \"院\", \"start\": 844.118, \"end\": 844.198, \"score\": 0.75}, {\"word\": \"評\"}, {\"word\": \"鑑\"}, {\"word\": \"校\", \"start\": 844.198, \"end\": 844.218, \"score\": 0.0}, {\"word\": \"期\", \"start\": 844.218, \"end\": 844.238, \"score\": 0.0}, {\"word\": \"在\", \"start\": 844.238, \"end\": 844.379, \"score\": 0.917}, {\"word\": \"今\", \"start\": 844.379, \"end\": 844.439, \"score\": 0.666}, {\"word\": \"年\", \"start\": 844.439, \"end\": 844.459, \"score\": 0.0}, {\"word\": \"年\", \"start\": 844.459, \"end\": 844.479, \"score\": 0.0}, {\"word\": \"底\", \"start\": 844.479, \"end\": 844.559, \"score\": 0.749}, {\"word\": \"要\", \"start\": 844.559, \"end\": 844.579, \"score\": 0.0}, {\"word\": 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00:01:01,405\n但是我們不能當偽善和鄉怨的人這個問題很重要我們不是針對一家醫院我們要針對整個全部的醫院的安全如果在這裡的同事立委都不講話我不知道這個醫院安全的把關要怎麼進行我們先看第一張照片這張照片看起來讓我們覺得不可思議因為起火點是在前面這一棟機殿\n\n4\n00:01:03,480 --> 00:01:25,375\n但是死的是在後面不同棟這對醫院安全來講他不是火災燒死他是濃煙嗆死了這不要講醫院安全連公共安全這樣子的這樣的結果這樣的悲劇都是不應該發生的更何況是醫院或是護理之家\n\n5\n00:01:26,816 --> 00:01:29,660\n這個防火區劃是基本的配備怎麼會是這樣子的發生不同洞還濃煙嗆死嗆到隔壁洞\n\n6\n00:01:37,826 --> 00:02:03,200\n這現在在2024年的現在如果你說發生在1990幾年大家都還沒有法規都還可以覺得有可能可是2024年的醫院安全的配備不應該是這樣法律上規定也不是這樣子所以呢甚至是在加護病房可能這個死亡了4個人就是加護病房\n\n7\n00:02:20,735 --> 00:02:34,932\n委員我想火災發生的火場鑑定這個要由專家來鑑定那接下來檢調也已經去了解已經去調查了那檢調會根據現在這樣說跟衛福部都沒有關係嗎可能衛福部\n\n8\n00:02:37,395 --> 00:02:38,597\n我先把順序講一下,衛生局會做行政的調查\n\n9\n00:02:56,638 --> 00:03:11,483\n我現在問你啦10月4號東森獨家新聞說安泰醫院的評鑑今年年底到期8月底才剛進行下一階段的評鑑但是去評鑑的衛福部的中央主管機關已經發現有什麼問題了結果已經被醫策會委員提出檢討改進了\n\n10\n00:03:17,165 --> 00:03:29,255\n但是呢,醫策委從8月底他知道這個問題有嚴重的公共安全問題到發生之間沒有作為。而我現在問你,他到底是說他有什麼問題?部長你知道嗎?你知道嗎?你的醫策委去評過,8月就去評過安泰醫院,如果這個新聞沒有講錯的話,來你說,到底是發生什麼問題?當時就看到了。\n\n11\n00:03:44,685 --> 00:04:12,427\n當時的那個委員有提醒的部分不曉得那個這篇補充一下那個委員那邊是有補充意見就是那個這家可能要就是他的那個一些你們都不知道公美菜大家公公哩哩郎郎不是啦因為他的那個有一些那個人員疏散部分建議他們還是要有一些具體的那個\n\n12\n00:04:13,134 --> 00:04:15,755\n人員疏散而已嗎?所以你們第一個你們證實了的確在8月就是有進場去評鑑第二個你們也證實了評鑑的時候就看到有管線老舊和疏散動線等病安的部分好你們都看當時就看到但從8月到發生火災的10月3號之間我要問你們你們有要求醫療院所應立即改善嗎?\n\n13\n00:04:43,547 --> 00:04:51,392\n有沒有要求他們做我應立即改善什麼你都沒有要求結果到10月3號就發生這樣欸人命欸八條人命欸蛤有沒有要求他們做什麼所以今天不是只有說消防局去調查火災原因事故這都事後的事情了我現在講事發以前已經看到了我們要求他們做了什麼呢\n\n14\n00:05:12,718 --> 00:05:32,885\n來請那個護師跟委員報告一下在醫院評鑑實地作業的時候他會用各項目去做查核那實際上進行的時候在查核項目現場當天沒有特別提出不合合的項目但委員通常就會就品質面求好心切會有一些建議意見並且在與\n\n15\n00:05:34,906 --> 00:05:52,250\n品質面求好心切聽好所以管線老舊跟疏散動線等病安問題是求好心切的標準照你的講法這種話你講得出口嗎?部長你來講要求管線老舊和疏散動線這個問題是我們醫策會這個建議的意見是吹毛求癡求好心切還是應該是標配?\n\n16\n00:06:06,450 --> 00:06:19,314\n因為評鑑有評鑑的標準項目,那這個大概評鑑﹖等一下我會跟你交流,評鑑的標準項目才是大問題。那我現在問你說管線老舊速戰動線有問題這種東西是標配還是選配就好了?\n\n17\n00:06:25,420 --> 00:06:38,383\n這當然從那個病人的安全方面我們一定要做到但是在醫院的評鑑裡面他有一定的經過多少年多少專家你不要再說這種五四三都沒有重點你看這張圖會比較老實一點\n\n18\n00:06:44,705 --> 00:07:13,217\n配電式起火的濃煙讓隔壁棟的5樓10樓11樓這樣子傷亡欸不要忘了我們啊這個這個新營醫院的北門分院還有新北市台北醫院的護理之家這個都死亡多少人呢這重大傷亡我們都知道醫院護理之家裡面你叫這些病人請可以看啊在家務病房的人他們怎麼逃生啊\n\n19\n00:07:14,212 --> 00:07:29,579\n他們就跟失能的人一樣他沒有辦法逃生的欸所以你們現在在講這個這麼嚴肅的事情您現在跟他哥哥事不關己而且內湖的私人養護所死3個2018年台北護理之家死了10幾個\n\n20\n00:07:32,481 --> 00:07:48,490\n當時消防署就推動了修法不論新建或變更的長照機構都要配備自動灑水設備火警自動報警裝備以及設置119火災通報裝置但是我請問你部長醫院有沒有在其中他講的是護理之家長照機構請問醫院當時為什麼排除在外\n\n21\n00:07:57,291 --> 00:08:18,980\n為什麼醫院不再強制配置自動灑水設備、火警、自動警報設備的範圍呢?醫院不需要嗎?醫院這些家戶病房的人可以自動逃生嗎?為什麼他們不需要這些裝置基本配備、必要的配備來保護這些看病的人?\n\n22\n00:08:21,032 --> 00:08:35,061\n你們的次長有講過一句話喔林靜儀次長說由於這次事故造成重大傷亡很多人擔心醫院安全欸對此感到疑慮你們的次長都這樣子講了可是\n\n23\n00:08:36,022 --> 00:08:53,701\n出一句詞沒好捏有黨我媽想吼啟動這個醫癒法的第35條什麼法醫療在衛生部我現在在講的是消防法捏那跟委員報告一下當天如果在評鑑的時候其實消防局他們提出來的在\n\n24\n00:08:54,882 --> 00:08:55,862\n為什麼當時的衛福部認為醫院不需要?你告訴我。\n\n25\n00:09:22,961 --> 00:09:45,706\n好那這樣子好了安泰是發生這個事情因為當時發生火車是護理之家所以特別負責當時發生護理之家然後都沒有想到醫院這就是現在的衛福部的能力喔專業喔老湖機構跟那個我現在當時你們就沒有專業不專業只想到護理之家沒想到醫院那現在你認為醫院醫院已經有一個非常說實在已經有一個非常好的一個評鑑\n\n26\n00:09:47,166 --> 00:09:56,534\n醫院有非常好的評鑑,好,那我問你,你就安泰醫院再重新評鑑一次,你覺不覺得他們會通過你們的評鑑?通過評鑑是要那個,整個審理...你不要在這裡齁,都沒專業啦,保證!您這位或這位醫生會?\n\n27\n00:10:12,782 --> 00:10:25,418\n醫師師副師長醫師師副師長來醫學中心就診民眾的命是命區域醫院第7醫院的人命不是命安泰中心是區域醫院我為什麼講這一句話因為呢\n\n28\n00:10:28,121 --> 00:10:42,148\n我們醫學中心的評鑑當然標準都比區域醫院還要高可是就區域醫院你們的醫院評鑑基準及評量項目的第一篇經營管理第1.7章風險和危機管理中的1.7.4的項目醫院應指定專責人員研擬火災的減災預防和準備措施評量項目我關起來我們看6789點\n\n29\n00:10:56,936 --> 00:11:11,167\n醫院應設防火管理人等6、7、8、9因依準診療環境建築病人及第一線應變人員特色規劃符合所需的檢災預防準備設施第6、7病人不亦疏散以採取就地避難的診療部門\n\n30\n00:11:16,852 --> 00:11:31,883\n然後具有適當的防火區劃及病人持續的照顧的備援計畫然後每年定期檢查火災災害的檢災預防和等等這樣子這些以上的評鑑都很棒很棒但是備註不要看備註第一點\n\n31\n00:11:33,188 --> 00:11:39,671\n本條為視頻條文,評鑑結果不納入評鑑成績計算。請問不納入評鑑成績計算的評鑑,這樣子的安泰醫院這些項目評鑑不合格會納入計算嗎?不會。我跟你講,不會。\n\n32\n00:11:57,412 --> 00:12:19,100\n所以如果安泰醫院在評估說他們有沒有減災預防準備措施然後他們的不易疏散就地避難的這個計畫提的不好如果說他們這一些通通都沒有改善的成效沒有提出來都沒關係因為這個叫做視頻\n\n33\n00:12:20,760 --> 00:12:20,920\n所以：\n\n34\n00:12:39,076 --> 00:12:39,256\n報告委員我們所有的\n\n35\n00:12:59,123 --> 00:13:22,930\n所以難怪你們副司長說這個是求好心切因為評鑑沒有管到這麼多這個視頻不納入成績如果你要求這個地方要做到好你如果要求這幾點要做到好就是你副司長講的叫求好心切站在病人站在這間死亡的病患的家屬的立場情何以堪\n\n36\n00:13:26,935 --> 00:13:30,245\n地區醫院區醫院這樣子可以嗎保電\n\n37\n00:13:32,569 --> 00:13:41,772\n當然我們病人的生命我們都要完全的珍惜那你不要說這種口號啦我現在要問你說啊好你有沒有掌握目前還有公安問題的醫院還有哪一些?還有幾家?你不要再說喔剛好七個還發生一件問題欸不要忘了一個颱風來兩家醫院起火欸\n\n38\n00:13:57,932 --> 00:14:04,739\n因為這些經驗我們一定會深切地去檢討整個...我現在不是要問你這個問題答非所問來浪費我們的時間部長依社會網站講106到112年合格醫院名單有417家那醫院評鑑校期在今年年底要到的有117家\n\n39\n00:14:19,694 --> 00:14:33,980\n所以呢,所有四分之一的家屬的平建都在年底要到期,你有沒有掌握到這117家要到期要平建的,有哪些跟安泰醫院一樣管線老舊、疏散動線還有病安的狀況有問題的,你們現在有沒有掌握啦?還是要等平建放房錢啊,放著等醫院出事燒起來?\n\n40\n00:14:44,614 --> 00:15:05,317\n還是說這消防署的問題跟你們無關?你們根本就是這樣的態度啊所以衛福部都不用監督不用輔導責任病患的生命安全在你們官員裡面都是評鑑後醫院該負的責任嗎?都跟政府無關是醫院的責任而已嗎?如果只是醫院的責任的話那我們評鑑是算什麼?\n\n41\n00:15:07,145 --> 00:15:22,678\n而醫院評鑑的翻修制度,醫院評鑑的這個問題標準已經多久沒有改了?我現在問你,請你回答我第一個問題,還有哪幾家醫院,初步看起來真的還有問題的?\n\n42\n00:15:24,656 --> 00:15:25,016\n當然也是要...\n\n43\n00:15:48,931 --> 00:16:13,327\n你們醫院評鑑尤其醫學中心評鑑的重點就是醫院的公共安全了怎麼會說是消防局的消防署的問題?醫院的公共安全都是重點啦只是說他要求的一個要求當然是最安全的情況但是...所以你的意思是說災災跟你衛福部沒有關係消息整個人跟衛福部也沒有關係都消防署會怕嗎?沒有沒有我明明要講就是說層層來\n\n44\n00:16:15,448 --> 00:16:18,751\n整層推卸啦!我現在是要問你,現在還有幾件病,它有類似的問題?啊你回答不出來說這都主要主責是消防署\n\n45\n00:16:28,956 --> 00:16:31,178\n你們的醫院評鑑標準已經多久沒改了?\n\n46\n00:16:54,786 --> 00:16:59,158\n這一輪是到112要啟動下一輪的調整你們的副司長\n\n47\n00:17:01,707 --> 00:17:03,748\n我現在問妳說妳的評鑑標準\n\n48\n00:17:25,938 --> 00:17:26,879\n這次我了解一定都有改\n\n49\n00:17:47,055 --> 00:17:56,564\n對那當時王碧正次長也講說他兩年內要訂出初稿要進行視頻三年後要下一次醫院評鑑請問這個這個標準項目會改變那個他們離開以後啊這個評鑑基準的調整他的翻修進度現在到哪裡了\n\n50\n00:18:06,897 --> 00:18:08,178\n我們還是補充一下第一個我們已經籌組好這個改革的小組\n\n51\n00:18:27,566 --> 00:18:30,407\n那這一次發生兩起醫院火災事件後,你們全部覺得醫院平建還有哪些地方可以再調整?\n\n52\n00:18:57,130 --> 00:18:57,250\n醫療機構的緊急應變手冊\n\n53\n00:19:24,504 --> 00:19:47,544\n應該要考慮復合式災難的情境火災加颱風而且要做實際的演練在一次颱風天你在疏散的時候你一般室內火災疏散戶外的空旷處可是今天洪災來你要疏散到哪裡去啊只能在走廊一樓的戶外的空旷處不可得你就只能在急診室門口的走廊\n\n54\n00:19:50,846 --> 00:20:13,093\n緊急救災消防警消的這些救災要進行還要一邊救治病患還要應對家屬詢問還要面對強風驟雨對病患的影響所以這種複合式災難到底應該要怎麼樣這種情境都要各種情境的scenario的analysis都必須要放進去\n\n55\n00:20:14,073 --> 00:20:31,734\n對不對?你們的評鑑在這種狀況裡面是不是要要求加強演練這種東西?那有沒有互併比的問題啊?互併比現在在醫學中心都還比條件都還比區域醫院還要好。區域醫院是不是因為人力太少了互併比不足啦?或是交班時間啊?\n\n56\n00:20:33,135 --> 00:20:51,629\n所以沒有人力談到疏散才會造成這麼大的傷亡可是呢這個問題沒有重視的話讓每一個到醫院看病的或是重症要看病的人也都是非常的負險啊再來最重要的是本來剛才那一張防火區化跟消防排煙系統問題失去功能\n\n57\n00:20:55,738 --> 00:21:15,784\n剛才第一張啊垂直防煙區防煙區化如果你做得好的話它不應該往上竄不應該它鎖在二樓如果水平的防煙區化做得好它只在機房也不會跑到隔壁棟所以這個東西防火區外沒有施作或施作後被破壞\n\n58\n00:21:17,153 --> 00:21:41,103\n在這種狀況裡面排煙系統也沒有發揮功能這個就是你們建在區域醫院跟地區醫院評鑑裡面要納入重點的怎麼可能這裡一個都不能夠死死怎麼死了八個一個也不行你們的評鑑要不要納入機電設備的檢查保養是不是應該要怎麼樣去處理\n\n59\n00:21:43,118 --> 00:22:01,368\n所以這些評鑑的基準不論在翻修新增你要加入複合式災難的SOP的檢栽預防和準備都是有其必要性的所以我們要講說啊寶定你都沒有在想像業務單位各司也沒有在想\n\n60\n00:22:02,228 --> 00:22:03,229\n如果醫院發生火災,電梯要不要切斷電源?\n\n61\n00:22:31,095 --> 00:22:48,382\n要不要切這一次切斷了全部的電源切斷了全部的電源我告訴你那高樓層的這一些加護病房的人每個人要被推著病床他要怎麼疏散加護病床死了4個啊啊你不切斷也不行啊啊那要怎麼辦\n\n62\n00:23:19,951 --> 00:23:47,098\n報告委員那個機種廠是剛好在屋頂對啊所以我跟你講中央主管機關和各個院所要進行我剛剛講scenario的analysis針對各家醫院不同的地理條件醫院特色樓層分配收治病人的行動力的特色各類災害的影響所以不是我加了一個消防署網站下載一個消防防護計畫案例交差了你就通過了\n\n63\n00:23:49,053 --> 00:24:08,885\n這個才是重點復合式災害發生者SOP還有細緻的討論我們醫院跟其他醫院不一樣到時候是要切斷電源還是不切斷電源所以這個災難我們要痛定思痛中央主管機關還能夠有什麼作為我們的角色還能夠積極做什麼在復合式災難極端氣候跟電力風險都要納入考量\n\n64\n00:24:15,929 --> 00:24:43,003\n護理人力流動率大,他的日常演練或訓練應變能力不足的時候,都要怎麼辦?這是你們要做的,不中的人要去收課,不是大家立委自己搞的嘛。所以在這裡我們真的是希望,我抱歉,我不是針對安泰醫院這一家。安泰醫院是剛好發生這麼不幸,但很多制度面還有醫院的個案面都值得拿出來討論的。\n\n65\n00:24:44,524 --> 00:25:10,220\n我再說一次我們做一個立委我不是要找這個醫院的麻煩我們希望中央的責任要扛起來我不談這個問題我們就太偽善太鄉怨了保定你要回去好好檢討啦好謝謝主委的指教我想我們一定痛定思痛從各方面來尋求最大的改善以給病人最大的安全謝謝謝謝林委員謝謝部長\n\n","tsv":"start\tend\ttext\n5566\t8996\t主席各位大家早安喔是不是請我們這個邱部長\n16204\t34639\t部長,其實我今天想問的不是這個問題。我今天比較想問的是9月3號安泰醫院發生火警,那這個事情為什麼很重要?大家明明立委同事,等於平常在這裡話也講很多。\n35640\t61405\t但是我們不能當偽善和鄉怨的人這個問題很重要我們不是針對一家醫院我們要針對整個全部的醫院的安全如果在這裡的同事立委都不講話我不知道這個醫院安全的把關要怎麼進行我們先看第一張照片這張照片看起來讓我們覺得不可思議因為起火點是在前面這一棟機殿\n63480\t85375\t但是死的是在後面不同棟這對醫院安全來講他不是火災燒死他是濃煙嗆死了這不要講醫院安全連公共安全這樣子的這樣的結果這樣的悲劇都是不應該發生的更何況是醫院或是護理之家\n86816\t89660\t這個防火區劃是基本的配備怎麼會是這樣子的發生不同洞還濃煙嗆死嗆到隔壁洞\n97826\t123200\t這現在在2024年的現在如果你說發生在1990幾年大家都還沒有法規都還可以覺得有可能可是2024年的醫院安全的配備不應該是這樣法律上規定也不是這樣子所以呢甚至是在加護病房可能這個死亡了4個人就是加護病房\n124343\t139701\t⋯⋯⋯\n140735\t154932\t委員我想火災發生的火場鑑定這個要由專家來鑑定那接下來檢調也已經去了解已經去調查了那檢調會根據現在這樣說跟衛福部都沒有關係嗎可能衛福部\n157395\t158597\t我先把順序講一下,衛生局會做行政的調查\n176638\t191483\t我現在問你啦10月4號東森獨家新聞說安泰醫院的評鑑今年年底到期8月底才剛進行下一階段的評鑑但是去評鑑的衛福部的中央主管機關已經發現有什麼問題了結果已經被醫策會委員提出檢討改進了\n197165\t209255\t但是呢,醫策委從8月底他知道這個問題有嚴重的公共安全問題到發生之間沒有作為。而我現在問你,他到底是說他有什麼問題?部長你知道嗎?你知道嗎?你的醫策委去評過,8月就去評過安泰醫院,如果這個新聞沒有講錯的話,來你說,到底是發生什麼問題?當時就看到了。\n224685\t252427\t當時的那個委員有提醒的部分不曉得那個這篇補充一下那個委員那邊是有補充意見就是那個這家可能要就是他的那個一些你們都不知道公美菜大家公公哩哩郎郎不是啦因為他的那個有一些那個人員疏散部分建議他們還是要有一些具體的那個\n253134\t255755\t人員疏散而已嗎?所以你們第一個你們證實了的確在8月就是有進場去評鑑第二個你們也證實了評鑑的時候就看到有管線老舊和疏散動線等病安的部分好你們都看當時就看到但從8月到發生火災的10月3號之間我要問你們你們有要求醫療院所應立即改善嗎?\n283547\t291392\t有沒有要求他們做我應立即改善什麼你都沒有要求結果到10月3號就發生這樣欸人命欸八條人命欸蛤 有沒有要求他們做什麼所以今天不是只有說消防局去調查火災原因事故這都事後的事情了我現在講事發以前已經看到了我們要求他們做了什麼呢\n312718\t332885\t來請那個護師跟委員報告一下在醫院評鑑實地作業的時候他會用各項目去做查核那實際上進行的時候在查核項目現場當天沒有特別提出不合合的項目但委員通常就會就品質面求好心切會有一些建議意見並且在與\n334906\t352250\t品質面求好心切聽好所以管線老舊跟疏散動線等病安問題是求好心切的標準照你的講法這種話你講得出口嗎?部長你來講要求管線老舊和疏散動線這個問題是我們醫策會這個建議的意見是吹毛求癡求好心切還是應該是標配?\n366450\t379314\t因為評鑑有評鑑的標準項目,那這個大概評鑑﹖等一下我會跟你交流,評鑑的標準項目才是大問題。那我現在問你說管線老舊速戰動線有問題這種東西是標配還是選配就好了?\n385420\t398383\t這當然從那個病人的安全方面我們一定要做到但是在醫院的評鑑裡面他有一定的經過多少年多少專家你不要再說這種五四三都沒有重點你看這張圖會比較老實一點\n404705\t433217\t配電式起火的濃煙讓隔壁棟的5樓10樓11樓這樣子傷亡欸不要忘了我們啊這個這個新營醫院的北門分院還有新北市台北醫院的護理之家這個都死亡多少人呢這重大傷亡我們都知道醫院護理之家裡面你叫這些病人請可以看啊在家務病房的人他們怎麼逃生啊\n434212\t449579\t他們就跟失能的人一樣他沒有辦法逃生的欸所以你們現在在講這個這麼嚴肅的事情您現在跟他哥哥事不關己而且內湖的私人養護所死3個2018年台北護理之家死了10幾個\n452481\t468490\t當時消防署就推動了修法不論新建或變更的長照機構都要配備自動灑水設備火警自動報警裝備以及設置119火災通報裝置但是我請問你部長醫院有沒有在其中他講的是護理之家長照機構請問醫院當時為什麼排除在外\n477291\t498980\t為什麼醫院不再強制配置自動灑水設備、火警、自動警報設備的範圍呢?醫院不需要嗎?醫院這些家戶病房的人可以自動逃生嗎?為什麼他們不需要這些裝置基本配備、必要的配備來保護這些看病的人?\n501032\t515061\t你們的次長有講過一句話喔林靜儀次長說由於這次事故造成重大傷亡很多人擔心醫院安全欸對此感到疑慮你們的次長都這樣子講了可是\n516022\t533701\t出一句詞沒好捏有黨我媽想吼啟動這個醫癒法的第35條什麼法醫療在衛生部我現在在講的是消防法捏那跟委員報告一下當天如果在評鑑的時候其實消防局他們提出來的在\n534882\t535862\t為什麼當時的衛福部認為醫院不需要?你告訴我。\n562961\t585706\t好那這樣子好了安泰是發生這個事情因為當時發生火車是護理之家所以特別負責當時發生護理之家然後都沒有想到醫院這就是現在的衛福部的能力喔專業喔老湖機構跟那個我現在當時你們就沒有專業不專業只想到護理之家沒想到醫院那現在你認為醫院醫院已經有一個非常說實在已經有一個非常好的一個評鑑\n587166\t596534\t醫院有非常好的評鑑,好,那我問你,你就安泰醫院再重新評鑑一次,你覺不覺得他們會通過你們的評鑑?通過評鑑是要那個,整個審理...你不要在這裡齁,都沒專業啦,保證!您這位或這位醫生會?\n612782\t625418\t醫師師副師長醫師師副師長來醫學中心就診民眾的命是命區域醫院第7醫院的人命不是命安泰中心是區域醫院我為什麼講這一句話因為呢\n628121\t642148\t我們醫學中心的評鑑當然標準都比區域醫院還要高可是就區域醫院你們的醫院評鑑基準及評量項目的第一篇經營管理第1.7章風險和危機管理中的1.7.4的項目醫院應指定專責人員研擬火災的減災預防和準備措施評量項目我關起來我們看6789點\n656936\t671167\t醫院應設防火管理人等6、7、8、9因依準診療環境建築病人及第一線應變人員特色規劃符合所需的檢災預防準備設施第6、7病人不亦疏散以採取就地避難的診療部門\n676852\t691883\t然後具有適當的防火區劃及病人持續的照顧的備援計畫然後每年定期檢查火災災害的檢災預防和等等這樣子這些以上的評鑑都很棒很棒但是備註不要看備註第一點\n693188\t699671\t本條為視頻條文,評鑑結果不納入評鑑成績計算。請問不納入評鑑成績計算的評鑑,這樣子的安泰醫院這些項目評鑑不合格會納入計算嗎?不會。我跟你講,不會。\n717412\t739100\t所以如果安泰醫院在評估說他們有沒有減災預防準備措施然後他們的不易疏散就地避難的這個計畫提的不好如果說他們這一些通通都沒有改善的成效沒有提出來都沒關係因為這個叫做視頻\n740760\t740920\t所以：\n759076\t759256\t報告委員 我們所有的\n779123\t802930\t所以難怪你們副司長說這個是求好心切因為評鑑沒有管到這麼多這個視頻不納入成績如果你要求這個地方要做到好你如果要求這幾點要做到好就是你副司長講的叫求好心切站在病人站在這間死亡的病患的家屬的立場情何以堪\n806935\t810245\t地區醫院區醫院這樣子可以嗎保電\n812569\t821772\t當然我們病人的生命我們都要完全的珍惜那你不要說這種口號啦我現在要問你說啊好 你有沒有掌握目前還有公安問題的醫院還有哪一些?還有幾家?你不要再說喔剛好七個還發生一件問題欸不要忘了一個颱風來兩家醫院起火欸\n837932\t844739\t因為這些經驗我們一定會深切地去檢討整個...我現在不是要問你這個問題答非所問來浪費我們的時間部長依社會網站講106到112年合格醫院名單有417家那醫院評鑑校期在今年年底要到的有117家\n859694\t873980\t所以呢,所有四分之一的家屬的平建都在年底要到期,你有沒有掌握到這117家要到期要平建的,有哪些跟安泰醫院一樣管線老舊、疏散動線還有病安的狀況有問題的,你們現在有沒有掌握啦?還是要等平建放房錢啊,放著等醫院出事燒起來?\n884614\t905317\t還是說這消防署的問題跟你們無關?你們根本就是這樣的態度啊所以衛福部都不用監督不用輔導責任病患的生命安全在你們官員裡面都是評鑑後醫院該負的責任嗎?都跟政府無關是醫院的責任而已嗎?如果只是醫院的責任的話那我們評鑑是算什麼?\n907145\t922678\t而醫院評鑑的翻修制度,醫院評鑑的這個問題標準已經多久沒有改了?我現在問你,請你回答我第一個問題,還有哪幾家醫院,初步看起來真的還有問題的?\n924656\t925016\t當然也是要...\n948931\t973327\t你們醫院評鑑尤其醫學中心評鑑的重點就是醫院的公共安全了怎麼會說是消防局的消防署的問題?醫院的公共安全都是重點啦只是說他要求的一個要求當然是最安全的情況但是...所以你的意思是說災災跟你衛福部沒有關係消息整個人跟衛福部也沒有關係都消防署會怕嗎?沒有沒有我明明要講就是說層層來\n975448\t978751\t整層推卸啦!我現在是要問你,現在還有幾件病,它有類似的問題?啊你回答不出來說這都主要主責是消防署\n988956\t991178\t你們的醫院評鑑標準已經多久沒改了?\n1014786\t1019158\t這一輪是到112要啟動下一輪的調整你們的副司長\n1021707\t1023748\t我現在問妳說妳的評鑑標準\n1045938\t1046879\t這次我了解一定都有改\n1067055\t1076564\t對那當時王碧正次長也講說他兩年內要訂出初稿要進行視頻三年後要下一次醫院評鑑請問這個這個標準項目會改變那個他們離開以後啊這個評鑑基準的調整他的翻修進度現在到哪裡了\n1086897\t1088178\t我們還是補充一下第一個我們已經籌組好這個改革的小組\n1107566\t1110407\t那這一次發生兩起醫院火災事件後,你們全部覺得醫院平建還有哪些地方可以再調整?\n1137130\t1137250\t醫療機構的緊急應變手冊\n1164504\t1187544\t應該要考慮復合式災難的情境火災加颱風而且要做實際的演練在一次颱風天你在疏散的時候你一般室內火災疏散戶外的空旷處可是今天洪災來你要疏散到哪裡去啊只能在走廊一樓的戶外的空旷處不可得你就只能在急診室門口的走廊\n1190846\t1213093\t緊急救災消防警消的這些救災要進行還要一邊救治病患還要應對家屬詢問還要面對強風驟雨對病患的影響所以這種複合式災難到底應該要怎麼樣這種情境都要各種情境的scenario的analysis都必須要放進去\n1214073\t1231734\t對不對?你們的評鑑在這種狀況裡面是不是要要求加強演練這種東西?那有沒有互併比的問題啊?互併比現在在醫學中心都還比條件都還比區域醫院還要好。區域醫院是不是因為人力太少了互併比不足啦?或是交班時間啊?\n1233135\t1251629\t所以沒有人力談到疏散才會造成這麼大的傷亡可是呢 這個問題沒有重視的話讓每一個到醫院看病的或是重症要看病的人也都是非常的負險啊再來最重要的是本來剛才那一張防火區化跟消防排煙系統問題失去功能\n1255738\t1275784\t剛才第一張啊 垂直防煙區 防煙區化如果你做得好的話 它不應該往上竄 不應該 它鎖在二樓 如果水平的防煙區化做得好 它只在機房 也不會跑到隔壁棟 所以這個東西防火區外沒有施作 或施作後被破壞\n1277153\t1301103\t在這種狀況裡面排煙系統也沒有發揮功能這個就是你們建在區域醫院跟地區醫院評鑑裡面要納入重點的怎麼可能這裡一個都不能夠死死怎麼死了八個一個也不行你們的評鑑要不要納入機電設備的檢查保養是不是應該要怎麼樣去處理\n1303118\t1321368\t所以這些評鑑的基準不論在翻修新增你要加入複合式災難的SOP的檢栽預防和準備都是有其必要性的所以我們要講說啊寶定你都沒有在想像業務單位各司也沒有在想\n1322228\t1323229\t如果醫院發生火災,電梯要不要切斷電源?\n1351095\t1368382\t要不要切這一次切斷了全部的電源切斷了全部的電源我告訴你那高樓層的這一些加護病房的人每個人要被推著病床他要怎麼疏散加護病床死了4個啊啊你不切斷也不行啊啊那要怎麼辦\n1380435\t1399138\t︎1\n1399951\t1427098\t報告委員那個機種廠是剛好在屋頂對啊所以我跟你講中央主管機關和各個院所要進行我剛剛講 scenario 的 analysis針對各家醫院不同的地理條件醫院特色樓層分配收治病人的行動力的特色各類災害的影響所以不是我加了一個消防署網站下載一個消防防護計畫案例交差了你就通過了\n1429053\t1448885\t這個才是重點復合式災害發生者SOP還有細緻的討論我們醫院跟其他醫院不一樣到時候是要切斷電源還是不切斷電源所以這個災難我們要痛定思痛中央主管機關還能夠有什麼作為我們的角色還能夠積極做什麼在復合式災難極端氣候跟電力風險都要納入考量\n1455929\t1483003\t護理人力流動率大,他的日常演練或訓練應變能力不足的時候,都要怎麼辦?這是你們要做的,不中的人要去收課,不是大家立委自己搞的嘛。所以在這裡我們真的是希望,我抱歉,我不是針對安泰醫院這一家。安泰醫院是剛好發生這麼不幸,但很多制度面還有醫院的個案面都值得拿出來討論的。\n1484524\t1510220\t我再說一次我們做一個立委我不是要找這個醫院的麻煩我們希望中央的責任要扛起來我不談這個問題我們就太偽善太鄉怨了保定你要回去好好檢討啦好 謝謝主委的指教我想我們一定痛定思痛從各方面來尋求最大的改善以給病人最大的安全謝謝 謝謝林委員 謝謝部長\n","txt":"主席各位大家早安喔是不是請我們這個邱部長\n部長,其實我今天想問的不是這個問題。我今天比較想問的是9月3號安泰醫院發生火警,那這個事情為什麼很重要?大家明明立委同事,等於平常在這裡話也講很多。\n但是我們不能當偽善和鄉怨的人這個問題很重要我們不是針對一家醫院我們要針對整個全部的醫院的安全如果在這裡的同事立委都不講話我不知道這個醫院安全的把關要怎麼進行我們先看第一張照片這張照片看起來讓我們覺得不可思議因為起火點是在前面這一棟機殿\n但是死的是在後面不同棟這對醫院安全來講他不是火災燒死他是濃煙嗆死了這不要講醫院安全連公共安全這樣子的這樣的結果這樣的悲劇都是不應該發生的更何況是醫院或是護理之家\n這個防火區劃是基本的配備怎麼會是這樣子的發生不同洞還濃煙嗆死嗆到隔壁洞\n這現在在2024年的現在如果你說發生在1990幾年大家都還沒有法規都還可以覺得有可能可是2024年的醫院安全的配備不應該是這樣法律上規定也不是這樣子所以呢甚至是在加護病房可能這個死亡了4個人就是加護病房\n⋯⋯⋯\n委員我想火災發生的火場鑑定這個要由專家來鑑定那接下來檢調也已經去了解已經去調查了那檢調會根據現在這樣說跟衛福部都沒有關係嗎可能衛福部\n我先把順序講一下,衛生局會做行政的調查\n我現在問你啦10月4號東森獨家新聞說安泰醫院的評鑑今年年底到期8月底才剛進行下一階段的評鑑但是去評鑑的衛福部的中央主管機關已經發現有什麼問題了結果已經被醫策會委員提出檢討改進了\n但是呢,醫策委從8月底他知道這個問題有嚴重的公共安全問題到發生之間沒有作為。而我現在問你,他到底是說他有什麼問題?部長你知道嗎?你知道嗎?你的醫策委去評過,8月就去評過安泰醫院,如果這個新聞沒有講錯的話,來你說,到底是發生什麼問題?當時就看到了。\n當時的那個委員有提醒的部分不曉得那個這篇補充一下那個委員那邊是有補充意見就是那個這家可能要就是他的那個一些你們都不知道公美菜大家公公哩哩郎郎不是啦因為他的那個有一些那個人員疏散部分建議他們還是要有一些具體的那個\n人員疏散而已嗎?所以你們第一個你們證實了的確在8月就是有進場去評鑑第二個你們也證實了評鑑的時候就看到有管線老舊和疏散動線等病安的部分好你們都看當時就看到但從8月到發生火災的10月3號之間我要問你們你們有要求醫療院所應立即改善嗎?\n有沒有要求他們做我應立即改善什麼你都沒有要求結果到10月3號就發生這樣欸人命欸八條人命欸蛤 有沒有要求他們做什麼所以今天不是只有說消防局去調查火災原因事故這都事後的事情了我現在講事發以前已經看到了我們要求他們做了什麼呢\n來請那個護師跟委員報告一下在醫院評鑑實地作業的時候他會用各項目去做查核那實際上進行的時候在查核項目現場當天沒有特別提出不合合的項目但委員通常就會就品質面求好心切會有一些建議意見並且在與\n品質面求好心切聽好所以管線老舊跟疏散動線等病安問題是求好心切的標準照你的講法這種話你講得出口嗎?部長你來講要求管線老舊和疏散動線這個問題是我們醫策會這個建議的意見是吹毛求癡求好心切還是應該是標配?\n因為評鑑有評鑑的標準項目,那這個大概評鑑﹖等一下我會跟你交流,評鑑的標準項目才是大問題。那我現在問你說管線老舊速戰動線有問題這種東西是標配還是選配就好了?\n這當然從那個病人的安全方面我們一定要做到但是在醫院的評鑑裡面他有一定的經過多少年多少專家你不要再說這種五四三都沒有重點你看這張圖會比較老實一點\n配電式起火的濃煙讓隔壁棟的5樓10樓11樓這樣子傷亡欸不要忘了我們啊這個這個新營醫院的北門分院還有新北市台北醫院的護理之家這個都死亡多少人呢這重大傷亡我們都知道醫院護理之家裡面你叫這些病人請可以看啊在家務病房的人他們怎麼逃生啊\n他們就跟失能的人一樣他沒有辦法逃生的欸所以你們現在在講這個這麼嚴肅的事情您現在跟他哥哥事不關己而且內湖的私人養護所死3個2018年台北護理之家死了10幾個\n當時消防署就推動了修法不論新建或變更的長照機構都要配備自動灑水設備火警自動報警裝備以及設置119火災通報裝置但是我請問你部長醫院有沒有在其中他講的是護理之家長照機構請問醫院當時為什麼排除在外\n為什麼醫院不再強制配置自動灑水設備、火警、自動警報設備的範圍呢?醫院不需要嗎?醫院這些家戶病房的人可以自動逃生嗎?為什麼他們不需要這些裝置基本配備、必要的配備來保護這些看病的人?\n你們的次長有講過一句話喔林靜儀次長說由於這次事故造成重大傷亡很多人擔心醫院安全欸對此感到疑慮你們的次長都這樣子講了可是\n出一句詞沒好捏有黨我媽想吼啟動這個醫癒法的第35條什麼法醫療在衛生部我現在在講的是消防法捏那跟委員報告一下當天如果在評鑑的時候其實消防局他們提出來的在\n為什麼當時的衛福部認為醫院不需要?你告訴我。\n好那這樣子好了安泰是發生這個事情因為當時發生火車是護理之家所以特別負責當時發生護理之家然後都沒有想到醫院這就是現在的衛福部的能力喔專業喔老湖機構跟那個我現在當時你們就沒有專業不專業只想到護理之家沒想到醫院那現在你認為醫院醫院已經有一個非常說實在已經有一個非常好的一個評鑑\n醫院有非常好的評鑑,好,那我問你,你就安泰醫院再重新評鑑一次,你覺不覺得他們會通過你們的評鑑?通過評鑑是要那個,整個審理...你不要在這裡齁,都沒專業啦,保證!您這位或這位醫生會?\n醫師師副師長醫師師副師長來醫學中心就診民眾的命是命區域醫院第7醫院的人命不是命安泰中心是區域醫院我為什麼講這一句話因為呢\n我們醫學中心的評鑑當然標準都比區域醫院還要高可是就區域醫院你們的醫院評鑑基準及評量項目的第一篇經營管理第1.7章風險和危機管理中的1.7.4的項目醫院應指定專責人員研擬火災的減災預防和準備措施評量項目我關起來我們看6789點\n醫院應設防火管理人等6、7、8、9因依準診療環境建築病人及第一線應變人員特色規劃符合所需的檢災預防準備設施第6、7病人不亦疏散以採取就地避難的診療部門\n然後具有適當的防火區劃及病人持續的照顧的備援計畫然後每年定期檢查火災災害的檢災預防和等等這樣子這些以上的評鑑都很棒很棒但是備註不要看備註第一點\n本條為視頻條文,評鑑結果不納入評鑑成績計算。請問不納入評鑑成績計算的評鑑,這樣子的安泰醫院這些項目評鑑不合格會納入計算嗎?不會。我跟你講,不會。\n所以如果安泰醫院在評估說他們有沒有減災預防準備措施然後他們的不易疏散就地避難的這個計畫提的不好如果說他們這一些通通都沒有改善的成效沒有提出來都沒關係因為這個叫做視頻\n所以：\n報告委員 我們所有的\n所以難怪你們副司長說這個是求好心切因為評鑑沒有管到這麼多這個視頻不納入成績如果你要求這個地方要做到好你如果要求這幾點要做到好就是你副司長講的叫求好心切站在病人站在這間死亡的病患的家屬的立場情何以堪\n地區醫院區醫院這樣子可以嗎保電\n當然我們病人的生命我們都要完全的珍惜那你不要說這種口號啦我現在要問你說啊好 你有沒有掌握目前還有公安問題的醫院還有哪一些?還有幾家?你不要再說喔剛好七個還發生一件問題欸不要忘了一個颱風來兩家醫院起火欸\n因為這些經驗我們一定會深切地去檢討整個...我現在不是要問你這個問題答非所問來浪費我們的時間部長依社會網站講106到112年合格醫院名單有417家那醫院評鑑校期在今年年底要到的有117家\n所以呢,所有四分之一的家屬的平建都在年底要到期,你有沒有掌握到這117家要到期要平建的,有哪些跟安泰醫院一樣管線老舊、疏散動線還有病安的狀況有問題的,你們現在有沒有掌握啦?還是要等平建放房錢啊,放著等醫院出事燒起來?\n還是說這消防署的問題跟你們無關?你們根本就是這樣的態度啊所以衛福部都不用監督不用輔導責任病患的生命安全在你們官員裡面都是評鑑後醫院該負的責任嗎?都跟政府無關是醫院的責任而已嗎?如果只是醫院的責任的話那我們評鑑是算什麼?\n而醫院評鑑的翻修制度,醫院評鑑的這個問題標準已經多久沒有改了?我現在問你,請你回答我第一個問題,還有哪幾家醫院,初步看起來真的還有問題的?\n當然也是要...\n你們醫院評鑑尤其醫學中心評鑑的重點就是醫院的公共安全了怎麼會說是消防局的消防署的問題?醫院的公共安全都是重點啦只是說他要求的一個要求當然是最安全的情況但是...所以你的意思是說災災跟你衛福部沒有關係消息整個人跟衛福部也沒有關係都消防署會怕嗎?沒有沒有我明明要講就是說層層來\n整層推卸啦!我現在是要問你,現在還有幾件病,它有類似的問題?啊你回答不出來說這都主要主責是消防署\n你們的醫院評鑑標準已經多久沒改了?\n這一輪是到112要啟動下一輪的調整你們的副司長\n我現在問妳說妳的評鑑標準\n這次我了解一定都有改\n對那當時王碧正次長也講說他兩年內要訂出初稿要進行視頻三年後要下一次醫院評鑑請問這個這個標準項目會改變那個他們離開以後啊這個評鑑基準的調整他的翻修進度現在到哪裡了\n我們還是補充一下第一個我們已經籌組好這個改革的小組\n那這一次發生兩起醫院火災事件後,你們全部覺得醫院平建還有哪些地方可以再調整?\n醫療機構的緊急應變手冊\n應該要考慮復合式災難的情境火災加颱風而且要做實際的演練在一次颱風天你在疏散的時候你一般室內火災疏散戶外的空旷處可是今天洪災來你要疏散到哪裡去啊只能在走廊一樓的戶外的空旷處不可得你就只能在急診室門口的走廊\n緊急救災消防警消的這些救災要進行還要一邊救治病患還要應對家屬詢問還要面對強風驟雨對病患的影響所以這種複合式災難到底應該要怎麼樣這種情境都要各種情境的scenario的analysis都必須要放進去\n對不對?你們的評鑑在這種狀況裡面是不是要要求加強演練這種東西?那有沒有互併比的問題啊?互併比現在在醫學中心都還比條件都還比區域醫院還要好。區域醫院是不是因為人力太少了互併比不足啦?或是交班時間啊?\n所以沒有人力談到疏散才會造成這麼大的傷亡可是呢 這個問題沒有重視的話讓每一個到醫院看病的或是重症要看病的人也都是非常的負險啊再來最重要的是本來剛才那一張防火區化跟消防排煙系統問題失去功能\n剛才第一張啊 垂直防煙區 防煙區化如果你做得好的話 它不應該往上竄 不應該 它鎖在二樓 如果水平的防煙區化做得好 它只在機房 也不會跑到隔壁棟 所以這個東西防火區外沒有施作 或施作後被破壞\n在這種狀況裡面排煙系統也沒有發揮功能這個就是你們建在區域醫院跟地區醫院評鑑裡面要納入重點的怎麼可能這裡一個都不能夠死死怎麼死了八個一個也不行你們的評鑑要不要納入機電設備的檢查保養是不是應該要怎麼樣去處理\n所以這些評鑑的基準不論在翻修新增你要加入複合式災難的SOP的檢栽預防和準備都是有其必要性的所以我們要講說啊寶定你都沒有在想像業務單位各司也沒有在想\n如果醫院發生火災,電梯要不要切斷電源?\n要不要切這一次切斷了全部的電源切斷了全部的電源我告訴你那高樓層的這一些加護病房的人每個人要被推著病床他要怎麼疏散加護病床死了4個啊啊你不切斷也不行啊啊那要怎麼辦\n︎1\n報告委員那個機種廠是剛好在屋頂對啊所以我跟你講中央主管機關和各個院所要進行我剛剛講 scenario 的 analysis針對各家醫院不同的地理條件醫院特色樓層分配收治病人的行動力的特色各類災害的影響所以不是我加了一個消防署網站下載一個消防防護計畫案例交差了你就通過了\n這個才是重點復合式災害發生者SOP還有細緻的討論我們醫院跟其他醫院不一樣到時候是要切斷電源還是不切斷電源所以這個災難我們要痛定思痛中央主管機關還能夠有什麼作為我們的角色還能夠積極做什麼在復合式災難極端氣候跟電力風險都要納入考量\n護理人力流動率大,他的日常演練或訓練應變能力不足的時候,都要怎麼辦?這是你們要做的,不中的人要去收課,不是大家立委自己搞的嘛。所以在這裡我們真的是希望,我抱歉,我不是針對安泰醫院這一家。安泰醫院是剛好發生這麼不幸,但很多制度面還有醫院的個案面都值得拿出來討論的。\n我再說一次我們做一個立委我不是要找這個醫院的麻煩我們希望中央的責任要扛起來我不談這個問題我們就太偽善太鄉怨了保定你要回去好好檢討啦好 謝謝主委的指教我想我們一定痛定思痛從各方面來尋求最大的改善以給病人最大的安全謝謝 謝謝林委員 謝謝部長\n","vtt":"WEBVTT\n\n00:05.566 --> 00:08.996\n主席各位大家早安喔是不是請我們這個邱部長\n\n00:16.204 --> 00:34.639\n部長,其實我今天想問的不是這個問題。我今天比較想問的是9月3號安泰醫院發生火警,那這個事情為什麼很重要?大家明明立委同事,等於平常在這裡話也講很多。\n\n00:35.640 --> 01:01.405\n但是我們不能當偽善和鄉怨的人這個問題很重要我們不是針對一家醫院我們要針對整個全部的醫院的安全如果在這裡的同事立委都不講話我不知道這個醫院安全的把關要怎麼進行我們先看第一張照片這張照片看起來讓我們覺得不可思議因為起火點是在前面這一棟機殿\n\n01:03.480 --> 01:25.375\n但是死的是在後面不同棟這對醫院安全來講他不是火災燒死他是濃煙嗆死了這不要講醫院安全連公共安全這樣子的這樣的結果這樣的悲劇都是不應該發生的更何況是醫院或是護理之家\n\n01:26.816 --> 01:29.660\n這個防火區劃是基本的配備怎麼會是這樣子的發生不同洞還濃煙嗆死嗆到隔壁洞\n\n01:37.826 --> 02:03.200\n這現在在2024年的現在如果你說發生在1990幾年大家都還沒有法規都還可以覺得有可能可是2024年的醫院安全的配備不應該是這樣法律上規定也不是這樣子所以呢甚至是在加護病房可能這個死亡了4個人就是加護病房\n\n02:20.735 --> 02:34.932\n委員我想火災發生的火場鑑定這個要由專家來鑑定那接下來檢調也已經去了解已經去調查了那檢調會根據現在這樣說跟衛福部都沒有關係嗎可能衛福部\n\n02:37.395 --> 02:38.597\n我先把順序講一下,衛生局會做行政的調查\n\n02:56.638 --> 03:11.483\n我現在問你啦10月4號東森獨家新聞說安泰醫院的評鑑今年年底到期8月底才剛進行下一階段的評鑑但是去評鑑的衛福部的中央主管機關已經發現有什麼問題了結果已經被醫策會委員提出檢討改進了\n\n03:17.165 --> 03:29.255\n但是呢,醫策委從8月底他知道這個問題有嚴重的公共安全問題到發生之間沒有作為。而我現在問你,他到底是說他有什麼問題?部長你知道嗎?你知道嗎?你的醫策委去評過,8月就去評過安泰醫院,如果這個新聞沒有講錯的話,來你說,到底是發生什麼問題?當時就看到了。\n\n03:44.685 --> 04:12.427\n當時的那個委員有提醒的部分不曉得那個這篇補充一下那個委員那邊是有補充意見就是那個這家可能要就是他的那個一些你們都不知道公美菜大家公公哩哩郎郎不是啦因為他的那個有一些那個人員疏散部分建議他們還是要有一些具體的那個\n\n04:13.134 --> 04:15.755\n人員疏散而已嗎?所以你們第一個你們證實了的確在8月就是有進場去評鑑第二個你們也證實了評鑑的時候就看到有管線老舊和疏散動線等病安的部分好你們都看當時就看到但從8月到發生火災的10月3號之間我要問你們你們有要求醫療院所應立即改善嗎?\n\n04:43.547 --> 04:51.392\n有沒有要求他們做我應立即改善什麼你都沒有要求結果到10月3號就發生這樣欸人命欸八條人命欸蛤有沒有要求他們做什麼所以今天不是只有說消防局去調查火災原因事故這都事後的事情了我現在講事發以前已經看到了我們要求他們做了什麼呢\n\n05:12.718 --> 05:32.885\n來請那個護師跟委員報告一下在醫院評鑑實地作業的時候他會用各項目去做查核那實際上進行的時候在查核項目現場當天沒有特別提出不合合的項目但委員通常就會就品質面求好心切會有一些建議意見並且在與\n\n05:34.906 --> 05:52.250\n品質面求好心切聽好所以管線老舊跟疏散動線等病安問題是求好心切的標準照你的講法這種話你講得出口嗎?部長你來講要求管線老舊和疏散動線這個問題是我們醫策會這個建議的意見是吹毛求癡求好心切還是應該是標配?\n\n06:06.450 --> 06:19.314\n因為評鑑有評鑑的標準項目,那這個大概評鑑﹖等一下我會跟你交流,評鑑的標準項目才是大問題。那我現在問你說管線老舊速戰動線有問題這種東西是標配還是選配就好了?\n\n06:25.420 --> 06:38.383\n這當然從那個病人的安全方面我們一定要做到但是在醫院的評鑑裡面他有一定的經過多少年多少專家你不要再說這種五四三都沒有重點你看這張圖會比較老實一點\n\n06:44.705 --> 07:13.217\n配電式起火的濃煙讓隔壁棟的5樓10樓11樓這樣子傷亡欸不要忘了我們啊這個這個新營醫院的北門分院還有新北市台北醫院的護理之家這個都死亡多少人呢這重大傷亡我們都知道醫院護理之家裡面你叫這些病人請可以看啊在家務病房的人他們怎麼逃生啊\n\n07:14.212 --> 07:29.579\n他們就跟失能的人一樣他沒有辦法逃生的欸所以你們現在在講這個這麼嚴肅的事情您現在跟他哥哥事不關己而且內湖的私人養護所死3個2018年台北護理之家死了10幾個\n\n07:32.481 --> 07:48.490\n當時消防署就推動了修法不論新建或變更的長照機構都要配備自動灑水設備火警自動報警裝備以及設置119火災通報裝置但是我請問你部長醫院有沒有在其中他講的是護理之家長照機構請問醫院當時為什麼排除在外\n\n07:57.291 --> 08:18.980\n為什麼醫院不再強制配置自動灑水設備、火警、自動警報設備的範圍呢?醫院不需要嗎?醫院這些家戶病房的人可以自動逃生嗎?為什麼他們不需要這些裝置基本配備、必要的配備來保護這些看病的人?\n\n08:21.032 --> 08:35.061\n你們的次長有講過一句話喔林靜儀次長說由於這次事故造成重大傷亡很多人擔心醫院安全欸對此感到疑慮你們的次長都這樣子講了可是\n\n08:36.022 --> 08:53.701\n出一句詞沒好捏有黨我媽想吼啟動這個醫癒法的第35條什麼法醫療在衛生部我現在在講的是消防法捏那跟委員報告一下當天如果在評鑑的時候其實消防局他們提出來的在\n\n08:54.882 --> 08:55.862\n為什麼當時的衛福部認為醫院不需要?你告訴我。\n\n09:22.961 --> 09:45.706\n好那這樣子好了安泰是發生這個事情因為當時發生火車是護理之家所以特別負責當時發生護理之家然後都沒有想到醫院這就是現在的衛福部的能力喔專業喔老湖機構跟那個我現在當時你們就沒有專業不專業只想到護理之家沒想到醫院那現在你認為醫院醫院已經有一個非常說實在已經有一個非常好的一個評鑑\n\n09:47.166 --> 09:56.534\n醫院有非常好的評鑑,好,那我問你,你就安泰醫院再重新評鑑一次,你覺不覺得他們會通過你們的評鑑?通過評鑑是要那個,整個審理...你不要在這裡齁,都沒專業啦,保證!您這位或這位醫生會?\n\n10:12.782 --> 10:25.418\n醫師師副師長醫師師副師長來醫學中心就診民眾的命是命區域醫院第7醫院的人命不是命安泰中心是區域醫院我為什麼講這一句話因為呢\n\n10:28.121 --> 10:42.148\n我們醫學中心的評鑑當然標準都比區域醫院還要高可是就區域醫院你們的醫院評鑑基準及評量項目的第一篇經營管理第1.7章風險和危機管理中的1.7.4的項目醫院應指定專責人員研擬火災的減災預防和準備措施評量項目我關起來我們看6789點\n\n10:56.936 --> 11:11.167\n醫院應設防火管理人等6、7、8、9因依準診療環境建築病人及第一線應變人員特色規劃符合所需的檢災預防準備設施第6、7病人不亦疏散以採取就地避難的診療部門\n\n11:16.852 --> 11:31.883\n然後具有適當的防火區劃及病人持續的照顧的備援計畫然後每年定期檢查火災災害的檢災預防和等等這樣子這些以上的評鑑都很棒很棒但是備註不要看備註第一點\n\n11:33.188 --> 11:39.671\n本條為視頻條文,評鑑結果不納入評鑑成績計算。請問不納入評鑑成績計算的評鑑,這樣子的安泰醫院這些項目評鑑不合格會納入計算嗎?不會。我跟你講,不會。\n\n11:57.412 --> 12:19.100\n所以如果安泰醫院在評估說他們有沒有減災預防準備措施然後他們的不易疏散就地避難的這個計畫提的不好如果說他們這一些通通都沒有改善的成效沒有提出來都沒關係因為這個叫做視頻\n\n12:20.760 --> 12:20.920\n所以：\n\n12:39.076 --> 12:39.256\n報告委員我們所有的\n\n12:59.123 --> 13:22.930\n所以難怪你們副司長說這個是求好心切因為評鑑沒有管到這麼多這個視頻不納入成績如果你要求這個地方要做到好你如果要求這幾點要做到好就是你副司長講的叫求好心切站在病人站在這間死亡的病患的家屬的立場情何以堪\n\n13:26.935 --> 13:30.245\n地區醫院區醫院這樣子可以嗎保電\n\n13:32.569 --> 13:41.772\n當然我們病人的生命我們都要完全的珍惜那你不要說這種口號啦我現在要問你說啊好你有沒有掌握目前還有公安問題的醫院還有哪一些?還有幾家?你不要再說喔剛好七個還發生一件問題欸不要忘了一個颱風來兩家醫院起火欸\n\n13:57.932 --> 14:04.739\n因為這些經驗我們一定會深切地去檢討整個...我現在不是要問你這個問題答非所問來浪費我們的時間部長依社會網站講106到112年合格醫院名單有417家那醫院評鑑校期在今年年底要到的有117家\n\n14:19.694 --> 14:33.980\n所以呢,所有四分之一的家屬的平建都在年底要到期,你有沒有掌握到這117家要到期要平建的,有哪些跟安泰醫院一樣管線老舊、疏散動線還有病安的狀況有問題的,你們現在有沒有掌握啦?還是要等平建放房錢啊,放著等醫院出事燒起來?\n\n14:44.614 --> 15:05.317\n還是說這消防署的問題跟你們無關?你們根本就是這樣的態度啊所以衛福部都不用監督不用輔導責任病患的生命安全在你們官員裡面都是評鑑後醫院該負的責任嗎?都跟政府無關是醫院的責任而已嗎?如果只是醫院的責任的話那我們評鑑是算什麼?\n\n15:07.145 --> 15:22.678\n而醫院評鑑的翻修制度,醫院評鑑的這個問題標準已經多久沒有改了?我現在問你,請你回答我第一個問題,還有哪幾家醫院,初步看起來真的還有問題的?\n\n15:24.656 --> 15:25.016\n當然也是要...\n\n15:48.931 --> 16:13.327\n你們醫院評鑑尤其醫學中心評鑑的重點就是醫院的公共安全了怎麼會說是消防局的消防署的問題?醫院的公共安全都是重點啦只是說他要求的一個要求當然是最安全的情況但是...所以你的意思是說災災跟你衛福部沒有關係消息整個人跟衛福部也沒有關係都消防署會怕嗎?沒有沒有我明明要講就是說層層來\n\n16:15.448 --> 16:18.751\n整層推卸啦!我現在是要問你,現在還有幾件病,它有類似的問題?啊你回答不出來說這都主要主責是消防署\n\n16:28.956 --> 16:31.178\n你們的醫院評鑑標準已經多久沒改了?\n\n16:54.786 --> 16:59.158\n這一輪是到112要啟動下一輪的調整你們的副司長\n\n17:01.707 --> 17:03.748\n我現在問妳說妳的評鑑標準\n\n17:25.938 --> 17:26.879\n這次我了解一定都有改\n\n17:47.055 --> 17:56.564\n對那當時王碧正次長也講說他兩年內要訂出初稿要進行視頻三年後要下一次醫院評鑑請問這個這個標準項目會改變那個他們離開以後啊這個評鑑基準的調整他的翻修進度現在到哪裡了\n\n18:06.897 --> 18:08.178\n我們還是補充一下第一個我們已經籌組好這個改革的小組\n\n18:27.566 --> 18:30.407\n那這一次發生兩起醫院火災事件後,你們全部覺得醫院平建還有哪些地方可以再調整?\n\n18:57.130 --> 18:57.250\n醫療機構的緊急應變手冊\n\n19:24.504 --> 19:47.544\n應該要考慮復合式災難的情境火災加颱風而且要做實際的演練在一次颱風天你在疏散的時候你一般室內火災疏散戶外的空旷處可是今天洪災來你要疏散到哪裡去啊只能在走廊一樓的戶外的空旷處不可得你就只能在急診室門口的走廊\n\n19:50.846 --> 20:13.093\n緊急救災消防警消的這些救災要進行還要一邊救治病患還要應對家屬詢問還要面對強風驟雨對病患的影響所以這種複合式災難到底應該要怎麼樣這種情境都要各種情境的scenario的analysis都必須要放進去\n\n20:14.073 --> 20:31.734\n對不對?你們的評鑑在這種狀況裡面是不是要要求加強演練這種東西?那有沒有互併比的問題啊?互併比現在在醫學中心都還比條件都還比區域醫院還要好。區域醫院是不是因為人力太少了互併比不足啦?或是交班時間啊?\n\n20:33.135 --> 20:51.629\n所以沒有人力談到疏散才會造成這麼大的傷亡可是呢這個問題沒有重視的話讓每一個到醫院看病的或是重症要看病的人也都是非常的負險啊再來最重要的是本來剛才那一張防火區化跟消防排煙系統問題失去功能\n\n20:55.738 --> 21:15.784\n剛才第一張啊垂直防煙區防煙區化如果你做得好的話它不應該往上竄不應該它鎖在二樓如果水平的防煙區化做得好它只在機房也不會跑到隔壁棟所以這個東西防火區外沒有施作或施作後被破壞\n\n21:17.153 --> 21:41.103\n在這種狀況裡面排煙系統也沒有發揮功能這個就是你們建在區域醫院跟地區醫院評鑑裡面要納入重點的怎麼可能這裡一個都不能夠死死怎麼死了八個一個也不行你們的評鑑要不要納入機電設備的檢查保養是不是應該要怎麼樣去處理\n\n21:43.118 --> 22:01.368\n所以這些評鑑的基準不論在翻修新增你要加入複合式災難的SOP的檢栽預防和準備都是有其必要性的所以我們要講說啊寶定你都沒有在想像業務單位各司也沒有在想\n\n22:02.228 --> 22:03.229\n如果醫院發生火災,電梯要不要切斷電源?\n\n22:31.095 --> 22:48.382\n要不要切這一次切斷了全部的電源切斷了全部的電源我告訴你那高樓層的這一些加護病房的人每個人要被推著病床他要怎麼疏散加護病床死了4個啊啊你不切斷也不行啊啊那要怎麼辦\n\n23:19.951 --> 23:47.098\n報告委員那個機種廠是剛好在屋頂對啊所以我跟你講中央主管機關和各個院所要進行我剛剛講scenario的analysis針對各家醫院不同的地理條件醫院特色樓層分配收治病人的行動力的特色各類災害的影響所以不是我加了一個消防署網站下載一個消防防護計畫案例交差了你就通過了\n\n23:49.053 --> 24:08.885\n這個才是重點復合式災害發生者SOP還有細緻的討論我們醫院跟其他醫院不一樣到時候是要切斷電源還是不切斷電源所以這個災難我們要痛定思痛中央主管機關還能夠有什麼作為我們的角色還能夠積極做什麼在復合式災難極端氣候跟電力風險都要納入考量\n\n24:15.929 --> 24:43.003\n護理人力流動率大,他的日常演練或訓練應變能力不足的時候,都要怎麼辦?這是你們要做的,不中的人要去收課,不是大家立委自己搞的嘛。所以在這裡我們真的是希望,我抱歉,我不是針對安泰醫院這一家。安泰醫院是剛好發生這麼不幸,但很多制度面還有醫院的個案面都值得拿出來討論的。\n\n24:44.524 --> 25:10.220\n我再說一次我們做一個立委我不是要找這個醫院的麻煩我們希望中央的責任要扛起來我不談這個問題我們就太偽善太鄉怨了保定你要回去好好檢討啦好謝謝主委的指教我想我們一定痛定思痛從各方面來尋求最大的改善以給病人最大的安全謝謝謝謝林委員謝謝部長\n\n","segments":[{"start":5.566,"end":8.996,"text":"主席各位大家早安喔是不是請我們這個邱部長"},{"start":16.204,"end":34.639,"text":"部長,其實我今天想問的不是這個問題。我今天比較想問的是9月3號安泰醫院發生火警,那這個事情為什麼很重要?大家明明立委同事,等於平常在這裡話也講很多。"},{"start":35.64,"end":61.405,"text":"但是我們不能當偽善和鄉怨的人這個問題很重要我們不是針對一家醫院我們要針對整個全部的醫院的安全如果在這裡的同事立委都不講話我不知道這個醫院安全的把關要怎麼進行我們先看第一張照片這張照片看起來讓我們覺得不可思議因為起火點是在前面這一棟機殿"},{"start":63.48,"end":85.375,"text":"但是死的是在後面不同棟這對醫院安全來講他不是火災燒死他是濃煙嗆死了這不要講醫院安全連公共安全這樣子的這樣的結果這樣的悲劇都是不應該發生的更何況是醫院或是護理之家"},{"start":86.816,"end":89.66,"text":"這個防火區劃是基本的配備怎麼會是這樣子的發生不同洞還濃煙嗆死嗆到隔壁洞"},{"start":97.826,"end":123.2,"text":"這現在在2024年的現在如果你說發生在1990幾年大家都還沒有法規都還可以覺得有可能可是2024年的醫院安全的配備不應該是這樣法律上規定也不是這樣子所以呢甚至是在加護病房可能這個死亡了4個人就是加護病房"},{"start":124.343,"end":139.701,"text":"⋯⋯⋯"},{"start":140.735,"end":154.932,"text":"委員我想火災發生的火場鑑定這個要由專家來鑑定那接下來檢調也已經去了解已經去調查了那檢調會根據現在這樣說跟衛福部都沒有關係嗎可能衛福部"},{"start":157.395,"end":158.597,"text":"我先把順序講一下,衛生局會做行政的調查"},{"start":176.638,"end":191.483,"text":"我現在問你啦10月4號東森獨家新聞說安泰醫院的評鑑今年年底到期8月底才剛進行下一階段的評鑑但是去評鑑的衛福部的中央主管機關已經發現有什麼問題了結果已經被醫策會委員提出檢討改進了"},{"start":197.165,"end":209.255,"text":"但是呢,醫策委從8月底他知道這個問題有嚴重的公共安全問題到發生之間沒有作為。而我現在問你,他到底是說他有什麼問題?部長你知道嗎?你知道嗎?你的醫策委去評過,8月就去評過安泰醫院,如果這個新聞沒有講錯的話,來你說,到底是發生什麼問題?當時就看到了。"},{"start":224.685,"end":252.427,"text":"當時的那個委員有提醒的部分不曉得那個這篇補充一下那個委員那邊是有補充意見就是那個這家可能要就是他的那個一些你們都不知道公美菜大家公公哩哩郎郎不是啦因為他的那個有一些那個人員疏散部分建議他們還是要有一些具體的那個"},{"start":253.134,"end":255.755,"text":"人員疏散而已嗎?所以你們第一個你們證實了的確在8月就是有進場去評鑑第二個你們也證實了評鑑的時候就看到有管線老舊和疏散動線等病安的部分好你們都看當時就看到但從8月到發生火災的10月3號之間我要問你們你們有要求醫療院所應立即改善嗎?"},{"start":283.547,"end":291.392,"text":"有沒有要求他們做我應立即改善什麼你都沒有要求結果到10月3號就發生這樣欸人命欸八條人命欸蛤 有沒有要求他們做什麼所以今天不是只有說消防局去調查火災原因事故這都事後的事情了我現在講事發以前已經看到了我們要求他們做了什麼呢"},{"start":312.718,"end":332.885,"text":"來請那個護師跟委員報告一下在醫院評鑑實地作業的時候他會用各項目去做查核那實際上進行的時候在查核項目現場當天沒有特別提出不合合的項目但委員通常就會就品質面求好心切會有一些建議意見並且在與"},{"start":334.906,"end":352.25,"text":"品質面求好心切聽好所以管線老舊跟疏散動線等病安問題是求好心切的標準照你的講法這種話你講得出口嗎?部長你來講要求管線老舊和疏散動線這個問題是我們醫策會這個建議的意見是吹毛求癡求好心切還是應該是標配?"},{"start":366.45,"end":379.314,"text":"因為評鑑有評鑑的標準項目,那這個大概評鑑﹖等一下我會跟你交流,評鑑的標準項目才是大問題。那我現在問你說管線老舊速戰動線有問題這種東西是標配還是選配就好了?"},{"start":385.42,"end":398.383,"text":"這當然從那個病人的安全方面我們一定要做到但是在醫院的評鑑裡面他有一定的經過多少年多少專家你不要再說這種五四三都沒有重點你看這張圖會比較老實一點"},{"start":404.705,"end":433.217,"text":"配電式起火的濃煙讓隔壁棟的5樓10樓11樓這樣子傷亡欸不要忘了我們啊這個這個新營醫院的北門分院還有新北市台北醫院的護理之家這個都死亡多少人呢這重大傷亡我們都知道醫院護理之家裡面你叫這些病人請可以看啊在家務病房的人他們怎麼逃生啊"},{"start":434.212,"end":449.579,"text":"他們就跟失能的人一樣他沒有辦法逃生的欸所以你們現在在講這個這麼嚴肅的事情您現在跟他哥哥事不關己而且內湖的私人養護所死3個2018年台北護理之家死了10幾個"},{"start":452.481,"end":468.49,"text":"當時消防署就推動了修法不論新建或變更的長照機構都要配備自動灑水設備火警自動報警裝備以及設置119火災通報裝置但是我請問你部長醫院有沒有在其中他講的是護理之家長照機構請問醫院當時為什麼排除在外"},{"start":477.291,"end":498.98,"text":"為什麼醫院不再強制配置自動灑水設備、火警、自動警報設備的範圍呢?醫院不需要嗎?醫院這些家戶病房的人可以自動逃生嗎?為什麼他們不需要這些裝置基本配備、必要的配備來保護這些看病的人?"},{"start":501.032,"end":515.061,"text":"你們的次長有講過一句話喔林靜儀次長說由於這次事故造成重大傷亡很多人擔心醫院安全欸對此感到疑慮你們的次長都這樣子講了可是"},{"start":516.022,"end":533.701,"text":"出一句詞沒好捏有黨我媽想吼啟動這個醫癒法的第35條什麼法醫療在衛生部我現在在講的是消防法捏那跟委員報告一下當天如果在評鑑的時候其實消防局他們提出來的在"},{"start":534.882,"end":535.862,"text":"為什麼當時的衛福部認為醫院不需要?你告訴我。"},{"start":562.961,"end":585.706,"text":"好那這樣子好了安泰是發生這個事情因為當時發生火車是護理之家所以特別負責當時發生護理之家然後都沒有想到醫院這就是現在的衛福部的能力喔專業喔老湖機構跟那個我現在當時你們就沒有專業不專業只想到護理之家沒想到醫院那現在你認為醫院醫院已經有一個非常說實在已經有一個非常好的一個評鑑"},{"start":587.166,"end":596.534,"text":"醫院有非常好的評鑑,好,那我問你,你就安泰醫院再重新評鑑一次,你覺不覺得他們會通過你們的評鑑?通過評鑑是要那個,整個審理...你不要在這裡齁,都沒專業啦,保證!您這位或這位醫生會?"},{"start":612.782,"end":625.418,"text":"醫師師副師長醫師師副師長來醫學中心就診民眾的命是命區域醫院第7醫院的人命不是命安泰中心是區域醫院我為什麼講這一句話因為呢"},{"start":628.121,"end":642.148,"text":"我們醫學中心的評鑑當然標準都比區域醫院還要高可是就區域醫院你們的醫院評鑑基準及評量項目的第一篇經營管理第1.7章風險和危機管理中的1.7.4的項目醫院應指定專責人員研擬火災的減災預防和準備措施評量項目我關起來我們看6789點"},{"start":656.936,"end":671.167,"text":"醫院應設防火管理人等6、7、8、9因依準診療環境建築病人及第一線應變人員特色規劃符合所需的檢災預防準備設施第6、7病人不亦疏散以採取就地避難的診療部門"},{"start":676.852,"end":691.883,"text":"然後具有適當的防火區劃及病人持續的照顧的備援計畫然後每年定期檢查火災災害的檢災預防和等等這樣子這些以上的評鑑都很棒很棒但是備註不要看備註第一點"},{"start":693.188,"end":699.671,"text":"本條為視頻條文,評鑑結果不納入評鑑成績計算。請問不納入評鑑成績計算的評鑑,這樣子的安泰醫院這些項目評鑑不合格會納入計算嗎?不會。我跟你講,不會。"},{"start":717.412,"end":739.1,"text":"所以如果安泰醫院在評估說他們有沒有減災預防準備措施然後他們的不易疏散就地避難的這個計畫提的不好如果說他們這一些通通都沒有改善的成效沒有提出來都沒關係因為這個叫做視頻"},{"start":740.76,"end":740.92,"text":"所以："},{"start":759.076,"end":759.256,"text":"報告委員 我們所有的"},{"start":779.123,"end":802.93,"text":"所以難怪你們副司長說這個是求好心切因為評鑑沒有管到這麼多這個視頻不納入成績如果你要求這個地方要做到好你如果要求這幾點要做到好就是你副司長講的叫求好心切站在病人站在這間死亡的病患的家屬的立場情何以堪"},{"start":806.935,"end":810.245,"text":"地區醫院區醫院這樣子可以嗎保電"},{"start":812.569,"end":821.772,"text":"當然我們病人的生命我們都要完全的珍惜那你不要說這種口號啦我現在要問你說啊好 你有沒有掌握目前還有公安問題的醫院還有哪一些?還有幾家?你不要再說喔剛好七個還發生一件問題欸不要忘了一個颱風來兩家醫院起火欸"},{"start":837.932,"end":844.739,"text":"因為這些經驗我們一定會深切地去檢討整個...我現在不是要問你這個問題答非所問來浪費我們的時間部長依社會網站講106到112年合格醫院名單有417家那醫院評鑑校期在今年年底要到的有117家"},{"start":859.694,"end":873.98,"text":"所以呢,所有四分之一的家屬的平建都在年底要到期,你有沒有掌握到這117家要到期要平建的,有哪些跟安泰醫院一樣管線老舊、疏散動線還有病安的狀況有問題的,你們現在有沒有掌握啦?還是要等平建放房錢啊,放著等醫院出事燒起來?"},{"start":884.614,"end":905.317,"text":"還是說這消防署的問題跟你們無關?你們根本就是這樣的態度啊所以衛福部都不用監督不用輔導責任病患的生命安全在你們官員裡面都是評鑑後醫院該負的責任嗎?都跟政府無關是醫院的責任而已嗎?如果只是醫院的責任的話那我們評鑑是算什麼?"},{"start":907.145,"end":922.678,"text":"而醫院評鑑的翻修制度,醫院評鑑的這個問題標準已經多久沒有改了?我現在問你,請你回答我第一個問題,還有哪幾家醫院,初步看起來真的還有問題的?"},{"start":924.656,"end":925.016,"text":"當然也是要..."},{"start":948.931,"end":973.327,"text":"你們醫院評鑑尤其醫學中心評鑑的重點就是醫院的公共安全了怎麼會說是消防局的消防署的問題?醫院的公共安全都是重點啦只是說他要求的一個要求當然是最安全的情況但是...所以你的意思是說災災跟你衛福部沒有關係消息整個人跟衛福部也沒有關係都消防署會怕嗎?沒有沒有我明明要講就是說層層來"},{"start":975.448,"end":978.751,"text":"整層推卸啦!我現在是要問你,現在還有幾件病,它有類似的問題?啊你回答不出來說這都主要主責是消防署"},{"start":988.956,"end":991.178,"text":"你們的醫院評鑑標準已經多久沒改了?"},{"start":1014.786,"end":1019.158,"text":"這一輪是到112要啟動下一輪的調整你們的副司長"},{"start":1021.707,"end":1023.748,"text":"我現在問妳說妳的評鑑標準"},{"start":1045.938,"end":1046.879,"text":"這次我了解一定都有改"},{"start":1067.055,"end":1076.564,"text":"對那當時王碧正次長也講說他兩年內要訂出初稿要進行視頻三年後要下一次醫院評鑑請問這個這個標準項目會改變那個他們離開以後啊這個評鑑基準的調整他的翻修進度現在到哪裡了"},{"start":1086.897,"end":1088.178,"text":"我們還是補充一下第一個我們已經籌組好這個改革的小組"},{"start":1107.566,"end":1110.407,"text":"那這一次發生兩起醫院火災事件後,你們全部覺得醫院平建還有哪些地方可以再調整?"},{"start":1137.13,"end":1137.25,"text":"醫療機構的緊急應變手冊"},{"start":1164.504,"end":1187.544,"text":"應該要考慮復合式災難的情境火災加颱風而且要做實際的演練在一次颱風天你在疏散的時候你一般室內火災疏散戶外的空旷處可是今天洪災來你要疏散到哪裡去啊只能在走廊一樓的戶外的空旷處不可得你就只能在急診室門口的走廊"},{"start":1190.846,"end":1213.093,"text":"緊急救災消防警消的這些救災要進行還要一邊救治病患還要應對家屬詢問還要面對強風驟雨對病患的影響所以這種複合式災難到底應該要怎麼樣這種情境都要各種情境的scenario的analysis都必須要放進去"},{"start":1214.073,"end":1231.734,"text":"對不對?你們的評鑑在這種狀況裡面是不是要要求加強演練這種東西?那有沒有互併比的問題啊?互併比現在在醫學中心都還比條件都還比區域醫院還要好。區域醫院是不是因為人力太少了互併比不足啦?或是交班時間啊?"},{"start":1233.135,"end":1251.629,"text":"所以沒有人力談到疏散才會造成這麼大的傷亡可是呢 這個問題沒有重視的話讓每一個到醫院看病的或是重症要看病的人也都是非常的負險啊再來最重要的是本來剛才那一張防火區化跟消防排煙系統問題失去功能"},{"start":1255.738,"end":1275.784,"text":"剛才第一張啊 垂直防煙區 防煙區化如果你做得好的話 它不應該往上竄 不應該 它鎖在二樓 如果水平的防煙區化做得好 它只在機房 也不會跑到隔壁棟 所以這個東西防火區外沒有施作 或施作後被破壞"},{"start":1277.153,"end":1301.103,"text":"在這種狀況裡面排煙系統也沒有發揮功能這個就是你們建在區域醫院跟地區醫院評鑑裡面要納入重點的怎麼可能這裡一個都不能夠死死怎麼死了八個一個也不行你們的評鑑要不要納入機電設備的檢查保養是不是應該要怎麼樣去處理"},{"start":1303.118,"end":1321.368,"text":"所以這些評鑑的基準不論在翻修新增你要加入複合式災難的SOP的檢栽預防和準備都是有其必要性的所以我們要講說啊寶定你都沒有在想像業務單位各司也沒有在想"},{"start":1322.228,"end":1323.229,"text":"如果醫院發生火災,電梯要不要切斷電源?"},{"start":1351.095,"end":1368.382,"text":"要不要切這一次切斷了全部的電源切斷了全部的電源我告訴你那高樓層的這一些加護病房的人每個人要被推著病床他要怎麼疏散加護病床死了4個啊啊你不切斷也不行啊啊那要怎麼辦"},{"start":1380.435,"end":1399.138,"text":" ︎1"},{"start":1399.951,"end":1427.098,"text":"報告委員那個機種廠是剛好在屋頂對啊所以我跟你講中央主管機關和各個院所要進行我剛剛講 scenario 的 analysis針對各家醫院不同的地理條件醫院特色樓層分配收治病人的行動力的特色各類災害的影響所以不是我加了一個消防署網站下載一個消防防護計畫案例交差了你就通過了"},{"start":1429.053,"end":1448.885,"text":"這個才是重點復合式災害發生者SOP還有細緻的討論我們醫院跟其他醫院不一樣到時候是要切斷電源還是不切斷電源所以這個災難我們要痛定思痛中央主管機關還能夠有什麼作為我們的角色還能夠積極做什麼在復合式災難極端氣候跟電力風險都要納入考量"},{"start":1455.929,"end":1483.003,"text":"護理人力流動率大,他的日常演練或訓練應變能力不足的時候,都要怎麼辦?這是你們要做的,不中的人要去收課,不是大家立委自己搞的嘛。所以在這裡我們真的是希望,我抱歉,我不是針對安泰醫院這一家。安泰醫院是剛好發生這麼不幸,但很多制度面還有醫院的個案面都值得拿出來討論的。"},{"start":1484.524,"end":1510.22,"text":"我再說一次我們做一個立委我不是要找這個醫院的麻煩我們希望中央的責任要扛起來我不談這個問題我們就太偽善太鄉怨了保定你要回去好好檢討啦好 謝謝主委的指教我想我們一定痛定思痛從各方面來尋求最大的改善以給病人最大的安全謝謝 謝謝林委員 謝謝部長"}]}}},"meet":{"sessionPeriod":2,"sessionTimes":2,"tmpMeeting":null,"committees":[26],"term":11,"id":"委員會-11-2-26-2","title":"第11屆第2會期社會福利及衛生環境委員會第2次全體委員會議","type":"委員會"},"會議時間":"2024-10-09T09:00:00+08:00","委員發言時間":"10:18:02 - 10:43:12","會議名稱":"立法院第11屆第2會期社會福利及衛生環境委員會第2次全體委員會議（事由：邀請衛生福利部部長就「我國人工生殖法制化作業進度」、「衛生福利部落實中央政府我國少子女化對策計畫之成效與未來規劃」及「衛生福利部本月因疏於督導地方評估特殊需求兒少利益所受監察院糾正之檢討」進行專題報告，並備質詢。\n【10月7日及9日二天一次會】）","id":155297,"gazette":{"lineno":355,"blocks":[["林委員淑芬：（10時18分）主席、各位大家早安，是不是請我們邱部長？"],["邱部長泰源：委員好。"],["林委員淑芬：部長，其實我今天想問的不是這個問題，我今天比較想問的是9月3號安泰醫院發生火警，這個事情為什麼很重要，大家同樣是立委同事，大家平常在這裡話也講很多啦！但是我們不能當偽善和鄉愿的人，這個問題很重要，不是針對一家醫院，我們要針對全部的醫院安全，如果在這裡的同事、立委都不講話，我不知道醫院安全的把關要怎麼進行？","我們先看第一張照片，這張照片看起來讓我們覺得不可思議，因為起火點是在前面這一棟配電室，可是死的是在後面不同棟，這對醫院安全來講，他不是火災燒死，他是濃煙嗆死的，這不要講醫院安全，連公共安全這樣的結果、這樣的悲劇都是不應該發生的，更何況是醫院或是護理之家，防火區劃是基本的配備，怎麼會是發生在不同棟？還是因濃煙嗆死、嗆到隔壁棟。現在是2024年，如果你說發生在一九九幾年，因為還沒有法規，大家還覺得有可能，可是2024年醫院安全的配備不應該是這樣子，法律上規定也不是這樣子，甚至是在加護病房可能死亡了4個人，這個加護病房的病人怎麼逃啊？加護病房的病人根本不可能逃，所以事發到現在已經將近一個禮拜了，你認為造成醫療院所這麼重大傷亡的原因，或是你初步瞭解是什麼？"],["邱部長泰源：報告委員，我想火災發生的火場鑑定，這個要由專家來鑑定，接下來檢調也已經去瞭解、已經去調查了，檢調會根據……"],["林委員淑芬：現在照這樣說起來，跟衛福部都沒關係嗎？"],["邱部長泰源：接下來衛福部……"],["林委員淑芬：照這樣講跟衛福部都沒關係嗎？"],["邱部長泰源：衛福部當然就會在……"],["林委員淑芬：你們衛福部對這家醫院在評鑑的時候、初評的時候，有沒有表示過任何意見？"],["邱部長泰源：我報告一下，我先把順序講一下，衛生局會做行政的調查……"],["林委員淑芬：我現在問你啦，10月4號東森獨家新聞報導，安泰醫院的評鑑今年年底到期，8月底才剛進行下一階段的評鑑，而去評鑑的衛福部中央主管機關已經發現有什麼問題醫策會委員已經提出檢討改進，但是醫策會從8月底知道有嚴重的公共安全問題到發生事故之間沒有作為，我現在問你，到底是說它有什麼問題，部長知道嗎？你知道嗎？你們的醫策會8月就去評過安泰醫院，如果這個新聞沒有講錯的話，來，你說，到底是發生什麼問題？當時就看到了。"],["邱部長泰源：當時的委員有提醒的部分，不曉得……"],["李科長巧玲：我們補充一下。"],["邱部長泰源：這邊補充一下。"],["李科長巧玲：委員那邊是有補充意見，就是這家可能要，呃，就是他的那個，一些呃……"],["林委員淑芬：你們都不知道？說不出來？在這裡說得「離離落落」的！"],["李科長巧玲：不是啦，是一些人員疏散的部分，建議他們還是要有一些具體的措施，因為那個……"],["林委員淑芬：人員疏散而已嗎？所以第一個，你們證實了的確在8月就是有進場去評鑑；第二個，你們也證實了評鑑的時候就看到有管線老舊和疏散動線等病安問題，你們當時就看到了，但是從8月到發生火災的10月3號之間，我要問你們，你們有要求醫療院所應立即改善嗎？有沒有要求他們應立即改善什麼？你都沒有要求，結果到10月3號就發生這樣的事故，人命耶！8條人命耶！有沒有要求他們做什麼？"],["邱部長泰源：報告委員……"],["林委員淑芬：所以今天不是只有消防局去調查火災原因事故，因為這都是事後的事情了，我現在講事發以前已經看到了，我們要求他們做了什麼呢？"],["邱部長泰源：請副司長跟委員報告。"],["劉副司長玉菁：跟委員報告一下，在醫院評鑑實地作業的時候會用各項目去做查核，實際上進行的時候，在查核項目上，現場當天沒有特別提出不符合的項目，但委員通常會就品質面求好心切，會有一些建議意見，並且在與……"],["林委員淑芬：品質面求好心切，聽好喔！所以管線老舊跟疏散動線等病安問題是求好心切的標準？照你的講法，這種話你講得出口嗎？"],["劉副司長玉菁：在醫院評鑑現場時都有……"],["林委員淑芬：部長，你來講，針對管線老舊和疏散動線的問題，醫策會的建議意見是吹毛求疵、求好心切，還是應該是標配？部長，你說說看。"],["邱部長泰源：因為評鑑有評鑑的標準項目，這個大概評鑑……"],["林委員淑芬：等一下我會跟你交流，評鑑的標準項目才是大問題！我現在問你說管線老舊及疏散動線有問題是標配還是選配就好了？"],["邱部長泰源：當然，病人的安全方面我們一定要做到，但是在醫院的評鑑裡面，它有一定的，經過多少年、多少專家……"],["林委員淑芬：部長，你不要再說這種五四三，都沒說到重點。你看這張圖，低樓層配電室起火的濃煙讓隔壁棟的5樓、10樓、11樓有這樣的傷亡，不要忘了，新營醫院北門分院及新北市臺北醫院附設護理之家，這個都死亡多少人啊，這重大傷亡，我們都知道醫院、護理之家裡面的情況，你叫這些病人情何以堪啊！在加護病房的人要怎麼逃生？他們就跟失能的人一樣，沒有辦法逃生的耶，所以你們現在講的這個，我提出這麼嚴肅的事情，你們現在好像還在事不關己。內湖的私人養護所死3個、2018年臺北護理之家死了十幾個，當時消防署就推動了修法，不論新建或變更的長照機構都要配備自動灑水設備、火警自動報警裝備以及設置119火災通報裝置，但是我請問部長，醫院有沒有在其中？這裡講的是護理之家、長照機構，請問醫院當時為什麼排除在外？為什麼醫院不在強制配置自動灑水設備、火警自動警報設備的範圍呢？醫院不需要嗎？醫院加護病房的人可以自動逃生嗎？為什麼他們不需要裝置這些必要的基本配備來保護這些看病的人？"],["邱部長泰源：報告委員……"],["林委員淑芬：你們的次長有講過一句話喔，林靜儀次長說，由於這次事故造成重大傷亡，很多人擔心醫院安全，對此感到疑慮，你們的次長都這樣講了，可是出一張嘴是沒用的！"],["邱部長泰源：有啦，我們有馬上啟動醫預法第三十五條……"],["林委員淑芬：什麼法？"],["邱部長泰源：醫療，呃，在衛福部這邊……"],["林委員淑芬：我現在講的是消防法耶！"],["邱部長泰源：跟委員報告一下，當天在評鑑的時候，其實消防局他們提出來的，在醫院裡面的消防法規跟他們應該具備的資料都是合格的……"],["林委員淑芬：我是在問你為什麼醫院不在強制配置自動灑水設備、火警自動警報設備的範圍？當時護理之家死了十幾個人，後來修法時，內政部消防署跟我們衛福部都有聯繫，為什麼當時的衛福部認為醫院不需要，你告訴我。"],["邱部長泰源：不是……"],["林委員淑芬：好，這樣好了，安泰是發生這個事情……"],["邱部長泰源：不好意思，因為當時發生火災是護理之家，所以特別……"],["林委員淑芬：當時發生火災是護理之家，然後都沒有想到醫院，這就是現在衛福部的能力與專業喔？"],["邱部長泰源：還有老福機構跟那個……"],["林委員淑芬：當時你們就沒有專業，不專業，只想到護理之家，沒想到醫院，那現在你認為醫院……"],["邱部長泰源：說實在的，醫院已經有一個非常好的評鑑，評鑑的時候……"],["林委員淑芬：醫院有非常好的評鑑，好，那我問你，就安泰醫院再重新評鑑一次，你覺不覺得他們會通過你們的評鑑？"],["邱部長泰源：通過評鑑是要整個實地查核、審議……"],["林委員淑芬：你不要在這裡都沒有專業啦，部長，這位是負責的醫策會代表嗎？"],["邱部長泰源：沒有，這位是醫事司副司長。"],["林委員淑芬：好，醫事司副司長，來，醫學中心就診民眾的命是命，區域醫院、地區醫院的人命不是命，安泰醫院是區域醫院，我為什麼講這一句話？因為醫學中心的評鑑標準當然都比區域醫院還要高，可是就區域醫院，你們的醫院評鑑基準及評量項目的第1篇「經營管理」第1.7章是「風險與危機管理」，其中「1.7.4」的項目是「醫院應指定專責人員研擬火災之減災、預防與準備措施」，評量項目很多，我們來看第6、7、8、9點，評量項目的第1點是「醫院設有防火管理人」，第6點是「能依診療環境、建築、病人及第一線應變人員特色，規劃符合所需之減災、預防與準備措施」，第7點是「病人不易疏散且宜採取就地避難之診療部門具有適當之防火區劃及病人持續性照護之備援計畫」，第8點是「每年定期檢討火災災害之減災、預防與準備措施之執行結果」。以上的評鑑項目都很棒很棒，但是備註第1點是「本條為試評條文，評量結果不納入評鑑成績計算」，請問不納入評鑑成績計算的評鑑，如果安泰醫院的這些項目評鑑不合格會納入計算嗎？不會！我跟你講不會。所以如果在評估安泰醫院他們有沒有減災、預防準備措施，他們的不易疏散、就地避難計畫提的不好，如果他們對於這些統統都沒有提出改善的成效，都沒關係，因為這個叫做試評，這些項目叫做試評，區域醫院跟地區醫院沒有評量這些項目，這些公共安全最核心的項目，區域醫院跟地區醫院是不在範疇裡面。換個角度，這些在醫學中心的評鑑是重點，是重點條文，可是審視你們現在在區域醫院、地區醫院，這個是試評，部長，這是試評，安泰醫院再去評還是一樣沒有關係。"],["邱部長泰源：報告委員，我們所有的醫院評鑑都是精益求精啦。"],["林委員淑芬：難怪你們副司長說這個是求好心切，因為評鑑沒有管到這麼多，這是試評，不納入成績……"],["邱部長泰源：因為在區域醫院……"],["林委員淑芬：如果你要求這個地方要做到好……"],["邱部長泰源：今年就要……"],["林委員淑芬：你先等一下，你如果要求這幾點要做到好，就是你副司長講的叫求好心切，可是站在病人、站在這些死亡病患家屬的立場，情何以堪？地區醫院、區域醫院這樣子可以嗎？部長，讓你說。"],["邱部長泰源：當然，對於病人的生命，我們都要完全的珍惜……"],["林委員淑芬：你不要說這種口號啦！我現在問你，你有沒有掌握目前還有公安問題的醫院有哪一些？還有幾家？你不要說完後，到時候又有一家發生問題……"],["邱部長泰源：因為這一次的經驗……"],["林委員淑芬：不要忘了，一個颱風來兩家醫院起火耶！"],["邱部長泰源：因為這些經驗，我們一定會深切的去檢討整個評鑑……"],["林委員淑芬：我現在不是在問你這個問題，你答非所問，浪費我們的時間。部長，醫策會網站也講了，106年到112年合格醫院名單有417家，但醫院評鑑效期在今年年底要到期的有117家，所以有四分之一家數的評鑑在年底要到期，你有沒有掌握到這117家到期要評鑑的醫院有哪些跟安泰醫院一樣有管線老舊及疏散動線的病安問題的，你們現在有沒有掌握？還是在評鑑放榜前，放著等醫院出事燒起來？還是說這是消防署的問題，跟你們無關？你們剛才就是這樣的態度啊！衛福部都不用監督、不用有輔導責任，病患的生命安全在你們官員裡面都是評鑑後醫院該負的責任嗎？都跟政府無關，是醫院的責任而已嗎？如果只是醫院的責任的話，那我們的評鑑算什麼！醫院評鑑的翻修制度，醫院評鑑的標準已經多久沒有改了……"],["邱部長泰源：醫院評鑑的確是品質跟安全啦。"],["林委員淑芬：我現在問你，你先回答我第一個問題，還有哪幾家醫院是你初步看起來真的還有問題的？不要說是哪幾家，還有幾家？"],["邱部長泰源：這個我們可能要做系統性的整理，把過去……"],["林委員淑芬：所以你們不知道，安泰醫院的狀況之前你們也沒有掌握。"],["邱部長泰源：因為所有醫院的消防設備是消防局那一邊要驗證的，要合乎規定……"],["林委員淑芬：醫院的消防設備在醫學中心是不是你們醫院評鑑的重點？什麼都推給消防局！"],["邱部長泰源：當然也是要……"],["林委員淑芬：你們醫院評鑑，尤其醫學中心評鑑的重點就醫院的公共安全，怎麼會說是消防局、消防署的問題！"],["邱部長泰源：任何一個醫院的公共安全都是重點啦，只是說他要求的當然是最安全的情況，但是……"],["林委員淑芬：所以你的意思是說火災跟你們衛福部沒關係，燒死幾個人跟衛福部也沒關係，那都是消防署的業務囉？"],["邱部長泰源：沒有、沒有，我不會這樣說，只是說層層來把關……"],["林委員淑芬：層層推卸啦！"],["邱部長泰源：層層來把關啦！"],["林委員淑芬：我現在問你的是，現在還有幾間醫院有類似的問題，你回答不出來卻說這個主責是在消防署！"],["邱部長泰源：沒有，我是說消防署是有他在消防方面的……"],["林委員淑芬：沒關係啦，你就回答我，因為你們就開始在進行評鑑了嘛。"],["邱部長泰源：至於說有幾間，我們再盤點一下。"],["林委員淑芬：你們有進行評鑑的地區醫院、區域醫院、醫學中心，因為醫學中心高標嘛……"],["邱部長泰源：我們再來盤點一下，大概……"],["林委員淑芬：所以你還要回去看？"],["邱部長泰源：對，我們來盤點一下。"],["林委員淑芬：那你們的醫院評鑑標準已經多久沒改了？副司長，現在怎麼樣了，你來說一下，醫院的評鑑標準多久沒改了？"],["劉副司長玉菁：跟委員報告，我們的醫院評鑑標準用一輪是四年，然後我們每年當中會……"],["林委員淑芬：我沒有問你評鑑的週期多久啦。"],["劉副司長玉菁：現在已經要啟動下一輪的評鑑……"],["林委員淑芬：我現在的問題是你的評鑑標準多久沒有改了，今年年初薛瑞元部長在的時候，他指出醫院評鑑包含醫學中心評鑑、教學醫院評鑑、醫學中心任務指標三項，這個都已經二十年沒有改變了，沒有大改變，所以已經啟動了醫學中心評鑑遊戲規則的調整……"],["邱部長泰源：這個據我瞭解一定都有改。"],["林委員淑芬：對，當時王必勝次長也說他兩年內要訂出初稿，要進行試評，表示三年後的下一次醫院評鑑，這個標準項目會改變，請問他們離開以後，這個評鑑基準調整的翻修進度現在到哪裡了？"],["邱部長泰源：其實以我的經驗來說，幾乎一直都在改……"],["林委員淑芬：我在問你進度到哪裡，我當然知道在改，但現到改到什麼程度了？進程是到哪裡了？副司長也不知道，部長也不知道，所以醫院評鑑不在你們業管範圍內嗎？"],["劉副司長玉菁：跟委員報告，我們還是補充一下，第一個，我們已經籌組好改革小組，再來會成立各基準討論增修的小組……"],["林委員淑芬：會成立？所以還沒成立，所以從今年年初薛瑞元到現在已經10月了，這一年快要過去了，只有要成立一個改革小組，組起來了沒？"],["劉副司長玉菁：已經組起來了。"],["林委員淑芬：組起來了，其他都還沒做？好，沒關係，這一次發生兩起醫院火災事件後，你們覺不覺得醫院評鑑還有哪些地方可以再調整？"],["邱部長泰源：我想在安全的部分，我們會特別加強……"],["林委員淑芬：安全講得太籠統了，什麼叫在安全的部分？"],["邱部長泰源：不管是消防的，當然醫療也有它的安全，還有消防硬體上的安全。"],["林委員淑芬：沒有啦，部長，你這樣太外行了，我們如果沒有消防專業的知識也要有常識，沒常識也要看電視，很多專技人員提出建議，譬如醫療機構的緊急應變手冊應該要考慮複合式災難的情境，火災加颱風，而且要做實際的演練。這一次颱風天在疏散的時候，一般室內火災是疏散戶外的空曠處，可是今天颱風來，你要疏散到哪裡去？只能在走廊，一樓戶外的空曠處不可得，就只能在急診室門口的走廊，急診室門口走廊是大家要緊急救災的，消防警消的救災要進行，要一邊救治病患，還要應對家屬詢問，還要面對強風驟雨對病患的影響，所以這種複合式災難到底應該要怎麼樣做，各種情境的scenario analysis都必須要放進去，對不對？你們的評鑑是不是要要求加強演練這種狀況？這有沒有護病比的問題啊？護病比現在在醫學中心的條件都比區域醫院還要好，區域醫院是不是因為人力太少了，護病比不足，或是交班時間，所以沒有人力可以疏散才會造成這麼大的傷亡？這個問題沒有重視的話，讓每一個到醫院看病的或是重症要看病的人都是非常的曝險啊！","再來，最重要的是防火區劃跟消防排煙系統問題失去功能，以剛才第一張來說，垂直防煙區劃如果做得好的話，煙不應該往上竄，應該鎖在二樓；如果水平防煙區劃做得好，煙就只會在機房，也不會跑到隔壁棟，所以這個是防火區劃沒有施作或施作後被破壞，在這種狀況下排煙系統沒有發揮功能，這個就是你們現在區域醫院跟地區醫院的評鑑裡面要納入重點的，這裡一個都不能夠死，怎麼會死了八個？一個也不行，你們的評鑑要不要納入機電設備的檢查保養？這個部分應該要怎麼樣去處理？所以這些評鑑的基準不論是翻修或新增，你要加入複合式災難的SOP的減災、預防和準備，都是有其必要性的。"],["邱部長泰源：好。"],["林委員淑芬：所以我剛剛講，部長，你們都沒有在想像，業務單位各司也沒有在想，覺得這都是消防署的事情，跟你們沒關係，問你現在醫院評鑑的基準，區域醫院、地區醫院要不要納入最重要的這些公安項目，要不要？地區醫院、區域醫院要不要把這些納入？"],["邱部長泰源：我想一定要，一定要。"],["林委員淑芬：好，那我再問你最後一個問題，抱歉，我講最後一點。如果醫院發生火災，電梯要不要切斷電源？要不要切？這一次切斷了全部的電源……"],["邱部長泰源：以目前的作法應該是切掉吧！"],["林委員淑芬：切斷了全部的電源，我告訴你，高樓層的加護病房的人，每個人要被推著病床，他們要怎麼疏散？加護病床死了四個啊！你不切斷也不行，那要怎麼辦？對不對？基隆長庚為什麼疏散這麼快？因為它還有電梯可以疏散，安泰醫院為什麼這麼慢？因為一開始，它所有電源都關掉了，都沒有了。到底要切掉電源還是不切掉電源？這兩家醫院作法不一樣。"],["邱部長泰源：報告委員，基隆長庚是剛好在屋頂。"],["林委員淑芬：對啊！所以我跟你講，中央主管機關和各個院所要進行我們剛剛講的scenario的analysis，針對各家醫院不同的地理條件、醫院特色、樓層分配、收治病人的行動力特色、各類災害的影響，所以不是在消防署網站下載一個消防防護計畫案例就交差了，你就通過了，這個才是重點。複合式災害發生時的SOP，還有細緻的討論我們醫院跟其他醫院不一樣，到時候是要切斷電源還是不切斷電源。對於這個災難，我們要痛定思痛，思考中央主管機關還能夠有什麼作為，我們的角色還能夠積極做什麼，避免複合式災難，極端氣候跟電力風險都要納入考量。護理人力流動率大，他的日常演練、訓練、應變能力不足的時候要怎麼辦，這是你們做部長的人要去思考的，不是立委要教你的嘛！所以在這裡我們真的是希望，抱歉！我不是針對安泰醫院這一家，安泰醫院是剛好發生這麼不幸的事情，但很多制度面還有醫院的個案面都值得拿出來討論。我再說一次，我們做一個立委，我不是要找這個醫院的麻煩，我們希望中央把責任扛起來，如果我不談這個問題，我們就太偽善、太鄉愿了。部長，你要回去好好檢討啦。"],["邱部長泰源：好，謝謝委員的指教，我想我們一定痛定思痛，從各方面來尋求最大的改善，給病人最大的安全，謝謝委員。"],["主席：謝謝林委員，謝謝部長。我在此報告，王育敏委員發言完畢後，我們休息10分鐘；我們中午不休息，等到我發言的時候我再補充一下，謝謝。","再來請邱鎮軍委員質詢。"]],"agenda":{"page_end":346,"meet_id":"委員會-11-2-26-2","speakers":["蘇清泉","林月琴","陳昭姿","陳菁徽","廖偉翔","盧縣一","林淑芬","邱鎮軍","王育敏","王正旭","黃秀芳","李坤城","楊曜","黃國昌","鍾佳濱","林楚茵","洪申翰","黃捷","吳春城","洪孟楷","楊瓊瓔","何欣純","林宜瑾","羅智強","張雅琳","涂權吉","陳培瑜","劉建國","陳瑩","林倩綺","張嘉郡"],"page_start":257,"meetingDate":["2024-10-09"],"gazette_id":"1138201","agenda_lcidc_ids":["1138201_00006"],"meet_name":"立法院第11屆第2會期社會福利及衛生環境委員會第2次全體委員會議紀錄","content":"邀請衛生福利部部長就「我國人工生殖法制化作業進度」、「衛生福利部落實中央政府我國少子\n女化對策計畫之成效與未來規劃」及「衛生福利部本月因疏於督導地方評估特殊需求兒少利益所\n受監察院糾正之檢討」進行專題報告，並備質詢","agenda_id":"1138201_00005"}}}