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366.485, \"end\": 369.648, \"text\": \"因為我們現在委員都還沒有這個委員佔了一個民間代表的缺他用民間代表的身份進去裡面當委員据有行政決策權\", \"words\": [{\"word\": \"因\", \"start\": 366.485, \"end\": 366.585, \"score\": 0.739}, {\"word\": \"為\"}, {\"word\": \"我\", \"start\": 366.585, \"end\": 366.605, \"score\": 0.0}, {\"word\": \"們\"}, {\"word\": \"現\"}, {\"word\": \"在\", \"start\": 366.605, \"end\": 366.725, \"score\": 0.823}, {\"word\": \"委\", \"start\": 366.725, \"end\": 366.805, \"score\": 0.295}, {\"word\": \"員\"}, {\"word\": \"都\", \"start\": 366.805, \"end\": 366.926, \"score\": 0.507}, {\"word\": \"還\"}, {\"word\": \"沒\", \"start\": 366.926, \"end\": 367.146, \"score\": 0.688}, {\"word\": \"有\", \"start\": 367.146, \"end\": 367.166, \"score\": 0.0}, {\"word\": \"這\"}, {\"word\": \"個\"}, {\"word\": \"委\", \"start\": 367.166, \"end\": 367.186, \"score\": 0.457}, {\"word\": \"員\"}, {\"word\": \"佔\"}, {\"word\": \"了\", \"start\": 367.186, \"end\": 367.306, \"score\": 0.741}, {\"word\": \"一\", \"start\": 367.306, \"end\": 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{\"word\": \"規\"}, {\"word\": \"定\", \"start\": 1028.602, \"end\": 1028.622, \"score\": 0.0}, {\"word\": \"就\", \"start\": 1028.622, \"end\": 1028.662, \"score\": 0.452}, {\"word\": \"是\", \"start\": 1028.662, \"end\": 1028.742, \"score\": 0.749}, {\"word\": \"要\", \"start\": 1028.742, \"end\": 1028.782, \"score\": 0.5}, {\"word\": \"兩\"}, {\"word\": \"位\", \"start\": 1028.782, \"end\": 1028.802, \"score\": 0.0}, {\"word\": \"醫\"}, {\"word\": \"師\"}]}, {\"start\": 1055.891, \"end\": 1078.732, \"text\": \"沒有啦,你的手術都沒有規定要麻醉專科醫師在那裡了,還什麼兩位醫師?你的手術本身就沒有規定要專科醫師執行麻醉了,還什麼兩個醫生?所以這樣你知道嗎?不好意思主席,你讓我這個主題問完了,這是一個安全的問題,我快說好了。所以我現在說這個這樣\", \"words\": [{\"word\": \"沒\", \"start\": 1055.891, \"end\": 1056.432, \"score\": 0.869}, {\"word\": \"有\", \"start\": 1056.432, \"end\": 1056.612, \"score\": 0.824}, {\"word\": \"啦\", \"start\": 1056.612, \"end\": 1057.132, \"score\": 0.92}, {\"word\": \",\"}, {\"word\": \"你\", \"start\": 1057.132, \"end\": 1057.312, \"score\": 0.693}, {\"word\": \"的\", \"start\": 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\"兩\"}, {\"word\": \"類\"}]}, {\"start\": 1386.007, \"end\": 1386.508, \"text\": \"新聞報告及專題報告\", \"words\": [{\"word\": \"新\", \"start\": 1386.007, \"end\": 1386.147, \"score\": 0.854}, {\"word\": \"聞\"}, {\"word\": \"報\"}, {\"word\": \"告\", \"start\": 1386.147, \"end\": 1386.327, \"score\": 0.882}, {\"word\": \"及\", \"start\": 1386.327, \"end\": 1386.488, \"score\": 0.821}, {\"word\": \"專\"}, {\"word\": \"題\"}, {\"word\": \"報\"}, {\"word\": \"告\", \"start\": 1386.488, \"end\": 1386.508, \"score\": 0.0}]}, {\"start\": 1407.071, \"end\": 1407.131, \"text\": \"這位蘇偉川講的\", \"words\": [{\"word\": \"這\"}, {\"word\": \"位\", \"start\": 1407.071, \"end\": 1407.091, \"score\": 0.0}, {\"word\": \"蘇\"}, {\"word\": \"偉\"}, {\"word\": \"川\", \"start\": 1407.091, \"end\": 1407.111, \"score\": 0.0}, {\"word\": \"講\"}, {\"word\": \"的\", \"start\": 1407.111, \"end\": 1407.131, \"score\": 0.0}]}, {\"start\": 1427.93, \"end\": 1446.585, \"text\": \"沒有所屬是診所自行去選填他要認證哪一類是要光電類還是手術類但是呢電波拉皮就是光電治療不會在醫策會現行診所的麻醉鎮靜安全查核的範圍內所以他如果認證為光電類認證何可\", \"words\": [{\"word\": \"沒\", \"start\": 1427.93, \"end\": 1428.23, \"score\": 0.903}, {\"word\": \"有\", \"start\": 1428.23, \"end\": 1428.45, \"score\": 0.761}, {\"word\": \"所\", \"start\": 1428.45, \"end\": 1428.971, \"score\": 0.884}, {\"word\": \"屬\"}, {\"word\": \"是\", \"start\": 1428.971, \"end\": 1429.531, \"score\": 0.848}, {\"word\": \"診\"}, {\"word\": \"所\", \"start\": 1429.531, \"end\": 1429.792, \"score\": 0.88}, {\"word\": \"自\", \"start\": 1429.792, \"end\": 1429.952, \"score\": 0.79}, {\"word\": \"行\", \"start\": 1429.952, \"end\": 1430.192, \"score\": 0.898}, {\"word\": \"去\", \"start\": 1430.192, \"end\": 1430.612, \"score\": 0.676}, {\"word\": \"選\"}, {\"word\": \"填\", \"start\": 1430.612, \"end\": 1430.912, \"score\": 0.885}, {\"word\": \"他\", \"start\": 1430.912, \"end\": 1431.073, \"score\": 0.854}, {\"word\": \"要\", \"start\": 1431.073, \"end\": 1431.573, \"score\": 0.727}, 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1674.698, \"score\": 0.956}, {\"word\": \"淑\", \"start\": 1674.698, \"end\": 1674.859, \"score\": 0.875}, {\"word\": \"芬\", \"start\": 1674.859, \"end\": 1674.879, \"score\": 0.0}], \"language\": \"zh\"}","srt":"1\n00:00:06,825 --> 00:00:10,348\n主席各位大家早是不是請我們邱部長部長早你當過立委嗎那你現在擔任部長所以你應該清楚立法權跟行政權的差異吧\n\n2\n00:00:31,176 --> 00:00:47,122\n你知道公共工程會在9月下旬預告修正採購評選委員會組織準則第4條之一它主要就針對考量各級民意機關、民意代表\n\n3\n00:00:48,182 --> 00:01:02,695\n擔任機關採購案的評選委員．有造成行政權和立法權．兩者混淆衝突的可能．所以進行修法．那部長你知道這個事情嗎?你知道這件事嗎?我沒有瞭解到那麼詳細．但是這樣的方向是對的這件事這麼大條你有沒有看過?好吧?方向是對的你認為有沒有必要?\n\n4\n00:01:19,377 --> 00:01:20,238\n你覺得他們這樣修正有沒有必要?不知道。\n\n5\n00:01:32,243 --> 00:01:56,914\n民意代表不能夠去擔任啊應該是這樣子啊因為我們從小公民課本就教學生啊三權分立或是五權分立嘛立法權跟行政權本身就有各自的權責啊憲法第63條你知道我們當立委的立法院有議決、法律案、預算案、戒嚴案、大設案、宣戰、構合、條約案及國家其他重要事項之權嘛\n\n6\n00:01:58,534 --> 00:02:12,368\n我們立法院就是在這樣的一個基礎上和範圍上來監督行政權所以民意代表同時擔任行政機關各類審議的委員當然不合理啊對不對\n\n7\n00:02:15,052 --> 00:02:27,278\n對阿所以工程會才會預告修正這個草案的原因也在這裡然後社會輿論也討論過了大家都覺得不合理阿那就你了解你覺得不合理嘛衛福部有沒有類似這樣的狀況\n\n8\n00:02:30,069 --> 00:02:39,099\n有沒有?你就你組織來,有沒有?對啊,你的評選委員啊,各類的行政組織的委員會的運作,你行政部門的各類的組織的各委員會的運作有沒有這種狀況,你知不知道?\n\n9\n00:02:52,613 --> 00:03:18,211\n主席委員好衛福部目前我們所知這個事情是沒有那所屬機關到目前為止沒有報過來過你說所屬機關怎樣沒有報上來過衛福部都沒有所屬機關你不知道意思是這樣子嘛來你不知道我給你報備來啦我們PowerPoint的給他看一下啦你看有人就自動上去了\n\n10\n00:03:19,505 --> 00:03:24,250\n有人自動上台了我都還沒有請署長上台他自己就上台了\n\n11\n00:03:26,314 --> 00:03:37,537\n署長自己知道啦健保署下的相關會議全民健康保險藥物共同擬定會議這個會議這麼重要哦重要哦他在決定啊什麼藥物要不要納入健保給付這個會議就是標準的行政權啊有行政決策權啊\n\n12\n00:03:51,847 --> 00:04:06,076\n這樣的一個會議裡面,這個共領會議,簡稱共領會議,現在,現在,仍然有專家委員,號稱專家委員是現職的民意代表。23、24年,兩年的名單。\n\n13\n00:04:12,382 --> 00:04:22,232\n結果暴力法院今年2月報到以後他也沒有辭職以自己黨的最高道德標準來看他決定要辭職他沒有辭了他沒有辭的狀況裡面\n\n14\n00:04:28,057 --> 00:04:53,874\n開了七次會議請假三次他自己請假三次參與四次我並不想針對他但是單純就事論事我在這裡提醒衛福部你們在各個機關下的審議會議設置要點或辦法當中要不要需不需要把民意代表是不是擔任相關委員會的委員要不要進行盤點\n\n15\n00:04:58,037 --> 00:05:07,104\n你們又不要把所有的辦法規定回去改一改,避免立法權跟行政權混亂混淆。部長。好,謝謝委員的主教。我們會回去做整體的檢討。你不敢說要改,你要檢討。什麼叫檢討?\n\n16\n00:05:22,820 --> 00:05:40,654\n檢討就是要改的然後要怎麼改你的各個委員會還有立法委員在裡面擔任委員嗎立委又兼行政決策權然後又說他來監督行政部門你自己都行政決策權然後監督你說要回頭去監督行政部門這不是笑話嗎署長你怎麼說要改\n\n17\n00:05:45,585 --> 00:06:00,318\n跟委員報告剛好這個任期也到了我們現在正在全面的檢討那個下一任就是明年二五二六會不會再有立委擔任委員我們會審慎的審慎你不敢說不會你不敢說不會你還要續聘他嗎\n\n18\n00:06:06,485 --> 00:06:09,648\n因為我們現在委員都還沒有這個委員佔了一個民間代表的缺他用民間代表的身份進去裡面當委員据有行政決策權\n\n19\n00:06:19,198 --> 00:06:38,705\n人家民間都沒其他的人啊。一會兒在裏面,自己就可以監督行政機關了。還有理由在民間的發言機制代表民間去佔位子嗎?再來,立委以專家學者的身份在你們的會議裡面發言,我問你啦,這個立委對你預算有生殺大權。你們在開會的時候,\n\n20\n00:06:42,679 --> 00:06:59,522\n你敢對他所的意見提出不同意見嗎?他可以監督行政機關：有掌握你們的預算權：很多人都只能夠接受他所提出來的意見這一種立委當委員你們敢違逆他的意見嗎?你現在不跟我說嗎?跟委員報告一句話有這種立委做委員的嗎?不要說人啦!不一定是他啦!\n\n21\n00:07:12,858 --> 00:07:14,439\n你敢敢敢的什麼呢?立委自己做、立委自己去行政院內、行政部門內做委員又有行政決策權又有立委對行政的預算監督權都一共的贏\n\n22\n00:07:32,814 --> 00:08:00,060\n現在還有嗎?你這麼不敢說?不會啦這個跟委員報告當然過去這個陳委員齁長期是我們專家委員是我們專家會議的委員很久長期單院立委的時候就應該要知道角色衝突違反三權分立又是行政權又是立法權又是行政決策權又有立法院的監督預算權像話嗎?\n\n23\n00:08:02,865 --> 00:08:06,307\n你現在是他會代言的嗎,署長?不是針對他,我們就事論事。制度面!制度面改一改了啦!人家看到工程會被社會討論得沸沸揚揚了!\n\n24\n00:08:20,917 --> 00:08:29,085\n你們都還在那裏恃若無睹部長你不知道部長你的輸掉根本不知道明明都知道但是他有什麼不敢得罪立委他的委就是因為是立委啦所以不敢給他拿掉啦這就是為什麼需要改革這個就是為什麼今天輪到我在這裏當壞人的原因嘛\n\n25\n00:08:46,946 --> 00:08:50,128\n來你自己主動改革的甘需要關起來我都叫做派人所以這個由此可知啊立委又兼行政部門的委員多麼的多麼的憤憾格多麼的衝突多麼的不合理\n\n26\n00:09:07,318 --> 00:09:35,441\n市長,您要回去改改,都要改改啦,好不好?好,我們會檢討來改進。好,那很好。那我要問下一個問題。下一個問題也很嚴重。一個女子在中山區某連鎖醫美中心打電波拉皮。麻醉後血氧濃度下降,送醫搶救不至。然後麻醉醫師就出來呼籲,所有類型的醫美麻醉都應該由麻醉專科醫師執行。我們大家看到都說奇怪,怎麼這麼嚴重?\n\n27\n00:09:37,382 --> 00:09:45,465\n部長,你12月9日出席衛福部活動的時候有受訪。你說,如果相關專科醫學會有任何建議,你們會立即召開討論,進一步強化規範。我現在問你,過去十年裡面,因為醫美麻醉而導致死亡的案例和案件數量有多少?\n\n28\n00:10:01,283 --> 00:10:27,794\n一件事我相信你今天在看來說這問題有多嚴重啊會覺得一個個案過去十年過去十年因為醫美麻醉而死亡多少案例?報告委員我想我們品質安全就是這不是啦你就告訴我數量就好了不要講東講西的啦一、四、四你不知道你們看到這個個案發生你們都無動於衷嗎?\n\n29\n00:10:30,976 --> 00:10:55,489\n統計數據這次在過去裏面是沒有的,這缺點先跟...沒有,可是你看到個案發生了,你不會想說我快要看了,你看醫事司司長,你不會想到說這個問題有多嚴重嗎?去做電波拉皮的女性有多少、男性有多少,你不會覺得風險有多少跟你醫事司的業務有關,你不會聯想到嗎?你不覺得你有保護人民的權利義務、權利嗎?\n\n30\n00:10:58,365 --> 00:11:25,051\n所以我們這次是先了解到使用的藥物是所謂的POPOPO這個藥物是需要做…市長!你不要跟我講你有多關心啦!連一年多少個案發生麻醉死亡在醫美裡面你不知道我覺得你很害怕啦!我再問你一下你總是要去分析這些醫美麻醉產生醫療糾紛的案例的亂象有哪些吧那你才能想說你要怎麼去改善這一些亂象吧\n\n31\n00:11:26,391 --> 00:11:32,595\n你怎麽不能向你們部長說,誒,待會兒麻醉醫學會,醫學會來歡迎起來我就來討論。誒,中央沒有掌握問題,沒有分析亂象,然後叫醫學會、民間組織提對策,這樣不好做,您這醫事室司長太好做啊,您這部長太好做啊,如果這樣我林淑芬就可以來做啊。\n\n32\n00:11:50,166 --> 00:12:04,937\n報告委員真的我從我以前擔任醫師公會的幹部以後我非常清楚這整個醫美的管理所以這大概這10年來醫師是真的非常用很多的心因為醫美麻醉產生的糾紛\n\n33\n00:12:11,401 --> 00:12:14,164\n到底有多嚴重啊?你說你們很勇敢啊!你們說你們很多人在管理啊!你就告訴我問題有多嚴重?你說不出來說你們很勇敢在這裡睜眼說瞎話嘛!我跟你講安全就最重要可是你連安全的課題你都沒有掌握\n\n34\n00:12:33,183 --> 00:12:38,807\n你現在根據特定醫療技術檢驗醫療儀器施行或使用管理辦法第25、29只有執行第25條的第7、第8大類第7項8大類特定美容醫學手術的全身麻醉或非全身麻醉的靜脈注射麻醉你們才規定要有麻醉專科醫師執行你們認為中度及輕度的這個鎮靜麻醉不需要專科醫師執行\n\n35\n00:13:03,383 --> 00:13:28,458\n然後你們在這裡就告訴我們說來怎麼都很注重安全而這一次出事情的你們都知道是用所謂舒眠麻醉這一種話術讓消費者讓去做電波拉棉覺得說舒眠睡一下而已嘛舒眠麻醉然後其實你們打的是牛奶針你們自己都知道這個叫婆婆佛牛奶針\n\n36\n00:13:32,950 --> 00:13:52,491\n麻醉專科醫師蘇柏川表示,市面上主張的牛奶針大多都是深度鎮靜。現實上,只要俗稱牛奶針的Provo,都應該全部要找麻醉專科醫師。\n\n37\n00:13:54,213 --> 00:14:11,067\n中度鎮靜容易因為外界刺激減少或病患個人的因素瞬間會掉到深度鎮靜而病患在深度鎮靜的時候如果發生呼吸道阻塞只有5分鐘可以搶救所以站在安全的立場你們說你們管很多你們這一點就完全中放沒得管\n\n38\n00:14:16,631 --> 00:14:32,269\n所有的麻醉這種使用到牛奶針全部要麻醉專科醫師您沒有規範高雄長庚醫院麻醉部教授及的主治醫師吳少群有說醫美打電波清醒可以講話叫做中度鎮靜\n\n39\n00:14:34,651 --> 00:14:46,437\n打電波完全睡著叫深度鎮靜而深度鎮靜是最危險的一種麻醉方式非常容易呼吸抑制或心血管中樞抑制只有具專業的麻醉專科醫師在床監測才能確保病人安全\n\n40\n00:14:55,162 --> 00:15:01,205\n食藥署自己也說：食藥署的先翁稿說牛奶這一需要由專業醫師給藥使用過程必須由醫療人員持續監測病患的心臟及呼吸功能避免因藥物過量導致呼吸衰竭而死亡而台灣在2020年當時的麻醉醫學會的理事長陳坤寶他在撰寫美容醫學這個麻醉的時候也提到\n\n41\n00:15:21,414 --> 00:15:49,929\n靜脈全身麻醉是現行美容醫學為整形也漸漸在使用全身麻醉作為主要麻醉的方式是一種趨勢喔!欸!為整形現在很流行全身麻醉靜脈全身麻醉喔!你敢這樣管然後呢一定要有麻醉專科醫師在場否則一旦出事不堪後果不堪設想\n\n42\n00:15:51,041 --> 00:15:51,181\n同一個醫生．\n\n43\n00:16:08,584 --> 00:16:26,956\n同時執行兩項業務部長你覺得合適嗎?我又是麻醉科醫師我同時執行麻醉我又做電波拉皮的手術我同時在做這個手術你覺得一個醫生做兩個工作適合嗎?同時有關於這一點應該要有兩位醫師在處理\n\n44\n00:16:36,813 --> 00:16:39,881\n對,台灣麻醉醫學會吳少群李氏在他寫的\n\n45\n00:16:41,738 --> 00:17:07,441\n常見的麻醉迷思和安全建議如下實務上手術醫師因為要專注在手術如果又分心兼職麻醉常常因為受製者會動而他就會一直加深劑量或是給到受製者不動了卻忘了要頻繁監測受製者的生理治療重新評估一條降維持劑量\n\n46\n00:17:08,502 --> 00:17:08,802\n我們規定就是要兩位醫師\n\n47\n00:17:35,891 --> 00:17:58,732\n沒有啦,你的手術都沒有規定要麻醉專科醫師在那裡了,還什麼兩位醫師?你的手術本身就沒有規定要專科醫師執行麻醉了,還什麼兩個醫生?所以這樣你知道嗎?不好意思主席,你讓我這個主題問完了,這是一個安全的問題,我快說好了。所以我現在說這個這樣\n\n48\n00:18:01,598 --> 00:18:25,026\n你覺得醫美診所為了省下那個錢買來要加上沒規定衛福部醫事師沒有規定啦對醫美沒有這麼多規定啦那不要再講這個你知道各縣市喔核准施行特定美容醫學手術的醫療機構一共有幾家嗎醫美診所到今年全國有幾家你知道嗎應該是700多家\n\n49\n00:18:28,820 --> 00:18:36,026\n合準實行特定手術的啦。700多家。那你知道麻醉科人數全國一共有多少人嗎?\n\n50\n00:18:37,557 --> 00:19:01,901\n一千六百個不要講大醫院職業也不要講說有執照然後他會就業的光是你的醫美診所七百多家那大醫院的麻醉手術要怎麼進行所以台灣的麻醉專科醫師的量能夠嗎扣掉你說的七百多家的醫院他可以配置足夠的麻醉專科醫師嗎如果大家連個法律給丟回去大家都愛麻醉科醫師\n\n51\n00:19:06,549 --> 00:19:07,450\n欸?幹嘛搞?\n\n52\n00:19:07,450 --> 00:19:31,118\n所以部長你剛剛講的不可以手術醫師兼任麻醉業務這個叫驚罵醫美診所的常態在每次的醫美診所發生麻醉事故以後呢你們到底有沒有真的去反省每一次的不幸的事故都要成為你政策上除錯的反省的機制啊那你們剛才從剛才問到現在都沒有\n\n53\n00:19:36,255 --> 00:19:57,131\n您們有一個什麼東西可以把關醫美診所?我先補充幾件事。第一件事情陳國剛那個人在推詢的麻醉其實基本上面他為什麼要做危險分級的原因就是因為人力要用在最適當的位置那也因為這樣其實是由另外一個受過專業訓練的\n\n54\n00:19:58,672 --> 00:20:03,977\n其實所以訓練一起在協助醫生這才是重點你們的特定醫療技術檢查檢驗醫療儀器施行或使用的管理辦法只有第25條的第7項的八大類的特定美容醫學手術需要具備這個麻醉專科醫師啦而你們所謂的中度或輕度的鎮靜麻醉沒有規定啦他有需要訓練這個有寫\n\n55\n00:20:25,996 --> 00:20:35,980\n有訓練：現在就講手術醫師跟麻醉不能同一個人啦：這也是寫在裡面：這個就是最大的風險啦：現在寶弟我再跟你問啦：你們醫策會2019年其實有鑑於診所人力醫院資源不如醫院充足且沒有醫院評鑑這一種東西：\n\n56\n00:20:48,946 --> 00:20:56,731\n所以為了推升診所整體美容醫學服務品質你們辦了一個診所美容醫學的品質認證就是以安全為基軸要強調專業人員的資格資訊的透明、環境的安全專業及安全的醫療行為突發事件緊急應變措施及客訴處理追蹤服務等就是你講的來反正你們做這些醫美診所的要去認證安全結果呢\n\n57\n00:21:16,943 --> 00:21:22,008\n你全部認證和有通過你們認證的有幾家你知道嗎現在應該診所的部分好像剩30幾家左右30幾家41家我看的是41家你全部你說700多家只有41家從2019年到現在5年了\n\n58\n00:21:39,345 --> 00:21:56,686\n五年你全部獲得認證的比例低成這個樣子叫做你們重視醫美診所的安全你這樣說出來是笑話嘛所以呢全台核准的施行特定美容醫學手術機構這些診所是不是都安全\n\n59\n00:21:57,679 --> 00:22:03,426\n你們的認證率這麼低,不到一成。你說這樣的醫美診所的品質足夠叫做安全嗎?你們的認證都是最基本的、最核心的。含你的認證的不敢參加。\n\n60\n00:22:12,958 --> 00:22:27,747\n而由此可知外面的醫美診所的品質安全多麼堪憂啊!我補充一下其實就是法規是樓地板,品質的要求是天花板所以在這個中間的...你賣大家玩文字遊戲!\n\n61\n00:22:28,928 --> 00:22:43,917\n那如果這麼樣子的話為什麼你認證五年的時間認證只有四十一家他在這邊其實是會牽涉到就是我覺得要問你這個不要講那麼多出事的這一家醫美診所有沒有通過你們認證你回答我應該是沒有應該是阿來有勒這因為我不確定\n\n62\n00:22:52,316 --> 00:22:55,558\n蘇百川醫師來講喔你們在這個認證是以安全為基礎保障人民就醫的安全但是參與的診所偏少然後這個認證的項目分成兩類哪兩類\n\n63\n00:23:06,007 --> 00:23:06,508\n新聞報告及專題報告\n\n64\n00:23:27,071 --> 00:23:27,131\n這位蘇偉川講的\n\n65\n00:23:47,930 --> 00:24:06,585\n沒有所屬是診所自行去選填他要認證哪一類是要光電類還是手術類但是呢電波拉皮就是光電治療不會在醫策會現行診所的麻醉鎮靜安全查核的範圍內所以他如果認證為光電類認證何可\n\n66\n00:24:11,169 --> 00:24:19,576\n也不保證他的麻醉鎮靜安全的安全因為醫策會沒有集合這一個項目另外申請手術類人家醫美診所也有偷吃包我只要去選割雙眼皮就好了\n\n67\n00:24:30,504 --> 00:24:31,705\n因為割雙眼皮不在特管法規範的手術內．所以為依這位去認證．也不會特別去查有沒有符合麻醉規範．老實說啦,醫美診所．再去接一個麻醉專科醫師．\n\n68\n00:24:49,025 --> 00:25:15,681\n給開的大家都要寫這個字這個成本然後呢大家寫我光電類認證過了但是你的麻醉安全沒有其實政府不要管你我手術類認證過了但我申請的是雙眼皮然後消費者看不見看不見電波拉皮的光電類嘛然後你以為他手術安全認證了這麼好那我就選有認證的結果他的認證只有選割雙眼皮\n\n69\n00:25:18,800 --> 00:25:25,523\n不然這樣你聽得到嗎?你都不知道,你的問題很嚴重。你一、四、五、六、七、八、九、十幾年,個案發生了還是有動於中?沒有想到我整體的醫美診所、醫美的這一些要怎麼規範都沒在想,就要你為了這給你提起。不然這樣提起後,你聽得到嗎?要解釋嗎?\n\n70\n00:25:43,702 --> 00:25:47,025\n市長,那你在這裡承諾,市長你覺得就哪幾面向你要處理?我會覺得是第一個第一件事情其實是\n\n71\n00:26:01,072 --> 00:26:02,933\n那一個醫生同時執行麻醉又執行手術那要怎麼處理?\n\n72\n00:26:30,601 --> 00:26:46,845\n現況就是規定在美濃醫學這邊是不行的所以我才會說落實規定這件事情你們要去集合嗎?全國你說如果不行大家都這樣做呢那很簡單喔你去要求他執行這個叫電波拉皮執行什麼手術的然後他的專科醫師有用到這個蒸的牛奶蒸的\n\n73\n00:26:57,248 --> 00:27:22,687\n那她的醫師有使用麻醉科醫師嗎?麻醉科醫師有沒有蓋章?全國總機察就知道了啊,絕對沒有的嘛我會覺得是說落實這一塊其實是所有醫界都會很關心的然後怎麼樣在人力上面做到我現在講的是行政管理啦,行政管理沒有行政管理、沒有法規就等於是沒好大家講什麼都假\n\n74\n00:27:24,328 --> 00:27:52,376\n現在特管辦法裡面的美容醫療這一塊的輕度到中度就是需要兩個人的這件事情我覺得是我們可以來做弱勢的一項人家醫學會告訴你只要有牛奶針就絕對是必須要有麻醉科醫師啦不是一個人分四兩角啦對啊然後也不是中度的啦中度同時還要再把它煮下去讓它沒丁沒丁才比較好吸收對不對融液這個問題很嚴重你們要好好想一下\n\n75\n00:27:54,237 --> 00:27:54,879\n謝謝林淑芬\n\n","tsv":"start\tend\ttext\n6825\t10348\t主席各位大家早是不是請我們邱部長部長早你當過立委嗎那你現在擔任部長所以你應該清楚立法權跟行政權的差異吧\n31176\t47122\t你知道公共工程會在9月下旬預告修正採購評選委員會組織準則第4條之一它主要就針對考量各級民意機關、民意代表\n48182\t62695\t擔任機關採購案的評選委員．有造成行政權和立法權．兩者混淆衝突的可能．所以進行修法．那部長你知道這個事情嗎?你知道這件事嗎?我沒有瞭解到那麼詳細．但是這樣的方向是對的這件事這麼大條你有沒有看過?好吧?方向是對的你認為有沒有必要?\n79377\t80238\t你覺得他們這樣修正有沒有必要?不知道。\n92243\t116914\t民意代表不能夠去擔任啊應該是這樣子啊因為我們從小公民課本就教學生啊三權分立或是五權分立嘛立法權跟行政權本身就有各自的權責啊憲法第63條你知道我們當立委的立法院有議決、法律案、預算案、戒嚴案、大設案、宣戰、構合、條約案及國家其他重要事項之權嘛\n118534\t132368\t我們立法院就是在這樣的一個基礎上和範圍上來監督行政權所以民意代表同時擔任行政機關各類審議的委員當然不合理啊 對不對\n135052\t147278\t對阿所以工程會才會預告修正這個草案的原因也在這裡然後社會輿論也討論過了大家都覺得不合理阿那就你了解你覺得不合理嘛衛福部有沒有類似這樣的狀況\n150069\t159099\t有沒有?你就你組織來,有沒有?對啊,你的評選委員啊,各類的行政組織的委員會的運作,你行政部門的各類的組織的各委員會的運作有沒有這種狀況,你知不知道?\n172613\t198211\t主席委員好衛福部目前我們所知這個事情是沒有那所屬機關到目前為止沒有報過來過你說所屬機關怎樣沒有報上來過衛福部都沒有所屬機關你不知道意思是這樣子嘛來你不知道我給你報備來啦我們PowerPoint的給他看一下啦你看有人就自動上去了\n199505\t204250\t有人自動上台了我都還沒有請署長上台他自己就上台了\n206314\t217537\t署長自己知道啦健保署下的相關會議全民健康保險藥物共同擬定會議這個會議這麼重要哦重要哦他在決定啊什麼藥物要不要納入健保給付這個會議就是標準的行政權啊有行政決策權啊\n231847\t246076\t這樣的一個會議裡面,這個共領會議,簡稱共領會議,現在,現在,仍然有專家委員,號稱專家委員是現職的民意代表。23、24年,兩年的名單。\n252382\t262232\t結果暴力法院今年2月報到以後他也沒有辭職以自己黨的最高道德標準來看他決定要辭職他沒有辭了他沒有辭的狀況裡面\n268057\t293874\t開了七次會議請假三次他自己請假三次參與四次我並不想針對他但是單純就事論事我在這裡提醒衛福部你們在各個機關下的審議會議設置要點或辦法當中要不要需不需要把民意代表是不是擔任相關委員會的委員要不要進行盤點\n298037\t307104\t你們又不要把所有的辦法規定回去改一改,避免立法權跟行政權混亂混淆。部長。好,謝謝委員的主教。我們會回去做整體的檢討。你不敢說要改,你要檢討。什麼叫檢討?\n322820\t340654\t檢討就是要改的然後要怎麼改你的各個委員會還有立法委員在裡面擔任委員嗎立委又兼行政決策權然後又說他來監督行政部門你自己都行政決策權然後監督你說要回頭去監督行政部門這不是笑話嗎署長你怎麼說要改\n345585\t360318\t跟委員報告剛好這個任期也到了我們現在正在全面的檢討那個下一任就是明年 二五二六會不會再有立委擔任委員我們會審慎的審慎你不敢說不會你不敢說不會你還要續聘他嗎\n366485\t369648\t因為我們現在委員都還沒有這個委員佔了一個民間代表的缺他用民間代表的身份進去裡面當委員据有行政決策權\n379198\t398705\t人家民間都沒其他的人啊。一會兒在裏面,自己就可以監督行政機關了。還有理由在民間的發言機制代表民間去佔位子嗎?再來,立委以專家學者的身份在你們的會議裡面發言,我問你啦,這個立委對你預算有生殺大權。你們在開會的時候,\n402679\t419522\t你敢對他所的意見提出不同意見嗎?他可以監督行政機關：有掌握你們的預算權：很多人都只能夠接受他所提出來的意見這一種立委當委員你們敢違逆他的意見嗎?你現在不跟我說嗎?跟委員報告一句話有這種立委做委員的嗎?不要說人啦!不一定是他啦!\n432858\t434439\t你敢敢敢的什麼呢?立委自己做、立委自己去行政院內、行政部門內做委員又有行政決策權又有立委對行政的預算監督權都一共的贏\n452814\t480060\t現在還有嗎?你這麼不敢說?不會啦 這個跟委員報告當然過去這個陳委員齁長期是我們專家委員是我們專家會議的委員很久長期單院立委的時候就應該要知道角色衝突違反三權分立又是行政權又是立法權又是行政決策權又有立法院的監督預算權像話嗎?\n482865\t486307\t你現在是他會代言的嗎,署長?不是針對他,我們就事論事。制度面!制度面改一改了啦!人家看到工程會被社會討論得沸沸揚揚了!\n500917\t509085\t你們都還在那裏恃若無睹 部長你不知道 部長你的輸掉根本不知道 明明都知道 但是他有什麼不敢得罪立委 他的委就是因為是立委啦 所以不敢給他拿掉啦 這就是為什麼需要改革 這個就是為什麼今天輪到我在這裏當壞人的原因嘛\n526946\t530128\t來你自己主動改革的甘需要關起來我都叫做派人所以這個由此可知啊立委又兼行政部門的委員多麼的多麼的憤 憾格多麼的衝突多麼的不合理\n547318\t575441\t市長,您要回去改改,都要改改啦,好不好?好,我們會檢討來改進。好,那很好。那我要問下一個問題。下一個問題也很嚴重。一個女子在中山區某連鎖醫美中心打電波拉皮。麻醉後血氧濃度下降,送醫搶救不至。然後麻醉醫師就出來呼籲,所有類型的醫美麻醉都應該由麻醉專科醫師執行。我們大家看到都說奇怪,怎麼這麼嚴重?\n577382\t585465\t部長,你12月9日出席衛福部活動的時候有受訪。你說,如果相關專科醫學會有任何建議,你們會立即召開討論,進一步強化規範。我現在問你,過去十年裡面,因為醫美麻醉而導致死亡的案例和案件數量有多少?\n601283\t627794\t一件事我相信你今天在看來說這問題有多嚴重啊會覺得一個個案過去十年過去十年因為醫美麻醉而死亡多少案例?報告委員我想我們品質安全就是這不是啦你就告訴我數量就好了不要講東講西的啦一、四、四你不知道你們看到這個個案發生你們都無動於衷嗎?\n630976\t655489\t統計數據這次在過去裏面是沒有的,這缺點先跟...沒有,可是你看到個案發生了,你不會想說我快要看了,你看醫事司司長,你不會想到說這個問題有多嚴重嗎?去做電波拉皮的女性有多少、男性有多少,你不會覺得風險有多少跟你醫事司的業務有關,你不會聯想到嗎?你不覺得你有保護人民的權利義務、權利嗎?\n658365\t685051\t所以我們這次是先了解到使用的藥物是所謂的POPOPO這個藥物是需要做…市長!你不要跟我講你有多關心啦!連一年多少個案發生麻醉死亡在醫美裡面你不知道我覺得你很害怕啦!我再問你一下你總是要去分析這些醫美麻醉產生醫療糾紛的案例的亂象有哪些吧那你才能想說你要怎麼去改善這一些亂象吧\n686391\t692595\t你怎麽不能向你們部長說,誒,待會兒麻醉醫學會,醫學會來歡迎起來我就來討論。誒,中央沒有掌握問題,沒有分析亂象,然後叫醫學會、民間組織提對策,這樣不好做,您這醫事室司長太好做啊,您這部長太好做啊,如果這樣我林淑芬就可以來做啊。\n710166\t724937\t報告委員真的我從我以前擔任醫師公會的幹部以後我非常清楚這整個醫美的管理所以這大概這10年來醫師是真的非常用很多的心因為醫美麻醉產生的糾紛\n731401\t734164\t到底有多嚴重啊?你說你們很勇敢啊!你們說你們很多人在管理啊!你就告訴我問題有多嚴重?你說不出來說你們很勇敢在這裡睜眼說瞎話嘛!我跟你講安全就最重要可是你連安全的課題你都沒有掌握\n753183\t758807\t你現在根據特定醫療技術檢驗醫療儀器施行或使用管理辦法第25、29只有執行第25條的第7、第8大類第7項8大類特定美容醫學手術的全身麻醉或非全身麻醉的靜脈注射麻醉你們才規定要有麻醉專科醫師執行你們認為中度及輕度的這個鎮靜麻醉不需要專科醫師執行\n783383\t808458\t然後你們在這裡就告訴我們說來怎麼都很注重安全而這一次出事情的你們都知道是用所謂舒眠麻醉這一種話術讓消費者讓去做電波拉棉覺得說舒眠睡一下而已嘛舒眠麻醉然後其實你們打的是牛奶針你們自己都知道這個叫婆婆佛牛奶針\n812950\t832491\t麻醉專科醫師蘇柏川表示,市面上主張的牛奶針大多都是深度鎮靜。現實上,只要俗稱牛奶針的Provo,都應該全部要找麻醉專科醫師。\n834213\t851067\t中度鎮靜容易因為外界刺激減少或病患個人的因素瞬間會掉到深度鎮靜而病患在深度鎮靜的時候如果發生呼吸道阻塞只有5分鐘可以搶救所以站在安全的立場你們說你們管很多你們這一點就完全中放沒得管\n856631\t872269\t所有的麻醉這種使用到牛奶針全部要麻醉專科醫師您沒有規範高雄長庚醫院麻醉部教授及的主治醫師吳少群有說醫美打電波清醒可以講話叫做中度鎮靜\n874651\t886437\t打電波完全睡著叫深度鎮靜而深度鎮靜是最危險的一種麻醉方式非常容易呼吸抑制或心血管中樞抑制只有具專業的麻醉專科醫師在床監測才能確保病人安全\n895162\t901205\t食藥署自己也說：食藥署的先翁稿說牛奶這一需要由專業醫師給藥使用過程必須由醫療人員持續監測病患的心臟及呼吸功能避免因藥物過量導致呼吸衰竭而死亡而台灣在2020年當時的麻醉醫學會的理事長陳坤寶他在撰寫美容醫學這個麻醉的時候也提到\n921414\t949929\t靜脈全身麻醉是現行美容醫學為整形也漸漸在使用全身麻醉作為主要麻醉的方式是一種趨勢喔!欸!為整形現在很流行全身麻醉靜脈全身麻醉喔!你敢這樣管然後呢一定要有麻醉專科醫師在場否則一旦出事不堪後果不堪設想\n951041\t951181\t同一個醫生．\n968584\t986956\t同時執行兩項業務部長你覺得合適嗎?我又是麻醉科醫師我同時執行麻醉我又做電波拉皮的手術我同時在做這個手術你覺得一個醫生做兩個工作適合嗎?同時有關於這一點應該要有兩位醫師在處理\n996813\t999881\t對,台灣麻醉醫學會吳少群李氏在他寫的\n1001738\t1027441\t常見的麻醉迷思和安全建議如下實務上手術醫師因為要專注在手術如果又分心兼職麻醉常常因為受製者會動而他就會一直加深劑量或是給到受製者不動了卻忘了要頻繁監測受製者的生理治療重新評估一條降維持劑量\n1028502\t1028802\t我們規定就是要兩位醫師\n1055891\t1078732\t沒有啦,你的手術都沒有規定要麻醉專科醫師在那裡了,還什麼兩位醫師?你的手術本身就沒有規定要專科醫師執行麻醉了,還什麼兩個醫生?所以這樣你知道嗎?不好意思主席,你讓我這個主題問完了,這是一個安全的問題,我快說好了。所以我現在說這個這樣\n1081598\t1105026\t你覺得醫美診所為了省下那個錢買來要加上沒規定衛福部醫事師沒有規定啦對醫美沒有這麼多規定啦那不要再講這個你知道各縣市喔核准施行特定美容醫學手術的醫療機構一共有幾家嗎醫美診所到今年全國有幾家你知道嗎應該是700多家\n1108820\t1116026\t合準實行特定手術的啦。700多家。那你知道麻醉科人數全國一共有多少人嗎?\n1117557\t1141901\t一千六百個不要講大醫院職業也不要講說有執照然後他會就業的光是你的醫美診所七百多家那大醫院的麻醉手術要怎麼進行所以台灣的麻醉專科醫師的量能夠嗎扣掉你說的七百多家的醫院他可以配置足夠的麻醉專科醫師嗎如果大家連個法律給丟回去大家都愛麻醉科醫師\n1146549\t1147450\t欸?幹嘛搞?\n1147450\t1171118\t所以部長你剛剛講的不可以手術醫師兼任麻醉業務這個叫驚罵醫美診所的常態在每次的醫美診所發生麻醉事故以後呢你們到底有沒有真的去反省每一次的不幸的事故都要成為你政策上除錯的反省的機制啊那你們剛才從剛才問到現在都沒有\n1176255\t1197131\t您們有一個什麼東西可以把關醫美診所?我先補充幾件事。第一件事情陳國剛那個人在推詢的麻醉其實基本上面他為什麼要做危險分級的原因就是因為人力要用在最適當的位置那也因為這樣其實是由另外一個受過專業訓練的\n1198672\t1203977\t其實所以訓練一起在協助醫生這才是重點你們的特定醫療技術檢查檢驗醫療儀器施行或使用的管理辦法只有第25條的第7項的八大類的特定美容醫學手術需要具備這個麻醉專科醫師啦而你們所謂的中度或輕度的鎮靜麻醉沒有規定啦他有需要訓練這個有寫\n1225996\t1235980\t有訓練：現在就講手術醫師跟麻醉不能同一個人啦：這也是寫在裡面：這個就是最大的風險啦：現在寶弟我再跟你問啦：你們醫策會2019年其實有鑑於診所人力醫院資源不如醫院充足且沒有醫院評鑑這一種東西：\n1248946\t1256731\t所以為了推升診所整體美容醫學服務品質你們辦了一個診所美容醫學的品質認證就是以安全為基軸要強調專業人員的資格資訊的透明、環境的安全專業及安全的醫療行為突發事件緊急應變措施及客訴處理追蹤服務等就是你講的來反正你們做這些醫美診所的要去認證安全結果呢\n1276943\t1282008\t你全部認證和有通過你們認證的有幾家你知道嗎現在應該診所的部分好像剩30幾家左右30幾家41家我看的是41家你全部你說700多家只有41家從2019年到現在5年了\n1299345\t1316686\t五年你全部獲得認證的比例低成這個樣子叫做你們重視醫美診所的安全你這樣說出來是笑話嘛所以呢全台核准的施行特定美容醫學手術機構這些診所是不是都安全\n1317679\t1323426\t你們的認證率這麼低,不到一成。你說這樣的醫美診所的品質足夠叫做安全嗎?你們的認證都是最基本的、最核心的。含你的認證的不敢參加。\n1332958\t1347747\t而由此可知外面的醫美診所的品質安全多麼堪憂啊!我補充一下其實就是法規是樓地板,品質的要求是天花板所以在這個中間的...你賣大家玩文字遊戲!\n1348928\t1363917\t那如果這麼樣子的話為什麼你認證五年的時間認證只有四十一家他在這邊其實是會牽涉到就是我覺得要問你這個不要講那麼多出事的這一家醫美診所有沒有通過你們認證你回答我應該是沒有應該是 阿來有勒這因為我不確定\n1372316\t1375558\t蘇百川醫師來講喔你們在這個認證是以安全為基礎保障人民就醫的安全但是參與的診所偏少然後這個認證的項目分成兩類哪兩類\n1386007\t1386508\t新聞報告及專題報告\n1407071\t1407131\t這位蘇偉川講的\n1427930\t1446585\t沒有所屬是診所自行去選填他要認證哪一類是要光電類還是手術類但是呢電波拉皮就是光電治療不會在醫策會現行診所的麻醉鎮靜安全查核的範圍內所以他如果認證為光電類認證何可\n1451169\t1459576\t也不保證他的麻醉鎮靜安全的安全因為醫策會沒有集合這一個項目另外申請手術類人家醫美診所也有偷吃包我只要去選割雙眼皮就好了\n1470504\t1471705\t因為割雙眼皮不在特管法規範的手術內．所以為依這位去認證．也不會特別去查有沒有符合麻醉規範．老實說啦,醫美診所．再去接一個麻醉專科醫師．\n1489025\t1515681\t給開的大家都要寫這個字這個成本然後呢大家寫我光電類認證過了但是你的麻醉安全沒有其實政府不要管你我手術類認證過了但我申請的是雙眼皮然後消費者看不見看不見電波拉皮的光電類嘛然後你以為他手術安全認證了這麼好那我就選有認證的結果他的認證只有選割雙眼皮\n1518800\t1525523\t不然這樣你聽得到嗎?你都不知道,你的問題很嚴重。你一、四、五、六、七、八、九、十幾年,個案發生了還是有動於中?沒有想到我整體的醫美診所、醫美的這一些要怎麼規範都沒在想,就要你為了這給你提起。不然這樣提起後,你聽得到嗎?要解釋嗎?\n1543702\t1547025\t市長,那你在這裡承諾,市長你覺得就哪幾面向你要處理?我會覺得是第一個第一件事情其實是\n1561072\t1562933\t那一個醫生同時執行麻醉又執行手術那要怎麼處理?\n1590601\t1606845\t現況就是規定在美濃醫學這邊是不行的所以我才會說落實規定這件事情你們要去集合嗎?全國你說如果不行大家都這樣做呢那很簡單喔你去要求他執行這個叫電波拉皮執行什麼手術的然後他的專科醫師有用到這個蒸的牛奶蒸的\n1617248\t1642687\t那她的醫師有使用麻醉科醫師嗎?麻醉科醫師有沒有蓋章?全國總機察就知道了啊,絕對沒有的嘛我會覺得是說落實這一塊其實是所有醫界都會很關心的然後怎麼樣在人力上面做到我現在講的是行政管理啦,行政管理沒有行政管理、沒有法規就等於是沒好大家講什麼都假\n1644328\t1672376\t現在特管辦法裡面的美容醫療這一塊的輕度到中度就是需要兩個人的這件事情我覺得是我們可以來做弱勢的一項人家醫學會告訴你只要有牛奶針就絕對是必須要有麻醉科醫師啦不是一個人分四兩角啦對啊然後也不是中度的啦中度同時還要再把它煮下去讓它沒丁沒丁才比較好吸收對不對融液這個問題很嚴重你們要好好想一下\n1674237\t1674879\t謝謝林淑芬\n","txt":"主席各位大家早是不是請我們邱部長部長早你當過立委嗎那你現在擔任部長所以你應該清楚立法權跟行政權的差異吧\n你知道公共工程會在9月下旬預告修正採購評選委員會組織準則第4條之一它主要就針對考量各級民意機關、民意代表\n擔任機關採購案的評選委員．有造成行政權和立法權．兩者混淆衝突的可能．所以進行修法．那部長你知道這個事情嗎?你知道這件事嗎?我沒有瞭解到那麼詳細．但是這樣的方向是對的這件事這麼大條你有沒有看過?好吧?方向是對的你認為有沒有必要?\n你覺得他們這樣修正有沒有必要?不知道。\n民意代表不能夠去擔任啊應該是這樣子啊因為我們從小公民課本就教學生啊三權分立或是五權分立嘛立法權跟行政權本身就有各自的權責啊憲法第63條你知道我們當立委的立法院有議決、法律案、預算案、戒嚴案、大設案、宣戰、構合、條約案及國家其他重要事項之權嘛\n我們立法院就是在這樣的一個基礎上和範圍上來監督行政權所以民意代表同時擔任行政機關各類審議的委員當然不合理啊 對不對\n對阿所以工程會才會預告修正這個草案的原因也在這裡然後社會輿論也討論過了大家都覺得不合理阿那就你了解你覺得不合理嘛衛福部有沒有類似這樣的狀況\n有沒有?你就你組織來,有沒有?對啊,你的評選委員啊,各類的行政組織的委員會的運作,你行政部門的各類的組織的各委員會的運作有沒有這種狀況,你知不知道?\n主席委員好衛福部目前我們所知這個事情是沒有那所屬機關到目前為止沒有報過來過你說所屬機關怎樣沒有報上來過衛福部都沒有所屬機關你不知道意思是這樣子嘛來你不知道我給你報備來啦我們PowerPoint的給他看一下啦你看有人就自動上去了\n有人自動上台了我都還沒有請署長上台他自己就上台了\n署長自己知道啦健保署下的相關會議全民健康保險藥物共同擬定會議這個會議這麼重要哦重要哦他在決定啊什麼藥物要不要納入健保給付這個會議就是標準的行政權啊有行政決策權啊\n這樣的一個會議裡面,這個共領會議,簡稱共領會議,現在,現在,仍然有專家委員,號稱專家委員是現職的民意代表。23、24年,兩年的名單。\n結果暴力法院今年2月報到以後他也沒有辭職以自己黨的最高道德標準來看他決定要辭職他沒有辭了他沒有辭的狀況裡面\n開了七次會議請假三次他自己請假三次參與四次我並不想針對他但是單純就事論事我在這裡提醒衛福部你們在各個機關下的審議會議設置要點或辦法當中要不要需不需要把民意代表是不是擔任相關委員會的委員要不要進行盤點\n你們又不要把所有的辦法規定回去改一改,避免立法權跟行政權混亂混淆。部長。好,謝謝委員的主教。我們會回去做整體的檢討。你不敢說要改,你要檢討。什麼叫檢討?\n檢討就是要改的然後要怎麼改你的各個委員會還有立法委員在裡面擔任委員嗎立委又兼行政決策權然後又說他來監督行政部門你自己都行政決策權然後監督你說要回頭去監督行政部門這不是笑話嗎署長你怎麼說要改\n跟委員報告剛好這個任期也到了我們現在正在全面的檢討那個下一任就是明年 二五二六會不會再有立委擔任委員我們會審慎的審慎你不敢說不會你不敢說不會你還要續聘他嗎\n因為我們現在委員都還沒有這個委員佔了一個民間代表的缺他用民間代表的身份進去裡面當委員据有行政決策權\n人家民間都沒其他的人啊。一會兒在裏面,自己就可以監督行政機關了。還有理由在民間的發言機制代表民間去佔位子嗎?再來,立委以專家學者的身份在你們的會議裡面發言,我問你啦,這個立委對你預算有生殺大權。你們在開會的時候,\n你敢對他所的意見提出不同意見嗎?他可以監督行政機關：有掌握你們的預算權：很多人都只能夠接受他所提出來的意見這一種立委當委員你們敢違逆他的意見嗎?你現在不跟我說嗎?跟委員報告一句話有這種立委做委員的嗎?不要說人啦!不一定是他啦!\n你敢敢敢的什麼呢?立委自己做、立委自己去行政院內、行政部門內做委員又有行政決策權又有立委對行政的預算監督權都一共的贏\n現在還有嗎?你這麼不敢說?不會啦 這個跟委員報告當然過去這個陳委員齁長期是我們專家委員是我們專家會議的委員很久長期單院立委的時候就應該要知道角色衝突違反三權分立又是行政權又是立法權又是行政決策權又有立法院的監督預算權像話嗎?\n你現在是他會代言的嗎,署長?不是針對他,我們就事論事。制度面!制度面改一改了啦!人家看到工程會被社會討論得沸沸揚揚了!\n你們都還在那裏恃若無睹 部長你不知道 部長你的輸掉根本不知道 明明都知道 但是他有什麼不敢得罪立委 他的委就是因為是立委啦 所以不敢給他拿掉啦 這就是為什麼需要改革 這個就是為什麼今天輪到我在這裏當壞人的原因嘛\n來你自己主動改革的甘需要關起來我都叫做派人所以這個由此可知啊立委又兼行政部門的委員多麼的多麼的憤 憾格多麼的衝突多麼的不合理\n市長,您要回去改改,都要改改啦,好不好?好,我們會檢討來改進。好,那很好。那我要問下一個問題。下一個問題也很嚴重。一個女子在中山區某連鎖醫美中心打電波拉皮。麻醉後血氧濃度下降,送醫搶救不至。然後麻醉醫師就出來呼籲,所有類型的醫美麻醉都應該由麻醉專科醫師執行。我們大家看到都說奇怪,怎麼這麼嚴重?\n部長,你12月9日出席衛福部活動的時候有受訪。你說,如果相關專科醫學會有任何建議,你們會立即召開討論,進一步強化規範。我現在問你,過去十年裡面,因為醫美麻醉而導致死亡的案例和案件數量有多少?\n一件事我相信你今天在看來說這問題有多嚴重啊會覺得一個個案過去十年過去十年因為醫美麻醉而死亡多少案例?報告委員我想我們品質安全就是這不是啦你就告訴我數量就好了不要講東講西的啦一、四、四你不知道你們看到這個個案發生你們都無動於衷嗎?\n統計數據這次在過去裏面是沒有的,這缺點先跟...沒有,可是你看到個案發生了,你不會想說我快要看了,你看醫事司司長,你不會想到說這個問題有多嚴重嗎?去做電波拉皮的女性有多少、男性有多少,你不會覺得風險有多少跟你醫事司的業務有關,你不會聯想到嗎?你不覺得你有保護人民的權利義務、權利嗎?\n所以我們這次是先了解到使用的藥物是所謂的POPOPO這個藥物是需要做…市長!你不要跟我講你有多關心啦!連一年多少個案發生麻醉死亡在醫美裡面你不知道我覺得你很害怕啦!我再問你一下你總是要去分析這些醫美麻醉產生醫療糾紛的案例的亂象有哪些吧那你才能想說你要怎麼去改善這一些亂象吧\n你怎麽不能向你們部長說,誒,待會兒麻醉醫學會,醫學會來歡迎起來我就來討論。誒,中央沒有掌握問題,沒有分析亂象,然後叫醫學會、民間組織提對策,這樣不好做,您這醫事室司長太好做啊,您這部長太好做啊,如果這樣我林淑芬就可以來做啊。\n報告委員真的我從我以前擔任醫師公會的幹部以後我非常清楚這整個醫美的管理所以這大概這10年來醫師是真的非常用很多的心因為醫美麻醉產生的糾紛\n到底有多嚴重啊?你說你們很勇敢啊!你們說你們很多人在管理啊!你就告訴我問題有多嚴重?你說不出來說你們很勇敢在這裡睜眼說瞎話嘛!我跟你講安全就最重要可是你連安全的課題你都沒有掌握\n你現在根據特定醫療技術檢驗醫療儀器施行或使用管理辦法第25、29只有執行第25條的第7、第8大類第7項8大類特定美容醫學手術的全身麻醉或非全身麻醉的靜脈注射麻醉你們才規定要有麻醉專科醫師執行你們認為中度及輕度的這個鎮靜麻醉不需要專科醫師執行\n然後你們在這裡就告訴我們說來怎麼都很注重安全而這一次出事情的你們都知道是用所謂舒眠麻醉這一種話術讓消費者讓去做電波拉棉覺得說舒眠睡一下而已嘛舒眠麻醉然後其實你們打的是牛奶針你們自己都知道這個叫婆婆佛牛奶針\n麻醉專科醫師蘇柏川表示,市面上主張的牛奶針大多都是深度鎮靜。現實上,只要俗稱牛奶針的Provo,都應該全部要找麻醉專科醫師。\n中度鎮靜容易因為外界刺激減少或病患個人的因素瞬間會掉到深度鎮靜而病患在深度鎮靜的時候如果發生呼吸道阻塞只有5分鐘可以搶救所以站在安全的立場你們說你們管很多你們這一點就完全中放沒得管\n所有的麻醉這種使用到牛奶針全部要麻醉專科醫師您沒有規範高雄長庚醫院麻醉部教授及的主治醫師吳少群有說醫美打電波清醒可以講話叫做中度鎮靜\n打電波完全睡著叫深度鎮靜而深度鎮靜是最危險的一種麻醉方式非常容易呼吸抑制或心血管中樞抑制只有具專業的麻醉專科醫師在床監測才能確保病人安全\n食藥署自己也說：食藥署的先翁稿說牛奶這一需要由專業醫師給藥使用過程必須由醫療人員持續監測病患的心臟及呼吸功能避免因藥物過量導致呼吸衰竭而死亡而台灣在2020年當時的麻醉醫學會的理事長陳坤寶他在撰寫美容醫學這個麻醉的時候也提到\n靜脈全身麻醉是現行美容醫學為整形也漸漸在使用全身麻醉作為主要麻醉的方式是一種趨勢喔!欸!為整形現在很流行全身麻醉靜脈全身麻醉喔!你敢這樣管然後呢一定要有麻醉專科醫師在場否則一旦出事不堪後果不堪設想\n同一個醫生．\n同時執行兩項業務部長你覺得合適嗎?我又是麻醉科醫師我同時執行麻醉我又做電波拉皮的手術我同時在做這個手術你覺得一個醫生做兩個工作適合嗎?同時有關於這一點應該要有兩位醫師在處理\n對,台灣麻醉醫學會吳少群李氏在他寫的\n常見的麻醉迷思和安全建議如下實務上手術醫師因為要專注在手術如果又分心兼職麻醉常常因為受製者會動而他就會一直加深劑量或是給到受製者不動了卻忘了要頻繁監測受製者的生理治療重新評估一條降維持劑量\n我們規定就是要兩位醫師\n沒有啦,你的手術都沒有規定要麻醉專科醫師在那裡了,還什麼兩位醫師?你的手術本身就沒有規定要專科醫師執行麻醉了,還什麼兩個醫生?所以這樣你知道嗎?不好意思主席,你讓我這個主題問完了,這是一個安全的問題,我快說好了。所以我現在說這個這樣\n你覺得醫美診所為了省下那個錢買來要加上沒規定衛福部醫事師沒有規定啦對醫美沒有這麼多規定啦那不要再講這個你知道各縣市喔核准施行特定美容醫學手術的醫療機構一共有幾家嗎醫美診所到今年全國有幾家你知道嗎應該是700多家\n合準實行特定手術的啦。700多家。那你知道麻醉科人數全國一共有多少人嗎?\n一千六百個不要講大醫院職業也不要講說有執照然後他會就業的光是你的醫美診所七百多家那大醫院的麻醉手術要怎麼進行所以台灣的麻醉專科醫師的量能夠嗎扣掉你說的七百多家的醫院他可以配置足夠的麻醉專科醫師嗎如果大家連個法律給丟回去大家都愛麻醉科醫師\n欸?幹嘛搞?\n所以部長你剛剛講的不可以手術醫師兼任麻醉業務這個叫驚罵醫美診所的常態在每次的醫美診所發生麻醉事故以後呢你們到底有沒有真的去反省每一次的不幸的事故都要成為你政策上除錯的反省的機制啊那你們剛才從剛才問到現在都沒有\n您們有一個什麼東西可以把關醫美診所?我先補充幾件事。第一件事情陳國剛那個人在推詢的麻醉其實基本上面他為什麼要做危險分級的原因就是因為人力要用在最適當的位置那也因為這樣其實是由另外一個受過專業訓練的\n其實所以訓練一起在協助醫生這才是重點你們的特定醫療技術檢查檢驗醫療儀器施行或使用的管理辦法只有第25條的第7項的八大類的特定美容醫學手術需要具備這個麻醉專科醫師啦而你們所謂的中度或輕度的鎮靜麻醉沒有規定啦他有需要訓練這個有寫\n有訓練：現在就講手術醫師跟麻醉不能同一個人啦：這也是寫在裡面：這個就是最大的風險啦：現在寶弟我再跟你問啦：你們醫策會2019年其實有鑑於診所人力醫院資源不如醫院充足且沒有醫院評鑑這一種東西：\n所以為了推升診所整體美容醫學服務品質你們辦了一個診所美容醫學的品質認證就是以安全為基軸要強調專業人員的資格資訊的透明、環境的安全專業及安全的醫療行為突發事件緊急應變措施及客訴處理追蹤服務等就是你講的來反正你們做這些醫美診所的要去認證安全結果呢\n你全部認證和有通過你們認證的有幾家你知道嗎現在應該診所的部分好像剩30幾家左右30幾家41家我看的是41家你全部你說700多家只有41家從2019年到現在5年了\n五年你全部獲得認證的比例低成這個樣子叫做你們重視醫美診所的安全你這樣說出來是笑話嘛所以呢全台核准的施行特定美容醫學手術機構這些診所是不是都安全\n你們的認證率這麼低,不到一成。你說這樣的醫美診所的品質足夠叫做安全嗎?你們的認證都是最基本的、最核心的。含你的認證的不敢參加。\n而由此可知外面的醫美診所的品質安全多麼堪憂啊!我補充一下其實就是法規是樓地板,品質的要求是天花板所以在這個中間的...你賣大家玩文字遊戲!\n那如果這麼樣子的話為什麼你認證五年的時間認證只有四十一家他在這邊其實是會牽涉到就是我覺得要問你這個不要講那麼多出事的這一家醫美診所有沒有通過你們認證你回答我應該是沒有應該是 阿來有勒這因為我不確定\n蘇百川醫師來講喔你們在這個認證是以安全為基礎保障人民就醫的安全但是參與的診所偏少然後這個認證的項目分成兩類哪兩類\n新聞報告及專題報告\n這位蘇偉川講的\n沒有所屬是診所自行去選填他要認證哪一類是要光電類還是手術類但是呢電波拉皮就是光電治療不會在醫策會現行診所的麻醉鎮靜安全查核的範圍內所以他如果認證為光電類認證何可\n也不保證他的麻醉鎮靜安全的安全因為醫策會沒有集合這一個項目另外申請手術類人家醫美診所也有偷吃包我只要去選割雙眼皮就好了\n因為割雙眼皮不在特管法規範的手術內．所以為依這位去認證．也不會特別去查有沒有符合麻醉規範．老實說啦,醫美診所．再去接一個麻醉專科醫師．\n給開的大家都要寫這個字這個成本然後呢大家寫我光電類認證過了但是你的麻醉安全沒有其實政府不要管你我手術類認證過了但我申請的是雙眼皮然後消費者看不見看不見電波拉皮的光電類嘛然後你以為他手術安全認證了這麼好那我就選有認證的結果他的認證只有選割雙眼皮\n不然這樣你聽得到嗎?你都不知道,你的問題很嚴重。你一、四、五、六、七、八、九、十幾年,個案發生了還是有動於中?沒有想到我整體的醫美診所、醫美的這一些要怎麼規範都沒在想,就要你為了這給你提起。不然這樣提起後,你聽得到嗎?要解釋嗎?\n市長,那你在這裡承諾,市長你覺得就哪幾面向你要處理?我會覺得是第一個第一件事情其實是\n那一個醫生同時執行麻醉又執行手術那要怎麼處理?\n現況就是規定在美濃醫學這邊是不行的所以我才會說落實規定這件事情你們要去集合嗎?全國你說如果不行大家都這樣做呢那很簡單喔你去要求他執行這個叫電波拉皮執行什麼手術的然後他的專科醫師有用到這個蒸的牛奶蒸的\n那她的醫師有使用麻醉科醫師嗎?麻醉科醫師有沒有蓋章?全國總機察就知道了啊,絕對沒有的嘛我會覺得是說落實這一塊其實是所有醫界都會很關心的然後怎麼樣在人力上面做到我現在講的是行政管理啦,行政管理沒有行政管理、沒有法規就等於是沒好大家講什麼都假\n現在特管辦法裡面的美容醫療這一塊的輕度到中度就是需要兩個人的這件事情我覺得是我們可以來做弱勢的一項人家醫學會告訴你只要有牛奶針就絕對是必須要有麻醉科醫師啦不是一個人分四兩角啦對啊然後也不是中度的啦中度同時還要再把它煮下去讓它沒丁沒丁才比較好吸收對不對融液這個問題很嚴重你們要好好想一下\n謝謝林淑芬\n","vtt":"WEBVTT\n\n00:06.825 --> 00:10.348\n主席各位大家早是不是請我們邱部長部長早你當過立委嗎那你現在擔任部長所以你應該清楚立法權跟行政權的差異吧\n\n00:31.176 --> 00:47.122\n你知道公共工程會在9月下旬預告修正採購評選委員會組織準則第4條之一它主要就針對考量各級民意機關、民意代表\n\n00:48.182 --> 01:02.695\n擔任機關採購案的評選委員．有造成行政權和立法權．兩者混淆衝突的可能．所以進行修法．那部長你知道這個事情嗎?你知道這件事嗎?我沒有瞭解到那麼詳細．但是這樣的方向是對的這件事這麼大條你有沒有看過?好吧?方向是對的你認為有沒有必要?\n\n01:19.377 --> 01:20.238\n你覺得他們這樣修正有沒有必要?不知道。\n\n01:32.243 --> 01:56.914\n民意代表不能夠去擔任啊應該是這樣子啊因為我們從小公民課本就教學生啊三權分立或是五權分立嘛立法權跟行政權本身就有各自的權責啊憲法第63條你知道我們當立委的立法院有議決、法律案、預算案、戒嚴案、大設案、宣戰、構合、條約案及國家其他重要事項之權嘛\n\n01:58.534 --> 02:12.368\n我們立法院就是在這樣的一個基礎上和範圍上來監督行政權所以民意代表同時擔任行政機關各類審議的委員當然不合理啊對不對\n\n02:15.052 --> 02:27.278\n對阿所以工程會才會預告修正這個草案的原因也在這裡然後社會輿論也討論過了大家都覺得不合理阿那就你了解你覺得不合理嘛衛福部有沒有類似這樣的狀況\n\n02:30.069 --> 02:39.099\n有沒有?你就你組織來,有沒有?對啊,你的評選委員啊,各類的行政組織的委員會的運作,你行政部門的各類的組織的各委員會的運作有沒有這種狀況,你知不知道?\n\n02:52.613 --> 03:18.211\n主席委員好衛福部目前我們所知這個事情是沒有那所屬機關到目前為止沒有報過來過你說所屬機關怎樣沒有報上來過衛福部都沒有所屬機關你不知道意思是這樣子嘛來你不知道我給你報備來啦我們PowerPoint的給他看一下啦你看有人就自動上去了\n\n03:19.505 --> 03:24.250\n有人自動上台了我都還沒有請署長上台他自己就上台了\n\n03:26.314 --> 03:37.537\n署長自己知道啦健保署下的相關會議全民健康保險藥物共同擬定會議這個會議這麼重要哦重要哦他在決定啊什麼藥物要不要納入健保給付這個會議就是標準的行政權啊有行政決策權啊\n\n03:51.847 --> 04:06.076\n這樣的一個會議裡面,這個共領會議,簡稱共領會議,現在,現在,仍然有專家委員,號稱專家委員是現職的民意代表。23、24年,兩年的名單。\n\n04:12.382 --> 04:22.232\n結果暴力法院今年2月報到以後他也沒有辭職以自己黨的最高道德標準來看他決定要辭職他沒有辭了他沒有辭的狀況裡面\n\n04:28.057 --> 04:53.874\n開了七次會議請假三次他自己請假三次參與四次我並不想針對他但是單純就事論事我在這裡提醒衛福部你們在各個機關下的審議會議設置要點或辦法當中要不要需不需要把民意代表是不是擔任相關委員會的委員要不要進行盤點\n\n04:58.037 --> 05:07.104\n你們又不要把所有的辦法規定回去改一改,避免立法權跟行政權混亂混淆。部長。好,謝謝委員的主教。我們會回去做整體的檢討。你不敢說要改,你要檢討。什麼叫檢討?\n\n05:22.820 --> 05:40.654\n檢討就是要改的然後要怎麼改你的各個委員會還有立法委員在裡面擔任委員嗎立委又兼行政決策權然後又說他來監督行政部門你自己都行政決策權然後監督你說要回頭去監督行政部門這不是笑話嗎署長你怎麼說要改\n\n05:45.585 --> 06:00.318\n跟委員報告剛好這個任期也到了我們現在正在全面的檢討那個下一任就是明年二五二六會不會再有立委擔任委員我們會審慎的審慎你不敢說不會你不敢說不會你還要續聘他嗎\n\n06:06.485 --> 06:09.648\n因為我們現在委員都還沒有這個委員佔了一個民間代表的缺他用民間代表的身份進去裡面當委員据有行政決策權\n\n06:19.198 --> 06:38.705\n人家民間都沒其他的人啊。一會兒在裏面,自己就可以監督行政機關了。還有理由在民間的發言機制代表民間去佔位子嗎?再來,立委以專家學者的身份在你們的會議裡面發言,我問你啦,這個立委對你預算有生殺大權。你們在開會的時候,\n\n06:42.679 --> 06:59.522\n你敢對他所的意見提出不同意見嗎?他可以監督行政機關：有掌握你們的預算權：很多人都只能夠接受他所提出來的意見這一種立委當委員你們敢違逆他的意見嗎?你現在不跟我說嗎?跟委員報告一句話有這種立委做委員的嗎?不要說人啦!不一定是他啦!\n\n07:12.858 --> 07:14.439\n你敢敢敢的什麼呢?立委自己做、立委自己去行政院內、行政部門內做委員又有行政決策權又有立委對行政的預算監督權都一共的贏\n\n07:32.814 --> 08:00.060\n現在還有嗎?你這麼不敢說?不會啦這個跟委員報告當然過去這個陳委員齁長期是我們專家委員是我們專家會議的委員很久長期單院立委的時候就應該要知道角色衝突違反三權分立又是行政權又是立法權又是行政決策權又有立法院的監督預算權像話嗎?\n\n08:02.865 --> 08:06.307\n你現在是他會代言的嗎,署長?不是針對他,我們就事論事。制度面!制度面改一改了啦!人家看到工程會被社會討論得沸沸揚揚了!\n\n08:20.917 --> 08:29.085\n你們都還在那裏恃若無睹部長你不知道部長你的輸掉根本不知道明明都知道但是他有什麼不敢得罪立委他的委就是因為是立委啦所以不敢給他拿掉啦這就是為什麼需要改革這個就是為什麼今天輪到我在這裏當壞人的原因嘛\n\n08:46.946 --> 08:50.128\n來你自己主動改革的甘需要關起來我都叫做派人所以這個由此可知啊立委又兼行政部門的委員多麼的多麼的憤憾格多麼的衝突多麼的不合理\n\n09:07.318 --> 09:35.441\n市長,您要回去改改,都要改改啦,好不好?好,我們會檢討來改進。好,那很好。那我要問下一個問題。下一個問題也很嚴重。一個女子在中山區某連鎖醫美中心打電波拉皮。麻醉後血氧濃度下降,送醫搶救不至。然後麻醉醫師就出來呼籲,所有類型的醫美麻醉都應該由麻醉專科醫師執行。我們大家看到都說奇怪,怎麼這麼嚴重?\n\n09:37.382 --> 09:45.465\n部長,你12月9日出席衛福部活動的時候有受訪。你說,如果相關專科醫學會有任何建議,你們會立即召開討論,進一步強化規範。我現在問你,過去十年裡面,因為醫美麻醉而導致死亡的案例和案件數量有多少?\n\n10:01.283 --> 10:27.794\n一件事我相信你今天在看來說這問題有多嚴重啊會覺得一個個案過去十年過去十年因為醫美麻醉而死亡多少案例?報告委員我想我們品質安全就是這不是啦你就告訴我數量就好了不要講東講西的啦一、四、四你不知道你們看到這個個案發生你們都無動於衷嗎?\n\n10:30.976 --> 10:55.489\n統計數據這次在過去裏面是沒有的,這缺點先跟...沒有,可是你看到個案發生了,你不會想說我快要看了,你看醫事司司長,你不會想到說這個問題有多嚴重嗎?去做電波拉皮的女性有多少、男性有多少,你不會覺得風險有多少跟你醫事司的業務有關,你不會聯想到嗎?你不覺得你有保護人民的權利義務、權利嗎?\n\n10:58.365 --> 11:25.051\n所以我們這次是先了解到使用的藥物是所謂的POPOPO這個藥物是需要做…市長!你不要跟我講你有多關心啦!連一年多少個案發生麻醉死亡在醫美裡面你不知道我覺得你很害怕啦!我再問你一下你總是要去分析這些醫美麻醉產生醫療糾紛的案例的亂象有哪些吧那你才能想說你要怎麼去改善這一些亂象吧\n\n11:26.391 --> 11:32.595\n你怎麽不能向你們部長說,誒,待會兒麻醉醫學會,醫學會來歡迎起來我就來討論。誒,中央沒有掌握問題,沒有分析亂象,然後叫醫學會、民間組織提對策,這樣不好做,您這醫事室司長太好做啊,您這部長太好做啊,如果這樣我林淑芬就可以來做啊。\n\n11:50.166 --> 12:04.937\n報告委員真的我從我以前擔任醫師公會的幹部以後我非常清楚這整個醫美的管理所以這大概這10年來醫師是真的非常用很多的心因為醫美麻醉產生的糾紛\n\n12:11.401 --> 12:14.164\n到底有多嚴重啊?你說你們很勇敢啊!你們說你們很多人在管理啊!你就告訴我問題有多嚴重?你說不出來說你們很勇敢在這裡睜眼說瞎話嘛!我跟你講安全就最重要可是你連安全的課題你都沒有掌握\n\n12:33.183 --> 12:38.807\n你現在根據特定醫療技術檢驗醫療儀器施行或使用管理辦法第25、29只有執行第25條的第7、第8大類第7項8大類特定美容醫學手術的全身麻醉或非全身麻醉的靜脈注射麻醉你們才規定要有麻醉專科醫師執行你們認為中度及輕度的這個鎮靜麻醉不需要專科醫師執行\n\n13:03.383 --> 13:28.458\n然後你們在這裡就告訴我們說來怎麼都很注重安全而這一次出事情的你們都知道是用所謂舒眠麻醉這一種話術讓消費者讓去做電波拉棉覺得說舒眠睡一下而已嘛舒眠麻醉然後其實你們打的是牛奶針你們自己都知道這個叫婆婆佛牛奶針\n\n13:32.950 --> 13:52.491\n麻醉專科醫師蘇柏川表示,市面上主張的牛奶針大多都是深度鎮靜。現實上,只要俗稱牛奶針的Provo,都應該全部要找麻醉專科醫師。\n\n13:54.213 --> 14:11.067\n中度鎮靜容易因為外界刺激減少或病患個人的因素瞬間會掉到深度鎮靜而病患在深度鎮靜的時候如果發生呼吸道阻塞只有5分鐘可以搶救所以站在安全的立場你們說你們管很多你們這一點就完全中放沒得管\n\n14:16.631 --> 14:32.269\n所有的麻醉這種使用到牛奶針全部要麻醉專科醫師您沒有規範高雄長庚醫院麻醉部教授及的主治醫師吳少群有說醫美打電波清醒可以講話叫做中度鎮靜\n\n14:34.651 --> 14:46.437\n打電波完全睡著叫深度鎮靜而深度鎮靜是最危險的一種麻醉方式非常容易呼吸抑制或心血管中樞抑制只有具專業的麻醉專科醫師在床監測才能確保病人安全\n\n14:55.162 --> 15:01.205\n食藥署自己也說：食藥署的先翁稿說牛奶這一需要由專業醫師給藥使用過程必須由醫療人員持續監測病患的心臟及呼吸功能避免因藥物過量導致呼吸衰竭而死亡而台灣在2020年當時的麻醉醫學會的理事長陳坤寶他在撰寫美容醫學這個麻醉的時候也提到\n\n15:21.414 --> 15:49.929\n靜脈全身麻醉是現行美容醫學為整形也漸漸在使用全身麻醉作為主要麻醉的方式是一種趨勢喔!欸!為整形現在很流行全身麻醉靜脈全身麻醉喔!你敢這樣管然後呢一定要有麻醉專科醫師在場否則一旦出事不堪後果不堪設想\n\n15:51.041 --> 15:51.181\n同一個醫生．\n\n16:08.584 --> 16:26.956\n同時執行兩項業務部長你覺得合適嗎?我又是麻醉科醫師我同時執行麻醉我又做電波拉皮的手術我同時在做這個手術你覺得一個醫生做兩個工作適合嗎?同時有關於這一點應該要有兩位醫師在處理\n\n16:36.813 --> 16:39.881\n對,台灣麻醉醫學會吳少群李氏在他寫的\n\n16:41.738 --> 17:07.441\n常見的麻醉迷思和安全建議如下實務上手術醫師因為要專注在手術如果又分心兼職麻醉常常因為受製者會動而他就會一直加深劑量或是給到受製者不動了卻忘了要頻繁監測受製者的生理治療重新評估一條降維持劑量\n\n17:08.502 --> 17:08.802\n我們規定就是要兩位醫師\n\n17:35.891 --> 17:58.732\n沒有啦,你的手術都沒有規定要麻醉專科醫師在那裡了,還什麼兩位醫師?你的手術本身就沒有規定要專科醫師執行麻醉了,還什麼兩個醫生?所以這樣你知道嗎?不好意思主席,你讓我這個主題問完了,這是一個安全的問題,我快說好了。所以我現在說這個這樣\n\n18:01.598 --> 18:25.026\n你覺得醫美診所為了省下那個錢買來要加上沒規定衛福部醫事師沒有規定啦對醫美沒有這麼多規定啦那不要再講這個你知道各縣市喔核准施行特定美容醫學手術的醫療機構一共有幾家嗎醫美診所到今年全國有幾家你知道嗎應該是700多家\n\n18:28.820 --> 18:36.026\n合準實行特定手術的啦。700多家。那你知道麻醉科人數全國一共有多少人嗎?\n\n18:37.557 --> 19:01.901\n一千六百個不要講大醫院職業也不要講說有執照然後他會就業的光是你的醫美診所七百多家那大醫院的麻醉手術要怎麼進行所以台灣的麻醉專科醫師的量能夠嗎扣掉你說的七百多家的醫院他可以配置足夠的麻醉專科醫師嗎如果大家連個法律給丟回去大家都愛麻醉科醫師\n\n19:06.549 --> 19:07.450\n欸?幹嘛搞?\n\n19:07.450 --> 19:31.118\n所以部長你剛剛講的不可以手術醫師兼任麻醉業務這個叫驚罵醫美診所的常態在每次的醫美診所發生麻醉事故以後呢你們到底有沒有真的去反省每一次的不幸的事故都要成為你政策上除錯的反省的機制啊那你們剛才從剛才問到現在都沒有\n\n19:36.255 --> 19:57.131\n您們有一個什麼東西可以把關醫美診所?我先補充幾件事。第一件事情陳國剛那個人在推詢的麻醉其實基本上面他為什麼要做危險分級的原因就是因為人力要用在最適當的位置那也因為這樣其實是由另外一個受過專業訓練的\n\n19:58.672 --> 20:03.977\n其實所以訓練一起在協助醫生這才是重點你們的特定醫療技術檢查檢驗醫療儀器施行或使用的管理辦法只有第25條的第7項的八大類的特定美容醫學手術需要具備這個麻醉專科醫師啦而你們所謂的中度或輕度的鎮靜麻醉沒有規定啦他有需要訓練這個有寫\n\n20:25.996 --> 20:35.980\n有訓練：現在就講手術醫師跟麻醉不能同一個人啦：這也是寫在裡面：這個就是最大的風險啦：現在寶弟我再跟你問啦：你們醫策會2019年其實有鑑於診所人力醫院資源不如醫院充足且沒有醫院評鑑這一種東西：\n\n20:48.946 --> 20:56.731\n所以為了推升診所整體美容醫學服務品質你們辦了一個診所美容醫學的品質認證就是以安全為基軸要強調專業人員的資格資訊的透明、環境的安全專業及安全的醫療行為突發事件緊急應變措施及客訴處理追蹤服務等就是你講的來反正你們做這些醫美診所的要去認證安全結果呢\n\n21:16.943 --> 21:22.008\n你全部認證和有通過你們認證的有幾家你知道嗎現在應該診所的部分好像剩30幾家左右30幾家41家我看的是41家你全部你說700多家只有41家從2019年到現在5年了\n\n21:39.345 --> 21:56.686\n五年你全部獲得認證的比例低成這個樣子叫做你們重視醫美診所的安全你這樣說出來是笑話嘛所以呢全台核准的施行特定美容醫學手術機構這些診所是不是都安全\n\n21:57.679 --> 22:03.426\n你們的認證率這麼低,不到一成。你說這樣的醫美診所的品質足夠叫做安全嗎?你們的認證都是最基本的、最核心的。含你的認證的不敢參加。\n\n22:12.958 --> 22:27.747\n而由此可知外面的醫美診所的品質安全多麼堪憂啊!我補充一下其實就是法規是樓地板,品質的要求是天花板所以在這個中間的...你賣大家玩文字遊戲!\n\n22:28.928 --> 22:43.917\n那如果這麼樣子的話為什麼你認證五年的時間認證只有四十一家他在這邊其實是會牽涉到就是我覺得要問你這個不要講那麼多出事的這一家醫美診所有沒有通過你們認證你回答我應該是沒有應該是阿來有勒這因為我不確定\n\n22:52.316 --> 22:55.558\n蘇百川醫師來講喔你們在這個認證是以安全為基礎保障人民就醫的安全但是參與的診所偏少然後這個認證的項目分成兩類哪兩類\n\n23:06.007 --> 23:06.508\n新聞報告及專題報告\n\n23:27.071 --> 23:27.131\n這位蘇偉川講的\n\n23:47.930 --> 24:06.585\n沒有所屬是診所自行去選填他要認證哪一類是要光電類還是手術類但是呢電波拉皮就是光電治療不會在醫策會現行診所的麻醉鎮靜安全查核的範圍內所以他如果認證為光電類認證何可\n\n24:11.169 --> 24:19.576\n也不保證他的麻醉鎮靜安全的安全因為醫策會沒有集合這一個項目另外申請手術類人家醫美診所也有偷吃包我只要去選割雙眼皮就好了\n\n24:30.504 --> 24:31.705\n因為割雙眼皮不在特管法規範的手術內．所以為依這位去認證．也不會特別去查有沒有符合麻醉規範．老實說啦,醫美診所．再去接一個麻醉專科醫師．\n\n24:49.025 --> 25:15.681\n給開的大家都要寫這個字這個成本然後呢大家寫我光電類認證過了但是你的麻醉安全沒有其實政府不要管你我手術類認證過了但我申請的是雙眼皮然後消費者看不見看不見電波拉皮的光電類嘛然後你以為他手術安全認證了這麼好那我就選有認證的結果他的認證只有選割雙眼皮\n\n25:18.800 --> 25:25.523\n不然這樣你聽得到嗎?你都不知道,你的問題很嚴重。你一、四、五、六、七、八、九、十幾年,個案發生了還是有動於中?沒有想到我整體的醫美診所、醫美的這一些要怎麼規範都沒在想,就要你為了這給你提起。不然這樣提起後,你聽得到嗎?要解釋嗎?\n\n25:43.702 --> 25:47.025\n市長,那你在這裡承諾,市長你覺得就哪幾面向你要處理?我會覺得是第一個第一件事情其實是\n\n26:01.072 --> 26:02.933\n那一個醫生同時執行麻醉又執行手術那要怎麼處理?\n\n26:30.601 --> 26:46.845\n現況就是規定在美濃醫學這邊是不行的所以我才會說落實規定這件事情你們要去集合嗎?全國你說如果不行大家都這樣做呢那很簡單喔你去要求他執行這個叫電波拉皮執行什麼手術的然後他的專科醫師有用到這個蒸的牛奶蒸的\n\n26:57.248 --> 27:22.687\n那她的醫師有使用麻醉科醫師嗎?麻醉科醫師有沒有蓋章?全國總機察就知道了啊,絕對沒有的嘛我會覺得是說落實這一塊其實是所有醫界都會很關心的然後怎麼樣在人力上面做到我現在講的是行政管理啦,行政管理沒有行政管理、沒有法規就等於是沒好大家講什麼都假\n\n27:24.328 --> 27:52.376\n現在特管辦法裡面的美容醫療這一塊的輕度到中度就是需要兩個人的這件事情我覺得是我們可以來做弱勢的一項人家醫學會告訴你只要有牛奶針就絕對是必須要有麻醉科醫師啦不是一個人分四兩角啦對啊然後也不是中度的啦中度同時還要再把它煮下去讓它沒丁沒丁才比較好吸收對不對融液這個問題很嚴重你們要好好想一下\n\n27:54.237 --> 27:54.879\n謝謝林淑芬\n\n","segments":[{"start":6.825,"end":10.348,"text":"主席各位大家早是不是請我們邱部長部長早你當過立委嗎那你現在擔任部長所以你應該清楚立法權跟行政權的差異吧"},{"start":31.176,"end":47.122,"text":"你知道公共工程會在9月下旬預告修正採購評選委員會組織準則第4條之一它主要就針對考量各級民意機關、民意代表"},{"start":48.182,"end":62.695,"text":"擔任機關採購案的評選委員．有造成行政權和立法權．兩者混淆衝突的可能．所以進行修法．那部長你知道這個事情嗎?你知道這件事嗎?我沒有瞭解到那麼詳細．但是這樣的方向是對的這件事這麼大條你有沒有看過?好吧?方向是對的你認為有沒有必要?"},{"start":79.377,"end":80.238,"text":"你覺得他們這樣修正有沒有必要?不知道。"},{"start":92.243,"end":116.914,"text":"民意代表不能夠去擔任啊應該是這樣子啊因為我們從小公民課本就教學生啊三權分立或是五權分立嘛立法權跟行政權本身就有各自的權責啊憲法第63條你知道我們當立委的立法院有議決、法律案、預算案、戒嚴案、大設案、宣戰、構合、條約案及國家其他重要事項之權嘛"},{"start":118.534,"end":132.368,"text":"我們立法院就是在這樣的一個基礎上和範圍上來監督行政權所以民意代表同時擔任行政機關各類審議的委員當然不合理啊 對不對"},{"start":135.052,"end":147.278,"text":"對阿所以工程會才會預告修正這個草案的原因也在這裡然後社會輿論也討論過了大家都覺得不合理阿那就你了解你覺得不合理嘛衛福部有沒有類似這樣的狀況"},{"start":150.069,"end":159.099,"text":"有沒有?你就你組織來,有沒有?對啊,你的評選委員啊,各類的行政組織的委員會的運作,你行政部門的各類的組織的各委員會的運作有沒有這種狀況,你知不知道?"},{"start":172.613,"end":198.211,"text":"主席委員好衛福部目前我們所知這個事情是沒有那所屬機關到目前為止沒有報過來過你說所屬機關怎樣沒有報上來過衛福部都沒有所屬機關你不知道意思是這樣子嘛來你不知道我給你報備來啦我們PowerPoint的給他看一下啦你看有人就自動上去了"},{"start":199.505,"end":204.25,"text":"有人自動上台了我都還沒有請署長上台他自己就上台了"},{"start":206.314,"end":217.537,"text":"署長自己知道啦健保署下的相關會議全民健康保險藥物共同擬定會議這個會議這麼重要哦重要哦他在決定啊什麼藥物要不要納入健保給付這個會議就是標準的行政權啊有行政決策權啊"},{"start":231.847,"end":246.076,"text":"這樣的一個會議裡面,這個共領會議,簡稱共領會議,現在,現在,仍然有專家委員,號稱專家委員是現職的民意代表。23、24年,兩年的名單。"},{"start":252.382,"end":262.232,"text":"結果暴力法院今年2月報到以後他也沒有辭職以自己黨的最高道德標準來看他決定要辭職他沒有辭了他沒有辭的狀況裡面"},{"start":268.057,"end":293.874,"text":"開了七次會議請假三次他自己請假三次參與四次我並不想針對他但是單純就事論事我在這裡提醒衛福部你們在各個機關下的審議會議設置要點或辦法當中要不要需不需要把民意代表是不是擔任相關委員會的委員要不要進行盤點"},{"start":298.037,"end":307.104,"text":"你們又不要把所有的辦法規定回去改一改,避免立法權跟行政權混亂混淆。部長。好,謝謝委員的主教。我們會回去做整體的檢討。你不敢說要改,你要檢討。什麼叫檢討?"},{"start":322.82,"end":340.654,"text":"檢討就是要改的然後要怎麼改你的各個委員會還有立法委員在裡面擔任委員嗎立委又兼行政決策權然後又說他來監督行政部門你自己都行政決策權然後監督你說要回頭去監督行政部門這不是笑話嗎署長你怎麼說要改"},{"start":345.585,"end":360.318,"text":"跟委員報告剛好這個任期也到了我們現在正在全面的檢討那個下一任就是明年 二五二六會不會再有立委擔任委員我們會審慎的審慎你不敢說不會你不敢說不會你還要續聘他嗎"},{"start":366.485,"end":369.648,"text":"因為我們現在委員都還沒有這個委員佔了一個民間代表的缺他用民間代表的身份進去裡面當委員据有行政決策權"},{"start":379.198,"end":398.705,"text":"人家民間都沒其他的人啊。一會兒在裏面,自己就可以監督行政機關了。還有理由在民間的發言機制代表民間去佔位子嗎?再來,立委以專家學者的身份在你們的會議裡面發言,我問你啦,這個立委對你預算有生殺大權。你們在開會的時候,"},{"start":402.679,"end":419.522,"text":"你敢對他所的意見提出不同意見嗎?他可以監督行政機關：有掌握你們的預算權：很多人都只能夠接受他所提出來的意見這一種立委當委員你們敢違逆他的意見嗎?你現在不跟我說嗎?跟委員報告一句話有這種立委做委員的嗎?不要說人啦!不一定是他啦!"},{"start":432.858,"end":434.439,"text":"你敢敢敢的什麼呢?立委自己做、立委自己去行政院內、行政部門內做委員又有行政決策權又有立委對行政的預算監督權都一共的贏"},{"start":452.814,"end":480.06,"text":"現在還有嗎?你這麼不敢說?不會啦 這個跟委員報告當然過去這個陳委員齁長期是我們專家委員是我們專家會議的委員很久長期單院立委的時候就應該要知道角色衝突違反三權分立又是行政權又是立法權又是行政決策權又有立法院的監督預算權像話嗎?"},{"start":482.865,"end":486.307,"text":"你現在是他會代言的嗎,署長?不是針對他,我們就事論事。制度面!制度面改一改了啦!人家看到工程會被社會討論得沸沸揚揚了!"},{"start":500.917,"end":509.085,"text":"你們都還在那裏恃若無睹 部長你不知道 部長你的輸掉根本不知道 明明都知道 但是他有什麼不敢得罪立委 他的委就是因為是立委啦 所以不敢給他拿掉啦 這就是為什麼需要改革 這個就是為什麼今天輪到我在這裏當壞人的原因嘛"},{"start":526.946,"end":530.128,"text":"來你自己主動改革的甘需要關起來我都叫做派人所以這個由此可知啊立委又兼行政部門的委員多麼的多麼的憤 憾格多麼的衝突多麼的不合理"},{"start":547.318,"end":575.441,"text":"市長,您要回去改改,都要改改啦,好不好?好,我們會檢討來改進。好,那很好。那我要問下一個問題。下一個問題也很嚴重。一個女子在中山區某連鎖醫美中心打電波拉皮。麻醉後血氧濃度下降,送醫搶救不至。然後麻醉醫師就出來呼籲,所有類型的醫美麻醉都應該由麻醉專科醫師執行。我們大家看到都說奇怪,怎麼這麼嚴重?"},{"start":577.382,"end":585.465,"text":"部長,你12月9日出席衛福部活動的時候有受訪。你說,如果相關專科醫學會有任何建議,你們會立即召開討論,進一步強化規範。我現在問你,過去十年裡面,因為醫美麻醉而導致死亡的案例和案件數量有多少?"},{"start":601.283,"end":627.794,"text":"一件事我相信你今天在看來說這問題有多嚴重啊會覺得一個個案過去十年過去十年因為醫美麻醉而死亡多少案例?報告委員我想我們品質安全就是這不是啦你就告訴我數量就好了不要講東講西的啦一、四、四你不知道你們看到這個個案發生你們都無動於衷嗎?"},{"start":630.976,"end":655.489,"text":"統計數據這次在過去裏面是沒有的,這缺點先跟...沒有,可是你看到個案發生了,你不會想說我快要看了,你看醫事司司長,你不會想到說這個問題有多嚴重嗎?去做電波拉皮的女性有多少、男性有多少,你不會覺得風險有多少跟你醫事司的業務有關,你不會聯想到嗎?你不覺得你有保護人民的權利義務、權利嗎?"},{"start":658.365,"end":685.051,"text":"所以我們這次是先了解到使用的藥物是所謂的POPOPO這個藥物是需要做…市長!你不要跟我講你有多關心啦!連一年多少個案發生麻醉死亡在醫美裡面你不知道我覺得你很害怕啦!我再問你一下你總是要去分析這些醫美麻醉產生醫療糾紛的案例的亂象有哪些吧那你才能想說你要怎麼去改善這一些亂象吧"},{"start":686.391,"end":692.595,"text":"你怎麽不能向你們部長說,誒,待會兒麻醉醫學會,醫學會來歡迎起來我就來討論。誒,中央沒有掌握問題,沒有分析亂象,然後叫醫學會、民間組織提對策,這樣不好做,您這醫事室司長太好做啊,您這部長太好做啊,如果這樣我林淑芬就可以來做啊。"},{"start":710.166,"end":724.937,"text":"報告委員真的我從我以前擔任醫師公會的幹部以後我非常清楚這整個醫美的管理所以這大概這10年來醫師是真的非常用很多的心因為醫美麻醉產生的糾紛"},{"start":731.401,"end":734.164,"text":"到底有多嚴重啊?你說你們很勇敢啊!你們說你們很多人在管理啊!你就告訴我問題有多嚴重?你說不出來說你們很勇敢在這裡睜眼說瞎話嘛!我跟你講安全就最重要可是你連安全的課題你都沒有掌握"},{"start":753.183,"end":758.807,"text":"你現在根據特定醫療技術檢驗醫療儀器施行或使用管理辦法第25、29只有執行第25條的第7、第8大類第7項8大類特定美容醫學手術的全身麻醉或非全身麻醉的靜脈注射麻醉你們才規定要有麻醉專科醫師執行你們認為中度及輕度的這個鎮靜麻醉不需要專科醫師執行"},{"start":783.383,"end":808.458,"text":"然後你們在這裡就告訴我們說來怎麼都很注重安全而這一次出事情的你們都知道是用所謂舒眠麻醉這一種話術讓消費者讓去做電波拉棉覺得說舒眠睡一下而已嘛舒眠麻醉然後其實你們打的是牛奶針你們自己都知道這個叫婆婆佛牛奶針"},{"start":812.95,"end":832.491,"text":"麻醉專科醫師蘇柏川表示,市面上主張的牛奶針大多都是深度鎮靜。現實上,只要俗稱牛奶針的Provo,都應該全部要找麻醉專科醫師。"},{"start":834.213,"end":851.067,"text":"中度鎮靜容易因為外界刺激減少或病患個人的因素瞬間會掉到深度鎮靜而病患在深度鎮靜的時候如果發生呼吸道阻塞只有5分鐘可以搶救所以站在安全的立場你們說你們管很多你們這一點就完全中放沒得管"},{"start":856.631,"end":872.269,"text":"所有的麻醉這種使用到牛奶針全部要麻醉專科醫師您沒有規範高雄長庚醫院麻醉部教授及的主治醫師吳少群有說醫美打電波清醒可以講話叫做中度鎮靜"},{"start":874.651,"end":886.437,"text":"打電波完全睡著叫深度鎮靜而深度鎮靜是最危險的一種麻醉方式非常容易呼吸抑制或心血管中樞抑制只有具專業的麻醉專科醫師在床監測才能確保病人安全"},{"start":895.162,"end":901.205,"text":"食藥署自己也說：食藥署的先翁稿說牛奶這一需要由專業醫師給藥使用過程必須由醫療人員持續監測病患的心臟及呼吸功能避免因藥物過量導致呼吸衰竭而死亡而台灣在2020年當時的麻醉醫學會的理事長陳坤寶他在撰寫美容醫學這個麻醉的時候也提到"},{"start":921.414,"end":949.929,"text":"靜脈全身麻醉是現行美容醫學為整形也漸漸在使用全身麻醉作為主要麻醉的方式是一種趨勢喔!欸!為整形現在很流行全身麻醉靜脈全身麻醉喔!你敢這樣管然後呢一定要有麻醉專科醫師在場否則一旦出事不堪後果不堪設想"},{"start":951.041,"end":951.181,"text":"同一個醫生．"},{"start":968.584,"end":986.956,"text":"同時執行兩項業務部長你覺得合適嗎?我又是麻醉科醫師我同時執行麻醉我又做電波拉皮的手術我同時在做這個手術你覺得一個醫生做兩個工作適合嗎?同時有關於這一點應該要有兩位醫師在處理"},{"start":996.813,"end":999.881,"text":"對,台灣麻醉醫學會吳少群李氏在他寫的"},{"start":1001.738,"end":1027.441,"text":"常見的麻醉迷思和安全建議如下實務上手術醫師因為要專注在手術如果又分心兼職麻醉常常因為受製者會動而他就會一直加深劑量或是給到受製者不動了卻忘了要頻繁監測受製者的生理治療重新評估一條降維持劑量"},{"start":1028.502,"end":1028.802,"text":"我們規定就是要兩位醫師"},{"start":1055.891,"end":1078.732,"text":"沒有啦,你的手術都沒有規定要麻醉專科醫師在那裡了,還什麼兩位醫師?你的手術本身就沒有規定要專科醫師執行麻醉了,還什麼兩個醫生?所以這樣你知道嗎?不好意思主席,你讓我這個主題問完了,這是一個安全的問題,我快說好了。所以我現在說這個這樣"},{"start":1081.598,"end":1105.026,"text":"你覺得醫美診所為了省下那個錢買來要加上沒規定衛福部醫事師沒有規定啦對醫美沒有這麼多規定啦那不要再講這個你知道各縣市喔核准施行特定美容醫學手術的醫療機構一共有幾家嗎醫美診所到今年全國有幾家你知道嗎應該是700多家"},{"start":1108.82,"end":1116.026,"text":"合準實行特定手術的啦。700多家。那你知道麻醉科人數全國一共有多少人嗎?"},{"start":1117.557,"end":1141.901,"text":"一千六百個不要講大醫院職業也不要講說有執照然後他會就業的光是你的醫美診所七百多家那大醫院的麻醉手術要怎麼進行所以台灣的麻醉專科醫師的量能夠嗎扣掉你說的七百多家的醫院他可以配置足夠的麻醉專科醫師嗎如果大家連個法律給丟回去大家都愛麻醉科醫師"},{"start":1146.549,"end":1147.45,"text":"欸?幹嘛搞?"},{"start":1147.45,"end":1171.118,"text":"所以部長你剛剛講的不可以手術醫師兼任麻醉業務這個叫驚罵醫美診所的常態在每次的醫美診所發生麻醉事故以後呢你們到底有沒有真的去反省每一次的不幸的事故都要成為你政策上除錯的反省的機制啊那你們剛才從剛才問到現在都沒有"},{"start":1176.255,"end":1197.131,"text":"您們有一個什麼東西可以把關醫美診所?我先補充幾件事。第一件事情陳國剛那個人在推詢的麻醉其實基本上面他為什麼要做危險分級的原因就是因為人力要用在最適當的位置那也因為這樣其實是由另外一個受過專業訓練的"},{"start":1198.672,"end":1203.977,"text":"其實所以訓練一起在協助醫生這才是重點你們的特定醫療技術檢查檢驗醫療儀器施行或使用的管理辦法只有第25條的第7項的八大類的特定美容醫學手術需要具備這個麻醉專科醫師啦而你們所謂的中度或輕度的鎮靜麻醉沒有規定啦他有需要訓練這個有寫"},{"start":1225.996,"end":1235.98,"text":"有訓練：現在就講手術醫師跟麻醉不能同一個人啦：這也是寫在裡面：這個就是最大的風險啦：現在寶弟我再跟你問啦：你們醫策會2019年其實有鑑於診所人力醫院資源不如醫院充足且沒有醫院評鑑這一種東西："},{"start":1248.946,"end":1256.731,"text":"所以為了推升診所整體美容醫學服務品質你們辦了一個診所美容醫學的品質認證就是以安全為基軸要強調專業人員的資格資訊的透明、環境的安全專業及安全的醫療行為突發事件緊急應變措施及客訴處理追蹤服務等就是你講的來反正你們做這些醫美診所的要去認證安全結果呢"},{"start":1276.943,"end":1282.008,"text":"你全部認證和有通過你們認證的有幾家你知道嗎現在應該診所的部分好像剩30幾家左右30幾家41家我看的是41家你全部你說700多家只有41家從2019年到現在5年了"},{"start":1299.345,"end":1316.686,"text":"五年你全部獲得認證的比例低成這個樣子叫做你們重視醫美診所的安全你這樣說出來是笑話嘛所以呢全台核准的施行特定美容醫學手術機構這些診所是不是都安全"},{"start":1317.679,"end":1323.426,"text":"你們的認證率這麼低,不到一成。你說這樣的醫美診所的品質足夠叫做安全嗎?你們的認證都是最基本的、最核心的。含你的認證的不敢參加。"},{"start":1332.958,"end":1347.747,"text":"而由此可知外面的醫美診所的品質安全多麼堪憂啊!我補充一下其實就是法規是樓地板,品質的要求是天花板所以在這個中間的...你賣大家玩文字遊戲!"},{"start":1348.928,"end":1363.917,"text":"那如果這麼樣子的話為什麼你認證五年的時間認證只有四十一家他在這邊其實是會牽涉到就是我覺得要問你這個不要講那麼多出事的這一家醫美診所有沒有通過你們認證你回答我應該是沒有應該是 阿來有勒這因為我不確定"},{"start":1372.316,"end":1375.558,"text":"蘇百川醫師來講喔你們在這個認證是以安全為基礎保障人民就醫的安全但是參與的診所偏少然後這個認證的項目分成兩類哪兩類"},{"start":1386.007,"end":1386.508,"text":"新聞報告及專題報告"},{"start":1407.071,"end":1407.131,"text":"這位蘇偉川講的"},{"start":1427.93,"end":1446.585,"text":"沒有所屬是診所自行去選填他要認證哪一類是要光電類還是手術類但是呢電波拉皮就是光電治療不會在醫策會現行診所的麻醉鎮靜安全查核的範圍內所以他如果認證為光電類認證何可"},{"start":1451.169,"end":1459.576,"text":"也不保證他的麻醉鎮靜安全的安全因為醫策會沒有集合這一個項目另外申請手術類人家醫美診所也有偷吃包我只要去選割雙眼皮就好了"},{"start":1470.504,"end":1471.705,"text":"因為割雙眼皮不在特管法規範的手術內．所以為依這位去認證．也不會特別去查有沒有符合麻醉規範．老實說啦,醫美診所．再去接一個麻醉專科醫師．"},{"start":1489.025,"end":1515.681,"text":"給開的大家都要寫這個字這個成本然後呢大家寫我光電類認證過了但是你的麻醉安全沒有其實政府不要管你我手術類認證過了但我申請的是雙眼皮然後消費者看不見看不見電波拉皮的光電類嘛然後你以為他手術安全認證了這麼好那我就選有認證的結果他的認證只有選割雙眼皮"},{"start":1518.8,"end":1525.523,"text":"不然這樣你聽得到嗎?你都不知道,你的問題很嚴重。你一、四、五、六、七、八、九、十幾年,個案發生了還是有動於中?沒有想到我整體的醫美診所、醫美的這一些要怎麼規範都沒在想,就要你為了這給你提起。不然這樣提起後,你聽得到嗎?要解釋嗎?"},{"start":1543.702,"end":1547.025,"text":"市長,那你在這裡承諾,市長你覺得就哪幾面向你要處理?我會覺得是第一個第一件事情其實是"},{"start":1561.072,"end":1562.933,"text":"那一個醫生同時執行麻醉又執行手術那要怎麼處理?"},{"start":1590.601,"end":1606.845,"text":"現況就是規定在美濃醫學這邊是不行的所以我才會說落實規定這件事情你們要去集合嗎?全國你說如果不行大家都這樣做呢那很簡單喔你去要求他執行這個叫電波拉皮執行什麼手術的然後他的專科醫師有用到這個蒸的牛奶蒸的"},{"start":1617.248,"end":1642.687,"text":"那她的醫師有使用麻醉科醫師嗎?麻醉科醫師有沒有蓋章?全國總機察就知道了啊,絕對沒有的嘛我會覺得是說落實這一塊其實是所有醫界都會很關心的然後怎麼樣在人力上面做到我現在講的是行政管理啦,行政管理沒有行政管理、沒有法規就等於是沒好大家講什麼都假"},{"start":1644.328,"end":1672.376,"text":"現在特管辦法裡面的美容醫療這一塊的輕度到中度就是需要兩個人的這件事情我覺得是我們可以來做弱勢的一項人家醫學會告訴你只要有牛奶針就絕對是必須要有麻醉科醫師啦不是一個人分四兩角啦對啊然後也不是中度的啦中度同時還要再把它煮下去讓它沒丁沒丁才比較好吸收對不對融液這個問題很嚴重你們要好好想一下"},{"start":1674.237,"end":1674.879,"text":"謝謝林淑芬"}]}}},"gazette":{"lineno":1220,"blocks":[["林委員淑芬：（10時40分）主席，各位大家早。是不是請我們邱部長？"],["邱部長泰源：委員早。"],["林委員淑芬：部長早。你當過立委嘛！你現在擔任部長，所以你應該清楚立法權跟行政權的差異，對吧？"],["邱部長泰源：是。"],["林委員淑芬：對，你知道公共工程會在9月下旬的時候預告修正採購評選委員會組織準則第四條之一，它主要就是針對考量各級民意機關、民意代表擔任機關採購案的評選委員，有造成行政權和立法權兩者混淆衝突的可能，所以進行修法。部長，你知道這個事情嗎？你知道這件事情嗎？"],["邱部長泰源：沒有了解得那麼詳細，但是這樣的方向是對的。"],["林委員淑芬：這事情很大條，你沒看過喔？好吧，方向是對的，你認為有沒有必要啦？對吧？你覺得他們這樣修正有沒有必要？不知道？簡單來說，採購評選委員會的委員，你民意代表不能夠去擔任啦！"],["邱部長泰源：這個應該是這樣子。"],["林委員淑芬：應該是這樣子，因為我們從小公民課本就教學生三權分立或是五權分立。"],["邱部長泰源：是、是。"],["林委員淑芬：立法權跟行政權本身就有各自的權責，憲法第六十三條，你知道我們當立委的，立法院有議決法律案、預算案、戒嚴案、大赦案、宣戰案、媾和案、條約案及國家其他重要事項之權。我們立法權就是在這樣一個基礎上和範圍上來監督行政權，所以民意代表同時擔任行政機關各類審議的委員，當然不合理啊，對不對？"],["邱部長泰源：是。我想……"],["林委員淑芬：所以工程會才會預告修正這個草案的原因也在這裡，然後社會輿論也討論過了，大家都覺得不合理啊，就你了解，你覺得不合理嘛！衛福部有沒有類似這樣的狀況？有沒有？就你所知，有沒有？"],["邱部長泰源：評審委員有沒有民意代表的問題？"],["林委員淑芬：對啊，你的評選委員，各類行政組織委員會的運作，你行政部門各類組織的各委員會的運作有沒有這種狀況？你知不知道？"],["邱部長泰源：由主責的秘書處處長說明。"],["林委員淑芬：好，有沒有？"],["許處長朝程：主席、委員好。目前我們所知衛福部這個事情是沒有，所屬機關到目前為止沒有報過來過。"],["林委員淑芬：你說所屬機關怎樣？"],["許處長朝程：沒有報上來過。"],["林委員淑芬：衛福部都沒有，所屬機關你不知道，意思是這樣子嘛！來，你不知道，我給你報備，來啦，我們的PowerPoint給他看一下啦，你看有人就自動上去了，有人自動上臺了，我都還沒請署長上臺，他自己就上臺了，署長自己知道啦，健保署下的相關會議，全民健康保險藥物共同擬定會議，這個會議重要不重要？重要喔！它在決定什麼藥物要不要納入健保給付，這個會議就是標準的行政權，有行政決策權，這樣的一個會議裡面，簡稱共擬會議，現在仍然有專家委員，號稱專家委員是現職的民意代表，這是23、24年兩年的名單，結果到立法院今年2月報到以後，他也沒有辭職，以自己黨的最高道德標準來看，他絕對要辭職，他沒有辭啦，但沒有辭的狀況裡面，開了7次會議，請假3次，他自己請假3次，參與4次，我並不想針對他，但是單純就事論事，我在這裡提醒衛福部，你們在各個機關下的審議會議設置要點或辦法當中，要不要、需不需要把民意代表適不適合擔任相關委員會的委員來進行盤點？你們要不要把所有的辦法規定回去改一改，避免立法權跟行政權混亂、混淆？"],["邱部長泰源：謝謝委員的指教，我們回去會做整體檢討。"],["林委員淑芬：你不敢說要改，你說要檢討，什麼叫檢討？"],["邱部長泰源：檢討就是要改的……然後要怎麼改……"],["林委員淑芬：你的各個委員會還有立法委員在裡面擔任委員嗎？立委兼行政決策權，然後又說他要來監督行政部門，他自己都有行政決策權，然後他說要回頭去監督行政部門，這不是笑話嗎？署長，你什麼時候要改？"],["石署長崇良：跟委員報告，剛好這個任期也到了，我們現在正在全面檢討，下一任就是明年……"],["林委員淑芬：25、26會不會再有立委擔任委員？"],["石署長崇良：我們會審慎的……"],["林委員淑芬：審慎？你不敢說不會，你還要續聘他嗎？"],["石署長崇良：因為現在委員都還沒有……"],["林委員淑芬：這個委員占了一個民間代表的缺耶！他用民間代表的身分進去裡面當委員，具有行政決策權耶！難道民間都沒有其他的人了？他在立法院裡面當立委，自己就可以監督行政機關了，還有理由用民間的發言機制代表民間去占位置嗎？再來，以立委、專家學者的身分在你們的會議裡面發言，這個立委對你們的預算有生殺大權，你們在開會的時候，你敢對他的意見提出不同意見嗎？他可以監督行政機關、掌握你們的預算權，很多人都只能夠接受他所提出來的意見，這一種立委當委員，你們敢違逆他的意見嗎？你現在不敢說了吧？"],["石署長崇良：跟委員報告……"],["林委員淑芬：下一屆還有沒有這種立委當委員的？不要說是誰，不一定是他啦！你覺得可以嗎？自己當立委，還去行政部門裡面當委員，又有行政決策權，又有立委對行政的預算監督權，都他說的贏啊！現在到底是有還是沒有？你現在不敢說？"],["石署長崇良：不會啦！跟委員報告，當然過去陳委員長期是我們……"],["林委員淑芬：我都沒有講哦！"],["石署長崇良：是我們專家會議的委員很久了啦！長期……"],["林委員淑芬：長期？擔任立委的時候，就應該要知道角色衝突……"],["石署長崇良：不過我們明年會做調整。"],["林委員淑芬：違反三權分立，又是行政權、又是立法權，又是行政決策權、又有立法院的監督預算權，像話嗎？你現在是他的代言人嗎？署長。"],["石署長崇良：沒有，我說明年就會調整了。"],["林委員淑芬：不是針對他，我們就事論事，制度面改一改了啦！人家看到工程會被社會討論得沸沸揚揚了，你們都還在那裡視若無睹，部長你不知道，署長會不知道嗎？他明明都知道，但是他為什麼不敢得罪立委？就因為他是立委，所以不敢把他拿掉，這就是為什麼需要改革，這個就是為什麼今天輪到我在這裡當壞人的原因嘛！如果你們自己自動改一改，需要我今天在這裡當壞人嗎？由此可知，立委又兼行政部門的委員，多麼的扞格、多麼的衝突、多麼的不合理，部長，你回去把該改的都改一改，好不好？"],["邱部長泰源：好，我們會檢討改進。"],["林委員淑芬：那很好，那我問下一個問題，下一個問題也很嚴重。一個女子在中山區某連鎖醫美中心打電波拉皮，麻醉後血氧濃度下降，送醫搶救不治，然後麻醉醫師就出來呼籲，所有類型的醫美麻醉都應該由麻醉專科醫師執行，我們大家看到都覺得：奇怪，怎麼這麼嚴重？部長，你12月9號出席衛福部活動的時候有受訪，你說如果相關專科醫學會有任何建議，你們會立即召開討論，進一步強化規範。我覺得你好像抓不到重點，我現在問你，過去10年裡面，因為醫美麻醉而導致死亡的案例和案件數量有多少？一個事情發生，你就要趕快回去看看這個問題有多嚴重啊！難道會是只有一個個案而已？過去每年因為醫美麻醉而死亡的有多少案例？"],["邱部長泰源：報告委員，我想品質安全就是……"],["林委員淑芬：不是啦，你告訴我數量就好了，不要講東講西的啦！"],["邱部長泰源：數量的部分可能醫事司……"],["林委員淑芬：醫事司你不知道？你們看到這個個案發生，你們都無動於衷嗎？"],["劉司長越萍：統計數據在過去裡面是沒有的，這一點先跟……"],["林委員淑芬：沒有？可是你看到個案發生了，你不會想說我趕快回來看看，你是醫事司司長，你沒想到這個問題有多嚴重嗎？去做電波拉皮的女性有多少、男性有多少，你不會覺得風險有多少跟你醫事司的業務有關，你不會聯想到嗎？你不覺得你應該保護人民的權利嗎？"],["劉司長越萍：所以我們這次是先了解到使用的藥物是所謂的Propofol，這一個藥物是需要加強……"],["林委員淑芬：司長，你不要跟我講你有多關心啦！連一年多少個案在醫美裡面麻醉死亡都不知道，我覺得你很糟糕！。我再問你，你總是要去分析這些醫美麻醉產生醫療糾紛案例的亂象有哪些，然後你才能想說你要怎麼去改善這一些亂象吧！你總不能像你們部長說丟給麻醉醫學會，醫學會如果有反映上來，我就來討論。中央沒有掌握問題、沒有分析亂象，然後叫民間組織醫學會提對策。部長，這樣你們的醫事司司長太好當了，部長也太好當了，那我林淑芬就可以來當了，怎麼可以說都跟你們沒關係？"],["邱部長泰源：報告委員，從我以前擔任醫師公會的幹部，我非常清楚這整個醫美的管理，大概這10年來，醫事司是真的用很多的心……"],["林委員淑芬：這麼用心？我問你一年糾紛多少、亂象有多少、因為醫美麻醉產生的糾紛到底有多嚴重？你說你們很用心、你說你們出很多力在管理，那你就跟我說問題有多嚴重，你說不出來，還說你很用心？在這裡睜眼說瞎話嘛！"],["邱部長泰源：我們在品質的認證跟安全的維護，我想……"],["林委員淑芬：我跟你講，安全最重要，可是你連安全的課題都沒有掌握，根據特定醫療技術檢查檢驗醫療儀器施行或使用管理辦法第二十五條及第二十九條，只有執行第二十五條的七項八大類特定美容醫學手術的全身麻醉或非全身麻醉的靜脈注射麻醉，你們才規定要由麻醉專科醫師執行，你們認為中度及輕度的鎮靜麻醉不需要由專科醫師執行。然後你們在這裡就告訴我們說你們都很注重安全，而這一次出事情的，你們都知道是用所謂舒眠麻醉這一種話術，讓去做電波拉皮的消費者覺得說舒眠麻醉只是睡一下而已，其實你們打的是牛奶針，你們自己都知道這個叫Propofol（牛奶針）。麻醉專科醫師蘇百川表示，市面上主張的牛奶針大多都是深度鎮靜，現實上只要俗稱牛奶針的Propofol都應該全部要找麻醉專科醫師，中度鎮靜很容易因外界刺激減少或病患個人的因素，瞬間掉到深度鎮靜，而病患在深度鎮靜的時候，如果發生呼吸道阻塞，只有5分鐘可以搶救。站在安全的立場，你們說你們管很多，你們這一點就完全縱放沒在管，這種使用到牛奶針全部要由麻醉專科醫師執行，你們卻沒有規範。高雄長庚醫院麻醉部教授級的主治醫師吳紹群也說，醫美打電波清醒可以講話叫做中度鎮靜，打電波完全睡著叫深度鎮靜，而深度鎮靜是最危險的一種麻醉方式，非常容易呼吸抑制或心血管中樞抑制，只有具專業的麻醉專科醫師在旁監測，才能確保病人安全。食藥署自己的新聞稿也說，牛奶針需要由專業醫師給藥，使用過程必須有醫療人員持續監測病患的心臟及呼吸功能，避免因藥物過量，導致呼吸衰竭而死亡。臺灣在2020年當時的麻醉醫學會理事長陳坤堡在撰寫麻醉相關文章的時候也提到，靜脈全身麻醉是現行美容醫學……微整型也漸漸在使用全身麻醉作為主要麻醉的方式，是一種趨勢。微整型現在很流行靜脈全身麻醉，你有在管嗎？他說一定要有麻醉專科醫師在場，否則一旦出事，後果不堪設想。然後就有人說，包括行政部門也說：不是啦，這個出事的醫生也有麻醉專科的執照，也有執行電波拉皮，他是兩個專科耶！現在問題來了，同一個醫生同時執行兩項業務，部長你覺得合適嗎？我又是麻醉科醫師，我執行麻醉，我同時又在做電波拉皮的手術，你覺得一個醫生做兩個工作適合嗎？"],["邱部長泰源：有關於這一點，應該要有兩位醫師在處理。"],["林委員淑芬：對啊！台灣麻醉醫學會吳紹群理事在他寫的文章中提到：常見的麻醉迷思和安全建議如下：實務上，手術醫師因為要專注在手術，如果又分心兼職麻醉，常常因為受制者會動，而他就會一直加深劑量，或是給到受制者不動了，卻忘了要頻繁監測受制者的生理指標，重新評估與調降維持劑量，如果沒有這樣子監測好的話，最後有可能會走向藥物過量或麻醉過深，導致嚴重的呼吸及血管抑制。所以你講的沒有錯，他專心在做手術，但是手術的時候這個人會動，然後他又做麻醉，既做手術又做麻醉，把人麻醉到他動彈不得，一個人有辦法做兩項工作嗎？"],["邱部長泰源：我們規定就是要兩位醫師。"],["林委員淑芬：沒有啦，針對手術都沒有規定要麻醉專科醫師在那裡了，還什麼兩位醫師？針對手術本身你們就沒有規定要專科醫師執行麻醉了，還說什麼兩個醫生？這樣你知道了嗎？","不好意思，主席，你讓我把這個主題問完，這是一個安全的問題，我趕快說完。你知道有多少醫美診所為了省下那個錢而亂來，加上衛福部醫事司對醫美沒有這麼多規定，你知道各縣市核准施行特定美容醫學手術的醫療機構一共有幾家嗎？醫美診所到今年全國有幾家你知道嗎？"],["劉司長越萍：應該是七百多家。"],["林委員淑芬：核准施行特定手術的有七百多家，那你知道麻醉科人數全國一共有多少人嗎？"],["劉司長越萍：一千六百多人。"],["林委員淑芬：1,600個，不要講在大醫院執業，也不要講有執照而未就業的，光是醫美診所就有七百多家，那大醫院的麻醉手術要怎麼進行？所以臺灣麻醉專科醫師的量能夠嗎？扣掉你說的七百多家，它可以配置足夠的麻醉專科醫師嗎？如果你們把法律訂下去，大家都必須要有麻醉科醫師，他們的量能夠嗎？部長，你剛剛講手術醫師不可以兼任麻醉業務，這個都是現在醫美診所的常態，在每次醫美診所發生麻醉事故以後，你們到底有沒有真的去反省？每一次的不幸事故，都要成為你政策上除錯的反省機制啊！結果我從剛才問到現在都沒有，你們有一個什麼東西可以把關醫美診所嗎？"],["劉司長越萍：我先補充幾件事：第一件事情，誠如剛剛委員在垂詢的，麻醉基本上為什麼要做危險分級的原因，就是因為人力要用在最適當的位置，也因為這樣，其實是由另外一個受過專業訓練的，所以訓練是一起協助醫生，這才是重點。"],["林委員淑芬：你都沒有講重點，你們的特定醫療技術檢查檢驗醫療儀器施行或使用管理辦法只有第二十五條第七項的八大類特定美容醫學手術需要具備麻醉專科醫師，而你們所謂的中度或輕度的鎮靜麻醉沒有規定。"],["劉司長越萍：他有需要訓練，這個有寫。"],["林委員淑芬：有訓練，現在就講手術醫師跟麻醉不能同一個人，這就是最大的風險嘛。"],["劉司長越萍：這也寫在特管辦法裡面……"],["林委員淑芬：這個就是最大的風險。部長，我再問你，醫策會在2019年鑑於診所人力資源不如醫院充足，且沒有醫院評鑑這種東西，所以為了提升診所整體美容醫學服務品質，你們辦了一個診所美容醫學的品質認證，就是以安全為基軸，強調專業人員的資格、資訊透明、環境的安全，專業及安全的醫療行為、突發事件緊急應變措施及客訴處理、追蹤服務等，就是你講的，反正你們做了這些，醫美診所要去認證安全，結果呢？結果全部認證合格、通過你們認證的有幾家，你知道嗎？"],["劉司長越萍：診所的部分，現在好像剩三十幾家左右。"],["林委員淑芬：三十幾家？41家，我看的是41家，你說全部有七百多家，只有41家，從2019年到現在5年了，5年！全部獲得認證的比例低成這個樣子，叫做你們重視醫美診所的安全？你們這樣說出來的是笑話嘛！所以全臺核准施行的特定美容醫學手術機構，這些診所是不是都安全？你們的認證率這麼低，不到一成，你說這樣的醫美診所品質足夠安全嗎？你們的認證都是最基本的、最核心的，連你們的認證都不敢參加，由此可知外面醫美診所的品質安全多麼堪憂啊！"],["劉司長越萍：我補充一下，其實法規就是樓地板，品質的要求是天花板，所以在這個中間的……"],["林委員淑芬：你不要在這裡玩文字遊戲，如果這樣子的話，為什麼5年的時間，你們認證的只有41家？"],["劉司長越萍：在這邊其實牽扯到當時剛好碰到疫情……"],["林委員淑芬：我就要問你這個，不要講那麼多！出事的這家醫美診所有沒有通過你們認證？你回答我。"],["劉司長越萍：應該是沒有。"],["林委員淑芬：應該是啊？那如果有呢？"],["劉司長越萍：因為我不確定。"],["林委員淑芬：蘇百川醫師講，你們推這個認證是以安全為基礎，保障人民就醫的安全，但是參與的診所偏少，然後這個認證的項目分成兩類，哪兩類？"],["劉司長越萍：基本上是分成光電治療跟手術兩類。"],["林委員淑芬：對，美容手術分成光電跟手術，然後大家都講，如果要認證，不會認證全部，他們只做光電，就申請光電項目就好了。這次出事的是什麼？光電技術，因為進行光電認證的話，不會對麻醉鎮靜做安全稽核，對吧？因為是光電啊，他幹嘛對麻醉鎮靜的安全去稽核，不會嘛，對不對？"],["劉司長越萍：這個細節我要確認。"],["林委員淑芬：好，這個是蘇百川講的，美容手術是診所自行去選填要認證哪一類，是要光電類還是手術類，但是電波拉皮就是光電治療，不會在醫策會現行診所的麻醉鎮靜安全查核的範圍內，所以如果在光電類認證核可，也不保證他的麻醉鎮靜是否安全，因為醫策會沒有稽核這一個項目；另外，申請手術類的醫美診所也有「偷吃步」，只要選割雙眼皮就好了，因為割雙眼皮不在特管法規範的手術內，所以醫策會認證也不會特別去查有沒有符合麻醉規範。老實說，醫美診所多請一個麻醉專科醫師就是多花錢的，大家都要省這個錢、省這個成本。若光電類認證過了，但是麻醉安全沒有過，其實政府不管你；手術類認證過了，但他申請的是割雙眼皮，消費者也看不懂，電波拉皮的就是光電類嘛，然後以為他手術安全認證了，這麼好！那就去選有認證的，結果他的認證只有選了割雙眼皮，部長，這樣你聽懂嗎？你都不知道問題這麼嚴重，醫事司內你讚美有加的司長，當個案發生了還是無動於衷，沒有想到整體醫美診所的醫美要怎麼規範，這些都沒在想，還要立委在這裡提醒你們！部長，我提醒完了之後，你聽懂了嗎？要改嗎？不要立委說完也沒用。"],["邱部長泰源：我們一定馬上嚴肅來檢討，然後也請……"],["林委員淑芬：那司長你在這裡承諾，你覺得就哪幾個面向要處理？"],["劉司長越萍：我會覺得……"],["林委員淑芬：具體的。"],["劉司長越萍：第一件事情，原本我們過去在講的這個分類裡面，強化醫策會評鑑裡面的麻醉，特別是訓練這一塊怎麼去做強化，我覺得這是短時間就可以做到的；另外，怎麼加強訓練這件事情並落實規定，我覺得這應該是重新檢討要去優化的部分。"],["林委員淑芬：一個醫生同時執行麻醉又執行手術，那要怎麼處理？"],["劉司長越萍：現況規定在美容醫學這邊是不行的，所以我才會說落實規定這件事情是重點。"],["林委員淑芬：你們要去稽核嗎？你說不行，但大家都這樣做耶，那很簡單，你去要求他們，他們執行電波拉皮、執行什麼手術，專科醫師有用到牛奶針的，那他們有使用麻醉科醫師嗎？麻醉科醫師有沒有蓋章？全國總稽查就知道了，絕對沒有的嘛！"],["劉司長越萍：我覺得落實這一塊其實是所有醫界都會很關心的，然後怎麼樣在人力上面做到……"],["林委員淑芬：我現在講的是行政管理，沒有行政管理、沒有法規，就等於沒效，在這裡說什麼都是假的。"],["劉司長越萍：現在在特管辦法裡面，美容醫療這一塊的輕度到中度就是需要兩個人，這件事情我覺得是我們可以來落實的，以上。"],["林委員淑芬：人家醫學會告訴你，只要有牛奶針，就絕對必須要有麻醉科醫師，不是一個人分飾兩角，也不是中度的，他如果躺在那裡又幫他注射，讓他不能動彈才比較好手術，這樣問題就很嚴重，你們要好好想一下。"],["主席：好，謝謝林淑芬委員，謝謝部長。","接續我們請王正旭，王正旭委員質詢完之後休息10分鐘。"]],"agenda":{"page_end":284,"meet_id":"委員會-11-2-26-14","speakers":["蘇清泉","陳昭姿","林月琴","劉建國","陳菁徽","林淑芬","王正旭","羅廷瑋","黃秀芳","廖偉翔","王育敏","陳瑩","黃國昌","鄭天財Sra Kacaw","楊瓊瓔","盧縣一","伍麗華Saidhai‧Tahovecahe","楊曜","邱鎮軍","涂權吉"],"page_start":143,"meetingDate":["2024-12-16"],"gazette_id":"1140602","agenda_lcidc_ids":["1140602_00003"],"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14次全體委員會議紀錄","content":"一、邀請衛生福利部部長列席報告業務概況，並備質詢；二、邀請衛生福利部部長、考試院、行\n政院人事行政總處針對「所屬機關有關霸凌事件之調查檢討」進行專題報告，並備質詢","agenda_id":"1140602_00002"}}}