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00:00:07,609\n謝謝主席有請邱部長部長早安部長衛福部公布的這個雙倍醫學中心的護理師薪資統計被護理人員有引起很大的質疑他們說是跟現況是不符合那這個數據怎麼來的請教部長這個薪資你是怎麼來的得到的數字\n\n2\n00:00:33,368 --> 00:01:02,748\n是的我們這個從民國112年11月我們衛護部請那個各縣市衛生局邀請各轄內的各醫院醫療醫院醫院能夠上網去填寫他的薪資是就是說是醫院通報的醫院自己報出來醫院通報的而且當時的目的真的只是希望讓護理人員能夠知道各醫院的一個薪資的狀況求職比較方便請問你有制定格式標準或是說有勾擊制度嗎\n\n3\n00:01:04,469 --> 00:01:28,345\n我們的確是有一定有就是你讓他通報但是可能沒有做這樣的事情所以現在這個引起護理界的大反彈這個跟之前我向貴部這個要求那個看護病筆資料是結果就一樣就是由官方提供的護病筆資料因為當時他好像醫學中心就區議院跟地區議院是三塊然後三塊都是平均值那大概就這樣一個月數就時間的當這個另外一個座標\n\n4\n00:01:31,827 --> 00:01:53,752\n當時那個整個這個又毀滅華然說他們官方資料跟他們感受是不一樣那回到這個薪資因為已經有工作十幾年護理師告訴我說他都頂多落在一到五年這個區塊那部長所以就是說這個是長期通報但是並沒有一個標準的方式或是勾結的制度那其實薪資高低是一件事我覺得會\n\n5\n00:01:54,312 --> 00:02:18,388\n你公佈之後引起反彈那是另外一件事如果衛福部真的關心護理人員的這個待遇問題我覺得要用很小心不要用誤導的數字去處理而且要拿出具體的改善方案部長你還記得我們在第一個會期我們談健保法第62條我的第一個附帶決議就是說醫院有盈餘醫院有盈餘就是要用來改善尤其是護理師\n\n6\n00:02:19,329 --> 00:02:27,460\n的這個工作環境跟這個薪資待遇這個是首先要做的那部長這一次就是社群平台看到你的數字他整個跳起來他說這個數字經不起反驗為什麼呢因為看起來不錯嘛所以這個媒體有一些他就會\n\n7\n00:02:36,392 --> 00:02:50,789\n讓他們看成是寫成說是這個直擊說這個好像坐擁高薪啦那這樣子這個讓他們會覺得受到一些委屈因為部長我要談的是一個平均薪資是非常危險的因為你一旦公佈的話\n\n8\n00:02:51,650 --> 00:03:06,222\n會有很多後遺症為什麼因為台灣專科護理師產業工會指出這個因為衛福部公佈薪資的數據是平均月薪但是沒有區分說什麼叫基本的薪水那還有其他的這個津貼那這個津貼包括夜班\n\n9\n00:03:07,003 --> 00:03:29,081\n加班危險津貼還有額外的工作補助所以他們就說你們提供的資料剛好包含大量的加班費加班費跟津貼的數據其實正是代表了他們其實工作是超時的結果才能得到這樣的薪資就是也正坐實的說護理師是過勞的而且還有一點喔\n\n10\n00:03:29,781 --> 00:03:50,377\n部長你們把這個專科護理師跟一般護理師都混在一起了其實專科護理師是有他的一個專業價值跟他不同的承擔所以以後處理這些數字是要非常小心因為護理界他們最在意的是說因為媒體把它報導出心智這麼優渥你們還在爭執或是重點是什麼呢這個會讓人家已經很寶貝的我們很珍惜的護理人員用這種獨到這個說法\n\n11\n00:03:59,844 --> 00:04:16,010\n他們會生氣他們會很不滿所以是不是這樣部長我就跟您討論一下我們要公佈這個護理人員薪資結構的時候是不是應該合理一下就基本薪資還有他overtime他工作其他的種種因素這樣子加起來這樣就不會覺得是去掩蓋\n\n12\n00:04:17,410 --> 00:04:27,553\n就是他們是超時工作的事實我再跟您舉個例子以前國發會發布那個國人的平均薪資都是從平均數你看那平均數幾百萬勞工勞工大概將近千萬當時那幾百萬勞工他們看了很不開心他們覺得我怎麼距離那麼遙遠後來我有一位好朋友擔任國發會主委就是陳美玲主委我就建議他說以後你不要公佈平均數你要公佈中位數\n\n13\n00:04:41,958 --> 00:05:05,257\n因為總是有一些超級收入的人把真的帶動影響了結果你知道嗎相差一萬元那你要照對賺三四萬跟賺四五萬差一萬塊是差很大所以你要處理數字真的是要非常的小心所以你這次公布是醫學中心然後你又把相對讓它呈現是高的數字其實還有一個後遺症部長\n\n14\n00:05:06,198 --> 00:05:32,954\n這樣很多護理師要去大醫院你這個公佈結果有後遺症也有不實的地方包委員第一個我們上網的有400多家所以表示說各個醫院幾乎都有第二個公佈了以後有些醫院發現我的薪資是比別人低所以紛紛提升所以其實是有正面的效果但是我絕對\n\n15\n00:05:34,315 --> 00:05:56,025\n我必須我跟委員一樣我們都是長期在醫療第一線服務的我覺得我們完全了解到醫療團隊的幸福特別在護理人員所以他們的薪水如果待遇能夠一直提高是我們所...部長您接觸的都管理面嘛沒有啦我...因為我當...我也從陰症開始當期的啊陰症現在都當時的護理人員都幾十年的朋友嘛\n\n16\n00:06:02,228 --> 00:06:05,469\n因為時間有限我拜託台灣的醫院協會理事長拜託你去查一下他們這樣是不是真實的至少我問過大概七八家但是真的這個數據出來\n\n17\n00:06:22,516 --> 00:06:24,879\n讓大家說我沒有那麼多人我覺得很抱歉我們回到今天的急診的問題我想我們一定全力來再繼續改善護理的待遇\n\n18\n00:06:38,433 --> 00:06:42,135\n因為急診問題跟你口中你講出來過說改善中或趨緩中其實差很大那我就以臨近的臺大醫院我們兩個都服務過的醫院為例其實不時都有人就給我他們其實長期的那個急診病床流管床是整個湧到正門大廳那正門大廳有個舞臺\n\n19\n00:06:54,901 --> 00:06:59,386\n甚至會辦音樂會跟活動他可以同時辦這個數字我有請教過台大他們來跟我說一個副院長跟一個急診部副主任他們就跟我說這個就是我問他們護理師夠不夠他跟我說護理師是足夠的不過這個跟鋼灰跟我反應的不太一樣後來我又請教吳院長\n\n20\n00:07:16,404 --> 00:07:30,029\n一副無可奈何就是說這個就是常態啦病人就是要往我們這邊來因為神醫院嘛台灣人心腹中心醫院其實市長您上來了我其實有把照片傳給你啊我知道你也沒有辦法暫時沒有辦法無力回天啦因為市長說這個就是一個常態啦那部長我在質詢的時候跟你說你跟他說拜他比較嚴重拜你會比較好\n\n21\n00:07:37,432 --> 00:08:03,403\n就是說大家都說我大驚小怪小題大作結果不到一年就爆炸了急診的公債問題就爆炸了所以很多人認為說急診的這個看診收費要可以有機會改善這個崩壞的醫療分級那我覺得再進一步區分今天好像報告是還沒辦法處理我知道處理錢的費用不會這麼快就可以處理我已經轉折就到大醫院接著輕症病人提高收費因為韓國等等其他國家有這個做法\n\n22\n00:08:04,083 --> 00:08:19,802\n反而你當時視察過後,你寫的那個就醫指引,那個沒法律效力啊,那只是參考看看聽聽看啦,好嗎?我不是去視察,這間醫院每一個都是好朋友,所以沒有這麼好視察,我是去跟他們打氣而已啦\n\n23\n00:08:20,503 --> 00:08:22,904\n第13條我想石組長很清楚不經轉轉到地區醫院醫學中心就醫應該有30、40、50%的分攤這個部分請你就是今天實業有限本來就一條法律在這裡你想辦法都不好才會一直惡化\n\n24\n00:08:38,770 --> 00:09:00,367\n那另外就是你鼓勵大家轉型用指引但只有一成人會接受我今天回家請你做個功課因為原來只有一成人他會接受這個醫護的建議就轉到相對輕症到比較小的醫院去看但是只有一成根據報就一成人會接受那請你告訴我今天你們想了一些辦法有指引然後有些鼓勵那到底會進步多少就麻煩你這個幫我\n\n25\n00:09:02,508 --> 00:09:30,360\n好沒問題報告委員這個齁那接下來就麻煩我都等這個報告齁聰明GOE其實是國際的趨勢所以我們做無聯乃也一直在努力我自己知道的事情要請教江署長啦好來來來江署長謝謝你今天你專程來謝謝你因為對於食藥署對藥品特別是口服定劑跟這個膠囊保存的方法跟期限的怎麼說署長您知道嗎就是你們貴署是怎麼來說的請你看我這樣投影片他就寫了一個說\n\n26\n00:09:31,540 --> 00:09:59,586\n開封或調劑日算半年內要服用完畢署長這個說法太簡化了應該要更科學性的做法因為美國醫院要是有各種指引那我今天為什麼這樣講呢其實藥品那個效期也是你核定啊也是食藥署核定的啊藥品在他原包裝裡面只要按照他規定的儲存的條件比如溫度啊等等那他這個效期就是就是按照那個標示的效期啊那為什麼現在每一家醫院呢\n\n27\n00:10:00,106 --> 00:10:26,830\n他買藥的時候購買藥的時候都要求提供像衛福部醫院8個月以上的這個有效期間然後剩下兩個月的時候叫人家買回去買回去再換新的回來你又要賺取要價差又要占人家便宜但是這個源頭魚他們就拿這個資料來當作藉口署長怎麼辦這怎麼辦那藥廠是怎麼樣他要製造什麼樣藥品給大家用呢\n\n28\n00:10:28,322 --> 00:10:47,708\n謝謝委員的提問那我看到網站這部分裡面藥物食品安全週報我們特別稍微去了解一下那個理論的基礎大概是這樣子那是應該是大包裝的不是那種一排一排已經標示安全期限那個很標準大包裝也是效期啊還是有效的效期因為它是所謂所謂的非無菌固體製劑開封因為已經打開來了打開來就破壞原來的一個市長我要先跟你修正一下\n\n29\n00:10:56,710 --> 00:11:05,918\n如果打開以後會縮短的話都會寫這個要求都要寫就像我們知道眼藥一個月就不能用以前naturalglycerin消息該用一年內不能用沒有規範的時候按照這個標準不然你核准的那個效期是假的參考用嗎這個被醫院拿來利用等一下我要請這個\n\n30\n00:11:16,548 --> 00:11:35,905\n好請執行長稍微說明一下就是說我們參考的是打開來這種是USP795調製後的所謂的YoungYouthDay的BUD為六個月的體驗調製對調製之後六個所以這個是已經是定季的我們打開覺得可能已經完全有點跟原來的有一點點\n\n31\n00:11:36,866 --> 00:11:50,633\n所以這個是這樣的想法第二部分是有些異變值的確像阿布敏我們大概4個小時啊這個部分麻煩我們用科學性然後處理我現在可以造成後遺症但是我請執行長上來執行長你們這個衛福部的聯標院這個麻煩你先留著就了解你們衛福聯標醫院那個也是這樣規範說要8個月以上的留有8個月以上的效期\n\n32\n00:11:59,497 --> 00:12:12,671\n那你這個第一個就是說我請教他們他第一個問題跟我說因為別的醫院也這樣做你們副執行長來我嚇一跳衛福部醫院竟然說別的醫院也這樣做別的醫院就是對的別的醫院這樣做你就要跟著這樣子做嗎然後他給我第二個理由說這個什麼援揚於公\n\n33\n00:12:18,897 --> 00:12:42,325\n他要到這個遠洋去要領六個月所以我們校期要留很久遠洋移工根本就是政府欺負遠洋移工因為事實上他在那個環境那個環境又高濕又高熱然後那個環境根本他那個校期你就把丟給他去管理他根本還要更短才對你還跟他算到這個時候所以如果一個醫院三月買藥那五月有個遠洋移工來那你照你的規矩八個月你就不用了\n\n34\n00:12:42,625 --> 00:12:48,641\n那你還要不要把藥給這個遠洋漁工所以你就以偏概全你這個醫院的管理完全轉嫁到\n\n35\n00:12:49,667 --> 00:12:54,569\n藥廠身上你要買是要買一個效期這麼長的等到差兩個月你就叫他買回去然後又說什麼偏鄉藥師人力不足盤點困難所以效期是八個月你把管理的責任這個結構性問題偏鄉也缺醫師啊你就不只是缺藥師那你整個都丟給那個藥廠去承擔還要吃藥藥價差要再叫人說要再效期還很久很久的藥然後等到效期靠近都還可以用你就叫人家買回去買回去換過來\n\n36\n00:13:17,919 --> 00:13:44,854\n那吃人狗狗欺負人太累了執行長我跟他們溝通他們不接受欸那署長你要講公道話藥食品的安定區是你在管的好那第一個就是說跟委員說明實在有三項第一個就是說我們的藥品聯標是一個委員會是由各個醫院代表還有一些外部專家那特別是藥品聯標是所有的我們的偏鄉離島包含都會區的醫院再加上有一些衛生局衛生所所以裡面他需求的管理問題你是一般全部\n\n37\n00:13:45,575 --> 00:13:57,572\n第二個就是說剛剛提到其實在我們過去您提到的8個月其實我們是不是有超過6個月其實在這個部分裡面只佔非常小的比例不到1%那你今天可不可以承諾6個月\n\n38\n00:14:00,757 --> 00:14:15,699\n永泉又六個月你這樣太為難人家了八個月一年的都有啊你太為難人家了而且你也知道吧兩個月靠近兩個月你管理不善放了那麼久兩個月內你就叫人家換回去叫人家買回去有這種情形的只佔百分之一這兩邊佔人家便宜啊\n\n39\n00:14:16,340 --> 00:14:28,772\n跟委員報告只佔百分之一不是很高的比例那可不可以回到六個月執行長你一句話因為我已經跟他們溝通過了他們沒有人敢做決定這個是經過我們那個聯標但是我就是跟你討論專業啊我跟你討論專業跟管理啊醫院有關的你不要把管理全部丟給他們啊你把它丟給別人嘛\n\n40\n00:14:37,641 --> 00:14:44,123\n你可以處理這個問題嗎?執行長,你一句話我們再帶給聯標委員裡面,因為裡面還有一些外部的委員我已經跟他們溝通過了,剩你一句話,執行長你一句話科學性需要,就是說你要有一個科學性,不然你那個藥品標示是假的嗎?假的嗎?我們會去評估剛您提到的這一塊,但是因為在要聯標的委員會裡面,他們也要拿去討論\n\n41\n00:15:05,689 --> 00:15:22,583\n我想委員是專家啦,你一定希望他運轉得很順利那藥廠的一個管理跟醫院也有管理,藥局的管理,這兩個怎麼樣取得一個平衡那得到一個應該的對人民最保障的這個部分我會請那個執行長,待會兒去檢討好不好\n\n42\n00:15:27,247 --> 00:15:51,091\n好那江署長你這個科學性的部分要很清楚喔校期是你們標示你們同意的東西喔那你形同虛設各位委員只要校期內的其實在使用上都沒有問題的那這個調製麻煩你除了這個reconstitution還是什麼調製跟調劑是不一樣喔你經過泡水都不一樣喔所以要科學性的不要一致性的好嗎那執行長可以嗎部長也從你要檢討為什麼一定要做這樣那你要帶頭做你要帶頭做嘛好謝謝\n\n43\n00:15:56,912 --> 00:16:05,119\n我們部立醫院永遠有帶頭的作用一定要不要因為說別的醫院這樣做所以你就跟著這樣做他們給我第一個理由是這個好嗎要帶頭非常謝謝委員好謝謝\n\n","tsv":"start\tend\ttext\n5868\t7609\t謝謝主席 有請邱部長部長早安 部長 衛福部公布的這個雙倍醫學中心的護理師薪資統計被護理人員有引起很大的質疑他們說是跟現況是不符合那這個數據怎麼來的 請教部長這個薪資你是怎麼來的 得到的數字\n33368\t62748\t是的我們這個從民國112年11月我們衛護部請那個各縣市衛生局邀請各轄內的各醫院醫療醫院醫院能夠上網去填寫他的薪資是就是說是醫院通報的醫院自己報出來醫院通報的而且當時的目的真的只是希望讓護理人員能夠知道各醫院的一個薪資的狀況求職比較方便請問你有制定格式標準或是說有勾擊制度嗎\n64469\t88345\t我們的確是有一定有就是你讓他通報但是可能沒有做這樣的事情所以現在這個引起護理界的大反彈這個跟之前我向貴部這個要求那個看護病筆資料是結果就一樣就是由官方提供的護病筆資料因為當時他好像醫學中心就區議院跟地區議院是三塊然後三塊都是平均值那大概就這樣一個月數就時間的當這個另外一個座標\n91827\t113752\t當時那個整個這個又毀滅華然說他們官方資料跟他們感受是不一樣那回到這個薪資因為已經有工作十幾年護理師告訴我說他都頂多落在一到五年這個區塊那部長所以就是說這個是長期通報但是並沒有一個標準的方式或是勾結的制度那其實薪資高低是一件事我覺得會\n114312\t138388\t你公佈之後引起反彈那是另外一件事如果衛福部真的關心護理人員的這個待遇問題我覺得要用很小心不要用誤導的數字去處理而且要拿出具體的改善方案部長你還記得我們在第一個會期我們談健保法第62條我的第一個附帶決議就是說醫院有盈餘醫院有盈餘就是要用來改善尤其是護理師\n139329\t147460\t的這個工作環境跟這個薪資待遇這個是首先要做的那部長這一次就是社群平台看到你的數字他整個跳起來他說這個數字經不起反驗為什麼呢因為看起來不錯嘛所以這個媒體有一些他就會\n156392\t170789\t讓他們看成是寫成說是這個直擊說這個好像坐擁高薪啦那這樣子這個讓他們會覺得受到一些委屈因為部長我要談的是一個平均薪資是非常危險的因為你一旦公佈的話\n171650\t186222\t會有很多後遺症為什麼因為台灣專科護理師產業工會指出這個因為衛福部公佈薪資的數據是平均月薪但是沒有區分說什麼叫基本的薪水那還有其他的這個津貼那這個津貼包括夜班\n187003\t209081\t加班危險津貼還有額外的工作補助所以他們就說你們提供的資料剛好包含大量的加班費加班費跟津貼的數據其實正是代表了他們其實工作是超時的結果才能得到這樣的薪資就是也正坐實的說護理師是過勞的而且還有一點喔\n209781\t230377\t部長你們把這個專科護理師跟一般護理師都混在一起了其實專科護理師是有他的一個專業價值跟他不同的承擔所以以後處理這些數字是要非常小心因為護理界他們最在意的是說因為媒體把它報導出心智這麼優渥你們還在爭執或是重點是什麼呢這個會讓人家已經很寶貝的我們很珍惜的護理人員用這種獨到這個說法\n239844\t256010\t他們會生氣他們會很不滿所以是不是這樣部長我就跟您討論一下我們要公佈這個護理人員薪資結構的時候是不是應該合理一下就基本薪資還有他 overtime他工作其他的種種因素這樣子加起來這樣就不會覺得是去掩蓋\n257410\t267553\t就是他們是超時工作的事實我再跟您舉個例子以前國發會發布那個國人的平均薪資都是從平均數你看那平均數幾百萬勞工勞工大概將近千萬當時那幾百萬勞工他們看了很不開心他們覺得我怎麼距離那麼遙遠後來我有一位好朋友擔任國發會主委就是陳美玲主委我就建議他說以後你不要公佈平均數你要公佈中位數\n281958\t305257\t因為總是有一些超級收入的人把真的帶動影響了結果你知道嗎相差一萬元那你要照對賺三四萬跟賺四五萬差一萬塊是差很大所以你要處理數字真的是要非常的小心所以你這次公布是醫學中心然後你又把相對讓它呈現是高的數字其實還有一個後遺症部長\n306198\t332954\t這樣很多護理師要去大醫院你這個公佈結果有後遺症也有不實的地方包委員第一個我們上網的有400多家所以表示說各個醫院幾乎都有第二個公佈了以後有些醫院發現我的薪資是比別人低所以紛紛提升所以其實是有正面的效果但是我絕對\n334315\t356025\t我必須 我跟委員一樣我們都是長期在醫療第一線服務的我覺得我們完全了解到醫療團隊的幸福特別在護理人員所以他們的薪水如果待遇能夠一直提高是我們所...部長您接觸的都管理面嘛沒有啦 我...因為我當...我也從陰症開始當期的啊陰症現在都當時的護理人員都幾十年的朋友嘛\n362228\t365469\t因為時間有限我拜託台灣的醫院協會理事長拜託你去查一下他們這樣是不是真實的至少我問過大概七八家但是真的這個數據出來\n382516\t384879\t讓大家說我沒有那麼多人 我覺得很抱歉我們回到今天的急診的問題我想我們一定全力來再繼續改善護理的待遇\n398433\t402135\t因為急診問題跟你口中你講出來過說改善中或趨緩中其實差很大那我就以臨近的臺大醫院我們兩個都服務過的醫院為例其實不時都有人就給我他們其實長期的那個急診病床流管床是整個湧到正門大廳那正門大廳有個舞臺\n414901\t419386\t甚至會辦音樂會跟活動他可以同時辦這個數字我有請教過台大他們來跟我說一個副院長跟一個急診部副主任他們就跟我說這個就是我問他們護理師夠不夠他跟我說護理師是足夠的不過這個跟鋼灰跟我反應的不太一樣後來我又請教吳院長\n436404\t450029\t一副無可奈何就是說這個就是常態啦病人就是要往我們這邊來因為神醫院嘛台灣人心腹中心醫院其實市長您上來了我其實有把照片傳給你啊我知道你也沒有辦法暫時沒有辦法無力回天啦因為市長說這個就是一個常態啦那部長我在質詢的時候跟你說你跟他說拜他比較嚴重拜你會比較好\n457432\t483403\t就是說大家都說我大驚小怪小題大作結果不到一年就爆炸了急診的公債問題就爆炸了所以很多人認為說急診的這個看診收費要可以有機會改善這個崩壞的醫療分級那我覺得再進一步區分今天好像報告是還沒辦法處理我知道處理錢的費用不會這麼快就可以處理我已經轉折就到大醫院接著輕症病人提高收費因為韓國等等其他國家有這個做法\n484083\t499802\t反而你當時視察過後,你寫的那個就醫指引,那個沒法律效力啊,那只是參考看看聽聽看啦,好嗎?我不是去視察,這間醫院每一個都是好朋友,所以沒有這麼好視察,我是去跟他們打氣而已啦\n500503\t502904\t第13條我想石組長很清楚不經轉轉到地區醫院醫學中心就醫應該有30、40、50%的分攤這個部分請你就是今天實業有限本來就一條法律在這裡你想辦法都不好才會一直惡化\n518770\t540367\t那另外就是你鼓勵大家轉型用指引但只有一成人會接受我今天回家請你做個功課因為原來只有一成人他會接受這個醫護的建議就轉到相對輕症到比較小的醫院去看但是只有一成根據報就一成人會接受那請你告訴我今天你們想了一些辦法有指引然後有些鼓勵那到底會進步多少就麻煩你這個幫我\n542508\t570360\t好沒問題 報告委員這個齁那接下來就麻煩我都等這個報告齁聰明GOE其實是國際的趨勢所以我們做無聯乃也一直在努力我自己知道的事情要請教江署長啦好來來來江署長謝謝你今天你專程來謝謝你因為對於食藥署對藥品特別是口服定劑跟這個膠囊保存的方法跟期限的怎麼說署長您知道嗎就是你們貴署是怎麼來說的請你看我這樣投影片他就寫了一個說\n571540\t599586\t開封或調劑日算半年內要服用完畢署長這個說法太簡化了應該要更科學性的做法因為美國醫院要是有各種指引那我今天為什麼這樣講呢其實藥品那個效期也是你核定啊也是食藥署核定的啊藥品在他原包裝裡面只要按照他規定的儲存的條件比如溫度啊等等那他這個效期就是就是按照那個標示的效期啊那為什麼現在每一家醫院呢\n600106\t626830\t他買藥的時候購買藥的時候都要求提供像衛福部醫院8個月以上的這個有效期間然後剩下兩個月的時候叫人家買回去買回去再換新的回來你又要賺取要價差又要占人家便宜但是這個源頭魚他們就拿這個資料來當作藉口署長怎麼辦這怎麼辦那藥廠是怎麼樣他要製造什麼樣藥品給大家用呢\n628322\t647708\t謝謝委員的提問那我看到網站這部分裡面藥物食品安全週報我們特別稍微去了解一下那個理論的基礎大概是這樣子那是應該是大包裝的不是那種一排一排已經標示安全期限那個很標準大包裝也是效期啊還是有效的效期因為它是所謂所謂的非無菌固體製劑開封因為已經打開來了打開來就破壞原來的一個市長我要先跟你修正一下\n656710\t665918\t如果打開以後會縮短的話都會寫這個要求都要寫就像我們知道眼藥一個月就不能用以前natural glycerin消息該用一年內不能用沒有規範的時候按照這個標準不然你核准的那個效期是假的參考用嗎這個被醫院拿來利用等一下我要請這個\n676548\t695905\t好 請執行長稍微說明一下就是說我們參考的是打開來這種是USP795調製後的所謂的Young Youth Day的BUD為六個月的體驗調製對 調製之後六個所以這個是已經是定季的我們打開覺得可能已經完全有點跟原來的有一點點\n696866\t710633\t所以這個是這樣的想法第二部分是有些異變值的確像阿布敏我們大概4個小時啊這個部分麻煩我們用科學性然後處理我現在可以造成後遺症但是我請執行長上來執行長你們這個衛福部的聯標院這個麻煩你先留著就了解你們衛福聯標醫院那個也是這樣規範說要8個月以上的留有8個月以上的效期\n719497\t732671\t那你這個第一個就是說我請教他們他第一個問題跟我說因為別的醫院也這樣做你們副執行長來我嚇一跳衛福部醫院竟然說別的醫院也這樣做別的醫院就是對的別的醫院這樣做你就要跟著這樣子做嗎然後他給我第二個理由說這個什麼援揚於公\n738897\t762325\t他要到這個遠洋去要領六個月所以我們校期要留很久遠洋移工根本就是政府欺負遠洋移工因為事實上他在那個環境那個環境又高濕又高熱然後那個環境根本他那個校期你就把丟給他去管理他根本還要更短才對你還跟他算到這個時候所以如果一個醫院三月買藥那五月有個遠洋移工來那你照你的規矩八個月你就不用了\n762625\t768641\t那你還要不要把藥給這個遠洋漁工所以你就以偏概全你這個醫院的管理完全轉嫁到\n769667\t774569\t藥廠身上 你要買是要買一個效期這麼長的等到差兩個月你就叫他買回去然後又說什麼偏鄉藥師人力不足盤點困難所以效期是八個月你把管理的責任這個結構性問題偏鄉也缺醫師啊你就不只是缺藥師那你整個都丟給那個藥廠去承擔還要吃藥 藥價差要再叫人說要再效期還很久很久的藥然後等到效期靠近都還可以用你就叫人家買回去買回去換過來\n797919\t824854\t那吃人狗狗欺負人太累了執行長 我跟他們溝通他們不接受欸那署長你要講公道話 藥食品的安定區是你在管的好 那第一個就是說跟委員說明實在有三項第一個就是說我們的藥品聯標是一個委員會是由各個醫院代表還有一些外部專家那特別是藥品聯標是所有的我們的偏鄉離島包含都會區的醫院再加上有一些衛生局 衛生所所以裡面他需求的管理問題 你是一般全部\n825575\t837572\t第二個就是說剛剛提到其實在我們過去您提到的8個月其實我們是不是有超過6個月其實在這個部分裡面只佔非常小的比例不到1%那你今天可不可以承諾6個月\n840757\t855699\t永泉又六個月你這樣太為難人家了八個月一年的都有啊你太為難人家了而且你也知道吧兩個月靠近兩個月你管理不善放了那麼久兩個月內你就叫人家換回去叫人家買回去有這種情形的只佔百分之一這兩邊佔人家便宜啊\n856340\t868772\t跟委員報告只佔百分之一不是很高的比例那可不可以回到六個月執行長你一句話因為我已經跟他們溝通過了他們沒有人敢做決定這個是經過我們那個聯標但是我就是跟你討論專業啊我跟你討論專業跟管理啊醫院有關的你不要把管理全部丟給他們啊你把它丟給別人嘛\n877641\t884123\t你可以處理這個問題嗎?執行長,你一句話我們再帶給聯標委員裡面,因為裡面還有一些外部的委員我已經跟他們溝通過了,剩你一句話,執行長你一句話科學性需要,就是說你要有一個科學性,不然你那個藥品標示是假的嗎?假的嗎?我們會去評估剛您提到的這一塊,但是因為在要聯標的委員會裡面,他們也要拿去討論\n905689\t922583\t我想委員是專家啦,你一定希望他運轉得很順利那藥廠的一個管理跟醫院也有管理,藥局的管理,這兩個怎麼樣取得一個平衡那得到一個應該的對人民最保障的這個部分我會請那個執行長,待會兒去檢討好不好\n927247\t951091\t好那江署長你這個科學性的部分要很清楚喔校期是你們標示你們同意的東西喔那你形同虛設 各位委員只要校期內的其實在使用上都沒有問題的那這個調製麻煩你除了這個reconstitution還是什麼調製跟調劑是不一樣喔你經過泡水都不一樣喔所以要科學性的不要一致性的好嗎那執行長可以嗎部長也從你要檢討為什麼一定要做這樣那你要帶頭做你要帶頭做嘛好謝謝\n956912\t965119\t我們部立醫院永遠有帶頭的作用一定要 不要因為說別的醫院這樣做所以你就跟著這樣做他們給我第一個理由是這個好嗎 要帶頭非常謝謝委員好 謝謝\n","txt":"謝謝主席 有請邱部長部長早安 部長 衛福部公布的這個雙倍醫學中心的護理師薪資統計被護理人員有引起很大的質疑他們說是跟現況是不符合那這個數據怎麼來的 請教部長這個薪資你是怎麼來的 得到的數字\n是的我們這個從民國112年11月我們衛護部請那個各縣市衛生局邀請各轄內的各醫院醫療醫院醫院能夠上網去填寫他的薪資是就是說是醫院通報的醫院自己報出來醫院通報的而且當時的目的真的只是希望讓護理人員能夠知道各醫院的一個薪資的狀況求職比較方便請問你有制定格式標準或是說有勾擊制度嗎\n我們的確是有一定有就是你讓他通報但是可能沒有做這樣的事情所以現在這個引起護理界的大反彈這個跟之前我向貴部這個要求那個看護病筆資料是結果就一樣就是由官方提供的護病筆資料因為當時他好像醫學中心就區議院跟地區議院是三塊然後三塊都是平均值那大概就這樣一個月數就時間的當這個另外一個座標\n當時那個整個這個又毀滅華然說他們官方資料跟他們感受是不一樣那回到這個薪資因為已經有工作十幾年護理師告訴我說他都頂多落在一到五年這個區塊那部長所以就是說這個是長期通報但是並沒有一個標準的方式或是勾結的制度那其實薪資高低是一件事我覺得會\n你公佈之後引起反彈那是另外一件事如果衛福部真的關心護理人員的這個待遇問題我覺得要用很小心不要用誤導的數字去處理而且要拿出具體的改善方案部長你還記得我們在第一個會期我們談健保法第62條我的第一個附帶決議就是說醫院有盈餘醫院有盈餘就是要用來改善尤其是護理師\n的這個工作環境跟這個薪資待遇這個是首先要做的那部長這一次就是社群平台看到你的數字他整個跳起來他說這個數字經不起反驗為什麼呢因為看起來不錯嘛所以這個媒體有一些他就會\n讓他們看成是寫成說是這個直擊說這個好像坐擁高薪啦那這樣子這個讓他們會覺得受到一些委屈因為部長我要談的是一個平均薪資是非常危險的因為你一旦公佈的話\n會有很多後遺症為什麼因為台灣專科護理師產業工會指出這個因為衛福部公佈薪資的數據是平均月薪但是沒有區分說什麼叫基本的薪水那還有其他的這個津貼那這個津貼包括夜班\n加班危險津貼還有額外的工作補助所以他們就說你們提供的資料剛好包含大量的加班費加班費跟津貼的數據其實正是代表了他們其實工作是超時的結果才能得到這樣的薪資就是也正坐實的說護理師是過勞的而且還有一點喔\n部長你們把這個專科護理師跟一般護理師都混在一起了其實專科護理師是有他的一個專業價值跟他不同的承擔所以以後處理這些數字是要非常小心因為護理界他們最在意的是說因為媒體把它報導出心智這麼優渥你們還在爭執或是重點是什麼呢這個會讓人家已經很寶貝的我們很珍惜的護理人員用這種獨到這個說法\n他們會生氣他們會很不滿所以是不是這樣部長我就跟您討論一下我們要公佈這個護理人員薪資結構的時候是不是應該合理一下就基本薪資還有他 overtime他工作其他的種種因素這樣子加起來這樣就不會覺得是去掩蓋\n就是他們是超時工作的事實我再跟您舉個例子以前國發會發布那個國人的平均薪資都是從平均數你看那平均數幾百萬勞工勞工大概將近千萬當時那幾百萬勞工他們看了很不開心他們覺得我怎麼距離那麼遙遠後來我有一位好朋友擔任國發會主委就是陳美玲主委我就建議他說以後你不要公佈平均數你要公佈中位數\n因為總是有一些超級收入的人把真的帶動影響了結果你知道嗎相差一萬元那你要照對賺三四萬跟賺四五萬差一萬塊是差很大所以你要處理數字真的是要非常的小心所以你這次公布是醫學中心然後你又把相對讓它呈現是高的數字其實還有一個後遺症部長\n這樣很多護理師要去大醫院你這個公佈結果有後遺症也有不實的地方包委員第一個我們上網的有400多家所以表示說各個醫院幾乎都有第二個公佈了以後有些醫院發現我的薪資是比別人低所以紛紛提升所以其實是有正面的效果但是我絕對\n我必須 我跟委員一樣我們都是長期在醫療第一線服務的我覺得我們完全了解到醫療團隊的幸福特別在護理人員所以他們的薪水如果待遇能夠一直提高是我們所...部長您接觸的都管理面嘛沒有啦 我...因為我當...我也從陰症開始當期的啊陰症現在都當時的護理人員都幾十年的朋友嘛\n因為時間有限我拜託台灣的醫院協會理事長拜託你去查一下他們這樣是不是真實的至少我問過大概七八家但是真的這個數據出來\n讓大家說我沒有那麼多人 我覺得很抱歉我們回到今天的急診的問題我想我們一定全力來再繼續改善護理的待遇\n因為急診問題跟你口中你講出來過說改善中或趨緩中其實差很大那我就以臨近的臺大醫院我們兩個都服務過的醫院為例其實不時都有人就給我他們其實長期的那個急診病床流管床是整個湧到正門大廳那正門大廳有個舞臺\n甚至會辦音樂會跟活動他可以同時辦這個數字我有請教過台大他們來跟我說一個副院長跟一個急診部副主任他們就跟我說這個就是我問他們護理師夠不夠他跟我說護理師是足夠的不過這個跟鋼灰跟我反應的不太一樣後來我又請教吳院長\n一副無可奈何就是說這個就是常態啦病人就是要往我們這邊來因為神醫院嘛台灣人心腹中心醫院其實市長您上來了我其實有把照片傳給你啊我知道你也沒有辦法暫時沒有辦法無力回天啦因為市長說這個就是一個常態啦那部長我在質詢的時候跟你說你跟他說拜他比較嚴重拜你會比較好\n就是說大家都說我大驚小怪小題大作結果不到一年就爆炸了急診的公債問題就爆炸了所以很多人認為說急診的這個看診收費要可以有機會改善這個崩壞的醫療分級那我覺得再進一步區分今天好像報告是還沒辦法處理我知道處理錢的費用不會這麼快就可以處理我已經轉折就到大醫院接著輕症病人提高收費因為韓國等等其他國家有這個做法\n反而你當時視察過後,你寫的那個就醫指引,那個沒法律效力啊,那只是參考看看聽聽看啦,好嗎?我不是去視察,這間醫院每一個都是好朋友,所以沒有這麼好視察,我是去跟他們打氣而已啦\n第13條我想石組長很清楚不經轉轉到地區醫院醫學中心就醫應該有30、40、50%的分攤這個部分請你就是今天實業有限本來就一條法律在這裡你想辦法都不好才會一直惡化\n那另外就是你鼓勵大家轉型用指引但只有一成人會接受我今天回家請你做個功課因為原來只有一成人他會接受這個醫護的建議就轉到相對輕症到比較小的醫院去看但是只有一成根據報就一成人會接受那請你告訴我今天你們想了一些辦法有指引然後有些鼓勵那到底會進步多少就麻煩你這個幫我\n好沒問題 報告委員這個齁那接下來就麻煩我都等這個報告齁聰明GOE其實是國際的趨勢所以我們做無聯乃也一直在努力我自己知道的事情要請教江署長啦好來來來江署長謝謝你今天你專程來謝謝你因為對於食藥署對藥品特別是口服定劑跟這個膠囊保存的方法跟期限的怎麼說署長您知道嗎就是你們貴署是怎麼來說的請你看我這樣投影片他就寫了一個說\n開封或調劑日算半年內要服用完畢署長這個說法太簡化了應該要更科學性的做法因為美國醫院要是有各種指引那我今天為什麼這樣講呢其實藥品那個效期也是你核定啊也是食藥署核定的啊藥品在他原包裝裡面只要按照他規定的儲存的條件比如溫度啊等等那他這個效期就是就是按照那個標示的效期啊那為什麼現在每一家醫院呢\n他買藥的時候購買藥的時候都要求提供像衛福部醫院8個月以上的這個有效期間然後剩下兩個月的時候叫人家買回去買回去再換新的回來你又要賺取要價差又要占人家便宜但是這個源頭魚他們就拿這個資料來當作藉口署長怎麼辦這怎麼辦那藥廠是怎麼樣他要製造什麼樣藥品給大家用呢\n謝謝委員的提問那我看到網站這部分裡面藥物食品安全週報我們特別稍微去了解一下那個理論的基礎大概是這樣子那是應該是大包裝的不是那種一排一排已經標示安全期限那個很標準大包裝也是效期啊還是有效的效期因為它是所謂所謂的非無菌固體製劑開封因為已經打開來了打開來就破壞原來的一個市長我要先跟你修正一下\n如果打開以後會縮短的話都會寫這個要求都要寫就像我們知道眼藥一個月就不能用以前natural glycerin消息該用一年內不能用沒有規範的時候按照這個標準不然你核准的那個效期是假的參考用嗎這個被醫院拿來利用等一下我要請這個\n好 請執行長稍微說明一下就是說我們參考的是打開來這種是USP795調製後的所謂的Young Youth Day的BUD為六個月的體驗調製對 調製之後六個所以這個是已經是定季的我們打開覺得可能已經完全有點跟原來的有一點點\n所以這個是這樣的想法第二部分是有些異變值的確像阿布敏我們大概4個小時啊這個部分麻煩我們用科學性然後處理我現在可以造成後遺症但是我請執行長上來執行長你們這個衛福部的聯標院這個麻煩你先留著就了解你們衛福聯標醫院那個也是這樣規範說要8個月以上的留有8個月以上的效期\n那你這個第一個就是說我請教他們他第一個問題跟我說因為別的醫院也這樣做你們副執行長來我嚇一跳衛福部醫院竟然說別的醫院也這樣做別的醫院就是對的別的醫院這樣做你就要跟著這樣子做嗎然後他給我第二個理由說這個什麼援揚於公\n他要到這個遠洋去要領六個月所以我們校期要留很久遠洋移工根本就是政府欺負遠洋移工因為事實上他在那個環境那個環境又高濕又高熱然後那個環境根本他那個校期你就把丟給他去管理他根本還要更短才對你還跟他算到這個時候所以如果一個醫院三月買藥那五月有個遠洋移工來那你照你的規矩八個月你就不用了\n那你還要不要把藥給這個遠洋漁工所以你就以偏概全你這個醫院的管理完全轉嫁到\n藥廠身上 你要買是要買一個效期這麼長的等到差兩個月你就叫他買回去然後又說什麼偏鄉藥師人力不足盤點困難所以效期是八個月你把管理的責任這個結構性問題偏鄉也缺醫師啊你就不只是缺藥師那你整個都丟給那個藥廠去承擔還要吃藥 藥價差要再叫人說要再效期還很久很久的藥然後等到效期靠近都還可以用你就叫人家買回去買回去換過來\n那吃人狗狗欺負人太累了執行長 我跟他們溝通他們不接受欸那署長你要講公道話 藥食品的安定區是你在管的好 那第一個就是說跟委員說明實在有三項第一個就是說我們的藥品聯標是一個委員會是由各個醫院代表還有一些外部專家那特別是藥品聯標是所有的我們的偏鄉離島包含都會區的醫院再加上有一些衛生局 衛生所所以裡面他需求的管理問題 你是一般全部\n第二個就是說剛剛提到其實在我們過去您提到的8個月其實我們是不是有超過6個月其實在這個部分裡面只佔非常小的比例不到1%那你今天可不可以承諾6個月\n永泉又六個月你這樣太為難人家了八個月一年的都有啊你太為難人家了而且你也知道吧兩個月靠近兩個月你管理不善放了那麼久兩個月內你就叫人家換回去叫人家買回去有這種情形的只佔百分之一這兩邊佔人家便宜啊\n跟委員報告只佔百分之一不是很高的比例那可不可以回到六個月執行長你一句話因為我已經跟他們溝通過了他們沒有人敢做決定這個是經過我們那個聯標但是我就是跟你討論專業啊我跟你討論專業跟管理啊醫院有關的你不要把管理全部丟給他們啊你把它丟給別人嘛\n你可以處理這個問題嗎?執行長,你一句話我們再帶給聯標委員裡面,因為裡面還有一些外部的委員我已經跟他們溝通過了,剩你一句話,執行長你一句話科學性需要,就是說你要有一個科學性,不然你那個藥品標示是假的嗎?假的嗎?我們會去評估剛您提到的這一塊,但是因為在要聯標的委員會裡面,他們也要拿去討論\n我想委員是專家啦,你一定希望他運轉得很順利那藥廠的一個管理跟醫院也有管理,藥局的管理,這兩個怎麼樣取得一個平衡那得到一個應該的對人民最保障的這個部分我會請那個執行長,待會兒去檢討好不好\n好那江署長你這個科學性的部分要很清楚喔校期是你們標示你們同意的東西喔那你形同虛設 各位委員只要校期內的其實在使用上都沒有問題的那這個調製麻煩你除了這個reconstitution還是什麼調製跟調劑是不一樣喔你經過泡水都不一樣喔所以要科學性的不要一致性的好嗎那執行長可以嗎部長也從你要檢討為什麼一定要做這樣那你要帶頭做你要帶頭做嘛好謝謝\n我們部立醫院永遠有帶頭的作用一定要 不要因為說別的醫院這樣做所以你就跟著這樣做他們給我第一個理由是這個好嗎 要帶頭非常謝謝委員好 謝謝\n","vtt":"WEBVTT\n\n00:05.868 --> 00:07.609\n謝謝主席有請邱部長部長早安部長衛福部公布的這個雙倍醫學中心的護理師薪資統計被護理人員有引起很大的質疑他們說是跟現況是不符合那這個數據怎麼來的請教部長這個薪資你是怎麼來的得到的數字\n\n00:33.368 --> 01:02.748\n是的我們這個從民國112年11月我們衛護部請那個各縣市衛生局邀請各轄內的各醫院醫療醫院醫院能夠上網去填寫他的薪資是就是說是醫院通報的醫院自己報出來醫院通報的而且當時的目的真的只是希望讓護理人員能夠知道各醫院的一個薪資的狀況求職比較方便請問你有制定格式標準或是說有勾擊制度嗎\n\n01:04.469 --> 01:28.345\n我們的確是有一定有就是你讓他通報但是可能沒有做這樣的事情所以現在這個引起護理界的大反彈這個跟之前我向貴部這個要求那個看護病筆資料是結果就一樣就是由官方提供的護病筆資料因為當時他好像醫學中心就區議院跟地區議院是三塊然後三塊都是平均值那大概就這樣一個月數就時間的當這個另外一個座標\n\n01:31.827 --> 01:53.752\n當時那個整個這個又毀滅華然說他們官方資料跟他們感受是不一樣那回到這個薪資因為已經有工作十幾年護理師告訴我說他都頂多落在一到五年這個區塊那部長所以就是說這個是長期通報但是並沒有一個標準的方式或是勾結的制度那其實薪資高低是一件事我覺得會\n\n01:54.312 --> 02:18.388\n你公佈之後引起反彈那是另外一件事如果衛福部真的關心護理人員的這個待遇問題我覺得要用很小心不要用誤導的數字去處理而且要拿出具體的改善方案部長你還記得我們在第一個會期我們談健保法第62條我的第一個附帶決議就是說醫院有盈餘醫院有盈餘就是要用來改善尤其是護理師\n\n02:19.329 --> 02:27.460\n的這個工作環境跟這個薪資待遇這個是首先要做的那部長這一次就是社群平台看到你的數字他整個跳起來他說這個數字經不起反驗為什麼呢因為看起來不錯嘛所以這個媒體有一些他就會\n\n02:36.392 --> 02:50.789\n讓他們看成是寫成說是這個直擊說這個好像坐擁高薪啦那這樣子這個讓他們會覺得受到一些委屈因為部長我要談的是一個平均薪資是非常危險的因為你一旦公佈的話\n\n02:51.650 --> 03:06.222\n會有很多後遺症為什麼因為台灣專科護理師產業工會指出這個因為衛福部公佈薪資的數據是平均月薪但是沒有區分說什麼叫基本的薪水那還有其他的這個津貼那這個津貼包括夜班\n\n03:07.003 --> 03:29.081\n加班危險津貼還有額外的工作補助所以他們就說你們提供的資料剛好包含大量的加班費加班費跟津貼的數據其實正是代表了他們其實工作是超時的結果才能得到這樣的薪資就是也正坐實的說護理師是過勞的而且還有一點喔\n\n03:29.781 --> 03:50.377\n部長你們把這個專科護理師跟一般護理師都混在一起了其實專科護理師是有他的一個專業價值跟他不同的承擔所以以後處理這些數字是要非常小心因為護理界他們最在意的是說因為媒體把它報導出心智這麼優渥你們還在爭執或是重點是什麼呢這個會讓人家已經很寶貝的我們很珍惜的護理人員用這種獨到這個說法\n\n03:59.844 --> 04:16.010\n他們會生氣他們會很不滿所以是不是這樣部長我就跟您討論一下我們要公佈這個護理人員薪資結構的時候是不是應該合理一下就基本薪資還有他overtime他工作其他的種種因素這樣子加起來這樣就不會覺得是去掩蓋\n\n04:17.410 --> 04:27.553\n就是他們是超時工作的事實我再跟您舉個例子以前國發會發布那個國人的平均薪資都是從平均數你看那平均數幾百萬勞工勞工大概將近千萬當時那幾百萬勞工他們看了很不開心他們覺得我怎麼距離那麼遙遠後來我有一位好朋友擔任國發會主委就是陳美玲主委我就建議他說以後你不要公佈平均數你要公佈中位數\n\n04:41.958 --> 05:05.257\n因為總是有一些超級收入的人把真的帶動影響了結果你知道嗎相差一萬元那你要照對賺三四萬跟賺四五萬差一萬塊是差很大所以你要處理數字真的是要非常的小心所以你這次公布是醫學中心然後你又把相對讓它呈現是高的數字其實還有一個後遺症部長\n\n05:06.198 --> 05:32.954\n這樣很多護理師要去大醫院你這個公佈結果有後遺症也有不實的地方包委員第一個我們上網的有400多家所以表示說各個醫院幾乎都有第二個公佈了以後有些醫院發現我的薪資是比別人低所以紛紛提升所以其實是有正面的效果但是我絕對\n\n05:34.315 --> 05:56.025\n我必須我跟委員一樣我們都是長期在醫療第一線服務的我覺得我們完全了解到醫療團隊的幸福特別在護理人員所以他們的薪水如果待遇能夠一直提高是我們所...部長您接觸的都管理面嘛沒有啦我...因為我當...我也從陰症開始當期的啊陰症現在都當時的護理人員都幾十年的朋友嘛\n\n06:02.228 --> 06:05.469\n因為時間有限我拜託台灣的醫院協會理事長拜託你去查一下他們這樣是不是真實的至少我問過大概七八家但是真的這個數據出來\n\n06:22.516 --> 06:24.879\n讓大家說我沒有那麼多人我覺得很抱歉我們回到今天的急診的問題我想我們一定全力來再繼續改善護理的待遇\n\n06:38.433 --> 06:42.135\n因為急診問題跟你口中你講出來過說改善中或趨緩中其實差很大那我就以臨近的臺大醫院我們兩個都服務過的醫院為例其實不時都有人就給我他們其實長期的那個急診病床流管床是整個湧到正門大廳那正門大廳有個舞臺\n\n06:54.901 --> 06:59.386\n甚至會辦音樂會跟活動他可以同時辦這個數字我有請教過台大他們來跟我說一個副院長跟一個急診部副主任他們就跟我說這個就是我問他們護理師夠不夠他跟我說護理師是足夠的不過這個跟鋼灰跟我反應的不太一樣後來我又請教吳院長\n\n07:16.404 --> 07:30.029\n一副無可奈何就是說這個就是常態啦病人就是要往我們這邊來因為神醫院嘛台灣人心腹中心醫院其實市長您上來了我其實有把照片傳給你啊我知道你也沒有辦法暫時沒有辦法無力回天啦因為市長說這個就是一個常態啦那部長我在質詢的時候跟你說你跟他說拜他比較嚴重拜你會比較好\n\n07:37.432 --> 08:03.403\n就是說大家都說我大驚小怪小題大作結果不到一年就爆炸了急診的公債問題就爆炸了所以很多人認為說急診的這個看診收費要可以有機會改善這個崩壞的醫療分級那我覺得再進一步區分今天好像報告是還沒辦法處理我知道處理錢的費用不會這麼快就可以處理我已經轉折就到大醫院接著輕症病人提高收費因為韓國等等其他國家有這個做法\n\n08:04.083 --> 08:19.802\n反而你當時視察過後,你寫的那個就醫指引,那個沒法律效力啊,那只是參考看看聽聽看啦,好嗎?我不是去視察,這間醫院每一個都是好朋友,所以沒有這麼好視察,我是去跟他們打氣而已啦\n\n08:20.503 --> 08:22.904\n第13條我想石組長很清楚不經轉轉到地區醫院醫學中心就醫應該有30、40、50%的分攤這個部分請你就是今天實業有限本來就一條法律在這裡你想辦法都不好才會一直惡化\n\n08:38.770 --> 09:00.367\n那另外就是你鼓勵大家轉型用指引但只有一成人會接受我今天回家請你做個功課因為原來只有一成人他會接受這個醫護的建議就轉到相對輕症到比較小的醫院去看但是只有一成根據報就一成人會接受那請你告訴我今天你們想了一些辦法有指引然後有些鼓勵那到底會進步多少就麻煩你這個幫我\n\n09:02.508 --> 09:30.360\n好沒問題報告委員這個齁那接下來就麻煩我都等這個報告齁聰明GOE其實是國際的趨勢所以我們做無聯乃也一直在努力我自己知道的事情要請教江署長啦好來來來江署長謝謝你今天你專程來謝謝你因為對於食藥署對藥品特別是口服定劑跟這個膠囊保存的方法跟期限的怎麼說署長您知道嗎就是你們貴署是怎麼來說的請你看我這樣投影片他就寫了一個說\n\n09:31.540 --> 09:59.586\n開封或調劑日算半年內要服用完畢署長這個說法太簡化了應該要更科學性的做法因為美國醫院要是有各種指引那我今天為什麼這樣講呢其實藥品那個效期也是你核定啊也是食藥署核定的啊藥品在他原包裝裡面只要按照他規定的儲存的條件比如溫度啊等等那他這個效期就是就是按照那個標示的效期啊那為什麼現在每一家醫院呢\n\n10:00.106 --> 10:26.830\n他買藥的時候購買藥的時候都要求提供像衛福部醫院8個月以上的這個有效期間然後剩下兩個月的時候叫人家買回去買回去再換新的回來你又要賺取要價差又要占人家便宜但是這個源頭魚他們就拿這個資料來當作藉口署長怎麼辦這怎麼辦那藥廠是怎麼樣他要製造什麼樣藥品給大家用呢\n\n10:28.322 --> 10:47.708\n謝謝委員的提問那我看到網站這部分裡面藥物食品安全週報我們特別稍微去了解一下那個理論的基礎大概是這樣子那是應該是大包裝的不是那種一排一排已經標示安全期限那個很標準大包裝也是效期啊還是有效的效期因為它是所謂所謂的非無菌固體製劑開封因為已經打開來了打開來就破壞原來的一個市長我要先跟你修正一下\n\n10:56.710 --> 11:05.918\n如果打開以後會縮短的話都會寫這個要求都要寫就像我們知道眼藥一個月就不能用以前naturalglycerin消息該用一年內不能用沒有規範的時候按照這個標準不然你核准的那個效期是假的參考用嗎這個被醫院拿來利用等一下我要請這個\n\n11:16.548 --> 11:35.905\n好請執行長稍微說明一下就是說我們參考的是打開來這種是USP795調製後的所謂的YoungYouthDay的BUD為六個月的體驗調製對調製之後六個所以這個是已經是定季的我們打開覺得可能已經完全有點跟原來的有一點點\n\n11:36.866 --> 11:50.633\n所以這個是這樣的想法第二部分是有些異變值的確像阿布敏我們大概4個小時啊這個部分麻煩我們用科學性然後處理我現在可以造成後遺症但是我請執行長上來執行長你們這個衛福部的聯標院這個麻煩你先留著就了解你們衛福聯標醫院那個也是這樣規範說要8個月以上的留有8個月以上的效期\n\n11:59.497 --> 12:12.671\n那你這個第一個就是說我請教他們他第一個問題跟我說因為別的醫院也這樣做你們副執行長來我嚇一跳衛福部醫院竟然說別的醫院也這樣做別的醫院就是對的別的醫院這樣做你就要跟著這樣子做嗎然後他給我第二個理由說這個什麼援揚於公\n\n12:18.897 --> 12:42.325\n他要到這個遠洋去要領六個月所以我們校期要留很久遠洋移工根本就是政府欺負遠洋移工因為事實上他在那個環境那個環境又高濕又高熱然後那個環境根本他那個校期你就把丟給他去管理他根本還要更短才對你還跟他算到這個時候所以如果一個醫院三月買藥那五月有個遠洋移工來那你照你的規矩八個月你就不用了\n\n12:42.625 --> 12:48.641\n那你還要不要把藥給這個遠洋漁工所以你就以偏概全你這個醫院的管理完全轉嫁到\n\n12:49.667 --> 12:54.569\n藥廠身上你要買是要買一個效期這麼長的等到差兩個月你就叫他買回去然後又說什麼偏鄉藥師人力不足盤點困難所以效期是八個月你把管理的責任這個結構性問題偏鄉也缺醫師啊你就不只是缺藥師那你整個都丟給那個藥廠去承擔還要吃藥藥價差要再叫人說要再效期還很久很久的藥然後等到效期靠近都還可以用你就叫人家買回去買回去換過來\n\n13:17.919 --> 13:44.854\n那吃人狗狗欺負人太累了執行長我跟他們溝通他們不接受欸那署長你要講公道話藥食品的安定區是你在管的好那第一個就是說跟委員說明實在有三項第一個就是說我們的藥品聯標是一個委員會是由各個醫院代表還有一些外部專家那特別是藥品聯標是所有的我們的偏鄉離島包含都會區的醫院再加上有一些衛生局衛生所所以裡面他需求的管理問題你是一般全部\n\n13:45.575 --> 13:57.572\n第二個就是說剛剛提到其實在我們過去您提到的8個月其實我們是不是有超過6個月其實在這個部分裡面只佔非常小的比例不到1%那你今天可不可以承諾6個月\n\n14:00.757 --> 14:15.699\n永泉又六個月你這樣太為難人家了八個月一年的都有啊你太為難人家了而且你也知道吧兩個月靠近兩個月你管理不善放了那麼久兩個月內你就叫人家換回去叫人家買回去有這種情形的只佔百分之一這兩邊佔人家便宜啊\n\n14:16.340 --> 14:28.772\n跟委員報告只佔百分之一不是很高的比例那可不可以回到六個月執行長你一句話因為我已經跟他們溝通過了他們沒有人敢做決定這個是經過我們那個聯標但是我就是跟你討論專業啊我跟你討論專業跟管理啊醫院有關的你不要把管理全部丟給他們啊你把它丟給別人嘛\n\n14:37.641 --> 14:44.123\n你可以處理這個問題嗎?執行長,你一句話我們再帶給聯標委員裡面,因為裡面還有一些外部的委員我已經跟他們溝通過了,剩你一句話,執行長你一句話科學性需要,就是說你要有一個科學性,不然你那個藥品標示是假的嗎?假的嗎?我們會去評估剛您提到的這一塊,但是因為在要聯標的委員會裡面,他們也要拿去討論\n\n15:05.689 --> 15:22.583\n我想委員是專家啦,你一定希望他運轉得很順利那藥廠的一個管理跟醫院也有管理,藥局的管理,這兩個怎麼樣取得一個平衡那得到一個應該的對人民最保障的這個部分我會請那個執行長,待會兒去檢討好不好\n\n15:27.247 --> 15:51.091\n好那江署長你這個科學性的部分要很清楚喔校期是你們標示你們同意的東西喔那你形同虛設各位委員只要校期內的其實在使用上都沒有問題的那這個調製麻煩你除了這個reconstitution還是什麼調製跟調劑是不一樣喔你經過泡水都不一樣喔所以要科學性的不要一致性的好嗎那執行長可以嗎部長也從你要檢討為什麼一定要做這樣那你要帶頭做你要帶頭做嘛好謝謝\n\n15:56.912 --> 16:05.119\n我們部立醫院永遠有帶頭的作用一定要不要因為說別的醫院這樣做所以你就跟著這樣做他們給我第一個理由是這個好嗎要帶頭非常謝謝委員好謝謝\n\n","segments":[{"start":5.868,"end":7.609,"text":"謝謝主席 有請邱部長部長早安 部長 衛福部公布的這個雙倍醫學中心的護理師薪資統計被護理人員有引起很大的質疑他們說是跟現況是不符合那這個數據怎麼來的 請教部長這個薪資你是怎麼來的 得到的數字"},{"start":33.368,"end":62.748,"text":"是的我們這個從民國112年11月我們衛護部請那個各縣市衛生局邀請各轄內的各醫院醫療醫院醫院能夠上網去填寫他的薪資是就是說是醫院通報的醫院自己報出來醫院通報的而且當時的目的真的只是希望讓護理人員能夠知道各醫院的一個薪資的狀況求職比較方便請問你有制定格式標準或是說有勾擊制度嗎"},{"start":64.469,"end":88.345,"text":"我們的確是有一定有就是你讓他通報但是可能沒有做這樣的事情所以現在這個引起護理界的大反彈這個跟之前我向貴部這個要求那個看護病筆資料是結果就一樣就是由官方提供的護病筆資料因為當時他好像醫學中心就區議院跟地區議院是三塊然後三塊都是平均值那大概就這樣一個月數就時間的當這個另外一個座標"},{"start":91.827,"end":113.752,"text":"當時那個整個這個又毀滅華然說他們官方資料跟他們感受是不一樣那回到這個薪資因為已經有工作十幾年護理師告訴我說他都頂多落在一到五年這個區塊那部長所以就是說這個是長期通報但是並沒有一個標準的方式或是勾結的制度那其實薪資高低是一件事我覺得會"},{"start":114.312,"end":138.388,"text":"你公佈之後引起反彈那是另外一件事如果衛福部真的關心護理人員的這個待遇問題我覺得要用很小心不要用誤導的數字去處理而且要拿出具體的改善方案部長你還記得我們在第一個會期我們談健保法第62條我的第一個附帶決議就是說醫院有盈餘醫院有盈餘就是要用來改善尤其是護理師"},{"start":139.329,"end":147.46,"text":"的這個工作環境跟這個薪資待遇這個是首先要做的那部長這一次就是社群平台看到你的數字他整個跳起來他說這個數字經不起反驗為什麼呢因為看起來不錯嘛所以這個媒體有一些他就會"},{"start":156.392,"end":170.789,"text":"讓他們看成是寫成說是這個直擊說這個好像坐擁高薪啦那這樣子這個讓他們會覺得受到一些委屈因為部長我要談的是一個平均薪資是非常危險的因為你一旦公佈的話"},{"start":171.65,"end":186.222,"text":"會有很多後遺症為什麼因為台灣專科護理師產業工會指出這個因為衛福部公佈薪資的數據是平均月薪但是沒有區分說什麼叫基本的薪水那還有其他的這個津貼那這個津貼包括夜班"},{"start":187.003,"end":209.081,"text":"加班危險津貼還有額外的工作補助所以他們就說你們提供的資料剛好包含大量的加班費加班費跟津貼的數據其實正是代表了他們其實工作是超時的結果才能得到這樣的薪資就是也正坐實的說護理師是過勞的而且還有一點喔"},{"start":209.781,"end":230.377,"text":"部長你們把這個專科護理師跟一般護理師都混在一起了其實專科護理師是有他的一個專業價值跟他不同的承擔所以以後處理這些數字是要非常小心因為護理界他們最在意的是說因為媒體把它報導出心智這麼優渥你們還在爭執或是重點是什麼呢這個會讓人家已經很寶貝的我們很珍惜的護理人員用這種獨到這個說法"},{"start":239.844,"end":256.01,"text":"他們會生氣他們會很不滿所以是不是這樣部長我就跟您討論一下我們要公佈這個護理人員薪資結構的時候是不是應該合理一下就基本薪資還有他 overtime他工作其他的種種因素這樣子加起來這樣就不會覺得是去掩蓋"},{"start":257.41,"end":267.553,"text":"就是他們是超時工作的事實我再跟您舉個例子以前國發會發布那個國人的平均薪資都是從平均數你看那平均數幾百萬勞工勞工大概將近千萬當時那幾百萬勞工他們看了很不開心他們覺得我怎麼距離那麼遙遠後來我有一位好朋友擔任國發會主委就是陳美玲主委我就建議他說以後你不要公佈平均數你要公佈中位數"},{"start":281.958,"end":305.257,"text":"因為總是有一些超級收入的人把真的帶動影響了結果你知道嗎相差一萬元那你要照對賺三四萬跟賺四五萬差一萬塊是差很大所以你要處理數字真的是要非常的小心所以你這次公布是醫學中心然後你又把相對讓它呈現是高的數字其實還有一個後遺症部長"},{"start":306.198,"end":332.954,"text":"這樣很多護理師要去大醫院你這個公佈結果有後遺症也有不實的地方包委員第一個我們上網的有400多家所以表示說各個醫院幾乎都有第二個公佈了以後有些醫院發現我的薪資是比別人低所以紛紛提升所以其實是有正面的效果但是我絕對"},{"start":334.315,"end":356.025,"text":"我必須 我跟委員一樣我們都是長期在醫療第一線服務的我覺得我們完全了解到醫療團隊的幸福特別在護理人員所以他們的薪水如果待遇能夠一直提高是我們所...部長您接觸的都管理面嘛沒有啦 我...因為我當...我也從陰症開始當期的啊陰症現在都當時的護理人員都幾十年的朋友嘛"},{"start":362.228,"end":365.469,"text":"因為時間有限我拜託台灣的醫院協會理事長拜託你去查一下他們這樣是不是真實的至少我問過大概七八家但是真的這個數據出來"},{"start":382.516,"end":384.879,"text":"讓大家說我沒有那麼多人 我覺得很抱歉我們回到今天的急診的問題我想我們一定全力來再繼續改善護理的待遇"},{"start":398.433,"end":402.135,"text":"因為急診問題跟你口中你講出來過說改善中或趨緩中其實差很大那我就以臨近的臺大醫院我們兩個都服務過的醫院為例其實不時都有人就給我他們其實長期的那個急診病床流管床是整個湧到正門大廳那正門大廳有個舞臺"},{"start":414.901,"end":419.386,"text":"甚至會辦音樂會跟活動他可以同時辦這個數字我有請教過台大他們來跟我說一個副院長跟一個急診部副主任他們就跟我說這個就是我問他們護理師夠不夠他跟我說護理師是足夠的不過這個跟鋼灰跟我反應的不太一樣後來我又請教吳院長"},{"start":436.404,"end":450.029,"text":"一副無可奈何就是說這個就是常態啦病人就是要往我們這邊來因為神醫院嘛台灣人心腹中心醫院其實市長您上來了我其實有把照片傳給你啊我知道你也沒有辦法暫時沒有辦法無力回天啦因為市長說這個就是一個常態啦那部長我在質詢的時候跟你說你跟他說拜他比較嚴重拜你會比較好"},{"start":457.432,"end":483.403,"text":"就是說大家都說我大驚小怪小題大作結果不到一年就爆炸了急診的公債問題就爆炸了所以很多人認為說急診的這個看診收費要可以有機會改善這個崩壞的醫療分級那我覺得再進一步區分今天好像報告是還沒辦法處理我知道處理錢的費用不會這麼快就可以處理我已經轉折就到大醫院接著輕症病人提高收費因為韓國等等其他國家有這個做法"},{"start":484.083,"end":499.802,"text":"反而你當時視察過後,你寫的那個就醫指引,那個沒法律效力啊,那只是參考看看聽聽看啦,好嗎?我不是去視察,這間醫院每一個都是好朋友,所以沒有這麼好視察,我是去跟他們打氣而已啦"},{"start":500.503,"end":502.904,"text":"第13條我想石組長很清楚不經轉轉到地區醫院醫學中心就醫應該有30、40、50%的分攤這個部分請你就是今天實業有限本來就一條法律在這裡你想辦法都不好才會一直惡化"},{"start":518.77,"end":540.367,"text":"那另外就是你鼓勵大家轉型用指引但只有一成人會接受我今天回家請你做個功課因為原來只有一成人他會接受這個醫護的建議就轉到相對輕症到比較小的醫院去看但是只有一成根據報就一成人會接受那請你告訴我今天你們想了一些辦法有指引然後有些鼓勵那到底會進步多少就麻煩你這個幫我"},{"start":542.508,"end":570.36,"text":"好沒問題 報告委員這個齁那接下來就麻煩我都等這個報告齁聰明GOE其實是國際的趨勢所以我們做無聯乃也一直在努力我自己知道的事情要請教江署長啦好來來來江署長謝謝你今天你專程來謝謝你因為對於食藥署對藥品特別是口服定劑跟這個膠囊保存的方法跟期限的怎麼說署長您知道嗎就是你們貴署是怎麼來說的請你看我這樣投影片他就寫了一個說"},{"start":571.54,"end":599.586,"text":"開封或調劑日算半年內要服用完畢署長這個說法太簡化了應該要更科學性的做法因為美國醫院要是有各種指引那我今天為什麼這樣講呢其實藥品那個效期也是你核定啊也是食藥署核定的啊藥品在他原包裝裡面只要按照他規定的儲存的條件比如溫度啊等等那他這個效期就是就是按照那個標示的效期啊那為什麼現在每一家醫院呢"},{"start":600.106,"end":626.83,"text":"他買藥的時候購買藥的時候都要求提供像衛福部醫院8個月以上的這個有效期間然後剩下兩個月的時候叫人家買回去買回去再換新的回來你又要賺取要價差又要占人家便宜但是這個源頭魚他們就拿這個資料來當作藉口署長怎麼辦這怎麼辦那藥廠是怎麼樣他要製造什麼樣藥品給大家用呢"},{"start":628.322,"end":647.708,"text":"謝謝委員的提問那我看到網站這部分裡面藥物食品安全週報我們特別稍微去了解一下那個理論的基礎大概是這樣子那是應該是大包裝的不是那種一排一排已經標示安全期限那個很標準大包裝也是效期啊還是有效的效期因為它是所謂所謂的非無菌固體製劑開封因為已經打開來了打開來就破壞原來的一個市長我要先跟你修正一下"},{"start":656.71,"end":665.918,"text":"如果打開以後會縮短的話都會寫這個要求都要寫就像我們知道眼藥一個月就不能用以前natural glycerin消息該用一年內不能用沒有規範的時候按照這個標準不然你核准的那個效期是假的參考用嗎這個被醫院拿來利用等一下我要請這個"},{"start":676.548,"end":695.905,"text":"好 請執行長稍微說明一下就是說我們參考的是打開來這種是USP795調製後的所謂的Young Youth Day的BUD為六個月的體驗調製對 調製之後六個所以這個是已經是定季的我們打開覺得可能已經完全有點跟原來的有一點點"},{"start":696.866,"end":710.633,"text":"所以這個是這樣的想法第二部分是有些異變值的確像阿布敏我們大概4個小時啊這個部分麻煩我們用科學性然後處理我現在可以造成後遺症但是我請執行長上來執行長你們這個衛福部的聯標院這個麻煩你先留著就了解你們衛福聯標醫院那個也是這樣規範說要8個月以上的留有8個月以上的效期"},{"start":719.497,"end":732.671,"text":"那你這個第一個就是說我請教他們他第一個問題跟我說因為別的醫院也這樣做你們副執行長來我嚇一跳衛福部醫院竟然說別的醫院也這樣做別的醫院就是對的別的醫院這樣做你就要跟著這樣子做嗎然後他給我第二個理由說這個什麼援揚於公"},{"start":738.897,"end":762.325,"text":"他要到這個遠洋去要領六個月所以我們校期要留很久遠洋移工根本就是政府欺負遠洋移工因為事實上他在那個環境那個環境又高濕又高熱然後那個環境根本他那個校期你就把丟給他去管理他根本還要更短才對你還跟他算到這個時候所以如果一個醫院三月買藥那五月有個遠洋移工來那你照你的規矩八個月你就不用了"},{"start":762.625,"end":768.641,"text":"那你還要不要把藥給這個遠洋漁工所以你就以偏概全你這個醫院的管理完全轉嫁到"},{"start":769.667,"end":774.569,"text":"藥廠身上 你要買是要買一個效期這麼長的等到差兩個月你就叫他買回去然後又說什麼偏鄉藥師人力不足盤點困難所以效期是八個月你把管理的責任這個結構性問題偏鄉也缺醫師啊你就不只是缺藥師那你整個都丟給那個藥廠去承擔還要吃藥 藥價差要再叫人說要再效期還很久很久的藥然後等到效期靠近都還可以用你就叫人家買回去買回去換過來"},{"start":797.919,"end":824.854,"text":"那吃人狗狗欺負人太累了執行長 我跟他們溝通他們不接受欸那署長你要講公道話 藥食品的安定區是你在管的好 那第一個就是說跟委員說明實在有三項第一個就是說我們的藥品聯標是一個委員會是由各個醫院代表還有一些外部專家那特別是藥品聯標是所有的我們的偏鄉離島包含都會區的醫院再加上有一些衛生局 衛生所所以裡面他需求的管理問題 你是一般全部"},{"start":825.575,"end":837.572,"text":"第二個就是說剛剛提到其實在我們過去您提到的8個月其實我們是不是有超過6個月其實在這個部分裡面只佔非常小的比例不到1%那你今天可不可以承諾6個月"},{"start":840.757,"end":855.699,"text":"永泉又六個月你這樣太為難人家了八個月一年的都有啊你太為難人家了而且你也知道吧兩個月靠近兩個月你管理不善放了那麼久兩個月內你就叫人家換回去叫人家買回去有這種情形的只佔百分之一這兩邊佔人家便宜啊"},{"start":856.34,"end":868.772,"text":"跟委員報告只佔百分之一不是很高的比例那可不可以回到六個月執行長你一句話因為我已經跟他們溝通過了他們沒有人敢做決定這個是經過我們那個聯標但是我就是跟你討論專業啊我跟你討論專業跟管理啊醫院有關的你不要把管理全部丟給他們啊你把它丟給別人嘛"},{"start":877.641,"end":884.123,"text":"你可以處理這個問題嗎?執行長,你一句話我們再帶給聯標委員裡面,因為裡面還有一些外部的委員我已經跟他們溝通過了,剩你一句話,執行長你一句話科學性需要,就是說你要有一個科學性,不然你那個藥品標示是假的嗎?假的嗎?我們會去評估剛您提到的這一塊,但是因為在要聯標的委員會裡面,他們也要拿去討論"},{"start":905.689,"end":922.583,"text":"我想委員是專家啦,你一定希望他運轉得很順利那藥廠的一個管理跟醫院也有管理,藥局的管理,這兩個怎麼樣取得一個平衡那得到一個應該的對人民最保障的這個部分我會請那個執行長,待會兒去檢討好不好"},{"start":927.247,"end":951.091,"text":"好那江署長你這個科學性的部分要很清楚喔校期是你們標示你們同意的東西喔那你形同虛設 各位委員只要校期內的其實在使用上都沒有問題的那這個調製麻煩你除了這個reconstitution還是什麼調製跟調劑是不一樣喔你經過泡水都不一樣喔所以要科學性的不要一致性的好嗎那執行長可以嗎部長也從你要檢討為什麼一定要做這樣那你要帶頭做你要帶頭做嘛好謝謝"},{"start":956.912,"end":965.119,"text":"我們部立醫院永遠有帶頭的作用一定要 不要因為說別的醫院這樣做所以你就跟著這樣做他們給我第一個理由是這個好嗎 要帶頭非常謝謝委員好 謝謝"}]}}},"gazette":{"lineno":136,"blocks":[["陳委員昭姿：（9時10分）謝謝主席，有請邱部長。"],["主席：請部長。"],["邱部長泰源：委員早。"],["陳委員昭姿：部長早安。部長，衛福部公布雙北市醫學中心護理師薪資統計，引起護理人員很大的質疑，他們說跟現況是不符合的，這個數據怎麼來的？請教部長，這份薪資是怎麼得到的數字？"],["邱部長泰源：是的，從民國112年11月，我們衛福部請各縣市衛生局，邀請轄內的各醫院能夠上網去填寫薪資……"],["陳委員昭姿：是，就是醫院通報的，醫院自己報出來的？"],["邱部長泰源：醫院通報的，而且當時的目的真的只是希望讓護理人員能夠知道各醫院薪資的狀況，求職比較方便。"],["陳委員昭姿：請問你有制定格式標準或是有勾稽制度嗎？"],["邱部長泰源：我們的確是一定有……"],["陳委員昭姿：你讓它通報，但是可能沒有做這樣的事情，所以現在引起護理界的大反彈，這個跟之前我向貴部要求看護病比資料結果一樣，就是由官方提供的護病比資料，因為當時好像分為醫學中心、區域醫院跟地區醫院三塊，然後三塊都是平均值，大概就要一個月數，就是以時間當另外一個座標，當時整個護理界也嘩然，說官方資料跟他們的感受不一樣。回到薪資，因為已經有工作十幾年的護理師告訴我，他說頂多落在一到五年這個區塊。部長，這個是長期通報，但是並沒有一個標準方式或是勾稽制度。其實薪資高低是一件事，我覺得在公布之後引起反彈，那是另外一件事，如果衛福部真的關心護理人員的待遇問題，我覺得要很小心，不要用誤導的數字去處理，而且要拿出具體的改善方案。部長，你還記得我們在第一個會期，我們談健保法第六十二條，我的第一個附帶決議就是醫院有盈餘要用來改善，尤其是護理師的工作環境跟薪資待遇，這個是首先要做的。"],["邱部長泰源：是的。"],["陳委員昭姿：部長，這一次社群平臺看到你們這些數字整個跳起來，說這個數字禁不起反驗，為什麼呢？因為看起來不錯嘛！所以媒體有一些引述讓他們被質疑好像坐擁高薪，這會讓他們覺得受到一些委屈。部長，我要談的是平均薪資是非常危險的，因為你一旦公布的話，會有很多後遺症，為什麼？因為臺灣專科護理師產業工會指出，因為衛福部公布薪資的數據是平均月薪，但是沒有區分什麼叫基本的薪水，還有其他的津貼，這個津貼包括夜班、加班、危險津貼，還有額外的工作補助，所以他們就說你們提供的資料剛好包含大量的加班費跟津貼的數據，這正代表他們工作超時的結果，才能得到這樣的薪資，也正坐實護理師是過勞的。而且還有一點，部長，你們把專科護理師跟一般護理師都混在一起，其實專科護理師是有他的專業價值跟不同的承擔，以後處理這些數字要非常小心。護理界他們最在意的是，因為媒體把他們報導成薪資這麼優渥，你們還在爭執或重點是什麼呢？這個會讓人家已經很寶貝的、我們很珍惜的護理人員讀到這種說法，他們會生氣、他們會很不滿，所以是不是這樣，部長，我就跟您討論一下，我們以後公布護理人員薪資結構的時候，是不是應該合理一下，就是基本薪資，還有他overtime、工作的其他種種因素這樣子加起來，就不會覺得是去掩蓋他們超時工作的事實。","我再跟您舉個例子，以前國發會發布國人平均薪資都是從平均數，你知道平均數是幾百萬勞工，當時勞工大概將近千萬，那幾百萬勞工看了很不開心，他們覺得我怎麼距離那麼遙遠，後來我有一個好朋友擔任國發會主委，就是陳美伶主委，我就建議他說以後你不要公布平均數，你要公布中位數，因為總是有一些超級收入的人真的影響了，結果你知道嗎？相差1萬元，你要知道對賺三、四萬跟賺四、五萬的人，差1萬塊是差很大，所以你處理數字真的是要非常地小心。所以你這次公布是醫學中心，然後你相對讓它呈現是高的數字，其實還有一個後遺症，部長，這樣很多護理師要去大醫院，你這個公布結果有後遺症也有不實的地方，部長，我的建議……"],["邱部長泰源：報告委員，第一個，我們上網的有四百多家，所以表示說各個醫院幾乎都有；第二個，公布了以後，有些醫院發現我的竟然薪資比別人低，所以紛紛提升，所以其實是有正面的效果。我跟委員一樣，我們都是長期在醫療第一線服務的，我覺得我們完全了解到醫療團隊的辛苦，特別在護理人員，所以他們的薪水如果待遇能夠一直提高，是我們所……"],["陳委員昭姿：部長，您接觸的都管理面嘛！基層的護理……"],["邱部長泰源：沒有啦，我也從intern開始當起。"],["陳委員昭姿：好，就是說他們看這個數字，他們的感受不一樣。"],["邱部長泰源：我當intern時的護理人員，現在和我都是幾十年的朋友……"],["陳委員昭姿：部長，因為時間有限……"],["邱部長泰源：我是說，真的我有拜託臺灣醫院協會理事長，我說你去查一下他們這樣是不是真實的，至少我問過大概七、八家醫學中心，但是……"],["陳委員昭姿：好，部長，這樣OK的，就是要確認一下……"],["邱部長泰源：但是如果真的這個數字……"],["陳委員昭姿：不要把最漂亮的數字呈上來。"],["邱部長泰源：這個數據出來如果讓沒領那麼多的人覺得……"],["陳委員昭姿：部長，抱歉……"],["邱部長泰源：我也覺得不好意思，因為我們公布就是……"],["陳委員昭姿：謝謝，我們回到今天的急診的問題，部長，抱歉……"],["邱部長泰源：所以我想我們一定全力來再繼續改善護理人員的待遇……"],["陳委員昭姿：好，謝謝部長，因為急診問題跟你口中、你講出來說改善中或趨緩中也差很大，我就以鄰近的臺大醫院、我們兩個都服務過的醫院為例，其實不時有人告訴我他們長期的急診病床、留觀床是整個湧到正門大廳，正門大廳有個舞台，甚至會辦音樂會跟活動，它可以同時辦耶！這個數字我有請教過臺大，他們來跟我說，一個副院長跟一個急診部副主任，我問他們護理師夠不夠，他們跟我說護理師是足夠的，不過這個跟工會跟我反映的不太一樣。後來我又請教吳院長，吳院長一副無可奈何，說這個就是常態，病人就是要往我們這邊來，因為神醫院嘛！臺灣人心目中神醫院。司長您上來了，我其實有把照片傳給你，我知道你也沒有辦法，暫時沒有辦法，無力迴天，因為司長說這個就是一個常態。部長，我在質詢的時候跟你說，你跟我說星期一比較嚴重，星期二會比較好，大家都說我大驚小怪、小題大作，結果不到一年就爆炸了，急診的壅塞問題就爆炸了。","很多人認為說急診的看診收費可以有機會改善崩壞的醫療分級，我覺得再進一步區分，今天好像報告說還沒辦法處理，我知道費用不會這麼快就可以處理，針對未經轉診就到大醫院的輕症病人提高收費，韓國等等其他國家有這個作法，反而你當時視察過後寫的那個就醫指引又沒有法律效力，只是參考看看、聽聽看，好嗎？"],["邱部長泰源：跟委員報告，我不是去視察，這些醫院每一個都是好朋友，所以沒有這麼好視察，我是去跟他們打氣而已，關心、打氣。"],["陳委員昭姿：那我再提醒你，第四十三條，我想石署長很清楚，不經轉診到地區醫院、區域醫院、醫學中心就醫，應該有30%、40%、50%的自行分擔，這個部分請你就是……我覺得本來就有一條法律在這裡，你想的辦法都沒有用，才會一直惡化。另外就是你鼓勵大家轉診，用指引，但是只有一成的人會接受，我請你今天回家做個功課，因為原來只有一成的人會接受醫護的建議，相對輕症就轉到比較小的醫院去看，但是只有一成，根據報告，只有一成的人會接受，那請你告訴我，今天你們想了一些辦法，有指引然後有些鼓勵，那到底會進步多少？就麻煩你幫我，給我……"],["邱部長泰源：好，沒問題，報告委員，choosing wisely、聰明就醫其實是國際的趨勢……"],["陳委員昭姿：抱歉，還有一件事……"],["邱部長泰源：所以我們這5年來也一直在努力。"],["陳委員昭姿：要請教姜署長，姜署長，謝謝你，今天你專程來，謝謝你。因為食藥署對藥品，特別是口服錠劑跟膠囊保存的方法跟期限怎麼說，署長您知道嗎？就是貴署是怎麼來說的？請你看我這張投影片，它就寫了一個說開封後或調劑日起算半年內要服用完畢，署長，這個說法太簡化了，應該要有更科學性的作法，因為美國醫院藥劑有各種指引，我今天為什麼這樣講呢？其實藥品效期也是你核定，也是食藥署核定的，藥品在它的原包裝裡面，只要按照它規定的儲存條件，比如溫度等等，那它這個效期就是按照標示的效期，為什麼現在每一家醫院購買藥的時候，都要求提供……像衛福部醫院，8個月以上的有效期間，然後剩下2個月的時候叫人家買回去，再換新的回來，你又要賺取藥價差，又要占人家便宜，但是這個源頭，他們就拿這個資料來當作藉口，署長，怎麼辦？藥廠是怎麼樣，它要製造什麼樣的藥品給大家用呢？"],["姜署長至剛：謝謝委員的提問，我看到網站這部分裡面藥物食品安全週報，我們特別稍微去了解一下，立論的基礎大概是這樣子，應該是大包裝的，不是那種一排一排已經標示安全期限那個很標準的，可是我們大包裝……"],["陳委員昭姿：大包裝也有效期啊！"],["姜署長至剛：因為它是所謂的非無菌固體製劑開封，因為已經打開來了，打開來就破壞原來的狀況的時候……"],["陳委員昭姿：沒有，署長，我要先跟你修正一下，如果打開以後會縮短的話都會寫，這個要求都要寫，就像我們知道眼藥1個月就不能用，以前nitroglycerin（硝基甘油）一年內不能用，沒有規範的時候就按照這個標準，不然你核准的那個效期是假的？參考用嗎？這個被醫院拿來利用，等一下請執行長上來。"],["姜署長至剛：我跟委員說明一下，就是說我們參考的是打開來這種是USP 795裡面調製後的，所謂的Beyond-use dates（BUDs）為6個月的……"],["陳委員昭姿：調製……"],["姜署長至剛：對，調製之後6個月……"],["陳委員昭姿：什麼叫調製？"],["姜署長至剛：所以這個是已經是錠劑的，我們打開來覺得可能已經跟原來的有一點點……所以這個是這樣的想法。第二個部分是有些易變質，的確像Albumin，我們大概4個小時……"],["陳委員昭姿：署長，這個部分麻煩用科學性的處理，以免造成後遺症。我也請執行長上來，執行長，你們衛福部的聯標醫院，麻煩也請你先留著了解一下。"],["姜署長至剛：是。"],["陳委員昭姿：你們衛福聯標醫院也是這樣規範說要留有8個月以上的效期，我請教他們，他第一個跟我說因為別的醫院也這樣做，你們副執行長來。我嚇一跳，衛福部醫院竟然說別的醫院也這樣做，別的醫院就是對的嗎？別的醫院這樣做，你就要跟著這樣子做嗎？然後他給我的第二個理由是說遠洋漁工要到遠洋去要領6個月的藥，所以效期要留很久。這根本就是政府欺負遠洋漁工，因為事實上他在那個環境，那個環境又高溼又高熱，然後那個環境它那個效期，你就丟給他去管理，它根本還要更短才對，你還跟他算到這個時候！所以如果一個醫院3月買藥，那5月有個遠洋漁工來，照你的規矩，8個月你就不用了，你還要不要把藥給遠洋漁工？所以你就以偏概全，把醫院的管理完全轉嫁到藥廠身上！你要買的時候要跟人家買效期這麼長的，等到差2個月你就叫人家買回去，然後你又說什麼偏鄉藥師人力不足、盤點困難，所以效期是8個月，你把管理責任這個結構性問題……偏鄉也缺醫師，不只是缺藥師，那你整個都丟給藥廠去承擔，既要賺人家藥價差，又要跟人家要效期還很久很久的藥，然後等到效期一靠近，你都還可以用，你就叫人家買回去、買回去、換過來，「吃人家夠夠」，欺負人家，太累了！","執行長，我跟他們溝通，他們不接受耶！"],["林執行長慶豐：了解，好，委員，跟你說明一下。"],["陳委員昭姿：署長你也要講公道話，要持平地，食品的安定性是你在管的啊。"],["林執行長慶豐：跟委員說明一下有三項，第一個就是說我們的藥品聯標是一個委員會，是由各個醫院代表，還有一些外部專家，特別是藥品聯標是所有偏鄉離島包含都會區的醫院，再加上有一些衛生局、衛生所，所以裡面它的需求……"],["陳委員昭姿：這是管理問題，你是一般全部都是這樣。"],["林執行長慶豐：第二個就是剛剛您提到的8個月，其實我們是不是有超過6個月，其實在這個部分只占非常小的比例，大概不到1%，所以在這個部分裡面其實……"],["陳委員昭姿：執行長，那你今天可不可以承諾，6個月？先用6個月。你這樣太為難人家了，8個月、1年的都有啊，你太為難人家了，而且你也知道吧，你管理不善，放了那麼久，2個月內你就叫人家換回去，叫人家買回去……"],["林執行長慶豐：是，有這種情形的只占1%。"],["陳委員昭姿：這樣兩邊占人家便宜啊！"],["林執行長慶豐：跟委員報告，這只占1%，不是很高的比例。"],["陳委員昭姿：那可不可以回到6個月？"],["林執行長慶豐：這個部分……"],["陳委員昭姿：執行長，你一句話，因為我已經跟他們溝通過了，他們沒有人敢做決定。"],["林執行長慶豐：因為這個是經過我們聯標……是他們的委員裡面……"],["陳委員昭姿：我就是跟你討論專業啊，我跟你討論專業跟管理啊，醫院有關的，你不要把管理全部丟給他們啊，你把它丟給別人嘛，反正我要占便宜嘛……"],["林執行長慶豐：好，委員，我們……"],["陳委員昭姿：你可以處理這個問題嗎？執行長，你一句話，可以嗎？"],["林執行長慶豐：是，我們再帶給聯標委員，因為裡面還有一些外部的委員，我們還是要跟他們談。"],["陳委員昭姿：我已經跟他們溝通過了，剩你一句話，執行長，你一句話，就是要有一個科學性……"],["林執行長慶豐：當然我們會在這裡面評估……"],["陳委員昭姿：不然你的藥品標示是假的嗎？假的嗎？它標示還有……"],["林執行長慶豐：是，我們會去評估剛剛您提到的這一塊，但是因為聯標委員會裡面他們也要拿去討論。"],["陳委員昭姿：執行長，那就拜託你。"],["邱部長泰源：報告委員，我想委員是專家，你一定希望讓它運轉得很順利，藥廠的管理跟……"],["陳委員昭姿：醫院也有管理責任喔！"],["邱部長泰源：跟第一線藥局的管理，這兩個要怎麼樣取得平衡，來得到一個對於人民最有保障的部分……"],["陳委員昭姿：我重點就是在這邊也要占便宜、在那邊也要占便宜啦！這部分可以檢討吧？"],["邱部長泰源：感謝你的關心，我會請執行長帶回去檢討，好不好？"],["陳委員昭姿：好。姜署長，有關科學性的部分要很清楚喔，效期是你們標示、你們同意的東西喔！那這樣你就形同虛設。"],["姜署長至剛：報告委員，只要在效期內的，其實在使用上都是沒有問題的，這是確定的。"],["陳委員昭姿：對阿！還有調製的部分也麻煩你，除了reconstitution還是什麼，調製跟調劑是不一樣喔，你經過泡水什麼的，都不一樣喔！"],["姜署長至剛：是的，是不一樣的。"],["陳委員昭姿：所以要科學性的，不要一致性的，好嗎？"],["姜署長至剛：沒有問題。"],["陳委員昭姿：那執行長可以嗎？部長，你要檢討，為什麼一定要這樣做，那你要帶頭做，一定要帶頭做，你要帶頭做嘛。好，謝謝。"],["邱部長泰源：我們部立醫院永遠有帶頭的作用，所以我們會好好地研議。"],["陳委員昭姿：一定要，不要因為別的醫院這樣做，所以你就跟著這樣做，他們給我的第一個理由是這個，好嗎？要帶頭做。"],["邱部長泰源：好，非常謝謝委員。"],["主席：謝謝陳委員，謝謝部長。","接續我們請林月琴委員質詢。"]],"agenda":{"page_end":314,"meet_id":"委員會-11-3-26-2","speakers":["蘇清泉","陳昭姿","林月琴","陳菁徽","王育敏","邱鎮軍","廖偉翔","涂權吉","黃秀芳","王正旭","林淑芬","羅智強","黃國昌","楊瓊瓔","陳瑩","洪孟楷","張啓楷","劉建國","陳培瑜","楊曜","王義川"],"page_start":227,"meetingDate":["2025-03-13"],"gazette_id":"1142701","agenda_lcidc_ids":["1142701_00006"],"meet_name":"立法院第11屆第3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「有關全國急重症醫療量能」進行專題報告，並備質詢","agenda_id":"1142701_00005"}}}