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盧森堡這些我們大概都在二左右那我們現在台灣是三左右可是我們曾經是世界上最好的可是我們現在竟然是推不到現在這樣子而且我們原住民還是在六左右我們再看一下\", \"words\": [{\"word\": \"新\", \"start\": 159.352, \"end\": 159.532, \"score\": 0.987}, {\"word\": \"生\", \"start\": 159.532, \"end\": 159.892, \"score\": 0.89}, {\"word\": \"兒\"}, {\"word\": \"死\", \"start\": 159.892, \"end\": 160.032, \"score\": 0.998}, {\"word\": \"亡\", \"start\": 160.032, \"end\": 160.192, \"score\": 0.982}, {\"word\": \"率\", \"start\": 160.192, \"end\": 160.352, \"score\": 0.875}, {\"word\": \"最\", \"start\": 160.352, \"end\": 160.593, \"score\": 0.996}, {\"word\": \"低\", \"start\": 160.593, \"end\": 161.053, \"score\": 0.963}, {\"word\": \"目\", \"start\": 161.053, \"end\": 161.233, \"score\": 0.989}, {\"word\": \"前\", \"start\": 161.233, \"end\": 162.013, \"score\": 0.995}, {\"word\": \"如\", \"start\": 162.013, \"end\": 162.213, \"score\": 0.997}, {\"word\": \"果\", \"start\": 162.213, \"end\": 162.333, \"score\": 0.994}, {\"word\": \"沒\", \"start\": 162.333, \"end\": 162.433, \"score\": 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嬰兒健康措施陸陸續續都有些計畫然後我看一下IDS 育兒專責意識制度還有周產期高風險期我們的產婦的追蹤關懷計畫上面都寫得很好可是我在想第一個IDS即使它就沒有強制規定說我這個一定要小兒科或者是婦產\", \"words\": [{\"word\": \"好\", \"start\": 282.23, \"end\": 282.41, \"score\": 0.88}, {\"word\": \"那\", \"start\": 282.41, \"end\": 282.81, \"score\": 0.958}, {\"word\": \"至\", \"start\": 282.81, \"end\": 282.95, \"score\": 0.833}, {\"word\": \"少\", \"start\": 282.95, \"end\": 283.17, \"score\": 0.995}, {\"word\": \"先\", \"start\": 283.17, \"end\": 283.35, \"score\": 0.872}, {\"word\": \"看\", \"start\": 283.35, \"end\": 283.47, \"score\": 0.832}, {\"word\": \"到\", \"start\": 283.47, \"end\": 283.67, \"score\": 0.984}, {\"word\": \"初\", \"start\": 283.67, \"end\": 283.89, \"score\": 0.911}, {\"word\": \"型\", \"start\": 283.89, \"end\": 284.35, \"score\": 0.901}, {\"word\": \"讓\"}, {\"word\": \"他\", \"start\": 284.35, \"end\": 285.031, \"score\": 0.91}, {\"word\": \"們\"}, {\"word\": \"至\", \"start\": 285.031, \"end\": 285.131, \"score\": 0.807}, {\"word\": \"少\", \"start\": 285.131, 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\"副廠科的一個科別所以基本上來值班的都是原來的在那邊服務的醫師大部分都是內科或者是加一科的醫師所以這個部分其實沒有辦法真正幫忙到所謂以後要解決兒科的問題那幼兒專制的醫師制度\", \"words\": [{\"word\": \"副\", \"start\": 311.096, \"end\": 311.437, \"score\": 0.881}, {\"word\": \"廠\"}, {\"word\": \"科\", \"start\": 311.437, \"end\": 311.577, \"score\": 0.984}, {\"word\": \"的\", \"start\": 311.577, \"end\": 311.697, \"score\": 0.998}, {\"word\": \"一\", \"start\": 311.697, \"end\": 311.937, \"score\": 0.886}, {\"word\": \"個\"}, {\"word\": \"科\", \"start\": 311.937, \"end\": 312.178, \"score\": 0.967}, {\"word\": \"別\", \"start\": 312.178, \"end\": 312.458, \"score\": 0.932}, {\"word\": \"所\", \"start\": 312.458, \"end\": 312.618, \"score\": 0.875}, {\"word\": \"以\", \"start\": 312.618, \"end\": 312.999, \"score\": 0.946}, {\"word\": \"基\", \"start\": 312.999, \"end\": 313.159, \"score\": 0.991}, {\"word\": \"本\", \"start\": 313.159, \"end\": 313.319, \"score\": 0.999}, {\"word\": \"上\", \"start\": 313.319, \"end\": 313.68, \"score\": 0.943}, {\"word\": \"來\"}, {\"word\": 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\"謂\"}, {\"word\": \"以\", \"start\": 322.292, \"end\": 322.372, \"score\": 0.751}, {\"word\": \"後\", \"start\": 322.372, \"end\": 322.492, \"score\": 0.833}, {\"word\": \"要\", \"start\": 322.492, \"end\": 322.632, \"score\": 0.916}, {\"word\": \"解\", \"start\": 322.632, \"end\": 322.752, \"score\": 0.945}, {\"word\": \"決\"}, {\"word\": \"兒\"}, {\"word\": \"科\", \"start\": 322.752, \"end\": 322.872, \"score\": 0.833}, {\"word\": \"的\", \"start\": 322.872, \"end\": 323.033, \"score\": 0.874}, {\"word\": \"問\"}, {\"word\": \"題\"}, {\"word\": \"那\", \"start\": 323.033, \"end\": 323.193, \"score\": 0.868}, {\"word\": \"幼\", \"start\": 323.193, \"end\": 323.313, \"score\": 0.833}, {\"word\": \"兒\"}, {\"word\": \"專\"}, {\"word\": \"制\", \"start\": 323.313, \"end\": 323.333, \"score\": 0.0}, {\"word\": \"的\", \"start\": 323.333, \"end\": 323.453, \"score\": 0.997}, {\"word\": \"醫\"}, {\"word\": \"師\"}, {\"word\": \"制\", \"start\": 323.453, \"end\": 323.573, \"score\": 0.832}, {\"word\": \"度\", \"start\": 323.573, \"end\": 323.593, \"score\": 0.0}]}, {\"start\": 326.557, \"end\": 344.29, \"text\": \"我相信啦在所謂的比如說屏東縣好了把小兒科的醫師全部拉進去然後大家來分所謂的照顧比然後可是其實到最後還是落在衛生所的醫生上面所以其實這個幼兒專責醫師制度真的可以解決我們現在的問題嗎OK好來來來我們請那個郁金副市長來講\", \"words\": [{\"word\": \"我\", \"start\": 326.557, \"end\": 326.697, \"score\": 0.991}, {\"word\": \"相\", \"start\": 326.697, \"end\": 326.937, \"score\": 0.998}, {\"word\": \"信\", \"start\": 326.937, \"end\": 327.118, \"score\": 0.959}, {\"word\": \"啦\", \"start\": 327.118, \"end\": 327.798, \"score\": 0.971}, {\"word\": \"在\", \"start\": 327.798, \"end\": 328.298, \"score\": 0.999}, {\"word\": \"所\", \"start\": 328.298, \"end\": 328.579, \"score\": 0.859}, {\"word\": \"謂\"}, {\"word\": \"的\", \"start\": 328.579, \"end\": 328.899, \"score\": 0.959}, {\"word\": \"比\", \"start\": 328.899, \"end\": 329.019, \"score\": 0.833}, {\"word\": \"如\", \"start\": 329.019, \"end\": 329.179, \"score\": 0.875}, {\"word\": \"說\"}, {\"word\": \"屏\", \"start\": 329.179, \"end\": 329.619, 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\"這個資料我們會會後再去做一下確認我們再看那個周產婦高風險產婦這個桌中關懷計畫我看到一二年應該是說他服務了八千九百七十七人可是呢我看到真正服務員罪名三地員罪名是九百零九也就是說只有十分之一然後看了那個經費是四千五百萬這樣平均看來一個產婦的那個所收的補助大概是五千塊你覺得這樣子是合理的嗎\", \"words\": [{\"word\": \"這\"}, {\"word\": \"個\"}, {\"word\": \"資\"}, {\"word\": \"料\", \"start\": 413.273, \"end\": 413.393, \"score\": 0.833}, {\"word\": \"我\", \"start\": 413.393, \"end\": 414.413, \"score\": 0.941}, {\"word\": \"們\"}, {\"word\": \"會\"}, {\"word\": \"會\"}, {\"word\": \"後\", \"start\": 414.413, \"end\": 414.593, \"score\": 0.886}, {\"word\": \"再\", \"start\": 414.593, \"end\": 414.733, \"score\": 0.953}, {\"word\": \"去\", \"start\": 414.733, \"end\": 414.953, \"score\": 0.957}, {\"word\": \"做\", \"start\": 414.953, \"end\": 415.294, \"score\": 0.887}, {\"word\": \"一\", \"start\": 415.294, \"end\": 415.534, \"score\": 0.83}, {\"word\": \"下\", \"start\": 415.534, \"end\": 416.034, \"score\": 0.861}, {\"word\": \"確\"}, {\"word\": \"認\"}, {\"word\": \"我\", \"start\": 416.034, \"end\": 416.914, \"score\": 0.939}, {\"word\": 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\"助\", \"start\": 453.133, \"end\": 453.874, \"score\": 0.843}, {\"word\": \"這\"}, {\"word\": \"個\"}, {\"word\": \"產\"}, {\"word\": \"婦\"}, {\"word\": \"定\", \"start\": 453.874, \"end\": 454.054, \"score\": 0.995}, {\"word\": \"期\", \"start\": 454.054, \"end\": 454.394, \"score\": 0.822}, {\"word\": \"來\"}, {\"word\": \"接\", \"start\": 454.394, \"end\": 454.534, \"score\": 0.997}, {\"word\": \"受\", \"start\": 454.534, \"end\": 454.734, \"score\": 0.999}, {\"word\": \"產\"}, {\"word\": \"檢\"}, {\"word\": \"然\", \"start\": 454.734, \"end\": 455.015, \"score\": 0.928}, {\"word\": \"後\", \"start\": 455.015, \"end\": 455.675, \"score\": 0.909}, {\"word\": \"以\", \"start\": 455.675, \"end\": 455.775, \"score\": 0.9}, {\"word\": \"及\", \"start\": 455.775, \"end\": 455.915, \"score\": 0.972}, {\"word\": \"提\", \"start\": 455.915, \"end\": 456.055, \"score\": 0.999}, {\"word\": \"升\", \"start\": 456.055, \"end\": 456.255, \"score\": 0.993}, {\"word\": \"健\", \"start\": 456.255, \"end\": 456.396, 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{\"word\": \"康\", \"start\": 459.538, \"end\": 459.558, \"score\": 0.982}]}, {\"start\": 459.978, \"end\": 484.537, \"text\": \"對啦我知道 可是現在上面寫說收案率打129%可是我就看了這個裡面我們的原住民人數只有909所以我希望是不是因為他比較偏遠所以他可能沒有受到應該有的照顧而是比較偏重於在杜惠區因為這邊是8977那實際原住民是只有909是不是這個部分可以再加強雖然說你們已經說收案率已經達到129%\", \"words\": [{\"word\": \"對\"}, {\"word\": \"啦\", \"start\": 459.978, \"end\": 460.078, \"score\": 0.801}, {\"word\": \"我\", \"start\": 460.078, \"end\": 460.198, \"score\": 0.988}, {\"word\": \"知\", \"start\": 460.198, \"end\": 460.298, \"score\": 0.997}, {\"word\": \"道\", \"start\": 460.298, \"end\": 460.438, \"score\": 0.945}, {\"word\": \"可\", \"start\": 460.438, \"end\": 460.539, \"score\": 0.817}, {\"word\": \"是\", \"start\": 460.539, \"end\": 460.819, \"score\": 0.925}, {\"word\": \"現\"}, {\"word\": \"在\", \"start\": 460.819, \"end\": 461.019, \"score\": 0.899}, {\"word\": \"上\", \"start\": 461.019, \"end\": 461.159, \"score\": 0.886}, {\"word\": \"面\", \"start\": 461.159, \"end\": 461.739, \"score\": 0.896}, 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625.153, \"score\": 0.999}, {\"word\": \"的\", \"start\": 625.153, \"end\": 625.293, \"score\": 0.996}, {\"word\": \"負\", \"start\": 625.293, \"end\": 625.914, \"score\": 0.901}, {\"word\": \"擔\"}, {\"word\": \"謝\"}, {\"word\": \"謝\"}, {\"word\": \"O\", \"start\": 625.914, \"end\": 626.054, \"score\": 0.857}, {\"word\": \"K\", \"start\": 626.054, \"end\": 626.996, \"score\": 0.941}, {\"word\": \"感\", \"start\": 626.996, \"end\": 627.216, \"score\": 0.881}, {\"word\": \"謝\"}, {\"word\": \"委\", \"start\": 627.216, \"end\": 627.236, \"score\": 0.039}, {\"word\": \"員\"}, {\"word\": \"謝\"}, {\"word\": \"謝\"}], \"language\": \"zh\"}","srt":"1\n00:00:06,250 --> 00:00:06,390\n有請次長\n\n2\n00:00:16,733 --> 00:00:41,203\n市長我們像第一次見面嗎沒有沒有那個包委員我們之前我們到那個一起到那個園民那個區域都非常感那個感佩委員對於這一個我們園民相關的福利的這一個我們之前委員有指示嘛就是在這個園鄉地區我們的醫療部分的一個強化非常感謝委員那麼針對我們園鄉的少子化來做一些我們溝通\n\n3\n00:00:42,043 --> 00:01:08,033\n那現在我們小朋友的那個死亡率還是全國的兩倍那也就是說我們目前看到的困境就是說我們衛生所的一個編制其實很少可以特定的說來要求是小兒科或者是婦產科當然也有一些我們所謂的IDS的合作不過還是沒有辦法解決這個問題所以我們來看一下目前我們的產檢次數有的人是一年可能這次生產只有產檢到五次\n\n4\n00:01:08,753 --> 00:01:35,514\n所以造成我們現在嬰兒死亡率還是你看現在大概第二段的部分看到是9.5平地相似10.3跟都會區的5.8還是有差距也就是說目前我們全國大概是4左右我們原住民還在9.5大概是一倍的量看第二個所以說現在看到我們在產檢的部分現在在努力的是我們一個基金會叫至善基金會在新竹他有提供安心媽媽專車那\n\n5\n00:01:37,495 --> 00:01:52,712\n我們全鄉我們全國大概有30個原鄉如果每一個鄉有這樣的一個服務的話當然那些媽媽會安心的住在我們的原鄉部落可是常常遇到是沒有沒有這方面的一個所謂的慈善單位那我們國家已經\n\n6\n00:01:53,553 --> 00:02:18,552\n可憐到說需要到慈善單位來幫忙做這樣的事情也就是說我們衛福部還是沒有努力在來解決這個問題那叫不到計程車也就算了如果要出去的話可能就是如果沒有這些基金會的話要自己想辦法下山那像我昨天去復興區那最遠的地方到大溪大概也要一兩個小時的時間那更何況是有一些部落的環境還是不是很好所以\n\n7\n00:02:19,472 --> 00:02:38,307\n幾乎我在部落裡面幾乎沒有看到這些所謂的產戶或者是說即將生產的人所以基本上我在想他們應該都是住在都會區然後我們看下一個我們看平均移民的部分就是小朋友的出生率我大概考你一下目前全世界最低的所謂的新生兒的死亡率是在哪裡\n\n8\n00:02:39,352 --> 00:03:03,302\n新生兒死亡率最低目前如果沒有記錯是不是丹麥對日本是日本就芬蘭日本盧森堡這些我們大概都在二左右那我們現在台灣是三左右可是我們曾經是世界上最好的可是我們現在竟然是推不到現在這樣子而且我們原住民還是在六左右我們再看一下\n\n9\n00:03:05,430 --> 00:03:25,178\n不僅是這樣因為我們平均明明是小大概六七歲左右所以我們可以看所有的一些發生率我們的死亡的時間大概都在你們的歲數的大概六七歲的差距那我為什麼要凸顯這一張其實就像剛才王一鳴委員講的現在少子化沒有專責單位我們原住民也沒有專責單位\n\n10\n00:03:26,238 --> 00:03:54,201\n其實在我們在立法的部分在112年的6月21號就已經通過原住民主健康法在第二條第二項裡面他必須要有專責單位可是已經快要兩年了我們還沒有看到這個單位的出行那我們是希望說他能夠在10級以上不然現在上帝李老的那個科號還是這個科的層級裡面所以你要怎麼來解決所有原住民的這些健康的議題所以就剛剛王委員講的你都沒有準備好你要解決這麼多繁雜\n\n11\n00:03:55,862 --> 00:04:14,891\n很困難的事情你要去找誰來解決是是這個部分我可以聽到一點點的聲音嗎有沒有規劃好非常感謝委員那個長期以來對於我們原鄉原住民的一個關心特別是我想我知道那個土耳其人自己也是醫生所以對於這個部分我想那個見解特別特別特別深刻那我們現在是不是先請那個對來請\n\n12\n00:04:20,333 --> 00:04:41,570\n謝謝委員有關於專責單位在研究法裡面他希望指定一個專責單位目前我們就是努力朝另外新增一個科的方式在處理我們在爭取人種的部分給我們這樣的一個資源也爭取了一年多所以還在持續努力中\n\n13\n00:04:42,230 --> 00:05:09,616\n好那至少先看到初型讓他們至少一個盼望那麼再看一下目前在推動的這些所謂要提升我們產婦嬰兒健康措施陸陸續續都有些計畫然後我看一下IDS育兒專責意識制度還有周產期高風險期我們的產婦的追蹤關懷計畫上面都寫得很好可是我在想第一個IDS即使它就沒有強制規定說我這個一定要小兒科或者是婦產\n\n14\n00:05:11,096 --> 00:05:23,593\n副廠科的一個科別所以基本上來值班的都是原來的在那邊服務的醫師大部分都是內科或者是加一科的醫師所以這個部分其實沒有辦法真正幫忙到所謂以後要解決兒科的問題那幼兒專制的醫師制度\n\n15\n00:05:26,557 --> 00:05:44,290\n我相信啦在所謂的比如說屏東縣好了把小兒科的醫師全部拉進去然後大家來分所謂的照顧比然後可是其實到最後還是落在衛生所的醫生上面所以其實這個幼兒專責醫師制度真的可以解決我們現在的問題嗎OK好來來來我們請那個郁金副市長來講\n\n16\n00:05:51,061 --> 00:06:14,866\n是謝謝委員的詢問委員剛剛所提到的確實也是我們在推動幼兒專責醫師制度計畫的時候非常重要的考量也就是服務人力的充足了所以我們也知道偏鄉的地區很多時候是仰賴衛生所那也不一定都有兒科醫師在那邊所以我們在幼兒專責醫師制度計畫裡面也納入了家庭醫學科的醫師經過一個適當的訓練也可以來協助推動這個計畫\n\n17\n00:06:18,668 --> 00:06:23,104\n對啦我的意思就是說就是還是原來這些人在承接loading嘛因為很多事情都是\n\n18\n00:06:23,922 --> 00:06:49,929\n反覆的在發生然後這件事情又是新的所以我覺得這件事情是不是應該要長遠的計畫以後你再招收公費生的時候應該是把兒科的比例用高一點這樣會以後再找人不會說都找不到人第二個就是我看到你們的所謂的涵蓋率已經到47.9%這個幼兒中可是我想知道說原住民的比例是多少真正照顧到原住民的比例你大概知道嗎\n\n19\n00:06:53,273 --> 00:07:20,325\n這個資料我們會會後再去做一下確認我們再看那個周產婦高風險產婦這個桌中關懷計畫我看到一二年應該是說他服務了八千九百七十七人可是呢我看到真正服務員罪名三地員罪名是九百零九也就是說只有十分之一然後看了那個經費是四千五百萬這樣平均看來一個產婦的那個所收的補助大概是五千塊你覺得這樣子是合理的嗎\n\n20\n00:07:21,545 --> 00:07:39,558\n還是要再更多報告委員這個部分的話我們會依據就是實際上在收案管理的時候這個產婦的實際的狀況但這個計畫主要是透過協助這個產婦定期來接受產檢然後以及提升健康適能來增加他在孕產期的整個的健康\n\n21\n00:07:39,978 --> 00:08:04,537\n對啦我知道可是現在上面寫說收案率打129%可是我就看了這個裡面我們的原住民人數只有909所以我希望是不是因為他比較偏遠所以他可能沒有受到應該有的照顧而是比較偏重於在杜惠區因為這邊是8977那實際原住民是只有909是不是這個部分可以再加強雖然說你們已經說收案率已經達到129%\n\n22\n00:08:08,606 --> 00:08:33,064\n這個收案率是相較於就是說地方政府共同訂定的目標值那這個部分我們會再來留意在比例上面我希望原住民可以多一點可以嗎我們再來留意因為時間的關係我就講到一個就是我上個禮拜接觸的一個問題就是罕見疾病的問題因為一個小朋友他大概國小五年級就因為臉皮血送到醫院結果後來我們再問的時候他就說他不屬於罕見疾病\n\n23\n00:08:33,664 --> 00:08:47,476\n那可是ITP所謂的ITP就是我們知道的免疫性就是血小板引起的止斑不過它的一個特效藥其實就是造成他們生活的困境因為一個月的藥費大概是3萬多塊接近4萬塊不過這個家庭剛好\n\n24\n00:08:49,778 --> 00:09:05,314\n比較可憐的是他們剛好是原住民又剛好是六個兄弟姊妹要養就是造成父母親非常大的壓力可是他們要申請罕見是不符合資格申請重道三病也沒有那個條件所以到底要怎麼來解決他們的困境呢\n\n25\n00:09:06,155 --> 00:09:28,673\n所以那我有問當下的那個我們來辦公室討論的時候他說ITP不算罕見可是我看到罕見的罕見疾病的一個所謂的定義歐盟是百萬分之27到36可是這個ITP的發生率是百萬分之50到100也就是說其實它跟罕見疾病的定義其實沒有差很遠所以是不是應該要把它列入考量\n\n26\n00:09:30,625 --> 00:09:51,205\n非常感謝委員跟委員報告因為他現在目前所罹患這個並不是我們公告的罹病事實上是後天免疫性的疾病其實我後來再去看一下所謂的後天其實它是IdiopathicIdiopathic它的兩個意義就是Spontaneous它是自然發生的第二個就是所謂的我看一下\n\n27\n00:09:52,563 --> 00:10:17,002\n所謂的peculiartotheindividual也就是說它是特定對這個病人的所以它並不是所謂的後天它就是spontaneous它怎麼可能是後天所以我就說其實不要說把它變成是所謂的一出生下來就有它本來就是因為它的基因的問題在那個時間區它就發生了嘛所以這個所謂罕見疾病應該是要把它考慮進去因為它的比例上的問題是不是可以從這邊來認定這樣\n\n28\n00:10:18,883 --> 00:10:27,236\n好不好如果以後如果ITP的小朋友的話在照顧他們會造成就不會造成家長很大的負擔謝謝OK感謝委員謝謝\n\n","tsv":"start\tend\ttext\n6250\t6390\t有請次長\n16733\t41203\t市長我們像第一次見面嗎沒有沒有那個包委員我們之前我們到那個一起到那個園民那個區域都非常感那個感佩委員對於這一個我們園民相關的福利的這一個我們之前委員有指示嘛就是在這個園鄉地區我們的醫療部分的一個強化非常感謝委員那麼針對我們園鄉的少子化來做一些我們溝通\n42043\t68033\t那現在我們小朋友的那個死亡率還是全國的兩倍那也就是說我們目前看到的困境就是說我們衛生所的一個編制其實很少可以特定的說來要求是小兒科或者是婦產科當然也有一些我們所謂的IDS的合作不過還是沒有辦法解決這個問題所以我們來看一下目前我們的產檢次數有的人是一年可能這次生產只有產檢到五次\n68753\t95514\t所以造成我們現在嬰兒死亡率還是你看現在大概第二段的部分看到是9.5平地相似10.3跟都會區的5.8還是有差距也就是說目前我們全國大概是4左右我們原住民還在9.5大概是一倍的量看第二個所以說現在看到我們在產檢的部分現在在努力的是我們一個基金會叫至善基金會在新竹他有提供安心媽媽專車那\n97495\t112712\t我們全鄉 我們全國大概有30個原鄉如果每一個鄉有這樣的一個服務的話當然那些媽媽會安心的住在我們的原鄉部落可是常常遇到是沒有沒有這方面的一個所謂的慈善單位那我們國家已經\n113553\t138552\t可憐到說需要到慈善單位來幫忙做這樣的事情也就是說我們衛福部還是沒有努力在來解決這個問題那叫不到計程車也就算了如果要出去的話可能就是如果沒有這些基金會的話要自己想辦法下山那像我昨天去復興區那最遠的地方到大溪大概也要一兩個小時的時間那更何況是有一些部落的環境還是不是很好所以\n139472\t158307\t幾乎我在部落裡面幾乎沒有看到這些所謂的產戶或者是說即將生產的人所以基本上我在想他們應該都是住在都會區然後我們看下一個我們看平均移民的部分就是小朋友的出生率我大概考你一下目前全世界最低的所謂的新生兒的死亡率是在哪裡\n159352\t183302\t新生兒死亡率最低目前如果沒有記錯 是不是丹麥對 日本 是日本就芬蘭 日本 盧森堡這些我們大概都在二左右那我們現在台灣是三左右可是我們曾經是世界上最好的可是我們現在竟然是推不到現在這樣子而且我們原住民還是在六左右我們再看一下\n185430\t205178\t不僅是這樣 因為我們平均明明是小大概六七歲左右所以我們可以看所有的一些發生率我們的死亡的時間大概都在你們的歲數的大概六七歲的差距那我為什麼要凸顯這一張其實就像剛才王一鳴委員講的現在少子化沒有專責單位我們原住民也沒有專責單位\n206238\t234201\t其實在我們在立法的部分在112年的6月21號就已經通過原住民主健康法在第二條第二項裡面他必須要有專責單位可是已經快要兩年了我們還沒有看到這個單位的出行那我們是希望說他能夠在10級以上不然現在上帝李老的那個科號還是這個科的層級裡面所以你要怎麼來解決所有原住民的這些健康的議題所以就剛剛王委員講的你都沒有準備好你要解決這麼多繁雜\n235862\t254891\t很困難的事情你要去找誰來解決是是這個部分我可以聽到一點點的聲音嗎有沒有規劃好非常感謝委員那個長期以來對於我們原鄉原住民的一個關心特別是我想我知道那個土耳其人自己也是醫生所以對於這個部分我想那個見解特別特別特別深刻那我們現在是不是先請那個對來請\n260333\t281570\t謝謝委員有關於專責單位在研究法裡面他希望指定一個專責單位目前我們就是努力朝另外新增一個科的方式在處理我們在爭取人種的部分給我們這樣的一個資源也爭取了一年多所以還在持續努力中\n282230\t309616\t好 那至少先看到初型讓他們至少一個盼望那麼再看一下目前在推動的這些所謂要提升我們產婦 嬰兒健康措施陸陸續續都有些計畫然後我看一下IDS 育兒專責意識制度還有周產期高風險期我們的產婦的追蹤關懷計畫上面都寫得很好可是我在想第一個IDS即使它就沒有強制規定說我這個一定要小兒科或者是婦產\n311096\t323593\t副廠科的一個科別所以基本上來值班的都是原來的在那邊服務的醫師大部分都是內科或者是加一科的醫師所以這個部分其實沒有辦法真正幫忙到所謂以後要解決兒科的問題那幼兒專制的醫師制度\n326557\t344290\t我相信啦在所謂的比如說屏東縣好了把小兒科的醫師全部拉進去然後大家來分所謂的照顧比然後可是其實到最後還是落在衛生所的醫生上面所以其實這個幼兒專責醫師制度真的可以解決我們現在的問題嗎OK好來來來我們請那個郁金副市長來講\n351061\t374866\t是謝謝委員的詢問委員剛剛所提到的確實也是我們在推動幼兒專責醫師制度計畫的時候非常重要的考量也就是服務人力的充足了所以我們也知道偏鄉的地區很多時候是仰賴衛生所那也不一定都有兒科醫師在那邊所以我們在幼兒專責醫師制度計畫裡面也納入了家庭醫學科的醫師經過一個適當的訓練也可以來協助推動這個計畫\n378668\t383104\t對啦我的意思就是說就是還是原來這些人在承接loading嘛因為很多事情都是\n383922\t409929\t反覆的在發生 然後這件事情又是新的所以我覺得這件事情是不是應該要長遠的計畫以後你再招收公費生的時候 應該是把兒科的比例用高一點這樣會以後再找人 不會說都找不到人第二個就是我看到你們的所謂的涵蓋率已經到47.9%這個幼兒中可是我想知道說原住民的比例是多少真正照顧到原住民的比例 你大概知道嗎\n413273\t440325\t這個資料我們會會後再去做一下確認我們再看那個周產婦高風險產婦這個桌中關懷計畫我看到一二年應該是說他服務了八千九百七十七人可是呢我看到真正服務員罪名三地員罪名是九百零九也就是說只有十分之一然後看了那個經費是四千五百萬這樣平均看來一個產婦的那個所收的補助大概是五千塊你覺得這樣子是合理的嗎\n441545\t459558\t還是要再更多報告委員這個部分的話我們會依據就是實際上在收案管理的時候這個產婦的實際的狀況但這個計畫主要是透過協助這個產婦定期來接受產檢然後以及提升健康適能來增加他在孕產期的整個的健康\n459978\t484537\t對啦我知道 可是現在上面寫說收案率打129%可是我就看了這個裡面我們的原住民人數只有909所以我希望是不是因為他比較偏遠所以他可能沒有受到應該有的照顧而是比較偏重於在杜惠區因為這邊是8977那實際原住民是只有909是不是這個部分可以再加強雖然說你們已經說收案率已經達到129%\n488606\t513064\t這個收案率是相較於就是說地方政府共同訂定的目標值那這個部分我們會再來留意在比例上面我希望原住民可以多一點可以嗎我們再來留意因為時間的關係我就講到一個就是我上個禮拜接觸的一個問題就是罕見疾病的問題因為一個小朋友他大概國小五年級就因為臉皮血送到醫院結果後來我們再問的時候他就說他不屬於罕見疾病\n513664\t527476\t那可是ITP所謂的ITP就是我們知道的免疫性就是血小板引起的止斑不過它的一個特效藥其實就是造成他們生活的困境因為一個月的藥費大概是3萬多塊接近4萬塊不過這個家庭剛好\n529778\t545314\t比較可憐的是他們剛好是原住民又剛好是六個兄弟姊妹要養就是造成父母親非常大的壓力可是他們要申請罕見是不符合資格申請重道三病也沒有那個條件所以到底要怎麼來解決他們的困境呢\n546155\t568673\t所以那我有問當下的那個我們來辦公室討論的時候他說ITP不算罕見可是我看到罕見的罕見疾病的一個所謂的定義歐盟是百萬分之27到36可是這個ITP的發生率是百萬分之50到100也就是說其實它跟罕見疾病的定義其實沒有差很遠所以是不是應該要把它列入考量\n570625\t591205\t非常感謝委員跟委員報告因為他現在目前所罹患這個並不是我們公告的罹病事實上是後天免疫性的疾病其實我後來再去看一下所謂的後天其實它是IdiopathicIdiopathic它的兩個意義就是Spontaneous它是自然發生的第二個就是所謂的我看一下\n592563\t617002\t所謂的 peculiar to the individual也就是說它是特定對這個病人的所以它並不是所謂的後天它就是spontaneous它怎麼可能是後天所以我就說其實不要說把它變成是所謂的一出生下來就有它本來就是因為它的基因的問題在那個時間區它就發生了嘛所以這個所謂罕見疾病應該是要把它考慮進去因為它的比例上的問題是不是可以從這邊來認定這樣\n618883\t627236\t好不好如果以後如果ITP的小朋友的話在照顧他們會造成就不會造成家長很大的負擔謝謝OK感謝委員謝謝\n","txt":"有請次長\n市長我們像第一次見面嗎沒有沒有那個包委員我們之前我們到那個一起到那個園民那個區域都非常感那個感佩委員對於這一個我們園民相關的福利的這一個我們之前委員有指示嘛就是在這個園鄉地區我們的醫療部分的一個強化非常感謝委員那麼針對我們園鄉的少子化來做一些我們溝通\n那現在我們小朋友的那個死亡率還是全國的兩倍那也就是說我們目前看到的困境就是說我們衛生所的一個編制其實很少可以特定的說來要求是小兒科或者是婦產科當然也有一些我們所謂的IDS的合作不過還是沒有辦法解決這個問題所以我們來看一下目前我們的產檢次數有的人是一年可能這次生產只有產檢到五次\n所以造成我們現在嬰兒死亡率還是你看現在大概第二段的部分看到是9.5平地相似10.3跟都會區的5.8還是有差距也就是說目前我們全國大概是4左右我們原住民還在9.5大概是一倍的量看第二個所以說現在看到我們在產檢的部分現在在努力的是我們一個基金會叫至善基金會在新竹他有提供安心媽媽專車那\n我們全鄉 我們全國大概有30個原鄉如果每一個鄉有這樣的一個服務的話當然那些媽媽會安心的住在我們的原鄉部落可是常常遇到是沒有沒有這方面的一個所謂的慈善單位那我們國家已經\n可憐到說需要到慈善單位來幫忙做這樣的事情也就是說我們衛福部還是沒有努力在來解決這個問題那叫不到計程車也就算了如果要出去的話可能就是如果沒有這些基金會的話要自己想辦法下山那像我昨天去復興區那最遠的地方到大溪大概也要一兩個小時的時間那更何況是有一些部落的環境還是不是很好所以\n幾乎我在部落裡面幾乎沒有看到這些所謂的產戶或者是說即將生產的人所以基本上我在想他們應該都是住在都會區然後我們看下一個我們看平均移民的部分就是小朋友的出生率我大概考你一下目前全世界最低的所謂的新生兒的死亡率是在哪裡\n新生兒死亡率最低目前如果沒有記錯 是不是丹麥對 日本 是日本就芬蘭 日本 盧森堡這些我們大概都在二左右那我們現在台灣是三左右可是我們曾經是世界上最好的可是我們現在竟然是推不到現在這樣子而且我們原住民還是在六左右我們再看一下\n不僅是這樣 因為我們平均明明是小大概六七歲左右所以我們可以看所有的一些發生率我們的死亡的時間大概都在你們的歲數的大概六七歲的差距那我為什麼要凸顯這一張其實就像剛才王一鳴委員講的現在少子化沒有專責單位我們原住民也沒有專責單位\n其實在我們在立法的部分在112年的6月21號就已經通過原住民主健康法在第二條第二項裡面他必須要有專責單位可是已經快要兩年了我們還沒有看到這個單位的出行那我們是希望說他能夠在10級以上不然現在上帝李老的那個科號還是這個科的層級裡面所以你要怎麼來解決所有原住民的這些健康的議題所以就剛剛王委員講的你都沒有準備好你要解決這麼多繁雜\n很困難的事情你要去找誰來解決是是這個部分我可以聽到一點點的聲音嗎有沒有規劃好非常感謝委員那個長期以來對於我們原鄉原住民的一個關心特別是我想我知道那個土耳其人自己也是醫生所以對於這個部分我想那個見解特別特別特別深刻那我們現在是不是先請那個對來請\n謝謝委員有關於專責單位在研究法裡面他希望指定一個專責單位目前我們就是努力朝另外新增一個科的方式在處理我們在爭取人種的部分給我們這樣的一個資源也爭取了一年多所以還在持續努力中\n好 那至少先看到初型讓他們至少一個盼望那麼再看一下目前在推動的這些所謂要提升我們產婦 嬰兒健康措施陸陸續續都有些計畫然後我看一下IDS 育兒專責意識制度還有周產期高風險期我們的產婦的追蹤關懷計畫上面都寫得很好可是我在想第一個IDS即使它就沒有強制規定說我這個一定要小兒科或者是婦產\n副廠科的一個科別所以基本上來值班的都是原來的在那邊服務的醫師大部分都是內科或者是加一科的醫師所以這個部分其實沒有辦法真正幫忙到所謂以後要解決兒科的問題那幼兒專制的醫師制度\n我相信啦在所謂的比如說屏東縣好了把小兒科的醫師全部拉進去然後大家來分所謂的照顧比然後可是其實到最後還是落在衛生所的醫生上面所以其實這個幼兒專責醫師制度真的可以解決我們現在的問題嗎OK好來來來我們請那個郁金副市長來講\n是謝謝委員的詢問委員剛剛所提到的確實也是我們在推動幼兒專責醫師制度計畫的時候非常重要的考量也就是服務人力的充足了所以我們也知道偏鄉的地區很多時候是仰賴衛生所那也不一定都有兒科醫師在那邊所以我們在幼兒專責醫師制度計畫裡面也納入了家庭醫學科的醫師經過一個適當的訓練也可以來協助推動這個計畫\n對啦我的意思就是說就是還是原來這些人在承接loading嘛因為很多事情都是\n反覆的在發生 然後這件事情又是新的所以我覺得這件事情是不是應該要長遠的計畫以後你再招收公費生的時候 應該是把兒科的比例用高一點這樣會以後再找人 不會說都找不到人第二個就是我看到你們的所謂的涵蓋率已經到47.9%這個幼兒中可是我想知道說原住民的比例是多少真正照顧到原住民的比例 你大概知道嗎\n這個資料我們會會後再去做一下確認我們再看那個周產婦高風險產婦這個桌中關懷計畫我看到一二年應該是說他服務了八千九百七十七人可是呢我看到真正服務員罪名三地員罪名是九百零九也就是說只有十分之一然後看了那個經費是四千五百萬這樣平均看來一個產婦的那個所收的補助大概是五千塊你覺得這樣子是合理的嗎\n還是要再更多報告委員這個部分的話我們會依據就是實際上在收案管理的時候這個產婦的實際的狀況但這個計畫主要是透過協助這個產婦定期來接受產檢然後以及提升健康適能來增加他在孕產期的整個的健康\n對啦我知道 可是現在上面寫說收案率打129%可是我就看了這個裡面我們的原住民人數只有909所以我希望是不是因為他比較偏遠所以他可能沒有受到應該有的照顧而是比較偏重於在杜惠區因為這邊是8977那實際原住民是只有909是不是這個部分可以再加強雖然說你們已經說收案率已經達到129%\n這個收案率是相較於就是說地方政府共同訂定的目標值那這個部分我們會再來留意在比例上面我希望原住民可以多一點可以嗎我們再來留意因為時間的關係我就講到一個就是我上個禮拜接觸的一個問題就是罕見疾病的問題因為一個小朋友他大概國小五年級就因為臉皮血送到醫院結果後來我們再問的時候他就說他不屬於罕見疾病\n那可是ITP所謂的ITP就是我們知道的免疫性就是血小板引起的止斑不過它的一個特效藥其實就是造成他們生活的困境因為一個月的藥費大概是3萬多塊接近4萬塊不過這個家庭剛好\n比較可憐的是他們剛好是原住民又剛好是六個兄弟姊妹要養就是造成父母親非常大的壓力可是他們要申請罕見是不符合資格申請重道三病也沒有那個條件所以到底要怎麼來解決他們的困境呢\n所以那我有問當下的那個我們來辦公室討論的時候他說ITP不算罕見可是我看到罕見的罕見疾病的一個所謂的定義歐盟是百萬分之27到36可是這個ITP的發生率是百萬分之50到100也就是說其實它跟罕見疾病的定義其實沒有差很遠所以是不是應該要把它列入考量\n非常感謝委員跟委員報告因為他現在目前所罹患這個並不是我們公告的罹病事實上是後天免疫性的疾病其實我後來再去看一下所謂的後天其實它是IdiopathicIdiopathic它的兩個意義就是Spontaneous它是自然發生的第二個就是所謂的我看一下\n所謂的 peculiar to the individual也就是說它是特定對這個病人的所以它並不是所謂的後天它就是spontaneous它怎麼可能是後天所以我就說其實不要說把它變成是所謂的一出生下來就有它本來就是因為它的基因的問題在那個時間區它就發生了嘛所以這個所謂罕見疾病應該是要把它考慮進去因為它的比例上的問題是不是可以從這邊來認定這樣\n好不好如果以後如果ITP的小朋友的話在照顧他們會造成就不會造成家長很大的負擔謝謝OK感謝委員謝謝\n","vtt":"WEBVTT\n\n00:06.250 --> 00:06.390\n有請次長\n\n00:16.733 --> 00:41.203\n市長我們像第一次見面嗎沒有沒有那個包委員我們之前我們到那個一起到那個園民那個區域都非常感那個感佩委員對於這一個我們園民相關的福利的這一個我們之前委員有指示嘛就是在這個園鄉地區我們的醫療部分的一個強化非常感謝委員那麼針對我們園鄉的少子化來做一些我們溝通\n\n00:42.043 --> 01:08.033\n那現在我們小朋友的那個死亡率還是全國的兩倍那也就是說我們目前看到的困境就是說我們衛生所的一個編制其實很少可以特定的說來要求是小兒科或者是婦產科當然也有一些我們所謂的IDS的合作不過還是沒有辦法解決這個問題所以我們來看一下目前我們的產檢次數有的人是一年可能這次生產只有產檢到五次\n\n01:08.753 --> 01:35.514\n所以造成我們現在嬰兒死亡率還是你看現在大概第二段的部分看到是9.5平地相似10.3跟都會區的5.8還是有差距也就是說目前我們全國大概是4左右我們原住民還在9.5大概是一倍的量看第二個所以說現在看到我們在產檢的部分現在在努力的是我們一個基金會叫至善基金會在新竹他有提供安心媽媽專車那\n\n01:37.495 --> 01:52.712\n我們全鄉我們全國大概有30個原鄉如果每一個鄉有這樣的一個服務的話當然那些媽媽會安心的住在我們的原鄉部落可是常常遇到是沒有沒有這方面的一個所謂的慈善單位那我們國家已經\n\n01:53.553 --> 02:18.552\n可憐到說需要到慈善單位來幫忙做這樣的事情也就是說我們衛福部還是沒有努力在來解決這個問題那叫不到計程車也就算了如果要出去的話可能就是如果沒有這些基金會的話要自己想辦法下山那像我昨天去復興區那最遠的地方到大溪大概也要一兩個小時的時間那更何況是有一些部落的環境還是不是很好所以\n\n02:19.472 --> 02:38.307\n幾乎我在部落裡面幾乎沒有看到這些所謂的產戶或者是說即將生產的人所以基本上我在想他們應該都是住在都會區然後我們看下一個我們看平均移民的部分就是小朋友的出生率我大概考你一下目前全世界最低的所謂的新生兒的死亡率是在哪裡\n\n02:39.352 --> 03:03.302\n新生兒死亡率最低目前如果沒有記錯是不是丹麥對日本是日本就芬蘭日本盧森堡這些我們大概都在二左右那我們現在台灣是三左右可是我們曾經是世界上最好的可是我們現在竟然是推不到現在這樣子而且我們原住民還是在六左右我們再看一下\n\n03:05.430 --> 03:25.178\n不僅是這樣因為我們平均明明是小大概六七歲左右所以我們可以看所有的一些發生率我們的死亡的時間大概都在你們的歲數的大概六七歲的差距那我為什麼要凸顯這一張其實就像剛才王一鳴委員講的現在少子化沒有專責單位我們原住民也沒有專責單位\n\n03:26.238 --> 03:54.201\n其實在我們在立法的部分在112年的6月21號就已經通過原住民主健康法在第二條第二項裡面他必須要有專責單位可是已經快要兩年了我們還沒有看到這個單位的出行那我們是希望說他能夠在10級以上不然現在上帝李老的那個科號還是這個科的層級裡面所以你要怎麼來解決所有原住民的這些健康的議題所以就剛剛王委員講的你都沒有準備好你要解決這麼多繁雜\n\n03:55.862 --> 04:14.891\n很困難的事情你要去找誰來解決是是這個部分我可以聽到一點點的聲音嗎有沒有規劃好非常感謝委員那個長期以來對於我們原鄉原住民的一個關心特別是我想我知道那個土耳其人自己也是醫生所以對於這個部分我想那個見解特別特別特別深刻那我們現在是不是先請那個對來請\n\n04:20.333 --> 04:41.570\n謝謝委員有關於專責單位在研究法裡面他希望指定一個專責單位目前我們就是努力朝另外新增一個科的方式在處理我們在爭取人種的部分給我們這樣的一個資源也爭取了一年多所以還在持續努力中\n\n04:42.230 --> 05:09.616\n好那至少先看到初型讓他們至少一個盼望那麼再看一下目前在推動的這些所謂要提升我們產婦嬰兒健康措施陸陸續續都有些計畫然後我看一下IDS育兒專責意識制度還有周產期高風險期我們的產婦的追蹤關懷計畫上面都寫得很好可是我在想第一個IDS即使它就沒有強制規定說我這個一定要小兒科或者是婦產\n\n05:11.096 --> 05:23.593\n副廠科的一個科別所以基本上來值班的都是原來的在那邊服務的醫師大部分都是內科或者是加一科的醫師所以這個部分其實沒有辦法真正幫忙到所謂以後要解決兒科的問題那幼兒專制的醫師制度\n\n05:26.557 --> 05:44.290\n我相信啦在所謂的比如說屏東縣好了把小兒科的醫師全部拉進去然後大家來分所謂的照顧比然後可是其實到最後還是落在衛生所的醫生上面所以其實這個幼兒專責醫師制度真的可以解決我們現在的問題嗎OK好來來來我們請那個郁金副市長來講\n\n05:51.061 --> 06:14.866\n是謝謝委員的詢問委員剛剛所提到的確實也是我們在推動幼兒專責醫師制度計畫的時候非常重要的考量也就是服務人力的充足了所以我們也知道偏鄉的地區很多時候是仰賴衛生所那也不一定都有兒科醫師在那邊所以我們在幼兒專責醫師制度計畫裡面也納入了家庭醫學科的醫師經過一個適當的訓練也可以來協助推動這個計畫\n\n06:18.668 --> 06:23.104\n對啦我的意思就是說就是還是原來這些人在承接loading嘛因為很多事情都是\n\n06:23.922 --> 06:49.929\n反覆的在發生然後這件事情又是新的所以我覺得這件事情是不是應該要長遠的計畫以後你再招收公費生的時候應該是把兒科的比例用高一點這樣會以後再找人不會說都找不到人第二個就是我看到你們的所謂的涵蓋率已經到47.9%這個幼兒中可是我想知道說原住民的比例是多少真正照顧到原住民的比例你大概知道嗎\n\n06:53.273 --> 07:20.325\n這個資料我們會會後再去做一下確認我們再看那個周產婦高風險產婦這個桌中關懷計畫我看到一二年應該是說他服務了八千九百七十七人可是呢我看到真正服務員罪名三地員罪名是九百零九也就是說只有十分之一然後看了那個經費是四千五百萬這樣平均看來一個產婦的那個所收的補助大概是五千塊你覺得這樣子是合理的嗎\n\n07:21.545 --> 07:39.558\n還是要再更多報告委員這個部分的話我們會依據就是實際上在收案管理的時候這個產婦的實際的狀況但這個計畫主要是透過協助這個產婦定期來接受產檢然後以及提升健康適能來增加他在孕產期的整個的健康\n\n07:39.978 --> 08:04.537\n對啦我知道可是現在上面寫說收案率打129%可是我就看了這個裡面我們的原住民人數只有909所以我希望是不是因為他比較偏遠所以他可能沒有受到應該有的照顧而是比較偏重於在杜惠區因為這邊是8977那實際原住民是只有909是不是這個部分可以再加強雖然說你們已經說收案率已經達到129%\n\n08:08.606 --> 08:33.064\n這個收案率是相較於就是說地方政府共同訂定的目標值那這個部分我們會再來留意在比例上面我希望原住民可以多一點可以嗎我們再來留意因為時間的關係我就講到一個就是我上個禮拜接觸的一個問題就是罕見疾病的問題因為一個小朋友他大概國小五年級就因為臉皮血送到醫院結果後來我們再問的時候他就說他不屬於罕見疾病\n\n08:33.664 --> 08:47.476\n那可是ITP所謂的ITP就是我們知道的免疫性就是血小板引起的止斑不過它的一個特效藥其實就是造成他們生活的困境因為一個月的藥費大概是3萬多塊接近4萬塊不過這個家庭剛好\n\n08:49.778 --> 09:05.314\n比較可憐的是他們剛好是原住民又剛好是六個兄弟姊妹要養就是造成父母親非常大的壓力可是他們要申請罕見是不符合資格申請重道三病也沒有那個條件所以到底要怎麼來解決他們的困境呢\n\n09:06.155 --> 09:28.673\n所以那我有問當下的那個我們來辦公室討論的時候他說ITP不算罕見可是我看到罕見的罕見疾病的一個所謂的定義歐盟是百萬分之27到36可是這個ITP的發生率是百萬分之50到100也就是說其實它跟罕見疾病的定義其實沒有差很遠所以是不是應該要把它列入考量\n\n09:30.625 --> 09:51.205\n非常感謝委員跟委員報告因為他現在目前所罹患這個並不是我們公告的罹病事實上是後天免疫性的疾病其實我後來再去看一下所謂的後天其實它是IdiopathicIdiopathic它的兩個意義就是Spontaneous它是自然發生的第二個就是所謂的我看一下\n\n09:52.563 --> 10:17.002\n所謂的peculiartotheindividual也就是說它是特定對這個病人的所以它並不是所謂的後天它就是spontaneous它怎麼可能是後天所以我就說其實不要說把它變成是所謂的一出生下來就有它本來就是因為它的基因的問題在那個時間區它就發生了嘛所以這個所謂罕見疾病應該是要把它考慮進去因為它的比例上的問題是不是可以從這邊來認定這樣\n\n10:18.883 --> 10:27.236\n好不好如果以後如果ITP的小朋友的話在照顧他們會造成就不會造成家長很大的負擔謝謝OK感謝委員謝謝\n\n","segments":[{"start":6.25,"end":6.39,"text":"有請次長"},{"start":16.733,"end":41.203,"text":"市長我們像第一次見面嗎沒有沒有那個包委員我們之前我們到那個一起到那個園民那個區域都非常感那個感佩委員對於這一個我們園民相關的福利的這一個我們之前委員有指示嘛就是在這個園鄉地區我們的醫療部分的一個強化非常感謝委員那麼針對我們園鄉的少子化來做一些我們溝通"},{"start":42.043,"end":68.033,"text":"那現在我們小朋友的那個死亡率還是全國的兩倍那也就是說我們目前看到的困境就是說我們衛生所的一個編制其實很少可以特定的說來要求是小兒科或者是婦產科當然也有一些我們所謂的IDS的合作不過還是沒有辦法解決這個問題所以我們來看一下目前我們的產檢次數有的人是一年可能這次生產只有產檢到五次"},{"start":68.753,"end":95.514,"text":"所以造成我們現在嬰兒死亡率還是你看現在大概第二段的部分看到是9.5平地相似10.3跟都會區的5.8還是有差距也就是說目前我們全國大概是4左右我們原住民還在9.5大概是一倍的量看第二個所以說現在看到我們在產檢的部分現在在努力的是我們一個基金會叫至善基金會在新竹他有提供安心媽媽專車那"},{"start":97.495,"end":112.712,"text":"我們全鄉 我們全國大概有30個原鄉如果每一個鄉有這樣的一個服務的話當然那些媽媽會安心的住在我們的原鄉部落可是常常遇到是沒有沒有這方面的一個所謂的慈善單位那我們國家已經"},{"start":113.553,"end":138.552,"text":"可憐到說需要到慈善單位來幫忙做這樣的事情也就是說我們衛福部還是沒有努力在來解決這個問題那叫不到計程車也就算了如果要出去的話可能就是如果沒有這些基金會的話要自己想辦法下山那像我昨天去復興區那最遠的地方到大溪大概也要一兩個小時的時間那更何況是有一些部落的環境還是不是很好所以"},{"start":139.472,"end":158.307,"text":"幾乎我在部落裡面幾乎沒有看到這些所謂的產戶或者是說即將生產的人所以基本上我在想他們應該都是住在都會區然後我們看下一個我們看平均移民的部分就是小朋友的出生率我大概考你一下目前全世界最低的所謂的新生兒的死亡率是在哪裡"},{"start":159.352,"end":183.302,"text":"新生兒死亡率最低目前如果沒有記錯 是不是丹麥對 日本 是日本就芬蘭 日本 盧森堡這些我們大概都在二左右那我們現在台灣是三左右可是我們曾經是世界上最好的可是我們現在竟然是推不到現在這樣子而且我們原住民還是在六左右我們再看一下"},{"start":185.43,"end":205.178,"text":"不僅是這樣 因為我們平均明明是小大概六七歲左右所以我們可以看所有的一些發生率我們的死亡的時間大概都在你們的歲數的大概六七歲的差距那我為什麼要凸顯這一張其實就像剛才王一鳴委員講的現在少子化沒有專責單位我們原住民也沒有專責單位"},{"start":206.238,"end":234.201,"text":"其實在我們在立法的部分在112年的6月21號就已經通過原住民主健康法在第二條第二項裡面他必須要有專責單位可是已經快要兩年了我們還沒有看到這個單位的出行那我們是希望說他能夠在10級以上不然現在上帝李老的那個科號還是這個科的層級裡面所以你要怎麼來解決所有原住民的這些健康的議題所以就剛剛王委員講的你都沒有準備好你要解決這麼多繁雜"},{"start":235.862,"end":254.891,"text":"很困難的事情你要去找誰來解決是是這個部分我可以聽到一點點的聲音嗎有沒有規劃好非常感謝委員那個長期以來對於我們原鄉原住民的一個關心特別是我想我知道那個土耳其人自己也是醫生所以對於這個部分我想那個見解特別特別特別深刻那我們現在是不是先請那個對來請"},{"start":260.333,"end":281.57,"text":"謝謝委員有關於專責單位在研究法裡面他希望指定一個專責單位目前我們就是努力朝另外新增一個科的方式在處理我們在爭取人種的部分給我們這樣的一個資源也爭取了一年多所以還在持續努力中"},{"start":282.23,"end":309.616,"text":"好 那至少先看到初型讓他們至少一個盼望那麼再看一下目前在推動的這些所謂要提升我們產婦 嬰兒健康措施陸陸續續都有些計畫然後我看一下IDS 育兒專責意識制度還有周產期高風險期我們的產婦的追蹤關懷計畫上面都寫得很好可是我在想第一個IDS即使它就沒有強制規定說我這個一定要小兒科或者是婦產"},{"start":311.096,"end":323.593,"text":"副廠科的一個科別所以基本上來值班的都是原來的在那邊服務的醫師大部分都是內科或者是加一科的醫師所以這個部分其實沒有辦法真正幫忙到所謂以後要解決兒科的問題那幼兒專制的醫師制度"},{"start":326.557,"end":344.29,"text":"我相信啦在所謂的比如說屏東縣好了把小兒科的醫師全部拉進去然後大家來分所謂的照顧比然後可是其實到最後還是落在衛生所的醫生上面所以其實這個幼兒專責醫師制度真的可以解決我們現在的問題嗎OK好來來來我們請那個郁金副市長來講"},{"start":351.061,"end":374.866,"text":"是謝謝委員的詢問委員剛剛所提到的確實也是我們在推動幼兒專責醫師制度計畫的時候非常重要的考量也就是服務人力的充足了所以我們也知道偏鄉的地區很多時候是仰賴衛生所那也不一定都有兒科醫師在那邊所以我們在幼兒專責醫師制度計畫裡面也納入了家庭醫學科的醫師經過一個適當的訓練也可以來協助推動這個計畫"},{"start":378.668,"end":383.104,"text":"對啦我的意思就是說就是還是原來這些人在承接loading嘛因為很多事情都是"},{"start":383.922,"end":409.929,"text":"反覆的在發生 然後這件事情又是新的所以我覺得這件事情是不是應該要長遠的計畫以後你再招收公費生的時候 應該是把兒科的比例用高一點這樣會以後再找人 不會說都找不到人第二個就是我看到你們的所謂的涵蓋率已經到47.9%這個幼兒中可是我想知道說原住民的比例是多少真正照顧到原住民的比例 你大概知道嗎"},{"start":413.273,"end":440.325,"text":"這個資料我們會會後再去做一下確認我們再看那個周產婦高風險產婦這個桌中關懷計畫我看到一二年應該是說他服務了八千九百七十七人可是呢我看到真正服務員罪名三地員罪名是九百零九也就是說只有十分之一然後看了那個經費是四千五百萬這樣平均看來一個產婦的那個所收的補助大概是五千塊你覺得這樣子是合理的嗎"},{"start":441.545,"end":459.558,"text":"還是要再更多報告委員這個部分的話我們會依據就是實際上在收案管理的時候這個產婦的實際的狀況但這個計畫主要是透過協助這個產婦定期來接受產檢然後以及提升健康適能來增加他在孕產期的整個的健康"},{"start":459.978,"end":484.537,"text":"對啦我知道 可是現在上面寫說收案率打129%可是我就看了這個裡面我們的原住民人數只有909所以我希望是不是因為他比較偏遠所以他可能沒有受到應該有的照顧而是比較偏重於在杜惠區因為這邊是8977那實際原住民是只有909是不是這個部分可以再加強雖然說你們已經說收案率已經達到129%"},{"start":488.606,"end":513.064,"text":"這個收案率是相較於就是說地方政府共同訂定的目標值那這個部分我們會再來留意在比例上面我希望原住民可以多一點可以嗎我們再來留意因為時間的關係我就講到一個就是我上個禮拜接觸的一個問題就是罕見疾病的問題因為一個小朋友他大概國小五年級就因為臉皮血送到醫院結果後來我們再問的時候他就說他不屬於罕見疾病"},{"start":513.664,"end":527.476,"text":"那可是ITP所謂的ITP就是我們知道的免疫性就是血小板引起的止斑不過它的一個特效藥其實就是造成他們生活的困境因為一個月的藥費大概是3萬多塊接近4萬塊不過這個家庭剛好"},{"start":529.778,"end":545.314,"text":"比較可憐的是他們剛好是原住民又剛好是六個兄弟姊妹要養就是造成父母親非常大的壓力可是他們要申請罕見是不符合資格申請重道三病也沒有那個條件所以到底要怎麼來解決他們的困境呢"},{"start":546.155,"end":568.673,"text":"所以那我有問當下的那個我們來辦公室討論的時候他說ITP不算罕見可是我看到罕見的罕見疾病的一個所謂的定義歐盟是百萬分之27到36可是這個ITP的發生率是百萬分之50到100也就是說其實它跟罕見疾病的定義其實沒有差很遠所以是不是應該要把它列入考量"},{"start":570.625,"end":591.205,"text":"非常感謝委員跟委員報告因為他現在目前所罹患這個並不是我們公告的罹病事實上是後天免疫性的疾病其實我後來再去看一下所謂的後天其實它是IdiopathicIdiopathic它的兩個意義就是Spontaneous它是自然發生的第二個就是所謂的我看一下"},{"start":592.563,"end":617.002,"text":"所謂的 peculiar to the individual也就是說它是特定對這個病人的所以它並不是所謂的後天它就是spontaneous它怎麼可能是後天所以我就說其實不要說把它變成是所謂的一出生下來就有它本來就是因為它的基因的問題在那個時間區它就發生了嘛所以這個所謂罕見疾病應該是要把它考慮進去因為它的比例上的問題是不是可以從這邊來認定這樣"},{"start":618.883,"end":627.236,"text":"好不好如果以後如果ITP的小朋友的話在照顧他們會造成就不會造成家長很大的負擔謝謝OK感謝委員謝謝"}]}}},"gazette":{"lineno":836,"blocks":[["盧委員縣一：（10時26分）有請衛福部次長。"],["主席：請次長。"],["盧委員縣一：次長，我們算第一次見面嗎？"],["呂次長建德：不是。報告委員，之前我們一起到原民的區域，都非常感佩委員對於原民相關福利的關心，之前委員也有指示，就是在原鄉地區醫療的強化，非常感謝委員。"],["盧委員縣一：針對原鄉的少子化我們來做一些溝通。現在我們小朋友的死亡率還是全國的兩倍，我們目前看到的困境就是衛生所的編制其實很少可以特定要求是小兒科或者是婦產科，當然也有一些所謂IDS的合作，不過還是沒有辦法解決這個問題。我們來看一下目前的產檢次數，有的人可能在生產前只有產檢5次，所以造成我們的嬰兒死亡率達到9.5，平地鄉是10.3，跟都會區的5.8還是有差距。也就是說，目前全國大概是4左右，但原住民還在9.5，大概是一倍的量。","第二個，針對產檢的部分，現在努力的是新竹的一個基金會叫至善基金會，它有提供安心媽媽專車，全國大概有30個原鄉，如果每一個鄉都有這樣的服務的話，當然那些媽媽會安心地住在原鄉部落，可是常常遇到的是沒有這方面的慈善單位。我們國家已經可憐到需要慈善單位來幫忙做這樣的事情，可見衛福部還是沒有努力在解決這個問題。叫不到計程車也就算了，如果沒有這些基金會的話，就要自己想辦法下山。像我昨天去復興區，最遠的地方到大溪大概也要一、兩個小時的時間，更何況有些部落的環境還不是很好，所以我在部落裡面幾乎沒有看到產婦或者是即將生產的人，我在想基本上他們應該都是住在都會區。","接著我們來看平均餘命的部分，關於小朋友的出生率，我大概考你一下，目前全世界最低的新生兒死亡率是在哪裡？"],["呂次長建德：如果我沒記錯，新生兒死亡率最低的是不是丹麥？對不起，應該是日本。"],["盧委員縣一：就是芬蘭、日本、盧森堡這些國家，大概都在2左右，現在臺灣是3左右，我們曾經是世界上最好的，可是我們現在竟然退步到這樣子，而且我們原住民還是在6左右。不僅是這樣，因為我們的平均餘命大概少6、7歲左右，所以我們可以看到我們死亡的時間與你們的歲數大概都有6、7歲的差距。","我為什麼要凸顯這一張？就像剛才王育敏委員講的，現在針對少子化沒有專責單位，針對原住民也沒有專責單位，其實在立法的部分，112年6月21號就已經通過原住民族健康法，其中第二條第二項規定必須要有專責單位。可是已經快要兩年了，我們還沒有看到這個單位的雛形，我們希望它能夠在司級以上，不然現在還是屬於山地離島科，還是在一個科的層級裡面，所以你要怎麼來解決我們所有原住民健康的議題？就像剛剛王委員講的，你都沒有準備好，這麼多繁雜、困難的事情，你要去找誰來解決？這個部分我可以聽到一點點的聲音嗎？有沒有規劃呢？"],["呂次長建德：非常感謝委員長期以來對於我們原鄉原住民的關心，特別是我知道盧委員自己也是醫生，所以對這個部分的見解特別深刻，本人先請陳代理副司長來說明一下。"],["陳代理副司長青梅：謝謝委員，有關於專責單位，原健法裡面是希望能夠指定一個專責單位，目前我們就是努力朝另外再新增一個科的方式在處理……"],["盧委員縣一：還是一個「科」？"],["陳代理副司長青梅：對，我們向人總爭取能給我們這樣的資源，也爭取了一年多了，現在還在持續努力中。"],["盧委員縣一：好，至少先看到雛形，讓我們至少有一個盼望。","再來，目前在推動所謂提升我們產婦、嬰兒等等的健康措施，陸陸續續都有提出一些計畫，包括IDS、幼兒專責醫師制度、周產期高風險孕產婦(兒)追蹤關懷計畫等等，上面都寫得很好，可是第一個，IDS就沒有強制規定一定要有小兒科或者是婦產科的科別，所以基本上來值班的都是原來在那邊服務的醫師，大部分都是內科或者是家醫科的醫師，所以這個部分其實沒有辦法真正幫忙到所謂要解決兒科的問題。至於幼兒專責醫師制度，以屏東縣為例好了，把小兒科的醫師全部納進去，然後大家再來分配所謂的照顧比，可是到最後還是落在衛生所的醫生上面，所以這個幼兒專責醫師制度，真的可以解決我們現在的問題嗎？"],["呂次長建德：我們請玉菁副司長來說明。"],["劉副司長玉菁：謝謝委員的詢問，委員剛剛所提到的，確實也是我們在推動幼兒專責醫師制度計畫時非常重要的考量，也就是服務人力的充足。我們也知道偏鄉地區很多時候是仰賴衛生所，也不一定都有兒科醫師在那邊，所以我們在幼兒專責醫師制度計畫裡面，也納入了家庭醫學科的醫師，經過一個適當的訓練，也可以來協助推動這個計畫。"],["盧委員縣一：對，我的意思是，就還是原來這些人在承接loading，因為很多事情都是反覆再發生，然後這件事情又是新的，所以我覺得這件事情是不是應該要有長遠的計畫，像以後在招收公費生的時候，應該要把兒科的比例提高一點，以後在找人時也比較不會找不到人。","第二個，我看到你們所謂幼兒專科醫師制度的涵蓋率已經到47.9%，但我想知道原住民這部分的比例是多少？真正照顧到原住民的比例大概是多少，知道嗎？"],["劉副司長玉菁：這個資料我們會後再去做一下確認。"],["盧委員縣一：請再提供給我。","再看周產期高風險孕產婦（兒）追蹤關懷計畫，112年共服務了8,977人，可是真正被服務到的山地原住民是909人，也就是只了占十分之一；再來，那個經費是4,500萬，這樣平均下來，一個產婦所受到的補助大概是5,000塊，你覺得這樣子是合理的嗎？還是要再更多？"],["林組長宇旋：報告委員，這個部分我們會依據實際上在收案管理時這個產婦的實際狀況，這個計畫主要是透過協助產婦定期來接受產檢，以及提升健康適能來增加他在孕產期的整個健康。"],["盧委員縣一：對，我知道，現在上面寫到收案率達129%，可是裡面我們的原住民人數只有909人，是不是因為他的位置比較偏遠，所以可能沒有受到應該有的照顧，而且是比較偏重在都會區？即受到服務的有8,977人，但實際上原住民的人數只有909人，是不是這個部分可以再加強？雖然你們說收案率已經達到129%。"],["林組長宇旋：是，這個收案率是相較於地方政府共同訂定的目標值，這個部分我們會再來留意。"],["盧委員縣一：在比例上面，我希望原住民人數可以再多一點，可以嗎？"],["林組長宇旋：我們再來留意。"],["盧委員縣一：因為時間的關係，我就來談上個禮拜所接觸到的一個問題，就是罕見疾病的問題。有一個大概是國小五年級的小朋友，因為流鼻血被送到醫院，後來我們再詢問的時候卻聽到，他不屬於罕見疾病而是ITP，所謂的ITP就是免疫性血小板低下引起的紫斑症，但他的特效藥費用卻造成他們生活的困境，因為一個月的藥費大概是三萬多塊、接近四萬塊，這個家庭比較可憐，剛好是原住民，又剛好有6個兄弟姐妹要養，所以造成父母親非常大的壓力，可是他們要申請罕見疾病補助是不符合資格的；申請重大傷病補助，也沒有那個條件，所以到底要怎麼解決他們的困境呢？當時官員到我們辦公室來討論的時候，他說ITP不算罕見疾病，可是我看了罕見疾病所謂的定義，歐盟是百萬分之二十七到三十六，而ITP的發生率是百萬分之五十到一百，也就是說，它跟罕見疾病的定義其實沒有差很遠，所以是不是應該要把它列入考量？"],["呂次長建德：非常感謝委員，跟委員報告，因為他目前所罹患的疾病並不是我們所公告的罕病，事實上是後天免疫性的疾病，是不符合罕病的……"],["盧委員縣一：沒有，我後來有再去看一下所謂的「後天」，其實就是idiopathic，它有兩個意義，第一個就是spontaneous、是自然發生的；第二個，所謂的peculiar to the individual，也就是說，它是特定對這個病人的，所以並不是所謂的後天，就是spontaneous的，怎麼可能是「後天」呢？所以我才說，不要把它變成是所謂一出生下來就有，他本來就是因為基因的問題，在那個時間序就發生了，所以所謂的罕見疾病應該要把它考慮進去，因為它比例上的問題，所以是不是可以從這邊來認定？如果可以的話，以後若是ITP的小朋友，在照顧上就不會造成家長很大的負擔，謝謝。"],["呂次長建德：OK，感謝委員。"],["主席：謝謝次長，謝謝盧委員。","接續我們請黃秀芳委員質詢。"]],"agenda":{"page_end":120,"meet_id":"委員會-11-3-26-4","speakers":["蘇清泉","陳昭姿","林月琴","陳菁徽","王育敏","盧縣一","黃秀芳","劉建國","邱鎮軍","廖偉翔","涂權吉","林淑芬","王正旭","羅廷瑋","楊瓊瓔","洪孟楷","張雅琳","楊曜","李坤城","麥玉珍","陳瑩","鄭正鈐","黃捷","林德福","陳培瑜"],"page_start":1,"meetingDate":["2025-03-27"],"gazette_id":"1143301","agenda_lcidc_ids":["1143301_00002"],"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4次全體委員會議紀錄","content":"邀請衛生福利部、勞動部、國家發展委員會、教育部、法務部針對「少子女化衝擊，如何營造\n友善托育環境」進行專題報告，並備質詢","agenda_id":"1143301_00001"}}}