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\"start\": 865.292, \"end\": 865.452, \"score\": 0.874}, {\"word\": \"長\"}, {\"word\": \"謝\"}, {\"word\": \"謝\"}, {\"word\": \"好\", \"start\": 865.452, \"end\": 865.552, \"score\": 0.786}, {\"word\": \"謝\"}, {\"word\": \"謝\"}, {\"word\": \"林\", \"start\": 865.552, \"end\": 866.093, \"score\": 0.937}, {\"word\": \"委\", \"start\": 866.093, \"end\": 866.193, \"score\": 0.802}, {\"word\": \"員\"}, {\"word\": \"你\", \"start\": 866.193, \"end\": 866.233, \"score\": 0.499}, {\"word\": \"用\", \"start\": 866.233, \"end\": 866.373, \"score\": 0.855}, {\"word\": \"心\", \"start\": 866.373, \"end\": 866.493, \"score\": 0.827}, {\"word\": \"喔\", \"start\": 866.493, \"end\": 866.513, \"score\": 0.0}], \"language\": \"zh\"}","srt":"1\n00:00:10,526 --> 00:00:11,292\n謝謝主席,有請邱部長\n\n2\n00:00:18,473 --> 00:00:44,856\n委員好部長早那藻寮議題一直是我很關心的因為藻寮做得好的話對幼兒未來的順利健全成長自為關鍵所以行政院也重視這一塊推動各項計畫持續加強我們國內藻寮服務的可敬性像譬如說優化兒童醫療照顧計畫還有是去年推出的六歲以下\n\n3\n00:00:46,217 --> 00:01:14,118\n補助六次的兒童篩檢服務這是都是很好的政策可是在執行端我還是要提出一些問題想問部長目前六歲以下接受藻寮服務的幼兒數量大概有多少目前接受藻寮的服務的那個量是大概有多少\n\n4\n00:01:19,297 --> 00:01:37,308\n公委報告目前在我們藻寮經過個管的案件有7萬多人為什麼我要這樣問因為實在太多小孩光是在排隊等待評估需要花一年半載這個也連帶影響到特殊教育端的服務跟資源供給\n\n5\n00:01:38,988 --> 00:01:51,580\n而且我還有看到的是隱藏起來的事實上沒有被發學的曼菲爾從數據上來看恐怕比目前你們現在服務的量需要還要更多所以剛剛我覺得周\n\n6\n00:01:54,411 --> 00:02:10,925\n周代理署長講的好像似乎跟我的數據有點落差為什麼實際接受找聊目前我們去看到給出來的數據是這樣就是說這是你們部內的自己的統計資料目前接受的人事實上是兩萬三千多人跟剛才\n\n7\n00:02:11,745 --> 00:02:19,208\n周副署長講的是說有7萬多好像有很大的落差這在國內6歲以下的115萬的幼兒不到2%的比例因為只有1.99%那國內研究就顯示6歲以下的兒童發展的遲緩的盛行率是2.0到5.7%\n\n8\n00:02:30,493 --> 00:02:56,035\n如果用這樣子推估的話大概是23125人或甚至如果是到5.7%的話是65905人所以我們看起來實際接受著療的幼兒跟我們看到研究他在推估的盛行率連最低的都有很多的落差所以表示有很多隱藏的需求而且不僅是低而且是低的離譜如果按照推估需求的話我們連低標都打不到\n\n9\n00:02:56,400 --> 00:03:13,681\n所以我想問部長,問題在哪裡?你認為問題在哪裡?為何這些幼兒有這些需求的時候是沒被看見的?好,謝謝委員長期對藻條這件事幼兒的關心我想這個部分,以我一個從事40年醫療的老醫師\n\n10\n00:03:22,462 --> 00:03:31,327\n我們真的非常重視,而且我覺得過去的確說一句實話,一個家長當小孩想要做早療的一個評估\n\n11\n00:03:32,708 --> 00:03:50,005\n真的要掛個號真的很幸福這是過去幾十年來我們一直覺得說實在我在醫院裡面覺得這一塊是的確需要努力那我們也了解到這幾年來當中可以說是不管從篩檢\n\n12\n00:03:51,587 --> 00:04:05,786\n以及藻寮以後的一個怎麼治療還有社區的不管是醫院跟社區的部件因為譬如說在台大醫院好了他看了以後他總不可能一直在台大追蹤他還是會到社區的藻寮中心去推動這樣的一個部件\n\n13\n00:04:07,067 --> 00:04:15,297\n其實是一直非常努力而且我覺得我也去參觀過幾個藻寮的社區的中心都非常的用心他們家長也很認真現在就是說阿塞典的話\n\n14\n00:04:23,306 --> 00:04:39,172\n有需求可是你們現在真的在服務的量次上就已經不夠因為委員提出這個量我也surprise所以我為什麼剛剛你一問的時候我不敢跟你確定的答案因為這個數字要對一下因為如果說真的這麼低那真的是如果是說兩個啦一個是說我們應該篩檢的我們一定要把它篩出來所以我們佈置了一千零多家的一個醫療院所\n\n15\n00:04:52,198 --> 00:05:07,860\n部長我們先來看像偏鄉篩檢今天主要還是要聚焦偏鄉偏鄉的篩檢量能跟資源是不足的從三道這個發展遲緩早期發現的這三道關卡就可以看得到\n\n16\n00:05:08,662 --> 00:05:31,799\n發展監測比較沒問題家長能不能去看到去記錄的時候了解他孩子發展狀況那第二個關卡呢事實上是在發展篩檢那110去年7月你有這樣子的一個所謂補助6歲以下的幼兒篩檢的這可是88處的偏遠地區是17處是沒有涵蓋發展那個篩檢的院所\n\n17\n00:05:32,359 --> 00:05:50,678\n全國整個篩檢率只有46.2%那偏鄉大概只有40.2%而已就全國46那偏鄉只有4040%左右那如果我們再進入到第三階段的話就是發展評估你全國六區有88家的聯平中心\n\n18\n00:05:51,338 --> 00:06:12,164\n那可是64處應該提供外展服務那可是有6處事實上是沒有提供而且我前面在講的那個發展篩檢那17區裡邊的10區的確你們事實上是按照你們全民健康保險3D離島地區的醫療給付的效益提升計畫\n\n19\n00:06:13,404 --> 00:06:30,771\n來可支援我們的篩檢服務剩下的七區啊你就說要透過地方政府衛生局來協調整合所以常常家長去的意願很低為什麼既然是偏鄉他到衛生局事實上還是有一定的困難困難程度所以我就在講應該\n\n20\n00:06:32,512 --> 00:06:44,541\n不僅是患寡而且患不均所以不知道說部長對於你是不是知道就是幼兒專責醫師的制度是不是有清楚的部件情形你有沒有掌握進度啊\n\n21\n00:06:47,235 --> 00:07:09,726\n因為其實我在當醫師公會理事長的時候就要全國各地盡量的配合即使像當時台北市因為我專責醫師的比例真的是蠻低的所以我也請台北市醫師公會邀請所有的醫療院所能夠多多參與所以比例也提起來所以我對這個的重視以及希望它會會功能\n\n22\n00:07:10,686 --> 00:07:22,951\n所以現在已經可以cover到99點那為什麼一次我今天談的好像數據都跟你們不太到可是這也是從你們部內去要到的數據齁你們提供給我的是說幼兒專責醫師的涵蓋率齁59.4%所以未達六成這是你們提供給我的數據齁人口啦人口那部件的地區大概\n\n23\n00:07:34,927 --> 00:07:51,966\n而且當初幼兒專責醫師主要是要提升偏遠地區跟或醫療資源比較匱乏的兒童的照護品質跟就醫的可及性他的目的在這邊目前如果沒有達到六成的話我不知道偏鄉的需求有被滿足嗎\n\n24\n00:07:53,207 --> 00:08:16,060\n甚至這樣子的一個發展篩檢服務怎麼會增加誘因呢因為它沒有列入品質成效的分數計算不會對於專者醫師事實上有些誘因更何況我們比較擔心的是針對發展篩檢的這樣子的一個教育訓練它不是你的專者醫師的必修學分所以這也讓我覺得蠻疑惑的我不知道\n\n25\n00:08:19,121 --> 00:08:36,011\n為什麼會是這樣他又不是必須要可是你又期待他做這個工作那我不知道說你們幼兒專責醫師到底有這樣子的一個發展篩檢教育訓練有有全部這個甚至你都已經沒達到六成那這五成\n\n26\n00:08:36,573 --> 00:08:50,527\n多59.4%的人都有受過這樣的教育訓練嗎這就會讓我們有點擔憂狀況二就是找到程序我們剛剛講前面就有一些機制事實上失靈家長似乎只能乾著急為什麼這樣講因為\n\n27\n00:08:53,169 --> 00:09:20,658\n去年的那個推動的六次補助就是發展篩檢那中央的標準化量表地方真的有在用嗎為什麼這樣問光台北市跟你中央的就不一樣托嬰中心的跟幼兒園的也不太一樣所以不同的老師不同的表格不同單位執行那如果托嬰中心跟幼兒園的就已經不一樣到底這樣篩出來集中在你們就是說\n\n28\n00:09:21,118 --> 00:09:35,542\n你這個所有的通報來源齁大概托營中心跟幼兒園就在112年就佔了四分之一喔如果沒有這樣互相串聯我不知道這些有沒有重複就是說這數據有沒有重複甚至有沒有重複通報甚至有沒有是無效的通報甚至我們去問到\n\n29\n00:09:41,533 --> 00:09:59,554\n國教署這邊還講說衛生局會主動來篩基本上現在都是老師或請家長填那我不知道衛生局到底有沒有做所以有這麼多不同的來源你到底怎麼去針對這個發災有沒有無效的甚至有重複通報的部長你怎麼看這個問題\n\n30\n00:10:00,915 --> 00:10:19,569\n謝謝委員的指教剛剛你提的所有的問題我們都會再度去檢討如果沒有做好的那我們一定要把它再恰恰希望你們這邊是不是跟教育部跟衛福部啊因為託營中心就是你們衛福部的可是幼兒園事實上是教育部的是不是可以去統整一下\n\n31\n00:10:20,129 --> 00:10:28,812\n而且各地方又不太一樣那中央又跟地方不太一樣的話那這樣填到表單我覺得似乎能夠有一個依據那個委員可不可以容許我請吳署長先檢要報告一下抱歉因為我想等一下主席搞不好又要站起來所以我待會再去提吳署長要不要\n\n32\n00:10:40,475 --> 00:11:05,479\n你今天不一樣嗎?剛提到的那個通報的確是從幼兒園也好,從家長也好,從醫療機構那是早期的那時候是沒有兒童成長評估,沒有用醫療這一端來做處理我們去年的需要才開始從醫療端來做通報就是幫忙做篩檢screen這件事情那這個是專列版的,那我目前正在發展\n\n33\n00:11:06,139 --> 00:11:25,159\n發展你剛所謂的教保育的人員的篩檢或者家長的置評的頒表目前還在發展那過去都是用台北2那個表門表所以過去是沒有我們沒有這個配體以前我們在去我個人去評鑑幼兒園評鑑拖延中心的時候每次看到表單就是不太一樣對過去是這樣我現在看你中央也不太一樣所以你講的是事實沒有錯\n\n34\n00:11:25,840 --> 00:11:54,943\n但是我們現在已經在改進了所以可能要速度快點否則拿到東西搞不好事實上是來自不同來源就不太一樣接下來我們來看就是整個我覺得聯平流程每名孩子大概二到三次才能完成可是如果按照112年的通報人數是三萬多那你們自己官方宣稱說每一年代你們可以做的是四萬人次那就差了兩萬因為每一個孩子至少兩次才能完成聯平的流程那你現在通報就有三萬四千多\n\n35\n00:11:55,943 --> 00:12:14,958\n你又號稱說你每一年可以做4萬那這樣子是不是還差2萬多市長你會不會回答112年的確是3萬4千多的年品的量那我們講的4萬多是這個是講的通報人數那114年的年品的總量是4萬3千多已經可以到達4萬3千多我們就已經擴大了年品的你知道家長願意帶著孩子來篩檢等待評估都應該\n\n36\n00:12:24,161 --> 00:12:52,398\n要知道他很注重這個而且藻寮黃金時期是三歲以下自為關鍵我還要再提一個問題就是好不容易拿到聯評報告了總算可以進入到藻寮體系去備服務問題又來了健保給付大概就30分鐘對很多忙碌的家長好不容易預約到了結果帶到給醫生看了要去做療癒服務的時候可是孩子在不同的情境當中他需要冷靜\n\n37\n00:12:52,938 --> 00:13:11,608\n那搞不好已經過了三分之一時間我剩下三分之二只有二十分鐘最後就只好怎樣要嘛就批一份命每次去另外一個就是要嘛就是自己付錢可是政府現在補助四千塊這個四千塊涵蓋交通費還要每次療癒的費用根本也是不夠所以難怪家長\n\n38\n00:13:13,677 --> 00:13:27,513\n不斷的訴求我們辦公室就很多找療單位來拜會我們是說希望是不是找療夫真的能夠真實回應他的需求所以我覺得這部長在費用跟時間上可不可能考慮增加\n\n39\n00:13:28,033 --> 00:13:50,596\n能不能評估看看所以接下來這四點麻煩你們能夠做到否則我就要找各部會一起來好討論盡速提升偏遠地區跟社區型的發塞跟鄰屏的量能落實分級的醫療機制那盡速提升你的幼兒專責醫師的制度的涵蓋率還有把發塞教育訓練要納入為必修學分\n\n40\n00:13:51,416 --> 00:14:18,455\n他全面檢視早療服務的程序跟國校組跟地方政府建立聯繫管道不是各吹各的調盤點我們的篩檢實施情況不要資源重複或者是無效利用還有加速我們的擴大聯合評估的量能而且不要沒有考慮到均衡要檢討我們早療服務的補助項目跟費用能夠滿足到我們家長和幼兒的需求\n\n41\n00:14:19,147 --> 00:14:26,513\n好以上兩週內請你們給我順便回覆我們不斷全力以赴兩週內可以給委員會好謝謝部長謝謝好謝謝林委員你用心喔\n\n","tsv":"start\tend\ttext\n10526\t11292\t謝謝主席,有請邱部長\n18473\t44856\t委員好部長早那藻寮議題一直是我很關心的因為藻寮做得好的話對幼兒未來的順利健全成長自為關鍵所以行政院也重視這一塊推動各項計畫持續加強我們國內藻寮服務的可敬性像譬如說優化兒童醫療照顧計畫還有是去年推出的六歲以下\n46217\t74118\t補助六次的兒童篩檢服務這是都是很好的政策可是在執行端我還是要提出一些問題想問部長目前六歲以下接受藻寮服務的幼兒數量大概有多少目前接受藻寮的服務的那個量是大概有多少\n79297\t97308\t公委報告目前在我們藻寮經過個管的案件有7萬多人為什麼我要這樣問因為實在太多小孩光是在排隊等待評估需要花一年半載這個也連帶影響到特殊教育端的服務跟資源供給\n98988\t111580\t而且我還有看到的是隱藏起來的事實上沒有被發學的曼菲爾從數據上來看恐怕比目前你們現在服務的量需要還要更多所以剛剛我覺得周\n114411\t130925\t周代理署長講的好像似乎跟我的數據有點落差為什麼實際接受找聊目前我們去看到給出來的數據是這樣就是說這是你們部內的自己的統計資料目前接受的人事實上是兩萬三千多人跟剛才\n131745\t139208\t周副署長講的是說有7萬多好像有很大的落差這在國內6歲以下的115萬的幼兒不到2%的比例因為只有1.99%那國內研究就顯示6歲以下的兒童發展的遲緩的盛行率是2.0到5.7%\n150493\t176035\t如果用這樣子推估的話大概是23125人或甚至如果是到5.7%的話是65905人所以我們看起來實際接受著療的幼兒跟我們看到研究他在推估的盛行率連最低的都有很多的落差所以表示有很多隱藏的需求而且不僅是低而且是低的離譜如果按照推估需求的話我們連低標都打不到\n176400\t193681\t所以我想問部長,問題在哪裡?你認為問題在哪裡?為何這些幼兒有這些需求的時候是沒被看見的?好,謝謝委員長期對藻條這件事幼兒的關心我想這個部分,以我一個從事40年醫療的老醫師\n202462\t211327\t我們真的非常重視,而且我覺得過去的確說一句實話,一個家長當小孩想要做早療的一個評估\n212708\t230005\t真的要掛個號真的很幸福這是過去幾十年來我們一直覺得說實在我在醫院裡面覺得這一塊是的確需要努力那我們也了解到這幾年來當中可以說是不管從篩檢\n231587\t245786\t以及藻寮以後的一個怎麼治療還有社區的不管是醫院跟社區的部件因為譬如說在台大醫院好了他看了以後他總不可能一直在台大追蹤他還是會到社區的藻寮中心去推動這樣的一個部件\n247067\t255297\t其實是一直非常努力而且我覺得 我也去參觀過幾個藻寮的社區的中心都非常的用心 他們家長也很認真現在就是說 阿塞典的話\n263306\t279172\t有需求可是你們現在真的在服務的量次上就已經不夠因為委員提出這個量我也surprise所以我為什麼剛剛你一問的時候我不敢跟你確定的答案因為這個數字要對一下因為如果說真的這麼低那真的是如果是說兩個啦一個是說我們應該篩檢的我們一定要把它篩出來所以我們佈置了一千零多家的一個醫療院所\n292198\t307860\t部長我們先來看像偏鄉篩檢今天主要還是要聚焦偏鄉偏鄉的篩檢量能跟資源是不足的從三道這個發展遲緩早期發現的這三道關卡就可以看得到\n308662\t331799\t發展監測比較沒問題家長能不能去看到去記錄的時候了解他孩子發展狀況那第二個關卡呢事實上是在發展篩檢那110去年7月你有這樣子的一個所謂補助6歲以下的幼兒篩檢的這可是88處的偏遠地區是17處是沒有涵蓋發展那個篩檢的院所\n332359\t350678\t全國整個篩檢率只有46.2%那偏鄉大概只有40.2%而已就全國46那偏鄉只有4040%左右那如果我們再進入到第三階段的話就是發展評估你全國六區有88家的聯平中心\n351338\t372164\t那可是64處應該提供外展服務那可是有6處事實上是沒有提供而且我前面在講的那個發展篩檢那17區裡邊的10區的確你們事實上是按照你們全民健康保險3D離島地區的醫療給付的效益提升計畫\n373404\t390771\t來可支援我們的篩檢服務剩下的七區啊你就說要透過地方政府衛生局來協調整合所以常常家長去的意願很低為什麼既然是偏鄉他到衛生局事實上還是有一定的困難困難程度所以我就在講應該\n392512\t404541\t不僅是患寡而且患不均所以不知道說部長對於你是不是知道就是幼兒專責醫師的制度是不是有清楚的部件情形你有沒有掌握進度啊\n407235\t429726\t因為其實我在當醫師公會理事長的時候就要全國各地盡量的配合即使像當時台北市因為我專責醫師的比例真的是蠻低的所以我也請台北市醫師公會邀請所有的醫療院所能夠多多參與所以比例也提起來所以我對這個的重視以及希望它會會功能\n430686\t442951\t所以現在已經可以cover到99點那為什麼一次我今天談的好像數據都跟你們不太到可是這也是從你們部內去要到的數據齁你們提供給我的是說幼兒專責醫師的涵蓋率齁59.4%所以未達六成這是你們提供給我的數據齁人口啦人口那部件的地區大概\n454927\t471966\t而且當初幼兒專責醫師主要是要提升偏遠地區跟或醫療資源比較匱乏的兒童的照護品質跟就醫的可及性他的目的在這邊目前如果沒有達到六成的話我不知道偏鄉的需求有被滿足嗎\n473207\t496060\t甚至這樣子的一個發展篩檢服務怎麼會增加誘因呢因為它沒有列入品質成效的分數計算不會對於專者醫師事實上有些誘因更何況我們比較擔心的是針對發展篩檢的這樣子的一個教育訓練它不是你的專者醫師的必修學分所以這也讓我覺得蠻疑惑的我不知道\n499121\t516011\t為什麼會是這樣他又不是必須要可是你又期待他做這個工作那我不知道說你們幼兒專責醫師到底有這樣子的一個發展篩檢教育訓練有有全部這個甚至你都已經沒達到六成那這五成\n516573\t530527\t多59.4%的人都有受過這樣的教育訓練嗎這就會讓我們有點擔憂 狀況二就是找到程序 我們剛剛講前面就有一些機制事實上失靈家長似乎只能乾著急 為什麼這樣講 因為\n533169\t560658\t去年的那個推動的六次補助就是發展篩檢那中央的標準化量表地方真的有在用嗎為什麼這樣問光台北市跟你中央的就不一樣托嬰中心的跟幼兒園的也不太一樣所以不同的老師不同的表格不同單位執行那如果托嬰中心跟幼兒園的就已經不一樣到底這樣篩出來集中在你們就是說\n561118\t575542\t你這個所有的通報來源齁大概托營中心跟幼兒園就在112年就佔了四分之一喔如果沒有這樣互相串聯我不知道這些有沒有重複就是說這數據有沒有重複甚至有沒有重複通報甚至有沒有是無效的通報甚至我們去問到\n581533\t599554\t國教署這邊還講說衛生局會主動來篩基本上現在都是老師或請家長填那我不知道衛生局到底有沒有做所以有這麼多不同的來源你到底怎麼去針對這個發災有沒有無效的甚至有重複通報的部長你怎麼看這個問題\n600915\t619569\t謝謝委員的指教 剛剛你提的所有的問題我們都會再度去檢討如果沒有做好的 那我們一定要把它再恰恰希望你們這邊是不是跟教育部跟衛福部啊因為託營中心就是你們衛福部的 可是幼兒園事實上是教育部的是不是可以去統整一下\n620129\t628812\t而且各地方又不太一樣那中央又跟地方不太一樣的話那這樣填到表單我覺得似乎能夠有一個依據那個委員可不可以容許我請吳署長先檢要報告一下抱歉因為我想等一下主席搞不好又要站起來所以我待會再去提吳署長要不要\n640475\t665479\t你今天不一樣嗎?剛提到的那個通報的確是從幼兒園也好,從家長也好,從醫療機構那是早期的那時候是沒有兒童成長評估,沒有用醫療這一端來做處理我們去年的需要才開始從醫療端來做通報就是幫忙做篩檢screen這件事情那這個是專列版的,那我目前正在發展\n666139\t685159\t發展你剛所謂的教保育的人員的篩檢或者家長的置評的頒表目前還在發展那過去都是用台北2那個表門表所以過去是沒有我們沒有這個配體以前我們在去我個人去評鑑幼兒園評鑑拖延中心的時候每次看到表單就是不太一樣對過去是這樣我現在看你中央也不太一樣所以你講的是事實沒有錯\n685840\t714943\t但是我們現在已經在改進了所以可能要速度快點否則拿到東西搞不好事實上是來自不同來源就不太一樣接下來我們來看就是整個我覺得聯平流程每名孩子大概二到三次才能完成可是如果按照112年的通報人數是三萬多那你們自己官方宣稱說每一年代你們可以做的是四萬人次那就差了兩萬因為每一個孩子至少兩次才能完成聯平的流程那你現在通報就有三萬四千多\n715943\t734958\t你又號稱說你每一年可以做4萬那這樣子是不是還差2萬多市長你會不會回答112年的確是3萬4千多的年品的量那我們講的4萬多是這個是講的通報人數那114年的年品的總量是4萬3千多已經可以到達4萬3千多我們就已經擴大了年品的你知道家長願意帶著孩子來篩檢等待評估都應該\n744161\t772398\t要知道他很注重這個而且藻寮黃金時期是三歲以下自為關鍵我還要再提一個問題就是好不容易拿到聯評報告了總算可以進入到藻寮體系去備服務問題又來了健保給付大概就30分鐘對很多忙碌的家長好不容易預約到了結果帶到給醫生看了要去做療癒服務的時候可是孩子在不同的情境當中他需要冷靜\n772938\t791608\t那搞不好已經過了三分之一時間我剩下三分之二 只有二十分鐘最後就只好怎樣要嘛就批一份命 每次去另外一個就是要嘛就是自己付錢可是政府現在補助四千塊這個四千塊涵蓋交通費還要每次療癒的費用根本也是不夠所以難怪家長\n793677\t807513\t不斷的訴求我們辦公室就很多找療單位來拜會我們是說希望是不是找療夫真的能夠真實回應他的需求所以我覺得這部長在費用跟時間上可不可能考慮增加\n808033\t830596\t能不能評估看看所以接下來這四點麻煩你們能夠做到否則我就要找各部會一起來好討論盡速提升偏遠地區跟社區型的發塞跟鄰屏的量能落實分級的醫療機制那盡速提升你的幼兒專責醫師的制度的涵蓋率還有把發塞教育訓練要納入為必修學分\n831416\t858455\t他全面檢視早療服務的程序跟國校組跟地方政府建立聯繫管道不是各吹各的調盤點我們的篩檢實施情況不要資源重複或者是無效利用還有加速我們的擴大聯合評估的量能而且不要沒有考慮到均衡要檢討我們早療服務的補助項目跟費用能夠滿足到我們家長和幼兒的需求\n859147\t866513\t好 以上兩週內請你們給我順便回覆我們不斷全力以赴 兩週內可以給委員會好 謝謝部長 謝謝好 謝謝林委員 你用心喔\n","txt":"謝謝主席,有請邱部長\n委員好部長早那藻寮議題一直是我很關心的因為藻寮做得好的話對幼兒未來的順利健全成長自為關鍵所以行政院也重視這一塊推動各項計畫持續加強我們國內藻寮服務的可敬性像譬如說優化兒童醫療照顧計畫還有是去年推出的六歲以下\n補助六次的兒童篩檢服務這是都是很好的政策可是在執行端我還是要提出一些問題想問部長目前六歲以下接受藻寮服務的幼兒數量大概有多少目前接受藻寮的服務的那個量是大概有多少\n公委報告目前在我們藻寮經過個管的案件有7萬多人為什麼我要這樣問因為實在太多小孩光是在排隊等待評估需要花一年半載這個也連帶影響到特殊教育端的服務跟資源供給\n而且我還有看到的是隱藏起來的事實上沒有被發學的曼菲爾從數據上來看恐怕比目前你們現在服務的量需要還要更多所以剛剛我覺得周\n周代理署長講的好像似乎跟我的數據有點落差為什麼實際接受找聊目前我們去看到給出來的數據是這樣就是說這是你們部內的自己的統計資料目前接受的人事實上是兩萬三千多人跟剛才\n周副署長講的是說有7萬多好像有很大的落差這在國內6歲以下的115萬的幼兒不到2%的比例因為只有1.99%那國內研究就顯示6歲以下的兒童發展的遲緩的盛行率是2.0到5.7%\n如果用這樣子推估的話大概是23125人或甚至如果是到5.7%的話是65905人所以我們看起來實際接受著療的幼兒跟我們看到研究他在推估的盛行率連最低的都有很多的落差所以表示有很多隱藏的需求而且不僅是低而且是低的離譜如果按照推估需求的話我們連低標都打不到\n所以我想問部長,問題在哪裡?你認為問題在哪裡?為何這些幼兒有這些需求的時候是沒被看見的?好,謝謝委員長期對藻條這件事幼兒的關心我想這個部分,以我一個從事40年醫療的老醫師\n我們真的非常重視,而且我覺得過去的確說一句實話,一個家長當小孩想要做早療的一個評估\n真的要掛個號真的很幸福這是過去幾十年來我們一直覺得說實在我在醫院裡面覺得這一塊是的確需要努力那我們也了解到這幾年來當中可以說是不管從篩檢\n以及藻寮以後的一個怎麼治療還有社區的不管是醫院跟社區的部件因為譬如說在台大醫院好了他看了以後他總不可能一直在台大追蹤他還是會到社區的藻寮中心去推動這樣的一個部件\n其實是一直非常努力而且我覺得 我也去參觀過幾個藻寮的社區的中心都非常的用心 他們家長也很認真現在就是說 阿塞典的話\n有需求可是你們現在真的在服務的量次上就已經不夠因為委員提出這個量我也surprise所以我為什麼剛剛你一問的時候我不敢跟你確定的答案因為這個數字要對一下因為如果說真的這麼低那真的是如果是說兩個啦一個是說我們應該篩檢的我們一定要把它篩出來所以我們佈置了一千零多家的一個醫療院所\n部長我們先來看像偏鄉篩檢今天主要還是要聚焦偏鄉偏鄉的篩檢量能跟資源是不足的從三道這個發展遲緩早期發現的這三道關卡就可以看得到\n發展監測比較沒問題家長能不能去看到去記錄的時候了解他孩子發展狀況那第二個關卡呢事實上是在發展篩檢那110去年7月你有這樣子的一個所謂補助6歲以下的幼兒篩檢的這可是88處的偏遠地區是17處是沒有涵蓋發展那個篩檢的院所\n全國整個篩檢率只有46.2%那偏鄉大概只有40.2%而已就全國46那偏鄉只有4040%左右那如果我們再進入到第三階段的話就是發展評估你全國六區有88家的聯平中心\n那可是64處應該提供外展服務那可是有6處事實上是沒有提供而且我前面在講的那個發展篩檢那17區裡邊的10區的確你們事實上是按照你們全民健康保險3D離島地區的醫療給付的效益提升計畫\n來可支援我們的篩檢服務剩下的七區啊你就說要透過地方政府衛生局來協調整合所以常常家長去的意願很低為什麼既然是偏鄉他到衛生局事實上還是有一定的困難困難程度所以我就在講應該\n不僅是患寡而且患不均所以不知道說部長對於你是不是知道就是幼兒專責醫師的制度是不是有清楚的部件情形你有沒有掌握進度啊\n因為其實我在當醫師公會理事長的時候就要全國各地盡量的配合即使像當時台北市因為我專責醫師的比例真的是蠻低的所以我也請台北市醫師公會邀請所有的醫療院所能夠多多參與所以比例也提起來所以我對這個的重視以及希望它會會功能\n所以現在已經可以cover到99點那為什麼一次我今天談的好像數據都跟你們不太到可是這也是從你們部內去要到的數據齁你們提供給我的是說幼兒專責醫師的涵蓋率齁59.4%所以未達六成這是你們提供給我的數據齁人口啦人口那部件的地區大概\n而且當初幼兒專責醫師主要是要提升偏遠地區跟或醫療資源比較匱乏的兒童的照護品質跟就醫的可及性他的目的在這邊目前如果沒有達到六成的話我不知道偏鄉的需求有被滿足嗎\n甚至這樣子的一個發展篩檢服務怎麼會增加誘因呢因為它沒有列入品質成效的分數計算不會對於專者醫師事實上有些誘因更何況我們比較擔心的是針對發展篩檢的這樣子的一個教育訓練它不是你的專者醫師的必修學分所以這也讓我覺得蠻疑惑的我不知道\n為什麼會是這樣他又不是必須要可是你又期待他做這個工作那我不知道說你們幼兒專責醫師到底有這樣子的一個發展篩檢教育訓練有有全部這個甚至你都已經沒達到六成那這五成\n多59.4%的人都有受過這樣的教育訓練嗎這就會讓我們有點擔憂 狀況二就是找到程序 我們剛剛講前面就有一些機制事實上失靈家長似乎只能乾著急 為什麼這樣講 因為\n去年的那個推動的六次補助就是發展篩檢那中央的標準化量表地方真的有在用嗎為什麼這樣問光台北市跟你中央的就不一樣托嬰中心的跟幼兒園的也不太一樣所以不同的老師不同的表格不同單位執行那如果托嬰中心跟幼兒園的就已經不一樣到底這樣篩出來集中在你們就是說\n你這個所有的通報來源齁大概托營中心跟幼兒園就在112年就佔了四分之一喔如果沒有這樣互相串聯我不知道這些有沒有重複就是說這數據有沒有重複甚至有沒有重複通報甚至有沒有是無效的通報甚至我們去問到\n國教署這邊還講說衛生局會主動來篩基本上現在都是老師或請家長填那我不知道衛生局到底有沒有做所以有這麼多不同的來源你到底怎麼去針對這個發災有沒有無效的甚至有重複通報的部長你怎麼看這個問題\n謝謝委員的指教 剛剛你提的所有的問題我們都會再度去檢討如果沒有做好的 那我們一定要把它再恰恰希望你們這邊是不是跟教育部跟衛福部啊因為託營中心就是你們衛福部的 可是幼兒園事實上是教育部的是不是可以去統整一下\n而且各地方又不太一樣那中央又跟地方不太一樣的話那這樣填到表單我覺得似乎能夠有一個依據那個委員可不可以容許我請吳署長先檢要報告一下抱歉因為我想等一下主席搞不好又要站起來所以我待會再去提吳署長要不要\n你今天不一樣嗎?剛提到的那個通報的確是從幼兒園也好,從家長也好,從醫療機構那是早期的那時候是沒有兒童成長評估,沒有用醫療這一端來做處理我們去年的需要才開始從醫療端來做通報就是幫忙做篩檢screen這件事情那這個是專列版的,那我目前正在發展\n發展你剛所謂的教保育的人員的篩檢或者家長的置評的頒表目前還在發展那過去都是用台北2那個表門表所以過去是沒有我們沒有這個配體以前我們在去我個人去評鑑幼兒園評鑑拖延中心的時候每次看到表單就是不太一樣對過去是這樣我現在看你中央也不太一樣所以你講的是事實沒有錯\n但是我們現在已經在改進了所以可能要速度快點否則拿到東西搞不好事實上是來自不同來源就不太一樣接下來我們來看就是整個我覺得聯平流程每名孩子大概二到三次才能完成可是如果按照112年的通報人數是三萬多那你們自己官方宣稱說每一年代你們可以做的是四萬人次那就差了兩萬因為每一個孩子至少兩次才能完成聯平的流程那你現在通報就有三萬四千多\n你又號稱說你每一年可以做4萬那這樣子是不是還差2萬多市長你會不會回答112年的確是3萬4千多的年品的量那我們講的4萬多是這個是講的通報人數那114年的年品的總量是4萬3千多已經可以到達4萬3千多我們就已經擴大了年品的你知道家長願意帶著孩子來篩檢等待評估都應該\n要知道他很注重這個而且藻寮黃金時期是三歲以下自為關鍵我還要再提一個問題就是好不容易拿到聯評報告了總算可以進入到藻寮體系去備服務問題又來了健保給付大概就30分鐘對很多忙碌的家長好不容易預約到了結果帶到給醫生看了要去做療癒服務的時候可是孩子在不同的情境當中他需要冷靜\n那搞不好已經過了三分之一時間我剩下三分之二 只有二十分鐘最後就只好怎樣要嘛就批一份命 每次去另外一個就是要嘛就是自己付錢可是政府現在補助四千塊這個四千塊涵蓋交通費還要每次療癒的費用根本也是不夠所以難怪家長\n不斷的訴求我們辦公室就很多找療單位來拜會我們是說希望是不是找療夫真的能夠真實回應他的需求所以我覺得這部長在費用跟時間上可不可能考慮增加\n能不能評估看看所以接下來這四點麻煩你們能夠做到否則我就要找各部會一起來好討論盡速提升偏遠地區跟社區型的發塞跟鄰屏的量能落實分級的醫療機制那盡速提升你的幼兒專責醫師的制度的涵蓋率還有把發塞教育訓練要納入為必修學分\n他全面檢視早療服務的程序跟國校組跟地方政府建立聯繫管道不是各吹各的調盤點我們的篩檢實施情況不要資源重複或者是無效利用還有加速我們的擴大聯合評估的量能而且不要沒有考慮到均衡要檢討我們早療服務的補助項目跟費用能夠滿足到我們家長和幼兒的需求\n好 以上兩週內請你們給我順便回覆我們不斷全力以赴 兩週內可以給委員會好 謝謝部長 謝謝好 謝謝林委員 你用心喔\n","vtt":"WEBVTT\n\n00:10.526 --> 00:11.292\n謝謝主席,有請邱部長\n\n00:18.473 --> 00:44.856\n委員好部長早那藻寮議題一直是我很關心的因為藻寮做得好的話對幼兒未來的順利健全成長自為關鍵所以行政院也重視這一塊推動各項計畫持續加強我們國內藻寮服務的可敬性像譬如說優化兒童醫療照顧計畫還有是去年推出的六歲以下\n\n00:46.217 --> 01:14.118\n補助六次的兒童篩檢服務這是都是很好的政策可是在執行端我還是要提出一些問題想問部長目前六歲以下接受藻寮服務的幼兒數量大概有多少目前接受藻寮的服務的那個量是大概有多少\n\n01:19.297 --> 01:37.308\n公委報告目前在我們藻寮經過個管的案件有7萬多人為什麼我要這樣問因為實在太多小孩光是在排隊等待評估需要花一年半載這個也連帶影響到特殊教育端的服務跟資源供給\n\n01:38.988 --> 01:51.580\n而且我還有看到的是隱藏起來的事實上沒有被發學的曼菲爾從數據上來看恐怕比目前你們現在服務的量需要還要更多所以剛剛我覺得周\n\n01:54.411 --> 02:10.925\n周代理署長講的好像似乎跟我的數據有點落差為什麼實際接受找聊目前我們去看到給出來的數據是這樣就是說這是你們部內的自己的統計資料目前接受的人事實上是兩萬三千多人跟剛才\n\n02:11.745 --> 02:19.208\n周副署長講的是說有7萬多好像有很大的落差這在國內6歲以下的115萬的幼兒不到2%的比例因為只有1.99%那國內研究就顯示6歲以下的兒童發展的遲緩的盛行率是2.0到5.7%\n\n02:30.493 --> 02:56.035\n如果用這樣子推估的話大概是23125人或甚至如果是到5.7%的話是65905人所以我們看起來實際接受著療的幼兒跟我們看到研究他在推估的盛行率連最低的都有很多的落差所以表示有很多隱藏的需求而且不僅是低而且是低的離譜如果按照推估需求的話我們連低標都打不到\n\n02:56.400 --> 03:13.681\n所以我想問部長,問題在哪裡?你認為問題在哪裡?為何這些幼兒有這些需求的時候是沒被看見的?好,謝謝委員長期對藻條這件事幼兒的關心我想這個部分,以我一個從事40年醫療的老醫師\n\n03:22.462 --> 03:31.327\n我們真的非常重視,而且我覺得過去的確說一句實話,一個家長當小孩想要做早療的一個評估\n\n03:32.708 --> 03:50.005\n真的要掛個號真的很幸福這是過去幾十年來我們一直覺得說實在我在醫院裡面覺得這一塊是的確需要努力那我們也了解到這幾年來當中可以說是不管從篩檢\n\n03:51.587 --> 04:05.786\n以及藻寮以後的一個怎麼治療還有社區的不管是醫院跟社區的部件因為譬如說在台大醫院好了他看了以後他總不可能一直在台大追蹤他還是會到社區的藻寮中心去推動這樣的一個部件\n\n04:07.067 --> 04:15.297\n其實是一直非常努力而且我覺得我也去參觀過幾個藻寮的社區的中心都非常的用心他們家長也很認真現在就是說阿塞典的話\n\n04:23.306 --> 04:39.172\n有需求可是你們現在真的在服務的量次上就已經不夠因為委員提出這個量我也surprise所以我為什麼剛剛你一問的時候我不敢跟你確定的答案因為這個數字要對一下因為如果說真的這麼低那真的是如果是說兩個啦一個是說我們應該篩檢的我們一定要把它篩出來所以我們佈置了一千零多家的一個醫療院所\n\n04:52.198 --> 05:07.860\n部長我們先來看像偏鄉篩檢今天主要還是要聚焦偏鄉偏鄉的篩檢量能跟資源是不足的從三道這個發展遲緩早期發現的這三道關卡就可以看得到\n\n05:08.662 --> 05:31.799\n發展監測比較沒問題家長能不能去看到去記錄的時候了解他孩子發展狀況那第二個關卡呢事實上是在發展篩檢那110去年7月你有這樣子的一個所謂補助6歲以下的幼兒篩檢的這可是88處的偏遠地區是17處是沒有涵蓋發展那個篩檢的院所\n\n05:32.359 --> 05:50.678\n全國整個篩檢率只有46.2%那偏鄉大概只有40.2%而已就全國46那偏鄉只有4040%左右那如果我們再進入到第三階段的話就是發展評估你全國六區有88家的聯平中心\n\n05:51.338 --> 06:12.164\n那可是64處應該提供外展服務那可是有6處事實上是沒有提供而且我前面在講的那個發展篩檢那17區裡邊的10區的確你們事實上是按照你們全民健康保險3D離島地區的醫療給付的效益提升計畫\n\n06:13.404 --> 06:30.771\n來可支援我們的篩檢服務剩下的七區啊你就說要透過地方政府衛生局來協調整合所以常常家長去的意願很低為什麼既然是偏鄉他到衛生局事實上還是有一定的困難困難程度所以我就在講應該\n\n06:32.512 --> 06:44.541\n不僅是患寡而且患不均所以不知道說部長對於你是不是知道就是幼兒專責醫師的制度是不是有清楚的部件情形你有沒有掌握進度啊\n\n06:47.235 --> 07:09.726\n因為其實我在當醫師公會理事長的時候就要全國各地盡量的配合即使像當時台北市因為我專責醫師的比例真的是蠻低的所以我也請台北市醫師公會邀請所有的醫療院所能夠多多參與所以比例也提起來所以我對這個的重視以及希望它會會功能\n\n07:10.686 --> 07:22.951\n所以現在已經可以cover到99點那為什麼一次我今天談的好像數據都跟你們不太到可是這也是從你們部內去要到的數據齁你們提供給我的是說幼兒專責醫師的涵蓋率齁59.4%所以未達六成這是你們提供給我的數據齁人口啦人口那部件的地區大概\n\n07:34.927 --> 07:51.966\n而且當初幼兒專責醫師主要是要提升偏遠地區跟或醫療資源比較匱乏的兒童的照護品質跟就醫的可及性他的目的在這邊目前如果沒有達到六成的話我不知道偏鄉的需求有被滿足嗎\n\n07:53.207 --> 08:16.060\n甚至這樣子的一個發展篩檢服務怎麼會增加誘因呢因為它沒有列入品質成效的分數計算不會對於專者醫師事實上有些誘因更何況我們比較擔心的是針對發展篩檢的這樣子的一個教育訓練它不是你的專者醫師的必修學分所以這也讓我覺得蠻疑惑的我不知道\n\n08:19.121 --> 08:36.011\n為什麼會是這樣他又不是必須要可是你又期待他做這個工作那我不知道說你們幼兒專責醫師到底有這樣子的一個發展篩檢教育訓練有有全部這個甚至你都已經沒達到六成那這五成\n\n08:36.573 --> 08:50.527\n多59.4%的人都有受過這樣的教育訓練嗎這就會讓我們有點擔憂狀況二就是找到程序我們剛剛講前面就有一些機制事實上失靈家長似乎只能乾著急為什麼這樣講因為\n\n08:53.169 --> 09:20.658\n去年的那個推動的六次補助就是發展篩檢那中央的標準化量表地方真的有在用嗎為什麼這樣問光台北市跟你中央的就不一樣托嬰中心的跟幼兒園的也不太一樣所以不同的老師不同的表格不同單位執行那如果托嬰中心跟幼兒園的就已經不一樣到底這樣篩出來集中在你們就是說\n\n09:21.118 --> 09:35.542\n你這個所有的通報來源齁大概托營中心跟幼兒園就在112年就佔了四分之一喔如果沒有這樣互相串聯我不知道這些有沒有重複就是說這數據有沒有重複甚至有沒有重複通報甚至有沒有是無效的通報甚至我們去問到\n\n09:41.533 --> 09:59.554\n國教署這邊還講說衛生局會主動來篩基本上現在都是老師或請家長填那我不知道衛生局到底有沒有做所以有這麼多不同的來源你到底怎麼去針對這個發災有沒有無效的甚至有重複通報的部長你怎麼看這個問題\n\n10:00.915 --> 10:19.569\n謝謝委員的指教剛剛你提的所有的問題我們都會再度去檢討如果沒有做好的那我們一定要把它再恰恰希望你們這邊是不是跟教育部跟衛福部啊因為託營中心就是你們衛福部的可是幼兒園事實上是教育部的是不是可以去統整一下\n\n10:20.129 --> 10:28.812\n而且各地方又不太一樣那中央又跟地方不太一樣的話那這樣填到表單我覺得似乎能夠有一個依據那個委員可不可以容許我請吳署長先檢要報告一下抱歉因為我想等一下主席搞不好又要站起來所以我待會再去提吳署長要不要\n\n10:40.475 --> 11:05.479\n你今天不一樣嗎?剛提到的那個通報的確是從幼兒園也好,從家長也好,從醫療機構那是早期的那時候是沒有兒童成長評估,沒有用醫療這一端來做處理我們去年的需要才開始從醫療端來做通報就是幫忙做篩檢screen這件事情那這個是專列版的,那我目前正在發展\n\n11:06.139 --> 11:25.159\n發展你剛所謂的教保育的人員的篩檢或者家長的置評的頒表目前還在發展那過去都是用台北2那個表門表所以過去是沒有我們沒有這個配體以前我們在去我個人去評鑑幼兒園評鑑拖延中心的時候每次看到表單就是不太一樣對過去是這樣我現在看你中央也不太一樣所以你講的是事實沒有錯\n\n11:25.840 --> 11:54.943\n但是我們現在已經在改進了所以可能要速度快點否則拿到東西搞不好事實上是來自不同來源就不太一樣接下來我們來看就是整個我覺得聯平流程每名孩子大概二到三次才能完成可是如果按照112年的通報人數是三萬多那你們自己官方宣稱說每一年代你們可以做的是四萬人次那就差了兩萬因為每一個孩子至少兩次才能完成聯平的流程那你現在通報就有三萬四千多\n\n11:55.943 --> 12:14.958\n你又號稱說你每一年可以做4萬那這樣子是不是還差2萬多市長你會不會回答112年的確是3萬4千多的年品的量那我們講的4萬多是這個是講的通報人數那114年的年品的總量是4萬3千多已經可以到達4萬3千多我們就已經擴大了年品的你知道家長願意帶著孩子來篩檢等待評估都應該\n\n12:24.161 --> 12:52.398\n要知道他很注重這個而且藻寮黃金時期是三歲以下自為關鍵我還要再提一個問題就是好不容易拿到聯評報告了總算可以進入到藻寮體系去備服務問題又來了健保給付大概就30分鐘對很多忙碌的家長好不容易預約到了結果帶到給醫生看了要去做療癒服務的時候可是孩子在不同的情境當中他需要冷靜\n\n12:52.938 --> 13:11.608\n那搞不好已經過了三分之一時間我剩下三分之二只有二十分鐘最後就只好怎樣要嘛就批一份命每次去另外一個就是要嘛就是自己付錢可是政府現在補助四千塊這個四千塊涵蓋交通費還要每次療癒的費用根本也是不夠所以難怪家長\n\n13:13.677 --> 13:27.513\n不斷的訴求我們辦公室就很多找療單位來拜會我們是說希望是不是找療夫真的能夠真實回應他的需求所以我覺得這部長在費用跟時間上可不可能考慮增加\n\n13:28.033 --> 13:50.596\n能不能評估看看所以接下來這四點麻煩你們能夠做到否則我就要找各部會一起來好討論盡速提升偏遠地區跟社區型的發塞跟鄰屏的量能落實分級的醫療機制那盡速提升你的幼兒專責醫師的制度的涵蓋率還有把發塞教育訓練要納入為必修學分\n\n13:51.416 --> 14:18.455\n他全面檢視早療服務的程序跟國校組跟地方政府建立聯繫管道不是各吹各的調盤點我們的篩檢實施情況不要資源重複或者是無效利用還有加速我們的擴大聯合評估的量能而且不要沒有考慮到均衡要檢討我們早療服務的補助項目跟費用能夠滿足到我們家長和幼兒的需求\n\n14:19.147 --> 14:26.513\n好以上兩週內請你們給我順便回覆我們不斷全力以赴兩週內可以給委員會好謝謝部長謝謝好謝謝林委員你用心喔\n\n","segments":[{"start":10.526,"end":11.292,"text":"謝謝主席,有請邱部長"},{"start":18.473,"end":44.856,"text":"委員好部長早那藻寮議題一直是我很關心的因為藻寮做得好的話對幼兒未來的順利健全成長自為關鍵所以行政院也重視這一塊推動各項計畫持續加強我們國內藻寮服務的可敬性像譬如說優化兒童醫療照顧計畫還有是去年推出的六歲以下"},{"start":46.217,"end":74.118,"text":"補助六次的兒童篩檢服務這是都是很好的政策可是在執行端我還是要提出一些問題想問部長目前六歲以下接受藻寮服務的幼兒數量大概有多少目前接受藻寮的服務的那個量是大概有多少"},{"start":79.297,"end":97.308,"text":"公委報告目前在我們藻寮經過個管的案件有7萬多人為什麼我要這樣問因為實在太多小孩光是在排隊等待評估需要花一年半載這個也連帶影響到特殊教育端的服務跟資源供給"},{"start":98.988,"end":111.58,"text":"而且我還有看到的是隱藏起來的事實上沒有被發學的曼菲爾從數據上來看恐怕比目前你們現在服務的量需要還要更多所以剛剛我覺得周"},{"start":114.411,"end":130.925,"text":"周代理署長講的好像似乎跟我的數據有點落差為什麼實際接受找聊目前我們去看到給出來的數據是這樣就是說這是你們部內的自己的統計資料目前接受的人事實上是兩萬三千多人跟剛才"},{"start":131.745,"end":139.208,"text":"周副署長講的是說有7萬多好像有很大的落差這在國內6歲以下的115萬的幼兒不到2%的比例因為只有1.99%那國內研究就顯示6歲以下的兒童發展的遲緩的盛行率是2.0到5.7%"},{"start":150.493,"end":176.035,"text":"如果用這樣子推估的話大概是23125人或甚至如果是到5.7%的話是65905人所以我們看起來實際接受著療的幼兒跟我們看到研究他在推估的盛行率連最低的都有很多的落差所以表示有很多隱藏的需求而且不僅是低而且是低的離譜如果按照推估需求的話我們連低標都打不到"},{"start":176.4,"end":193.681,"text":"所以我想問部長,問題在哪裡?你認為問題在哪裡?為何這些幼兒有這些需求的時候是沒被看見的?好,謝謝委員長期對藻條這件事幼兒的關心我想這個部分,以我一個從事40年醫療的老醫師"},{"start":202.462,"end":211.327,"text":"我們真的非常重視,而且我覺得過去的確說一句實話,一個家長當小孩想要做早療的一個評估"},{"start":212.708,"end":230.005,"text":"真的要掛個號真的很幸福這是過去幾十年來我們一直覺得說實在我在醫院裡面覺得這一塊是的確需要努力那我們也了解到這幾年來當中可以說是不管從篩檢"},{"start":231.587,"end":245.786,"text":"以及藻寮以後的一個怎麼治療還有社區的不管是醫院跟社區的部件因為譬如說在台大醫院好了他看了以後他總不可能一直在台大追蹤他還是會到社區的藻寮中心去推動這樣的一個部件"},{"start":247.067,"end":255.297,"text":"其實是一直非常努力而且我覺得 我也去參觀過幾個藻寮的社區的中心都非常的用心 他們家長也很認真現在就是說 阿塞典的話"},{"start":263.306,"end":279.172,"text":"有需求可是你們現在真的在服務的量次上就已經不夠因為委員提出這個量我也surprise所以我為什麼剛剛你一問的時候我不敢跟你確定的答案因為這個數字要對一下因為如果說真的這麼低那真的是如果是說兩個啦一個是說我們應該篩檢的我們一定要把它篩出來所以我們佈置了一千零多家的一個醫療院所"},{"start":292.198,"end":307.86,"text":"部長我們先來看像偏鄉篩檢今天主要還是要聚焦偏鄉偏鄉的篩檢量能跟資源是不足的從三道這個發展遲緩早期發現的這三道關卡就可以看得到"},{"start":308.662,"end":331.799,"text":"發展監測比較沒問題家長能不能去看到去記錄的時候了解他孩子發展狀況那第二個關卡呢事實上是在發展篩檢那110去年7月你有這樣子的一個所謂補助6歲以下的幼兒篩檢的這可是88處的偏遠地區是17處是沒有涵蓋發展那個篩檢的院所"},{"start":332.359,"end":350.678,"text":"全國整個篩檢率只有46.2%那偏鄉大概只有40.2%而已就全國46那偏鄉只有4040%左右那如果我們再進入到第三階段的話就是發展評估你全國六區有88家的聯平中心"},{"start":351.338,"end":372.164,"text":"那可是64處應該提供外展服務那可是有6處事實上是沒有提供而且我前面在講的那個發展篩檢那17區裡邊的10區的確你們事實上是按照你們全民健康保險3D離島地區的醫療給付的效益提升計畫"},{"start":373.404,"end":390.771,"text":"來可支援我們的篩檢服務剩下的七區啊你就說要透過地方政府衛生局來協調整合所以常常家長去的意願很低為什麼既然是偏鄉他到衛生局事實上還是有一定的困難困難程度所以我就在講應該"},{"start":392.512,"end":404.541,"text":"不僅是患寡而且患不均所以不知道說部長對於你是不是知道就是幼兒專責醫師的制度是不是有清楚的部件情形你有沒有掌握進度啊"},{"start":407.235,"end":429.726,"text":"因為其實我在當醫師公會理事長的時候就要全國各地盡量的配合即使像當時台北市因為我專責醫師的比例真的是蠻低的所以我也請台北市醫師公會邀請所有的醫療院所能夠多多參與所以比例也提起來所以我對這個的重視以及希望它會會功能"},{"start":430.686,"end":442.951,"text":"所以現在已經可以cover到99點那為什麼一次我今天談的好像數據都跟你們不太到可是這也是從你們部內去要到的數據齁你們提供給我的是說幼兒專責醫師的涵蓋率齁59.4%所以未達六成這是你們提供給我的數據齁人口啦人口那部件的地區大概"},{"start":454.927,"end":471.966,"text":"而且當初幼兒專責醫師主要是要提升偏遠地區跟或醫療資源比較匱乏的兒童的照護品質跟就醫的可及性他的目的在這邊目前如果沒有達到六成的話我不知道偏鄉的需求有被滿足嗎"},{"start":473.207,"end":496.06,"text":"甚至這樣子的一個發展篩檢服務怎麼會增加誘因呢因為它沒有列入品質成效的分數計算不會對於專者醫師事實上有些誘因更何況我們比較擔心的是針對發展篩檢的這樣子的一個教育訓練它不是你的專者醫師的必修學分所以這也讓我覺得蠻疑惑的我不知道"},{"start":499.121,"end":516.011,"text":"為什麼會是這樣他又不是必須要可是你又期待他做這個工作那我不知道說你們幼兒專責醫師到底有這樣子的一個發展篩檢教育訓練有有全部這個甚至你都已經沒達到六成那這五成"},{"start":516.573,"end":530.527,"text":"多59.4%的人都有受過這樣的教育訓練嗎這就會讓我們有點擔憂 狀況二就是找到程序 我們剛剛講前面就有一些機制事實上失靈家長似乎只能乾著急 為什麼這樣講 因為"},{"start":533.169,"end":560.658,"text":"去年的那個推動的六次補助就是發展篩檢那中央的標準化量表地方真的有在用嗎為什麼這樣問光台北市跟你中央的就不一樣托嬰中心的跟幼兒園的也不太一樣所以不同的老師不同的表格不同單位執行那如果托嬰中心跟幼兒園的就已經不一樣到底這樣篩出來集中在你們就是說"},{"start":561.118,"end":575.542,"text":"你這個所有的通報來源齁大概托營中心跟幼兒園就在112年就佔了四分之一喔如果沒有這樣互相串聯我不知道這些有沒有重複就是說這數據有沒有重複甚至有沒有重複通報甚至有沒有是無效的通報甚至我們去問到"},{"start":581.533,"end":599.554,"text":"國教署這邊還講說衛生局會主動來篩基本上現在都是老師或請家長填那我不知道衛生局到底有沒有做所以有這麼多不同的來源你到底怎麼去針對這個發災有沒有無效的甚至有重複通報的部長你怎麼看這個問題"},{"start":600.915,"end":619.569,"text":"謝謝委員的指教 剛剛你提的所有的問題我們都會再度去檢討如果沒有做好的 那我們一定要把它再恰恰希望你們這邊是不是跟教育部跟衛福部啊因為託營中心就是你們衛福部的 可是幼兒園事實上是教育部的是不是可以去統整一下"},{"start":620.129,"end":628.812,"text":"而且各地方又不太一樣那中央又跟地方不太一樣的話那這樣填到表單我覺得似乎能夠有一個依據那個委員可不可以容許我請吳署長先檢要報告一下抱歉因為我想等一下主席搞不好又要站起來所以我待會再去提吳署長要不要"},{"start":640.475,"end":665.479,"text":"你今天不一樣嗎?剛提到的那個通報的確是從幼兒園也好,從家長也好,從醫療機構那是早期的那時候是沒有兒童成長評估,沒有用醫療這一端來做處理我們去年的需要才開始從醫療端來做通報就是幫忙做篩檢screen這件事情那這個是專列版的,那我目前正在發展"},{"start":666.139,"end":685.159,"text":"發展你剛所謂的教保育的人員的篩檢或者家長的置評的頒表目前還在發展那過去都是用台北2那個表門表所以過去是沒有我們沒有這個配體以前我們在去我個人去評鑑幼兒園評鑑拖延中心的時候每次看到表單就是不太一樣對過去是這樣我現在看你中央也不太一樣所以你講的是事實沒有錯"},{"start":685.84,"end":714.943,"text":"但是我們現在已經在改進了所以可能要速度快點否則拿到東西搞不好事實上是來自不同來源就不太一樣接下來我們來看就是整個我覺得聯平流程每名孩子大概二到三次才能完成可是如果按照112年的通報人數是三萬多那你們自己官方宣稱說每一年代你們可以做的是四萬人次那就差了兩萬因為每一個孩子至少兩次才能完成聯平的流程那你現在通報就有三萬四千多"},{"start":715.943,"end":734.958,"text":"你又號稱說你每一年可以做4萬那這樣子是不是還差2萬多市長你會不會回答112年的確是3萬4千多的年品的量那我們講的4萬多是這個是講的通報人數那114年的年品的總量是4萬3千多已經可以到達4萬3千多我們就已經擴大了年品的你知道家長願意帶著孩子來篩檢等待評估都應該"},{"start":744.161,"end":772.398,"text":"要知道他很注重這個而且藻寮黃金時期是三歲以下自為關鍵我還要再提一個問題就是好不容易拿到聯評報告了總算可以進入到藻寮體系去備服務問題又來了健保給付大概就30分鐘對很多忙碌的家長好不容易預約到了結果帶到給醫生看了要去做療癒服務的時候可是孩子在不同的情境當中他需要冷靜"},{"start":772.938,"end":791.608,"text":"那搞不好已經過了三分之一時間我剩下三分之二 只有二十分鐘最後就只好怎樣要嘛就批一份命 每次去另外一個就是要嘛就是自己付錢可是政府現在補助四千塊這個四千塊涵蓋交通費還要每次療癒的費用根本也是不夠所以難怪家長"},{"start":793.677,"end":807.513,"text":"不斷的訴求我們辦公室就很多找療單位來拜會我們是說希望是不是找療夫真的能夠真實回應他的需求所以我覺得這部長在費用跟時間上可不可能考慮增加"},{"start":808.033,"end":830.596,"text":"能不能評估看看所以接下來這四點麻煩你們能夠做到否則我就要找各部會一起來好討論盡速提升偏遠地區跟社區型的發塞跟鄰屏的量能落實分級的醫療機制那盡速提升你的幼兒專責醫師的制度的涵蓋率還有把發塞教育訓練要納入為必修學分"},{"start":831.416,"end":858.455,"text":"他全面檢視早療服務的程序跟國校組跟地方政府建立聯繫管道不是各吹各的調盤點我們的篩檢實施情況不要資源重複或者是無效利用還有加速我們的擴大聯合評估的量能而且不要沒有考慮到均衡要檢討我們早療服務的補助項目跟費用能夠滿足到我們家長和幼兒的需求"},{"start":859.147,"end":866.513,"text":"好 以上兩週內請你們給我順便回覆我們不斷全力以赴 兩週內可以給委員會好 謝謝部長 謝謝好 謝謝林委員 你用心喔"}]}}},"gazette":{"lineno":275,"blocks":[["林委員月琴：（9時30分）謝謝主席，有請邱部長。"],["主席：部長請。"],["邱部長泰源：委員好。"],["林委員月琴：部長早。早療議題，一直是我很關心的，因為早療做得好，對幼兒未來順利健全的成長，至為關鍵，所以行政院也很重視這一塊，推動各項計畫，持續加強國內早療服務的可近性，比如像優化兒童醫療照護計畫，還有去年推出，補助6歲以下兒童6次的篩檢服務，這些都是很好的政策，可是在執行端，我還是要提出一些問題。想問部長，目前6歲以下接受早療服務的幼兒，數量大概有多少？"],["邱部長泰源：你說目前……"],["林委員月琴：目前接受早療服務的量，大概有多少？"],["周代理署長道君：跟委員報告，目前早療經過個管的案件有七萬多人。"],["林委員月琴：為什麼我要這樣問？因為實在太多小孩光是排隊等待評估就需要花一年半載，這也連帶影響到特殊教育端的服務跟資源供給面，而且我還看到被隱藏起來，事實上沒有被發覺的慢飛兒，從數據上來看，恐怕要比你們現在服務的量，還需要更多。我覺得周代理署長剛剛講的，似乎跟我的數據有點落差，我們看到實際接受早療的數據是這樣，這是你們部內自己的統計資料，目前接受的人事實上是兩萬三千多人，跟剛才周代理署長講的有七萬多，好像有很大落差，這占國內6歲以下115萬的幼兒不到2%的比例，只有1.99%，國內研究顯示，6歲以下兒童發展遲緩的盛行率是2.0到5.7%，如果用這樣子推估，大概是2萬3,125人，甚至到5.7%，是6萬5,905人，看起來實際接受早療的幼兒，跟研究推估的盛行率相比，連最低的數據都有很大的落差，表示有很多隱藏的需求，而且不僅是低，是低得離譜，如果按照推估需求，我們連低標都達不到，我想問部長，問題在哪裡？你認為問題在哪裡？為何這些有需求的幼兒沒被看見的？"],["邱部長泰源：謝謝委員長期對早療幼兒的關心，我想以我從事醫療40年的老醫師，召委不好意思，我如果算老，你也算老，我們真的非常重視，而且我說一句實話，過去家長帶小孩想要做早療的評估，真的要掛個號就很辛苦，這是過去幾十年來，我們在醫院就一直覺得這一塊的確需要努力。我們也了解這幾年來，篩檢以及早療以後的治療，還有不管是醫院跟社區的布建，因為譬如說在臺大醫院看診以後，總不能一直在臺大追蹤，後續還是要回到社區的早療中心去推動，這樣的布建，其實我們是一直非常努力，而且我也去參觀過幾個早療的社區中心，都非常的用心，家長也很令人感動，現在篩檢……"],["林委員月琴：那是比較後續，我是覺得前端有需求，可是你們現在真的在服務的量，事實上就已經不夠。"],["邱部長泰源：對，委員提出這個量我也surprise，所以為什麼剛剛你一問，我不敢跟你確定答案，因為這個數字要對一下……"],["林委員月琴：對，這也是你們部內提供的數據，跟剛才周代理署長提供的數據，事實上不太一致。"],["邱部長泰源：因為如果數字真的那麼低，分兩個，一個是我們應該篩檢的一定要把它篩出來，所以我們布建一千零多家的醫療院所，開始來做……"],["林委員月琴：部長，今天主要還是要聚焦偏鄉，偏鄉的篩檢量能跟資源是不足的，從發展遲緩早期發現的三道關卡就可以看得到，發展監測比較沒問題，家長利用紀錄了解他孩子發展狀況；第二個關卡，事實上是在發展篩檢，113（去年）7月，你們有所謂補助6歲以下的幼兒篩檢，可是88處的偏遠地區，有17處是沒有涵蓋發展篩檢的院所，全國篩檢率只有46.2%，偏鄉大概只有40.2%而已。如果再進入到第三階段的發展評估，全國6區有88家的聯評中心，64處應該提供外展服務，可是有6處事實上是沒有提供，而且我前面講的發展篩檢，17區裡面的10區，的確是按照全民健康保險山地離島地區醫療給付效益提昇計畫來支援的篩檢服務，剩下的7區，你說要透過地方政府衛生局來協調整合，所以常常家長去的意願很低，為什麼？既然是偏鄉，他到衛生局還是有一定的困難，所以我認為不僅是患寡，而且患不均，我不知道，部長知不知道幼兒專責醫師的制度，是不是有清楚的布建情形？你有沒有掌握進度？"],["邱部長泰源：因為其實我在當醫師公會理事長的時候，就要全國各地儘量配合，像當時臺北市幼兒專責醫師的比例真的是蠻低的，我也請台北市醫師公會邀集所有的醫療院所能夠多多參與，所以比例也有提起來，我對這部分很重視，以及希望它發揮功能，所以現在已經可以cover差不多百分之九十九點多……"],["林委員月琴：為什麼我今天談的數據好像跟你們不太一樣，可是這是從你們部內要到的數據，你們提供給我的數據，幼兒專責醫師的涵蓋率59.4%，未達六成，這是你提供給我的數據，所以……"],["邱部長泰源：那是人口啦，布建的地區大概……"],["林委員月琴：而且當初幼兒專責醫師主要是要提升偏遠地區或醫療資源比較匱乏地區兒童照護品質跟就醫的可及性，他的目的在這邊，可是如果目前沒有達到六成，我不知道偏鄉的需求有被滿足嗎？甚至這樣一個發展篩檢服務，怎麼會增加誘因？因為它沒有列入品質成效的分數計算，不會對於幼兒專責醫師有誘因，更何況，我們比較擔心，針對發展篩檢教育訓練不是專責醫師的必修學分，所以這也讓我覺得蠻疑惑，我不知道為什麼會這樣，他不是必須項目，可是你又期待他做這個工作，你們幼兒專責醫師發展篩檢的教育訓練，沒達到六成，只有五成多，59.4%的人都有受過這樣教育訓練嗎？這就會讓人有點擔憂。","狀況二，早療程序我們剛剛講了，前面就有一些機制失靈，家長似乎只能乾著急，為什麼這樣講？因為去年推動發展篩檢的6次補助，中央的標準化量表，地方真的有在用嗎？為什麼這樣問？光臺北市跟中央的就不一樣，托嬰中心跟幼兒園的也不太一樣，所以不同的老師、不同的表格，不同單位執行，如果托嬰中心跟幼兒園的就已經不一樣，在你們所有的通報來源，大概托嬰中心跟幼兒園在112年就占了四分之一，如果沒有互相串聯，我不知道這些數據有沒有重複，甚至有沒有重複通報，甚至有沒有是無效的通報，甚至我們去問國教署還講說衛生局會主動來篩，基本上現在都老師或請家長填，我不知道衛生局到底有沒有做？有這麼多不同的來源，有沒有無效的，甚至重複通報的，部長，你怎麼看這個問題？"],["邱部長泰源：謝謝委員的指教，剛剛你提所有的問題，我們都會再度檢討，如果沒有做好的，我們一定要再加強。"],["林委員月琴：希望你們跟教育部、衛福部……因為托嬰中心是衛福部的，可是幼兒園是教育部的，是不是可以統整？而且各地方不太一樣，那中央又跟地方不太一樣，我覺得填的表單似乎能不能作為依據……"],["邱部長泰源：委員，可不可以容許我請吳署長簡要報告？"],["林委員月琴：抱歉，因為等一下主席搞不好又要站起來，我還是要提……"],["邱部長泰源：他只要講一下沒關係，署長是專業的。"],["主席：可以讓署長回答。"],["林委員月琴：你今天不一樣喔！"],["邱部長泰源：他做到流汗流成這樣，給他講一下。"],["吳署長昭軍：跟委員報告，剛剛提到的通報的確是從幼兒園也好、從家長也好、從醫療機構也好，那是早期的，那時是沒有用醫療這一端來處理兒童成長評估。","我們去年7月1號才開始從醫療端來做通報，就是幫忙做篩檢screen這件事情，這個是專業版的，目前正在發展你剛剛提的教保育人員篩檢，或者家長自評的量表，目前還在發展，過去都是用Taipei-II的量表，所以過去是沒有package……"],["林委員月琴：我以前去評鑑幼兒園、托嬰中心，每次看到表單就是不太一樣。"],["吳署長昭軍：對，過去是這樣子……"],["林委員月琴：我現在看中央也不太一樣。"],["吳署長昭軍：您說的是事實沒有錯，但是我們現在已經在改進了。"],["林委員月琴：所以速度要快點，否則拿到東西搞不好是來自不同來源就會不太一樣。","接下來，聯評流程每名孩子大概2到3次才能完成，可是若按照112年的通報人數是三萬多，你們官方宣稱說每一年你們可以做4萬人次，那就差了2萬。因為每一個孩子至少2次才能完成聯評的流程，你現在通報就有三萬四千多，你又號稱每一年可以做4萬，這樣是不是還差兩萬多？"],["邱部長泰源：署長，你要不要回答一下？"],["吳署長昭軍：112年的確是三萬四千多聯評的量，那我們講的四萬多是這個……"],["林委員月琴：現在講的是通報人數。"],["吳署長昭軍：114年聯評的總量是四萬三千多。"],["邱部長泰源：已經可以到達四萬三千多。"],["吳署長昭軍：我們就是擴大了聯評的機構。"],["林委員月琴：你知道家長願意帶著孩子來篩檢、等待評估，都應該要知道他很注重這個，而且早療黃金時期是三歲以下視為關鍵。"],["吳署長昭軍：了解，我們希望每個都能進入評估……"],["林委員月琴：我還要再提一個問題，好不容易拿到聯評報告，總算可以進入到早療體系被服務，問題又來了，健保給付的療程大概30分鐘，對於很多忙碌的家長好不容易預約到了，結果帶給醫生看，要做療育服務的時候，孩子在不同情境當中需要冷靜，搞不好已經過了三分之一時間，只剩下三分之二，只有20分鐘，最後要嘛只好疲於奔命每次去，要嘛自己付錢，可是政府現在補助4,000塊，4,000塊含交通費還有每次療育的費用，根本不夠，難怪家長不斷提出訴求。","我們辦公室就有很多早療單位來拜會我們，希望早療服務能夠真實回應他的需求，部長，在費用跟時間上，可不可以考慮增加？能不能評估看看？","以下這四點麻煩你們做到，否則我就要找各部會一起來討論。第一、儘速提升偏遠地區跟社區型發展篩檢跟聯評量能，落實分級的醫療機制；第二、儘速提升幼兒專責醫師制度的涵蓋率，把發篩教育訓練納入必修學分；第三、全面檢視早療服務程序，跟國教署及地方政府建立聯繫管道，不是各吹各的調，盤點篩檢實施情況，不要資源重複或是無效利用，加速擴大聯合評估的量能，而且要考慮到均衡；第四、檢討早療服務的補助項目跟費用，滿足家長和幼兒的需求。以上2週內請你們給我書面回復。"],["邱部長泰源：我們不但全力以赴，也會2週內給委員回復。"],["林委員月琴：謝謝部長。"],["邱部長泰源：謝謝。"],["主席：謝謝林委員，很用心、不錯、讚。謝謝部長、署長。","接續請葛如鈞委員質詢。"]],"agenda":{"page_end":370,"meet_id":"委員會-11-3-26-7","speakers":["蘇清泉","陳昭姿","林月琴","葛如鈞","劉建國","王育敏","邱鎮軍","廖偉翔","林淑芬","王正旭","黃秀芳","羅廷瑋","鍾佳濱","陳菁徽","盧縣一","李坤城","陳培瑜","張雅琳","莊瑞雄","楊曜","陳瑩","林楚茵","林德福"],"page_start":287,"meetingDate":["2025-04-23"],"gazette_id":"1144101","agenda_lcidc_ids":["1144101_00005"],"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7次全體委員會議紀錄","content":"邀請衛生福利部部長、財政部次長就「國家社會福利政策財源檢討及偏鄉兒童發展篩檢執行情\n形」進行專題報告，並備質詢","agenda_id":"1144101_00004"}}}