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00:00:59,281\n委員委員\n\n","tsv":"start\tend\ttext\n469\t25125\t小子女化之后问题越来越严峻儿童医疗照护环境却没有获得重视跟有效的改善为充实儿童预防保健量能跟壮大儿少保护的防线提升资源的益助建议鼓励医疗院所投入疫苗接种等预防保健的业务自有其必要原件请卫福部\n25805\t26605\t謝謝李燕雄委員的發言\n58957\t59281\t委員委員\n","txt":"小子女化之后问题越来越严峻儿童医疗照护环境却没有获得重视跟有效的改善为充实儿童预防保健量能跟壮大儿少保护的防线提升资源的益助建议鼓励医疗院所投入疫苗接种等预防保健的业务自有其必要原件请卫福部\n謝謝李燕雄委員的發言\n委員委員\n","vtt":"WEBVTT\n\n00:00.469 --> 00:25.125\n小子女化之后问题越来越严峻儿童医疗照护环境却没有获得重视跟有效的改善为充实儿童预防保健量能跟壮大儿少保护的防线提升资源的益助建议鼓励医疗院所投入疫苗接种等预防保健的业务自有其必要原件请卫福部\n\n00:25.805 --> 00:26.605\n謝謝李燕雄委員的發言\n\n00:58.957 --> 00:59.281\n委員委員\n\n","segments":[{"start":0.469,"end":25.125,"text":"小子女化之后问题越来越严峻儿童医疗照护环境却没有获得重视跟有效的改善为充实儿童预防保健量能跟壮大儿少保护的防线提升资源的益助建议鼓励医疗院所投入疫苗接种等预防保健的业务自有其必要原件请卫福部"},{"start":25.805,"end":26.605,"text":"謝謝李燕雄委員的發言"},{"start":58.957,"end":59.281,"text":"委員委員"}]}}},"gazette":{"lineno":2,"blocks":[["李委員彥秀：（14時15分）院長好。各位同仁，大家午安。本院委員李彥秀等13人，鑑於少子女化問題越來越嚴峻，兒童醫療照護環境卻未獲重視與有效改善。為充實兒童預防保健量能與壯大兒少保護防線，提升資源挹注，藉以鼓勵醫療院所投入疫苗接種等預防保健業務，自有其必要。爰請衛生福利部研議提升兒童常規疫苗接種處置費，並於不影響接種品質之輕微履約瑕疵，對合約院所以規勸為主、契約罰為輔，另應建置疫苗冷鏈冷運配送至院所之機制，維持良好疫苗品質。是否有當？敬請公決。","第一案：","案由：本院委員李彥秀等13人，鑑於少子女化問題嚴峻，兒童醫療照護環境卻未獲重視與有效改善。為充實兒童預防保健量能與壯大兒少保護防線，提升資源挹注，藉以鼓勵醫療院所投入疫苗接種等預防保健業務，自有其必要。爰請衛生福利部研議調升兒童常規疫苗接種處置費，並於不影響接種品質之輕微履約瑕疵，對合約院所以規勸為主、契約罰為輔，另應建置疫苗冷鏈冷運配送至院所之機制，俾維持良好疫苗品質。是否有當？請公決案。","說明：","一、疫苗接種為疾病防治上最具成本效益之公共衛生措施，世界衛生組織及各國均將之作為重要公共衛生手段，我國亦然。而為鼓勵醫療院所投入含疫苗接種等預防保健業務，並分擔醫療院所執行預防保健業務之服務成本，行政部門多採發給補助、獎勵等誘因。例如於兒童常規疫苗、肺炎鏈球菌疫苗、流感疫苗、COVID-19疫苗等補助接種處置費；於執行各項預防保健服務項目時發給補助，以求擴大公共衛生政策效益。","二、衛生福利部為落實健康臺灣政策，達三高防治888政策目標，遂於114年起調整成人預防保健服務補助金額，由原合計520元調升為880元（增幅69%）；另就癌症篩檢費用，子宮頸癌自430元調升至630元（增幅47%），大腸癌自200元調升至400元（增幅100%），口腔癌自130元調升至250元（增幅92%）。然而，對比兒童常規疫苗，除曾於107年起將補助範圍擴及兒童常規疫苗入國小前之所有應接種劑次（共20劑）外，每劑補助接種處置費100元之金額，則多年未予調整。","三、惟少子女化為我國社會當前所面臨挑戰，總生育率低、新生兒/兒童死亡率偏高，數項兒童死亡率指標（如新生兒死亡率、5歲以下兒童死亡率等），近年來改善幅度有限。抑有進者，根據內政部統計，累計至今（113）年11月，新生兒人數僅有122,360人，出生人數已連續9年下降，尤其龍年光環不再，愈顯少子女化問題嚴峻。因此呵護每一位新生兒與兒童，精進兒童醫療照護網絡，降低兒童甚或成年期的罹病風險，獲取最大的健康效益，自至關重要。衛生福利部於優化兒童醫療照護計畫即開宗明義載明：「需確保有足夠且穩定的兒童醫療與健康照護人力與相關軟硬體資源。」詎對於增加兒童疫苗接種效益，衛生福利部卻吝於資源投注，不僅接種處置費多年未曾調整，且相較亞鄰國家所支付6歲以下兒童預防保健注射服務費用，日本為定額給付1,100-1,650元/劑，韓國為500元/劑、4合1疫苗為750元/劑、5合1疫苗為1,000元/劑，我國微薄百元之接種處置費，意味行政部門並未重視改善兒童醫療照護環境。","四、再者，兒童常規疫苗接種除具疾病預防效益外，亦有助於主動發掘潛在性高風險家庭。根據衛生福利部所著「兒少虐待及疏忽：醫事人員工作手冊」，其中明揭：「在兒童未產生任何需醫療之傷害前，幼兒是否定期接受預防接種，的確是有助於發現潛在疏忽個案的好方法。醫事人員亦可在嬰幼兒接受預防接種時，特別注意檢核表所示之各面向指標。」然而，廉價的接種處置費，恐致醫師怯於加入接種業務，進而減損發現潛在疏忽個案之兒少保護效益。依臺灣兒科醫學會統計，106年時全國3,721家兒科診所，參與疫苗接種者僅有1,700家（45.49%）；分析其原因，或係因疫苗冷藏配送成本高昂，或是因人事成本逐年增加，惟均表示政策誘因不足，將有害於兒童預防保健與兒虐防治。","五、綜上，鑑於兒童權利公約第24條規定：「（第1項）締約國確認兒童有權享有最高可達水準之健康與促進疾病治療以及恢復健康之權利。締約國應努力確保所有兒童享有健康照護服務之權利不遭受剝奪。（第2項）締約國應致力於充分執行此權利，並應特別針對下列事項採取適當之措施：……（b）確保提供所有兒童必須之醫療協助及健康照顧，並強調基礎健康照顧之發展……（f）發展預防健康照顧、針對父母與家庭計畫教育及服務之指導方針。……」爰請衛生福利部適度調升兒童常規疫苗接種處置費，並於不影響接種品質之輕微履約瑕疵，對合約院所以規勸為主、契約罰為輔，另應建置疫苗冷鏈冷運配送至院所之機制，俾維持良好疫苗品質。","提案人：李彥秀","連署人：顏寬恒　　翁曉玲　　邱鎮軍　　張智倫　　柯志恩　　羅明才　　葛如鈞　　徐欣瑩　　徐巧芯　　陳菁徽　　羅廷瑋　　許宇甄"],["主席：謝謝李彥秀委員的發言。","本院委員李彥秀等13人提案作如下決議：「函請行政院研處。」請問院會，有無異議？（無）沒有異議，我們就通過。","報告院會，臨時提案均已處理完畢，下午2時30分繼續進行財政組之質詢，現在休息。","休息（14時16分）","繼續開會（14時30分）"]],"agenda":{"page_end":195,"meet_id":"院會-11-3-9","speakers":["韓國瑜","廖偉翔","顏寬恒","李彥秀","陳玉珍","馬文君","伍麗華Saidhai‧Tahovecahe","牛煦庭","黃珊珊","鍾佳濱","吳秉叡","沈發惠","許宇甄","李昆澤","林思銘","葛如鈞","許智傑","林倩綺","蔡其昌","吳沛憶","李坤城","丁學忠","劉書彬"],"page_start":99,"meetingDate":["2025-04-29"],"gazette_id":"1143901","agenda_lcidc_ids":["1143901_00004","1143901_00005"],"meet_name":"立法院第11屆第3會期第9次會議紀錄","content":"施政質詢\n對行政院院長提出施政方針及施政報告繼續質詢─ 繼續質詢─","agenda_id":"1143901_00004"}}}