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0.958}, {\"word\": \"台\", \"start\": 86.846, \"end\": 87.146, \"score\": 0.999}, {\"word\": \"五\", \"start\": 87.146, \"end\": 87.406, \"score\": 0.953}, {\"word\": \"大\", \"start\": 87.406, \"end\": 87.727, \"score\": 0.998}, {\"word\": \"科\", \"start\": 87.727, \"end\": 87.747, \"score\": 0.942}]}, {\"start\": 88.967, \"end\": 95.494, \"text\": \"住院醫師的招募狀況分別為外科100%婦產科96.2%內科90%急診醫科為79.9%另外就是小兒科79.2%\", \"words\": [{\"word\": \"住\", \"start\": 88.967, \"end\": 89.228, \"score\": 0.922}, {\"word\": \"院\", \"start\": 89.228, \"end\": 90.089, \"score\": 0.942}, {\"word\": \"醫\"}, {\"word\": \"師\"}, {\"word\": \"的\", \"start\": 90.089, \"end\": 90.649, \"score\": 0.933}, {\"word\": \"招\", \"start\": 90.649, \"end\": 90.93, \"score\": 0.969}, {\"word\": \"募\", \"start\": 90.93, \"end\": 92.491, \"score\": 0.958}, {\"word\": \"狀\"}, {\"word\": \"況\"}, {\"word\": \"分\", \"start\": 92.491, \"end\": 92.631, \"score\": 0.998}, {\"word\": \"別\", \"start\": 92.631, \"end\": 93.152, \"score\": 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00:01:01,370\n那內容就是針對內外婦兒及五大科住院醫師的人力問題其實在這個是台灣整體醫療的問題不是龍總個別的面對的但是因為龍總是台灣醫療的龍頭那龍總的\n\n4\n00:01:06,193 --> 00:01:27,747\n作为会产生引灵的作用所以本席才提出这个组结议本席先针对台湾医疗整体的状况呈现一些资料待会再请退谱会回答我这个问题龙总的状况根据卫福部在2022到2024年的统计的资料全台五大科\n\n5\n00:01:28,967 --> 00:01:35,494\n住院醫師的招募狀況分別為外科100%婦產科96.2%內科90%急診醫科為79.9%另外就是小兒科79.2%\n\n6\n00:01:48,588 --> 00:02:15,477\n從資料看來武大科的招募情況還不至於太嚴重真正的問題在於流刃的問題雖然衛福表示武大科住院的醫師的第二年流刃率都接近百分之百但衛福這個是一個不誠實的說法真實的狀況是許多醫師在完成初期的訓練後\n\n7\n00:02:17,378 --> 00:02:44,183\n就選擇轉向這個其他科系的一個負擔較輕的風險較低的一個科別而不是繼續在五大科這個服務那另外就是衛福部並沒有針對五大科住院醫師離職的完整的統計那因此本學只針對離職率的推估的資料從第一個內科離職率在將近10%到15%\n\n8\n00:02:47,003 --> 00:03:10,409\n外科将近在20%到30%北农在2019年的报告曾指出外科住院的医师在三年内离职率约达15%到20%那妇产科在15%到25%那儿科在10%到20%那急诊科比较严重25%到35%\n\n9\n00:03:12,429 --> 00:03:34,006\n那2022年的在台湾医学杂志研究急诊科住院医师三年的离职率将近达为25%所以诸位你来回答一下这个数据那当然刚刚我提出的你也回应一下或者说由北农的农总来做回应你先回应前提的好不好\n\n10\n00:03:34,857 --> 00:04:03,857\n謝謝召委我先做一個整體的回應待會請我們龍總的北龍院長再做一個說明我想謝謝召委的關心我們醫療的人力有關於這個現任的醫療人力的狀況還有離職我們請北龍院長待會做說明但是我就針對我們的一些措施一些補充的一個具體作為我們每年我們輔導會委託國防醫學院代訓醫學生醫學的公費是19個另外衛福部\n\n11\n00:04:04,497 --> 00:04:20,489\n重點特別剛剛召委所提的這些分發五分之一的公費生到我們退補會然後我們也從115年明年學年度開始增加公費生兩個人另外針對偏鄉的醫療這部分我們補助各分院\n\n12\n00:04:21,109 --> 00:04:43,600\n有關偏鄉醫療的人力有1億6千多萬來補助醫事到偏鄉的一個榮總培養來做這是我們相關的一些具體措施那麼剛剛趙偉所提到的總院的這五大科提到的離職率的狀況我想請北榮院長再跟您做說明好謝謝主委非常謝謝主委謝謝委員關心這個重要的議題\n\n13\n00:04:44,865 --> 00:05:05,920\n那內外複合級人力的短缺的確是一個目前嚴重的問題尤其面對超高齡化跟少子化不過呢現在已經有了轉機我們用不同工不同酬醫院的環境改善教學環境改善今年外科已經收滿而且還有很多人在後補婦產科也收滿急診部也收滿\n\n14\n00:05:06,981 --> 00:05:35,421\n兒科跟內科也在成長進步中所以這個如果我們可以用不同的政策好好的照顧這些住院師給他好的教學我相信很多有理想有抱負的青年願意投入這一塊他們不怕累的那我們有足夠的人之後我們就可以把這些訓練好的人可以送到我們台灣各個偏鄉分院去幫助我們的偏鄉離島所以這個是我們積極在做好謝謝因為最主要今天我要講的\n\n15\n00:05:36,562 --> 00:06:04,250\n因為在五大課裡面希望能夠由他們自己的專業裡面繼續留任而不是借用他這五大課裡面然後再轉任到其他比較負擔比較輕的一點的我想這個問題剛剛書記都已經講出來了所以提醒提醒我們這個榮總的這個歌宴那另外就是我要特別我要特別跟全國的醫師也要講幾個公道話那在這個\n\n16\n00:06:06,358 --> 00:06:24,367\n龍總的五大科的住院醫事人力的情況的狀況那當然這個龍總雖然在衛福部配合採取的高健保支付的標準那調整及重難診科\n\n17\n00:06:29,056 --> 00:06:52,211\n別的支付標準增加住院醫師的津貼等但據本席了解真正的問題出在於過老然後籠總住院醫師平均每週工時高達80到100個小時尤其籠總體系醫院承擔大量農民慢性病及重症的照顧\n\n18\n00:06:53,752 --> 00:07:13,717\n急診更需承擔大量農民的急重診或是住院醫師工作負荷遠高於其他醫師的中心如何妥善調配人力給住院醫師足夠的支持這樣我想這是一個目前很大的問題\n\n19\n00:07:14,837 --> 00:07:26,103\n謝謝委員現在公使的問題當然要按照法規的規定來做那現在有足夠的人力我們當然所有的安排包括加班費、值班費他們是比一班科多了一倍\n\n20\n00:07:27,345 --> 00:07:48,927\n同仁現在士氣是高的,是不會有問題,這個我明明解決過老的問題我想你們也要解決現在就年輕人遵守公使但是有些年輕人他跟著刀他趕不走他想要學這個刀,時間到了老師求你讓我留下來現在還是有這種人這種人應該鼓勵,但是我說你不要害我違反公使\n\n21\n00:07:50,949 --> 00:08:19,318\n這個是我們目前的現況以前我們那個年代搞到半夜兩三點沒有人抱怨隔天又要來上班因為現在呢現在的公私保護是對的但是呢有很多熱情的青年我們要給他鼓勵對要應該予以鼓勵好不好就是因為現在來講的話我們醫師是非常很珍貴尤其是我們的醫婦人員也非常的珍貴我們也多給他們一個如果在今天上\n\n22\n00:08:20,259 --> 00:08:35,539\n加舉上我們應該給予最大的鼓勵好不好謝謝召委好謝謝黃任委員主委請回接下來有請林楚英\n\n","tsv":"start\tend\ttext\n69\t21484\t接下來我們請黃仁、趙偉上台質詢謝謝主席我請我們的原主委有請原主委\n30828\t33870\t有關於籠總醫療人力的問題,本期針對在114年度的退補會在預算提了一個主決議,\n46660\t61370\t那內容就是針對內外婦兒及五大科住院醫師的人力問題其實在這個是台灣整體醫療的問題不是龍總個別的面對的但是因為龍總是台灣醫療的龍頭那龍總的\n66193\t87747\t作为会产生引灵的作用所以本席才提出这个组结议本席先针对台湾医疗整体的状况呈现一些资料待会再请退谱会回答我这个问题龙总的状况根据卫福部在2022到2024年的统计的资料全台五大科\n88967\t95494\t住院醫師的招募狀況分別為外科100%婦產科96.2%內科90%急診醫科為79.9%另外就是小兒科79.2%\n108588\t135477\t從資料看來武大科的招募情況還不至於太嚴重真正的問題在於流刃的問題雖然衛福表示武大科住院的醫師的第二年流刃率都接近百分之百但衛福這個是一個不誠實的說法真實的狀況是許多醫師在完成初期的訓練後\n137378\t164183\t就選擇轉向這個其他科系的一個負擔較輕的風險較低的一個科別而不是繼續在五大科這個服務那另外就是衛福部並沒有針對五大科住院醫師離職的完整的統計那因此本學只針對離職率的推估的資料從第一個內科離職率在將近10%到15%\n167003\t190409\t外科将近在20%到30%北农在2019年的报告曾指出外科住院的医师在三年内离职率约达15%到20%那妇产科在15%到25%那儿科在10%到20%那急诊科比较严重25%到35%\n192429\t214006\t那2022年的在台湾医学杂志研究急诊科住院医师三年的离职率将近达为25%所以诸位你来回答一下这个数据那当然刚刚我提出的你也回应一下或者说由北农的农总来做回应你先回应前提的好不好\n214857\t243857\t謝謝召委我先做一個整體的回應待會請我們龍總的北龍院長再做一個說明我想謝謝召委的關心我們醫療的人力有關於這個現任的醫療人力的狀況還有離職我們請北龍院長待會做說明但是我就針對我們的一些措施一些補充的一個具體作為我們每年我們輔導會委託國防醫學院代訓醫學生醫學的公費是19個另外衛福部\n244497\t260489\t重點特別剛剛召委所提的這些分發五分之一的公費生到我們退補會然後我們也從115年明年學年度開始增加公費生兩個人另外針對偏鄉的醫療這部分我們補助各分院\n261109\t283600\t有關偏鄉醫療的人力有1億6千多萬來補助醫事到偏鄉的一個榮總培養來做這是我們相關的一些具體措施那麼剛剛趙偉所提到的總院的這五大科提到的離職率的狀況我想請北榮院長再跟您做說明好謝謝主委非常謝謝主委謝謝委員關心這個重要的議題\n284865\t305920\t那內外複合級人力的短缺的確是一個目前嚴重的問題尤其面對超高齡化跟少子化不過呢現在已經有了轉機我們用不同工不同酬醫院的環境改善教學環境改善今年外科已經收滿而且還有很多人在後補婦產科也收滿急診部也收滿\n306981\t335421\t兒科跟內科也在成長進步中所以這個如果我們可以用不同的政策好好的照顧這些住院師給他好的教學我相信很多有理想有抱負的青年願意投入這一塊他們不怕累的那我們有足夠的人之後我們就可以把這些訓練好的人可以送到我們台灣各個偏鄉分院去幫助我們的偏鄉離島所以這個是我們積極在做好 謝謝因為最主要今天我要講的\n336562\t364250\t因為在五大課裡面希望能夠由他們自己的專業裡面繼續留任而不是借用他這五大課裡面然後再轉任到其他比較負擔比較輕的一點的我想這個問題剛剛書記都已經講出來了所以提醒提醒我們這個榮總的這個歌宴那另外就是我要特別我要特別跟全國的醫師也要講幾個公道話那在這個\n366358\t384367\t龍總的五大科的住院醫事人力的情況的狀況那當然這個龍總雖然在衛福部配合採取的高健保支付的標準那調整及重難診科\n389056\t412211\t別的支付標準增加住院醫師的津貼等但據本席了解真正的問題出在於過老然後籠總住院醫師平均每週工時高達80到100個小時尤其籠總體系醫院承擔大量農民慢性病及重症的照顧\n413752\t433717\t急診更需承擔大量農民的急重診或是住院醫師工作負荷遠高於其他醫師的中心如何妥善調配人力給住院醫師足夠的支持這樣我想這是一個目前很大的問題\n434837\t446103\t謝謝委員現在公使的問題當然要按照法規的規定來做那現在有足夠的人力我們當然所有的安排包括加班費、值班費他們是比一班科多了一倍\n447345\t468927\t同仁現在士氣是高的,是不會有問題,這個我明明解決過老的問題我想你們也要解決現在就年輕人遵守公使但是有些年輕人他跟著刀他趕不走他想要學這個刀,時間到了老師求你讓我留下來現在還是有這種人這種人應該鼓勵,但是我說你不要害我違反公使\n470949\t499318\t這個是我們目前的現況以前我們那個年代搞到半夜兩三點沒有人抱怨隔天又要來上班因為現在呢現在的公私保護是對的但是呢有很多熱情的青年我們要給他鼓勵對要應該予以鼓勵好不好就是因為現在來講的話我們醫師是非常很珍貴尤其是我們的醫婦人員也非常的珍貴我們也多給他們一個如果在今天上\n500259\t515539\t加舉上 我們應該給予最大的鼓勵 好不好謝謝召委好 謝謝黃任委員主委請回接下來有請林楚英\n","txt":"接下來我們請黃仁、趙偉上台質詢謝謝主席我請我們的原主委有請原主委\n有關於籠總醫療人力的問題,本期針對在114年度的退補會在預算提了一個主決議,\n那內容就是針對內外婦兒及五大科住院醫師的人力問題其實在這個是台灣整體醫療的問題不是龍總個別的面對的但是因為龍總是台灣醫療的龍頭那龍總的\n作为会产生引灵的作用所以本席才提出这个组结议本席先针对台湾医疗整体的状况呈现一些资料待会再请退谱会回答我这个问题龙总的状况根据卫福部在2022到2024年的统计的资料全台五大科\n住院醫師的招募狀況分別為外科100%婦產科96.2%內科90%急診醫科為79.9%另外就是小兒科79.2%\n從資料看來武大科的招募情況還不至於太嚴重真正的問題在於流刃的問題雖然衛福表示武大科住院的醫師的第二年流刃率都接近百分之百但衛福這個是一個不誠實的說法真實的狀況是許多醫師在完成初期的訓練後\n就選擇轉向這個其他科系的一個負擔較輕的風險較低的一個科別而不是繼續在五大科這個服務那另外就是衛福部並沒有針對五大科住院醫師離職的完整的統計那因此本學只針對離職率的推估的資料從第一個內科離職率在將近10%到15%\n外科将近在20%到30%北农在2019年的报告曾指出外科住院的医师在三年内离职率约达15%到20%那妇产科在15%到25%那儿科在10%到20%那急诊科比较严重25%到35%\n那2022年的在台湾医学杂志研究急诊科住院医师三年的离职率将近达为25%所以诸位你来回答一下这个数据那当然刚刚我提出的你也回应一下或者说由北农的农总来做回应你先回应前提的好不好\n謝謝召委我先做一個整體的回應待會請我們龍總的北龍院長再做一個說明我想謝謝召委的關心我們醫療的人力有關於這個現任的醫療人力的狀況還有離職我們請北龍院長待會做說明但是我就針對我們的一些措施一些補充的一個具體作為我們每年我們輔導會委託國防醫學院代訓醫學生醫學的公費是19個另外衛福部\n重點特別剛剛召委所提的這些分發五分之一的公費生到我們退補會然後我們也從115年明年學年度開始增加公費生兩個人另外針對偏鄉的醫療這部分我們補助各分院\n有關偏鄉醫療的人力有1億6千多萬來補助醫事到偏鄉的一個榮總培養來做這是我們相關的一些具體措施那麼剛剛趙偉所提到的總院的這五大科提到的離職率的狀況我想請北榮院長再跟您做說明好謝謝主委非常謝謝主委謝謝委員關心這個重要的議題\n那內外複合級人力的短缺的確是一個目前嚴重的問題尤其面對超高齡化跟少子化不過呢現在已經有了轉機我們用不同工不同酬醫院的環境改善教學環境改善今年外科已經收滿而且還有很多人在後補婦產科也收滿急診部也收滿\n兒科跟內科也在成長進步中所以這個如果我們可以用不同的政策好好的照顧這些住院師給他好的教學我相信很多有理想有抱負的青年願意投入這一塊他們不怕累的那我們有足夠的人之後我們就可以把這些訓練好的人可以送到我們台灣各個偏鄉分院去幫助我們的偏鄉離島所以這個是我們積極在做好 謝謝因為最主要今天我要講的\n因為在五大課裡面希望能夠由他們自己的專業裡面繼續留任而不是借用他這五大課裡面然後再轉任到其他比較負擔比較輕的一點的我想這個問題剛剛書記都已經講出來了所以提醒提醒我們這個榮總的這個歌宴那另外就是我要特別我要特別跟全國的醫師也要講幾個公道話那在這個\n龍總的五大科的住院醫事人力的情況的狀況那當然這個龍總雖然在衛福部配合採取的高健保支付的標準那調整及重難診科\n別的支付標準增加住院醫師的津貼等但據本席了解真正的問題出在於過老然後籠總住院醫師平均每週工時高達80到100個小時尤其籠總體系醫院承擔大量農民慢性病及重症的照顧\n急診更需承擔大量農民的急重診或是住院醫師工作負荷遠高於其他醫師的中心如何妥善調配人力給住院醫師足夠的支持這樣我想這是一個目前很大的問題\n謝謝委員現在公使的問題當然要按照法規的規定來做那現在有足夠的人力我們當然所有的安排包括加班費、值班費他們是比一班科多了一倍\n同仁現在士氣是高的,是不會有問題,這個我明明解決過老的問題我想你們也要解決現在就年輕人遵守公使但是有些年輕人他跟著刀他趕不走他想要學這個刀,時間到了老師求你讓我留下來現在還是有這種人這種人應該鼓勵,但是我說你不要害我違反公使\n這個是我們目前的現況以前我們那個年代搞到半夜兩三點沒有人抱怨隔天又要來上班因為現在呢現在的公私保護是對的但是呢有很多熱情的青年我們要給他鼓勵對要應該予以鼓勵好不好就是因為現在來講的話我們醫師是非常很珍貴尤其是我們的醫婦人員也非常的珍貴我們也多給他們一個如果在今天上\n加舉上 我們應該給予最大的鼓勵 好不好謝謝召委好 謝謝黃任委員主委請回接下來有請林楚英\n","vtt":"WEBVTT\n\n00:00.069 --> 00:21.484\n接下來我們請黃仁、趙偉上台質詢謝謝主席我請我們的原主委有請原主委\n\n00:30.828 --> 00:33.870\n有關於籠總醫療人力的問題,本期針對在114年度的退補會在預算提了一個主決議,\n\n00:46.660 --> 01:01.370\n那內容就是針對內外婦兒及五大科住院醫師的人力問題其實在這個是台灣整體醫療的問題不是龍總個別的面對的但是因為龍總是台灣醫療的龍頭那龍總的\n\n01:06.193 --> 01:27.747\n作为会产生引灵的作用所以本席才提出这个组结议本席先针对台湾医疗整体的状况呈现一些资料待会再请退谱会回答我这个问题龙总的状况根据卫福部在2022到2024年的统计的资料全台五大科\n\n01:28.967 --> 01:35.494\n住院醫師的招募狀況分別為外科100%婦產科96.2%內科90%急診醫科為79.9%另外就是小兒科79.2%\n\n01:48.588 --> 02:15.477\n從資料看來武大科的招募情況還不至於太嚴重真正的問題在於流刃的問題雖然衛福表示武大科住院的醫師的第二年流刃率都接近百分之百但衛福這個是一個不誠實的說法真實的狀況是許多醫師在完成初期的訓練後\n\n02:17.378 --> 02:44.183\n就選擇轉向這個其他科系的一個負擔較輕的風險較低的一個科別而不是繼續在五大科這個服務那另外就是衛福部並沒有針對五大科住院醫師離職的完整的統計那因此本學只針對離職率的推估的資料從第一個內科離職率在將近10%到15%\n\n02:47.003 --> 03:10.409\n外科将近在20%到30%北农在2019年的报告曾指出外科住院的医师在三年内离职率约达15%到20%那妇产科在15%到25%那儿科在10%到20%那急诊科比较严重25%到35%\n\n03:12.429 --> 03:34.006\n那2022年的在台湾医学杂志研究急诊科住院医师三年的离职率将近达为25%所以诸位你来回答一下这个数据那当然刚刚我提出的你也回应一下或者说由北农的农总来做回应你先回应前提的好不好\n\n03:34.857 --> 04:03.857\n謝謝召委我先做一個整體的回應待會請我們龍總的北龍院長再做一個說明我想謝謝召委的關心我們醫療的人力有關於這個現任的醫療人力的狀況還有離職我們請北龍院長待會做說明但是我就針對我們的一些措施一些補充的一個具體作為我們每年我們輔導會委託國防醫學院代訓醫學生醫學的公費是19個另外衛福部\n\n04:04.497 --> 04:20.489\n重點特別剛剛召委所提的這些分發五分之一的公費生到我們退補會然後我們也從115年明年學年度開始增加公費生兩個人另外針對偏鄉的醫療這部分我們補助各分院\n\n04:21.109 --> 04:43.600\n有關偏鄉醫療的人力有1億6千多萬來補助醫事到偏鄉的一個榮總培養來做這是我們相關的一些具體措施那麼剛剛趙偉所提到的總院的這五大科提到的離職率的狀況我想請北榮院長再跟您做說明好謝謝主委非常謝謝主委謝謝委員關心這個重要的議題\n\n04:44.865 --> 05:05.920\n那內外複合級人力的短缺的確是一個目前嚴重的問題尤其面對超高齡化跟少子化不過呢現在已經有了轉機我們用不同工不同酬醫院的環境改善教學環境改善今年外科已經收滿而且還有很多人在後補婦產科也收滿急診部也收滿\n\n05:06.981 --> 05:35.421\n兒科跟內科也在成長進步中所以這個如果我們可以用不同的政策好好的照顧這些住院師給他好的教學我相信很多有理想有抱負的青年願意投入這一塊他們不怕累的那我們有足夠的人之後我們就可以把這些訓練好的人可以送到我們台灣各個偏鄉分院去幫助我們的偏鄉離島所以這個是我們積極在做好謝謝因為最主要今天我要講的\n\n05:36.562 --> 06:04.250\n因為在五大課裡面希望能夠由他們自己的專業裡面繼續留任而不是借用他這五大課裡面然後再轉任到其他比較負擔比較輕的一點的我想這個問題剛剛書記都已經講出來了所以提醒提醒我們這個榮總的這個歌宴那另外就是我要特別我要特別跟全國的醫師也要講幾個公道話那在這個\n\n06:06.358 --> 06:24.367\n龍總的五大科的住院醫事人力的情況的狀況那當然這個龍總雖然在衛福部配合採取的高健保支付的標準那調整及重難診科\n\n06:29.056 --> 06:52.211\n別的支付標準增加住院醫師的津貼等但據本席了解真正的問題出在於過老然後籠總住院醫師平均每週工時高達80到100個小時尤其籠總體系醫院承擔大量農民慢性病及重症的照顧\n\n06:53.752 --> 07:13.717\n急診更需承擔大量農民的急重診或是住院醫師工作負荷遠高於其他醫師的中心如何妥善調配人力給住院醫師足夠的支持這樣我想這是一個目前很大的問題\n\n07:14.837 --> 07:26.103\n謝謝委員現在公使的問題當然要按照法規的規定來做那現在有足夠的人力我們當然所有的安排包括加班費、值班費他們是比一班科多了一倍\n\n07:27.345 --> 07:48.927\n同仁現在士氣是高的,是不會有問題,這個我明明解決過老的問題我想你們也要解決現在就年輕人遵守公使但是有些年輕人他跟著刀他趕不走他想要學這個刀,時間到了老師求你讓我留下來現在還是有這種人這種人應該鼓勵,但是我說你不要害我違反公使\n\n07:50.949 --> 08:19.318\n這個是我們目前的現況以前我們那個年代搞到半夜兩三點沒有人抱怨隔天又要來上班因為現在呢現在的公私保護是對的但是呢有很多熱情的青年我們要給他鼓勵對要應該予以鼓勵好不好就是因為現在來講的話我們醫師是非常很珍貴尤其是我們的醫婦人員也非常的珍貴我們也多給他們一個如果在今天上\n\n08:20.259 --> 08:35.539\n加舉上我們應該給予最大的鼓勵好不好謝謝召委好謝謝黃任委員主委請回接下來有請林楚英\n\n","segments":[{"start":0.069,"end":21.484,"text":"接下來我們請黃仁、趙偉上台質詢謝謝主席我請我們的原主委有請原主委"},{"start":30.828,"end":33.87,"text":"有關於籠總醫療人力的問題,本期針對在114年度的退補會在預算提了一個主決議,"},{"start":46.66,"end":61.37,"text":"那內容就是針對內外婦兒及五大科住院醫師的人力問題其實在這個是台灣整體醫療的問題不是龍總個別的面對的但是因為龍總是台灣醫療的龍頭那龍總的"},{"start":66.193,"end":87.747,"text":"作为会产生引灵的作用所以本席才提出这个组结议本席先针对台湾医疗整体的状况呈现一些资料待会再请退谱会回答我这个问题龙总的状况根据卫福部在2022到2024年的统计的资料全台五大科"},{"start":88.967,"end":95.494,"text":"住院醫師的招募狀況分別為外科100%婦產科96.2%內科90%急診醫科為79.9%另外就是小兒科79.2%"},{"start":108.588,"end":135.477,"text":"從資料看來武大科的招募情況還不至於太嚴重真正的問題在於流刃的問題雖然衛福表示武大科住院的醫師的第二年流刃率都接近百分之百但衛福這個是一個不誠實的說法真實的狀況是許多醫師在完成初期的訓練後"},{"start":137.378,"end":164.183,"text":"就選擇轉向這個其他科系的一個負擔較輕的風險較低的一個科別而不是繼續在五大科這個服務那另外就是衛福部並沒有針對五大科住院醫師離職的完整的統計那因此本學只針對離職率的推估的資料從第一個內科離職率在將近10%到15%"},{"start":167.003,"end":190.409,"text":"外科将近在20%到30%北农在2019年的报告曾指出外科住院的医师在三年内离职率约达15%到20%那妇产科在15%到25%那儿科在10%到20%那急诊科比较严重25%到35%"},{"start":192.429,"end":214.006,"text":"那2022年的在台湾医学杂志研究急诊科住院医师三年的离职率将近达为25%所以诸位你来回答一下这个数据那当然刚刚我提出的你也回应一下或者说由北农的农总来做回应你先回应前提的好不好"},{"start":214.857,"end":243.857,"text":"謝謝召委我先做一個整體的回應待會請我們龍總的北龍院長再做一個說明我想謝謝召委的關心我們醫療的人力有關於這個現任的醫療人力的狀況還有離職我們請北龍院長待會做說明但是我就針對我們的一些措施一些補充的一個具體作為我們每年我們輔導會委託國防醫學院代訓醫學生醫學的公費是19個另外衛福部"},{"start":244.497,"end":260.489,"text":"重點特別剛剛召委所提的這些分發五分之一的公費生到我們退補會然後我們也從115年明年學年度開始增加公費生兩個人另外針對偏鄉的醫療這部分我們補助各分院"},{"start":261.109,"end":283.6,"text":"有關偏鄉醫療的人力有1億6千多萬來補助醫事到偏鄉的一個榮總培養來做這是我們相關的一些具體措施那麼剛剛趙偉所提到的總院的這五大科提到的離職率的狀況我想請北榮院長再跟您做說明好謝謝主委非常謝謝主委謝謝委員關心這個重要的議題"},{"start":284.865,"end":305.92,"text":"那內外複合級人力的短缺的確是一個目前嚴重的問題尤其面對超高齡化跟少子化不過呢現在已經有了轉機我們用不同工不同酬醫院的環境改善教學環境改善今年外科已經收滿而且還有很多人在後補婦產科也收滿急診部也收滿"},{"start":306.981,"end":335.421,"text":"兒科跟內科也在成長進步中所以這個如果我們可以用不同的政策好好的照顧這些住院師給他好的教學我相信很多有理想有抱負的青年願意投入這一塊他們不怕累的那我們有足夠的人之後我們就可以把這些訓練好的人可以送到我們台灣各個偏鄉分院去幫助我們的偏鄉離島所以這個是我們積極在做好 謝謝因為最主要今天我要講的"},{"start":336.562,"end":364.25,"text":"因為在五大課裡面希望能夠由他們自己的專業裡面繼續留任而不是借用他這五大課裡面然後再轉任到其他比較負擔比較輕的一點的我想這個問題剛剛書記都已經講出來了所以提醒提醒我們這個榮總的這個歌宴那另外就是我要特別我要特別跟全國的醫師也要講幾個公道話那在這個"},{"start":366.358,"end":384.367,"text":"龍總的五大科的住院醫事人力的情況的狀況那當然這個龍總雖然在衛福部配合採取的高健保支付的標準那調整及重難診科"},{"start":389.056,"end":412.211,"text":"別的支付標準增加住院醫師的津貼等但據本席了解真正的問題出在於過老然後籠總住院醫師平均每週工時高達80到100個小時尤其籠總體系醫院承擔大量農民慢性病及重症的照顧"},{"start":413.752,"end":433.717,"text":"急診更需承擔大量農民的急重診或是住院醫師工作負荷遠高於其他醫師的中心如何妥善調配人力給住院醫師足夠的支持這樣我想這是一個目前很大的問題"},{"start":434.837,"end":446.103,"text":"謝謝委員現在公使的問題當然要按照法規的規定來做那現在有足夠的人力我們當然所有的安排包括加班費、值班費他們是比一班科多了一倍"},{"start":447.345,"end":468.927,"text":"同仁現在士氣是高的,是不會有問題,這個我明明解決過老的問題我想你們也要解決現在就年輕人遵守公使但是有些年輕人他跟著刀他趕不走他想要學這個刀,時間到了老師求你讓我留下來現在還是有這種人這種人應該鼓勵,但是我說你不要害我違反公使"},{"start":470.949,"end":499.318,"text":"這個是我們目前的現況以前我們那個年代搞到半夜兩三點沒有人抱怨隔天又要來上班因為現在呢現在的公私保護是對的但是呢有很多熱情的青年我們要給他鼓勵對要應該予以鼓勵好不好就是因為現在來講的話我們醫師是非常很珍貴尤其是我們的醫婦人員也非常的珍貴我們也多給他們一個如果在今天上"},{"start":500.259,"end":515.539,"text":"加舉上 我們應該給予最大的鼓勵 好不好謝謝召委好 謝謝黃任委員主委請回接下來有請林楚英"}]}}},"gazette":{"lineno":198,"blocks":[["黃委員仁：（9時39分）謝謝主席，我請我們的嚴主委。"],["主席：有請嚴主委。"],["嚴主任委員德發：召委好。"],["黃委員仁：主委好。有關榮總醫療人力的問題，大家來探討一下。本席針對114年度退輔會的預算提了一個主決議，內容是針對內、外、婦、兒、急五大科住院醫師的人力問題。這其實是臺灣整體醫療的問題，不是榮總個別要面對的，但是因為榮總是臺灣醫療的龍頭，榮總的作為會產生引領的作用，所以本席才提出這個主決議。","本席先針對臺灣醫療整體的狀況呈現一些資料，待會再請退輔會回答我這個問題──榮總的狀況。根據衛福部2022年到2024年的統計資料，全臺五大科住院醫師的招募狀況分別為外科100%、婦產科96.2%、內科90%、急診醫科79.9%，另外就是小兒科是79.2%，從資料看來五大科的招募情況還不至於太嚴重，真正的問題在於留任上。雖然衛福部表示五大科住院醫師第二年的留任率都接近100%，但這卻是一個不誠實的說法，真實的狀況是許多醫師在完成初期訓練後就選擇轉向其他負擔較輕的、風險較低的科別，而不是繼續在五大科服務。","另外就是衛福部並沒有針對五大科住院醫師離職做完整的統計，因此本席要針對離職率的推估資料，第一個內科的離職率從將近10%到15%，外科將近20%到30%。北榮在2019年的報告曾指出，外科的住院醫師3年內的離職率約達15%到20%，婦產科在15%到25%，兒科在10%到20%，急診科比較嚴重是25%到35%。2022年的臺灣醫學雜誌研究急診科住院醫師3年內的離職率將近達25%。主委，你來回答一下這個數據，對於我剛剛提出的也回應一下，或是由北榮來回應，你先回應前一題，好不好？"],["嚴主任委員德發：謝謝召委，我先做一個整體的回應，待會請我們榮總的北榮院長再做個說明。謝謝召委關心醫療的人力，有關現任醫療人力的狀況還有離職率，請北榮院長待會說明，我就針對我們的一些措施和補充的具體作為說明。我們退輔會每年會委託國防醫學院代訓醫學的公費生19人，另外衛福部重點科別，也就是剛剛召委所提的這些分發五分之一的公費生到我們退輔會，我們也從115（明）年學年度開始增加公費生2人；另外針對偏鄉的醫療，我們有補助各分院有關偏鄉醫療的人力一億六千多萬，補助醫師到偏鄉的榮總分院，這是我們相關的具體措施。對於剛剛召委提到總院這五大科離職率的狀況，我想請北榮院長跟您說明。"],["黃委員仁：好。"],["陳院長威明：非常謝謝主委、謝謝委員關心這個重要的議題。內、外、婦、兒、急人力的短缺的確是目前嚴重的問題，尤其面對超高齡化跟少子化，不過現在已經有了轉機，我們用不同工、不同酬，還有讓醫院的環境改善、教學環境改善，今年外科已經收滿，而且還有很多人在候補，婦產科也收滿、急診部也收滿，兒科跟內科也在成長進步中，所以如果我們可以用不同的政策，好好地照顧這些住院醫師，給予好的教學，我相信很多有理想、有抱負的青年願意投入這一塊，他們是不怕累的。我們有足夠的人之後，就可以把這些訓練好的人送到臺灣各個偏鄉的分院，幫助我們的偏鄉離島，這個是我們積極在做的。"],["黃委員仁：好，謝謝。今天我最主要講的是，希望他們能在五大科裡面繼續留任在自己的專業上，而不是借用這五大科再轉任到其他負擔比較輕一點的科別。針對這個問題，剛剛數據都已經講出來了，所以就提醒榮總各院。","另外我要特別為全國的醫師講一句公道話，榮總五大科住院醫師人力的情況，榮總雖然配合衛福部採取高健保支付的標準，調整急、重、難診科別的支付標準，增加住院醫師的津貼等，但據本席瞭解，真正的問題是出在過勞。榮總住院醫師平均每週工時高達80到100個小時，尤其榮總體系的醫院承擔大量榮民慢性病及重症的照護，急診更須承擔大量榮民急重症，住院醫師工作負荷遠高於其他醫學中心。如何妥善調配人力給予住院醫師足夠的支持？我想這個就是目前很大的問題。"],["陳院長威明：謝謝委員，對於工時的問題當然要按照法規的規定來做，現在有足夠的人力，我們對於所有的安排，包括加班費、值班費他們就比一般科多了一倍，同仁現在的士氣是高的，這不會有問題，我們已經解決了。"],["黃委員仁：那過勞的問題你們也要解決啊！"],["陳院長威明：現在的年輕人會遵守工時，但是有些年輕人會跟著刀，趕都趕不走，他想要學這個刀，時間到了會說「老師，請你讓我留下來」，現在還是有這種人，這種人應該鼓勵，但是我說，你不要害我違反工時規定，所以這個是我們目前的現況。","以前我們那個年代，搞到半夜兩、三點都沒有人抱怨，隔天又來上班，現在這種工時的保護是對的，但是有很多熱情的青年，我們要給他鼓勵。"],["黃委員仁：對，應該要予以鼓勵，因為對現在來講，醫師很珍貴，尤其是我們的醫護人員都非常珍貴，我們應該要在津貼上或加給上給予他們最大的鼓勵，好不好？"],["嚴主任委員德發：謝謝召委。"],["主席：謝謝黃仁委員，主委請回。","接下來有請林楚茵委員上台質詢。"]],"agenda":{"page_end":194,"meet_id":"委員會-11-3-35-18","speakers":["沈伯洋","陳俊宇","黃仁","林楚茵","林憶君","陳冠廷","王定宇","馬文君","羅美玲","徐巧芯"],"page_start":141,"meetingDate":["2025-05-28"],"gazette_id":"1145401","agenda_lcidc_ids":["1145401_00005"],"meet_name":"立法院第11屆第3會期外交及國防委員會第18次全體委員會議紀錄","content":"一、處理院會交付114年度中央政府總預算決議，僑務委員會主管預算凍結案等16案；二、處理\n院會交付114年度中央政府總預算決議，國軍退除役官兵輔導委員會主管預算凍結案等40案","agenda_id":"1145401_00004"}}}