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委員許宇甄等18人、委員邱鎮軍等19人、委員林月琴等17人、委員陳菁徽等18人、台灣民眾黨黨團、委員范雲等17人、委員邱若華等17人【提案第11006882號】、委員魯明哲等19人、委員傅崐萁等24人、委員洪孟楷等17人、委員邱若華等17人【提案第11010755號】分別擬具「身心障礙者權益保障法第五十三條條文修正草案」等11案。\n三、審查\n（一）委員范雲等17人、委員何欣純等17人、委員羅廷瑋等16人、委員廖偉翔等19人、委員陳菁徽等16人、委員羅美玲等16人、委員劉建國等17人分別擬具「身心障礙者權益保障法部分條文修正草案」等7案。\n（二）委員郭昱晴等19人擬具「身心障礙者權益保障法第十六條條文修正草案」案。\n（三）委員陳冠廷等16人擬具「身心障礙者權益保障法第三十八條條文修正草案」案。\n（四）委員陳冠廷等20人擬具「身心障礙者權益保障法第二條、第五十三條及第九十九條條文修正草案」案。\n（五）委員徐富癸等18人擬具「身心障礙者權益保障法第十條條文修正草案」案。\n（六）委員黃捷等17人擬具「身心障礙者權益保障法第七十一條條文修正草案」案。\n（七）委員王鴻薇等20人擬具「身心障礙者權益保障法增訂第四十條之一條文草案」案。\n（八）委員柯志恩等18人擬具「身心障礙者權益保障法增訂第四十條之一條文草案」案。\n（九）委員柯志恩等17人擬具「身心障礙者權益保障法第六十條之一條文修正草案」案。\n（十）委員馬文君等19人擬具「身心障礙者權益保障法第三十條之一、第五十條及第五十二條條文修正草案」案。\n（十一）委員廖偉翔等21人擬具「身心障礙者權益保障法增訂第五十條之一條文草案」案。\n（十二）委員林楚茵等20人擬具「身心障礙者權益保障法第十條條文修正草案」案。\n（十三）委員洪孟楷等18人擬具「身心障礙者權益保障法增訂第四十條之一條文草案」案。\n（十四）委員陳俊宇等18人擬具「身心障礙者權益保障法第七十一條條文修正草案」案。\n（十五）委員林楚茵等17人擬具「身心障礙者權益保障法第七十一條條文修正草案」案。\n（十六）委員劉建國等17人擬具「身心障礙者權益保障法第七十一條條文修正草案」案。\n（十七）委員邱若華等17人擬具「身心障礙者權益保障法第七十一條條文修正草案」案。\n【第一案至第三案採綜合詢答；本日僅處理第一案及第二案。】\n【6月23日、25日及26日三天一次會】）","type":"Clip","date":"2025-06-23","start_time":"2025-06-23T12:44:02+08:00","end_time":"2025-06-23T13:02:56+08:00","duration":1134,"meet":{"tmpMeeting":null,"title":"第11屆第3會期社會福利及衛生環境委員會第18次全體委員會議","term":11,"type":"委員會","sessionPeriod":3,"sessionTimes":18,"committees":[26],"id":"委員會-11-3-26-18"},"features":["ai-transcript","gazette"],"transcript":{"id":"162793","pyannote":{"name":"ronny","tool":"pyannote","data":{"url":"https://ivod.ly.gov.tw/Play/Clip/1M/162793","tool":"pyannote","id":"162793-pyannote"},"job_id":"D9YBuGY50rZqpumO","queued_at":"2025-06-23 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545.806, \"score\": 0.665}, {\"word\": \"我\", \"start\": 545.806, \"end\": 545.946, \"score\": 0.857}, {\"word\": \"想\", \"start\": 545.946, \"end\": 546.607, \"score\": 0.999}, {\"word\": \"我\", \"start\": 546.607, \"end\": 547.008, \"score\": 0.925}, {\"word\": \"剛\"}, {\"word\": \"剛\"}, {\"word\": \"提\", \"start\": 547.008, \"end\": 547.128, \"score\": 0.852}, {\"word\": \"的\", \"start\": 547.128, \"end\": 547.228, \"score\": 0.998}, {\"word\": \"一\", \"start\": 547.228, \"end\": 547.369, \"score\": 1.0}, {\"word\": \"切\", \"start\": 547.369, \"end\": 547.529, \"score\": 0.993}, {\"word\": \"的\", \"start\": 547.529, \"end\": 547.629, \"score\": 0.79}, {\"word\": \"一\", \"start\": 547.629, \"end\": 547.749, \"score\": 1.0}, {\"word\": \"切\", \"start\": 547.749, \"end\": 547.929, \"score\": 0.998}, {\"word\": \"希\", \"start\": 547.929, \"end\": 548.05, \"score\": 0.835}, {\"word\": \"望\", \"start\": 548.05, \"end\": 548.13, \"score\": 0.757}, {\"word\": \"你\", \"start\": 548.13, 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\"針對這三天的這個連續射診的規定有進行系統性的評估因為我想我的這個評估是因為如果有相關數據顯示這樣安排可以提升受診人的醫療品質然後減少疾病惡化然後降低轉診的比例\", \"words\": [{\"word\": \"針\"}, {\"word\": \"對\"}, {\"word\": \"這\"}, {\"word\": \"三\", \"start\": 652.482, \"end\": 652.742, \"score\": 0.997}, {\"word\": \"天\", \"start\": 652.742, \"end\": 653.623, \"score\": 1.0}, {\"word\": \"的\", \"start\": 653.623, \"end\": 655.144, \"score\": 0.941}, {\"word\": \"這\"}, {\"word\": \"個\"}, {\"word\": \"連\"}, {\"word\": \"續\"}, {\"word\": \"射\", \"start\": 655.144, \"end\": 655.945, \"score\": 0.95}, {\"word\": \"診\"}, {\"word\": \"的\", \"start\": 655.945, \"end\": 656.305, \"score\": 0.898}, {\"word\": \"規\"}, {\"word\": \"定\", \"start\": 656.305, \"end\": 656.426, \"score\": 0.997}, {\"word\": \"有\", \"start\": 656.426, \"end\": 656.706, \"score\": 0.928}, {\"word\": \"進\"}, {\"word\": \"行\", \"start\": 656.706, \"end\": 656.866, \"score\": 0.993}, {\"word\": \"系\", \"start\": 656.866, \"end\": 657.166, \"score\": 0.926}, {\"word\": \"統\"}, {\"word\": \"性\", 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\"果\", \"start\": 661.671, \"end\": 661.791, \"score\": 0.963}, {\"word\": \"有\", \"start\": 661.791, \"end\": 662.011, \"score\": 0.997}, {\"word\": \"相\", \"start\": 662.011, \"end\": 663.092, \"score\": 0.922}, {\"word\": \"關\"}, {\"word\": \"數\"}, {\"word\": \"據\"}, {\"word\": \"顯\"}, {\"word\": \"示\", \"start\": 663.092, \"end\": 663.472, \"score\": 0.924}, {\"word\": \"這\"}, {\"word\": \"樣\"}, {\"word\": \"安\", \"start\": 663.472, \"end\": 663.673, \"score\": 0.997}, {\"word\": \"排\", \"start\": 663.673, \"end\": 664.213, \"score\": 0.994}, {\"word\": \"可\", \"start\": 664.213, \"end\": 664.333, \"score\": 0.886}, {\"word\": \"以\", \"start\": 664.333, \"end\": 664.453, \"score\": 0.991}, {\"word\": \"提\", \"start\": 664.453, \"end\": 664.674, \"score\": 0.992}, {\"word\": \"升\", \"start\": 664.674, \"end\": 664.874, \"score\": 0.91}, {\"word\": \"受\", \"start\": 664.874, \"end\": 665.174, \"score\": 0.865}, {\"word\": \"診\"}, {\"word\": \"人\", \"start\": 665.174, \"end\": 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{\"word\": \"過\"}, {\"word\": \"來\"}, {\"word\": \"看\", \"start\": 683.127, \"end\": 683.307, \"score\": 0.999}, {\"word\": \"就\", \"start\": 683.307, \"end\": 683.507, \"score\": 0.988}, {\"word\": \"是\", \"start\": 683.507, \"end\": 684.007, \"score\": 0.96}, {\"word\": \"說\"}, {\"word\": \"連\"}, {\"word\": \"續\"}, {\"word\": \"執\"}, {\"word\": \"勤\", \"start\": 684.007, \"end\": 684.147, \"score\": 0.857}, {\"word\": \"那\", \"start\": 684.147, \"end\": 684.347, \"score\": 0.9}, {\"word\": \"導\"}, {\"word\": \"致\", \"start\": 684.347, \"end\": 684.487, \"score\": 0.857}, {\"word\": \"這\"}, {\"word\": \"個\"}, {\"word\": \"醫\"}, {\"word\": \"護\"}, {\"word\": \"人\", \"start\": 684.487, \"end\": 684.587, \"score\": 0.8}, {\"word\": \"員\"}, {\"word\": \"疲\", \"start\": 684.587, \"end\": 684.808, \"score\": 0.909}, {\"word\": \"勞\"}, {\"word\": \"累\", \"start\": 684.808, \"end\": 685.308, \"score\": 0.96}, {\"word\": \"積\"}, {\"word\": \"那\", \"start\": 685.308, \"end\": 685.448, \"score\": 0.999}, {\"word\": \"也\", \"start\": 685.448, \"end\": 685.468, \"score\": 0.0}, {\"word\": \"會\"}, {\"word\": \"影\", \"start\": 685.468, \"end\": 685.648, \"score\": 0.889}, {\"word\": \"響\"}, {\"word\": \"這\"}, {\"word\": \"個\"}, {\"word\": \"診\"}, {\"word\": \"斷\"}, {\"word\": \"的\", \"start\": 685.648, \"end\": 685.668, \"score\": 0.0}, {\"word\": \"這\"}, {\"word\": \"個\"}]}, {\"start\": 693.093, \"end\": 699.562, \"text\": \"準確性跟應變能力所以這個部分我不知道你們是不是有這個數據上的一個研究統計\", \"words\": [{\"word\": \"準\", \"start\": 693.093, \"end\": 693.574, \"score\": 0.917}, {\"word\": \"確\"}, {\"word\": \"性\", \"start\": 693.574, \"end\": 693.774, \"score\": 0.992}, {\"word\": \"跟\", \"start\": 693.774, \"end\": 694.295, \"score\": 0.888}, {\"word\": \"應\"}, {\"word\": \"變\"}, {\"word\": \"能\", \"start\": 694.295, \"end\": 694.535, \"score\": 1.0}, {\"word\": \"力\", \"start\": 694.535, \"end\": 695.116, \"score\": 0.979}, {\"word\": \"所\", \"start\": 695.116, \"end\": 695.256, \"score\": 1.0}, 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00:00:30,849\n我想先看一下這個圖這部電影的畫面是1990年已故的金馬影帝陳崧勇主演的電影片名叫我在死牢的日子\n\n3\n00:00:45,845 --> 00:01:03,179\n那這個畫面的影片中呢一位死刑犯挾持監所護理師的畫面那雖然這是一部電影但是沒想到這樣的畫面卻真實在監獄裡面上演而且發生在我們台東那這個是\n\n4\n00:01:05,040 --> 00:01:20,523\n在这个月的10号东城监狱发生受刑人看诊时勒住护理师的颈部拿笔攻击护理师的新闻这是当天发生事件诊间的示意图我们看一下\n\n5\n00:01:21,244 --> 00:01:37,602\n受刑人進入診間之後坐在醫師的左邊當時那隻行兇的筆是放在醫師桌上的右手邊那位受刑人先把醫師右手邊的筆緩緩拿到醫師的左手邊放在桌上\n\n6\n00:01:38,163 --> 00:01:56,500\n那後來拿起筆就往護理師方向過去攻擊護理師那當時在那個診間沒有戒護人員發生事件之後診間走道上的兩位戒護人員就立即衝進去壓制受刑人\n\n7\n00:01:58,181 --> 00:02:14,366\n整間內這裡有個重點就是說整間內為什麼沒有戒護人員那為什麼放獸型人與這個醫護單獨處在一個空間內那這樣的戒護都沒有疏失嗎矯正署\n\n8\n00:02:20,165 --> 00:02:29,371\n好主席還有委員針對剛才委員的一個提問就是針對東城監獄在10號發生這個雙人攻擊這個醫護人員的事件剛才委員提到當時其實我們在整監其實都有有監護人員在戒護\n\n9\n00:02:38,717 --> 00:03:04,544\n但是他介護不是只有單純幾個人他整批帶過去看診大概也有數十個人那可能他站的位置大概當時可能是在這個外面的這個還看診區那真正他實際進入到診間去呢這部分我們一般介護人員並不會就是直接跟著他進去你說診間內有介護人員他另外診間還沒有我說那個看診區的地方他在等待看診區後診區後診區\n\n10\n00:03:07,205 --> 00:03:33,790\n好沒有關係我不跟你討論細節啦但是發生的當下整間內或許空間狹小那沒有確實裡面在整間內沒有健護人員在裡面好所以這個部分我在這裡點出來這也是未來你們要要這個檢討的事情那是不是因為那畢竟只有一坪左右大小的空間\n\n11\n00:03:35,190 --> 00:04:01,102\n那這樣的一個空間是不是你們要繼續如果發生這樣的事件我想空間的大小也是為了你們要檢討的一個問題那承辦這個業務的醫院其實是非常的憤慨那他們也揚言說如果就是說未來繼續這個樣子都沒有改善的話他們要退出這個服務那根據這個台東縣護理師公會\n\n12\n00:04:05,018 --> 00:04:23,074\n在6月15日發表一個最新的聲明他們對這個事件也表達強烈的不滿並且提出4點的具體訴求包括立即要制定入監醫療安全指引建立完善的這個醫療暴力通報與應變處理機制而且要立法將\n\n13\n00:04:23,735 --> 00:04:31,098\n第一線醫護人員的納入保護範圍以及這個全面檢討現行矯正機關的醫療服務契約內容以確保這個整個醫護人員的這個執行安全我想這些這些訴求不僅反映了這個基層的這個醫護人員的這個切身的需求更凸顯\n\n14\n00:04:44,644 --> 00:05:05,259\n長期以來矯正機關在醫療服務中這個安全保障機制的嚴重不足的這個結構性問題那我不知道說在這邊衛福部是不是在這個事件發生之後已經有立即跟這個矯正署來共同討論檢討如何改進了你們是不是已經有開會了有嗎\n\n15\n00:05:10,634 --> 00:05:31,413\n其實這個我們一樣是非常嚴厲的譴責這樣的一個情況我們與相關的單位我們有發表的聲明衛福部有發表的聲明部長我不是要你們衛福部發表聲明我的問題是你們有沒有跟剿政署共同來開會提出檢討\n\n16\n00:05:35,185 --> 00:05:53,929\n我們當時新聞稿是說我們將會與相關的單位好沒關係如果將會齁就不是出國的將會齁我希望你們立刻好不好在最短的時間內不然我跟你講這個醫療體系退出服務是很嚴重對他們受刑人權益也是一個傷害啦可以快一點嗎你們在那邊講個時間點在什麼時候之內你要完成\n\n17\n00:06:02,031 --> 00:06:16,038\n我們跟矯正單位馬上來進行在檢討整個作業我們本來有一個作業稀之你們是不是兩個禮拜內因為畢竟這件事情已經發生一段時間我們兩個禮拜內就馬上來召開相關的聯繫會議檢討流程然後跟委員報告\n\n18\n00:06:22,461 --> 00:06:44,780\n那因為根據自由時報的報導這個已經不是單一的事件因為近年來類似醫療暴力的事件在全國各地的這個監所都陸續發生例如在去年台北監獄跟高雄監獄都有類似的案例所以這個問題已經是一個就是說常年發生的問題必須我們要很嚴肅的來看待\n\n19\n00:06:51,128 --> 00:06:56,720\n我想聚焦在東城監獄這件令人痛心的暴力事件\n\n20\n00:06:59,517 --> 00:07:20,769\n在這個當然在這個部分剛剛有提到就是說在管理的部分有一個也出現很大的漏洞在監所內對於這個危險物品的管理儲存有這個重大的瑕疵那收容人他如何能夠輕易取得這個\n\n21\n00:07:21,710 --> 00:07:47,808\n尖尖的這個原子筆作為這個攻擊的工具也反映出說對這個高風險收容的這個風險評估還有這個無預警的機制這個是非常明顯不足的那我想在這個工會的護理師工會的這個訴求當中已經有特別強調就是說制定入監醫療安全指引這個部分那麼\n\n22\n00:07:50,034 --> 00:08:14,189\n那麼我們再看在特約根據全民健康保險提供的矯正機關醫療服務計畫裡面特約醫療院所必須要承擔來提供醫療服務的責任但是契約的內容幾乎都沒有提到風險保障還有安全協助的具體條款\n\n23\n00:08:15,520 --> 00:08:34,478\n好那這個在現實執行的這個環境的危險性其實看起來是明顯脫節同時我們在醫療法裡面24條還有106條雖然已經明定這個醫療暴力的刑事責任但是呢在這個矯正機關作為特殊\n\n24\n00:08:36,200 --> 00:08:59,397\n他們在矯正機關的這個特殊環境執法的保障保護的實際執行顯然是沒有辦法跟上這個法律的規範那我想在五月的時候莊惠雄委員質詢當中也有提出類似醫療暴力事件頻傳也需要法務部跟衛福部進行跨部會的合作跟系統性的解決\n\n25\n00:09:01,520 --> 00:09:08,550\n從第一個問題看起來你們目前都還沒有聚在一起所以我想我剛剛提的一切的一切希望你們兩個禮拜這個會議可以來啟動好\n\n26\n00:09:15,526 --> 00:09:30,759\n那再來我想有另外一個兩個問題就是說我們要檢討一下這個現行醫療服務的執行規範有特別矯正機關有要求這個醫療團隊連續三天設診再連續假期\n\n27\n00:09:36,664 --> 00:09:57,192\n的時候那每天最多分為上午跟下午兩個時段那每個時段呢原則上三個小時並且至少就是說至少就是說間隔半個小時那這項規定本來就是說要確保這個受刑人的醫療需求跟穩定\n\n28\n00:09:58,573 --> 00:10:25,275\n但是在執行當中也發生了嚴重的問題就是大家想一想連續三天高強度的執勤特別在介護人力有限的情況下顯著增加了醫護人員身心上的負擔也有可能就是說因為連續三天因為疲勞降低警覺性\n\n29\n00:10:25,936 --> 00:10:50,981\n好所以從這個間接來提升安全風險那這個部分東城監獄的事件當中我們了解就是說這護理師正處於連續執勤的第三天那或許這個也是他就是說未能及時察覺危險因素的其中之一啦好所以特別點出這個部分我不知道繳證署是不是也有\n\n30\n00:10:52,482 --> 00:11:09,738\n針對這三天的這個連續射診的規定有進行系統性的評估因為我想我的這個評估是因為如果有相關數據顯示這樣安排可以提升受診人的醫療品質然後減少疾病惡化然後降低轉診的比例\n\n31\n00:11:10,399 --> 00:11:25,668\n那當然這個是值得考慮但是就是說你到底有沒有充分的數據來支持能夠證明這項規定的必要性那再反過來看就是說連續執勤那導致這個醫護人員疲勞累積那也會影響這個診斷的這個\n\n32\n00:11:33,093 --> 00:11:39,562\n準確性跟應變能力所以這個部分我不知道你們是不是有這個數據上的一個研究統計\n\n33\n00:11:42,302 --> 00:11:55,693\n從我們醫療的角度來看,真的醫院本身就已經業務繁重那在年息假期又要增多這樣的一個服務,其實壓力會非常大,我想連手裡面的介護人員恐怕都\n\n34\n00:12:03,806 --> 00:12:20,821\n人力都不一定有辦法來配合我們希望在看門診的時候其實在我們覺得應該是不是都要為了保護醫跟護因為醫療暴力零容忍所以如果在這個叫矯正機關裡面的\n\n35\n00:12:26,944 --> 00:12:50,935\n的人也應該是比較更需要去關心因為他可能情緒不好或怎麼樣所以基本上我以前我們很多學生到監獄裡面去看像雲林在哪裡很多台大醫院訓練也負責很多其實他們都覺得很有意義但是無形中還是潛在的有他危險我聽了那麼久我是聽不到部長你的針對我的問題回答就是說\n\n36\n00:12:55,797 --> 00:13:04,341\n因為要檢討嘛你剛剛講這個問題我們都知道啊所以我是不是在這裡具體檢討我是希望因為這個是矯正機關矯正機關要求的啦我想是不是說這個部分對我剛剛問他嘛部長搶著回答我也不知道\n\n37\n00:13:12,864 --> 00:13:41,550\n医码疲劳啊说明一下针对这个三天以上有连续假期要请这个我们的医事的服务的企业的这些医疗机构来看诊但这个根本的考量也是根据我们的一个目前我们在我想我们不谈需求啦我这里讲你有没有什么应变的方式比如说把现行规定改为这个弹性排班嘛或者是每周轮替的频率增加嘛\n\n38\n00:13:42,861 --> 00:14:07,812\n好對不對所以或者是你們要根據這個實際的這個醫療需求來做一個整個射診的時段的調整嗎這部分我們會跟外部再研議那目前這個根據是根據我們不得連續三天不得開封不得什麼連續三天不開封不開就是說不開什麼讓他們能夠從設防出來到工廠去洗澡運動\n\n39\n00:14:09,033 --> 00:14:36,678\n那尤其一到年假像明年的過年有九天的假期你不可能說都不讓他們出來洗澡或是看電視或是這個抽菸幹嘛那趁這個時間的時候因為這時間的假期太長我們也希望安排有醫療看診一定有需求的這樣的一個需求所以我們才會有這樣的一個規範請衛福部或是真的相關的醫療機構對啦現在就是你們不能只考慮到受診人的需求嘛\n\n40\n00:14:37,498 --> 00:15:00,493\n阿現在就是發生這樣的問題請你們一併檢討我剛剛提供幾個方法然後我已經沒有時間了但我提一個最後最嚴重的問題就是我們現在來就是說壽星人看診欠費的問題你要看一下喔這個欠費截至目前為止總共積欠了1278萬元\n\n41\n00:15:04,821 --> 00:15:09,326\n這個統計只是現在在裡面的受刑人欠費的統計喔他們一旦畢業出監之後那些數據就\n\n42\n00:15:19,520 --> 00:15:41,668\n那個一筆勾銷然後全部都要醫院自己想辦法去追討我想這個是非常不合理的醫院已經冒著生命的危險派人去監所裡面去提供服務了然後這些受刑人他無力負擔的時候\n\n43\n00:15:42,938 --> 00:16:02,508\n你們那出間以後矯正署說沒有我的事啊這個是這個是天大沒有道理的如果你們這個不改的話我呼籲不用我呼籲啦我告訴你已經有醫院的院長在跟我們講說我們要全面退出啦看你們怎麼辦啦矯正署關起來了\n\n44\n00:16:05,990 --> 00:16:25,642\n當然委員剛才講的這個1278萬是到今年4月底為止,就是在間的部分現在只是4月,總計到4月而已那如果這個在間的部分,我們現在目前的一些都有強制在跟他扣款而且積極在扣款,那也有聯繫他的家屬,如果他沒有錢也會聯繫他的家屬來繳款\n\n45\n00:16:27,204 --> 00:16:44,466\n另外我們也有請他可以根據相關的健保法來申請這些減免或是要貸款等等的一個補助所以你的意思就是說那個醫院繼續自己去跟這些受刑人然後出監以後繼續去跟他們追討\n\n46\n00:16:46,090 --> 00:17:00,282\n我這樣啦齁我在這邊提出具體的建議第一個要求你們回頭去統計已經出間的就是說積欠的費用到底有多少我們很想看看我們替這些醫院\n\n47\n00:17:02,369 --> 00:17:18,564\n發聲一下到底還有多少錢沒有收回來我想看了以後搞不好都沒有醫院願意進去監鎖了然後我想這個其實是這個部分你們就是說有沒有\n\n48\n00:17:20,576 --> 00:17:41,004\n在這個我提出建議啦就是說矯正署你們研議能否代電受刑人的支付額啦並且針對這個無力支付的這個個案進行後續的追討啦你怎麼不能叫醫院自己去討啊醫院還要忙著救別人對不對難道醫院還要負責討債嗎\n\n49\n00:17:43,035 --> 00:18:03,005\n再來就是說能否在這個醫療服務契約當中增添這個欠費補償的機制保障這個醫療機構的權益我想我就提出這兩個建議剩下的你們就繼續研議我要在你們就是說剛剛都說了種種一切的一切我們兩個禮拜內啟動\n\n50\n00:18:06,171 --> 00:18:28,277\n這樣子的會議衛福部跟矯正署好那你們這個欠費這個我給你們幾個月的時間你們好好去研議好看要修要修哪裡你們的辦法要怎麼修就不要讓醫院進去承受這些風險出去討債你覺得他們會遇到什麼如果有人出去\n\n51\n00:18:29,591 --> 00:18:49,385\n我不知道他們未來是出監以後是什麼樣的狀況那個人頭銷也是很恐怖的好嗎好就那個你的衛福部兩個禮拜啊那個監這個這個矯正署的欠費的一個月好謝謝好謝謝\n\n","tsv":"start\tend\ttext\n10036\t18820\t謝主席麻煩請法部剿政署跟衛福部剿政署還有衛福部要哪位?部長是國建署?沒有\n27325\t30849\t我想先看一下這個圖這部電影的畫面是1990年已故的金馬影帝陳崧勇主演的電影片名叫我在死牢的日子\n45845\t63179\t那這個畫面的影片中呢一位死刑犯挾持監所護理師的畫面那雖然這是一部電影但是沒想到這樣的畫面卻真實在監獄裡面上演而且發生在我們台東那這個是\n65040\t80523\t在这个月的10号东城监狱发生受刑人看诊时勒住护理师的颈部拿笔攻击护理师的新闻这是当天发生事件诊间的示意图我们看一下\n81244\t97602\t受刑人進入診間之後坐在醫師的左邊當時那隻行兇的筆是放在醫師桌上的右手邊那位受刑人先把醫師右手邊的筆緩緩拿到醫師的左手邊放在桌上\n98163\t116500\t那後來拿起筆就往護理師方向過去攻擊護理師那當時在那個診間沒有戒護人員發生事件之後診間走道上的兩位戒護人員就立即衝進去壓制受刑人\n118181\t134366\t整間內這裡有個重點就是說整間內為什麼沒有戒護人員那為什麼放獸型人與這個醫護單獨處在一個空間內那這樣的戒護都沒有疏失嗎 矯正署\n140165\t149371\t好 主席還有委員 針對剛才委員的一個提問就是針對東城監獄在10號發生這個雙人攻擊這個醫護人員的事件剛才委員提到 當時其實我們在整監其實都有有監護人員在戒護\n158717\t184544\t但是他介護不是只有單純幾個人他整批帶過去看診大概也有數十個人那可能他站的位置大概當時可能是在這個外面的這個還看診區那真正他實際進入到診間去呢這部分我們一般介護人員並不會就是直接跟著他進去你說診間內有介護人員他另外診間還沒有我說那個看診區的地方他在等待看診區後診區後診區\n187205\t213790\t好沒有關係我不跟你討論細節啦但是發生的當下整間內或許空間狹小那沒有確實裡面在整間內沒有健護人員在裡面好所以這個部分我在這裡點出來這也是未來你們要要這個檢討的事情那是不是因為那畢竟只有一坪左右大小的空間\n215190\t241102\t那這樣的一個空間是不是你們要繼續如果發生這樣的事件我想空間的大小也是為了你們要檢討的一個問題那承辦這個業務的醫院其實是非常的憤慨那他們也揚言說如果就是說未來繼續這個樣子都沒有改善的話他們要退出這個服務那根據這個台東縣護理師公會\n245018\t263074\t在6月15日發表一個最新的聲明他們對這個事件也表達強烈的不滿並且提出4點的具體訴求包括立即要制定入監醫療安全指引建立完善的這個醫療暴力通報與應變處理機制而且要立法將\n263735\t271098\t第一線醫護人員的納入保護範圍以及這個全面檢討現行矯正機關的醫療服務契約內容以確保這個整個醫護人員的這個執行安全我想這些這些訴求不僅反映了這個基層的這個醫護人員的這個切身的需求更凸顯\n284644\t305259\t長期以來矯正機關在醫療服務中這個安全保障機制的嚴重不足的這個結構性問題那我不知道說在這邊衛福部是不是在這個事件發生之後已經有立即跟這個矯正署來共同討論檢討如何改進了你們是不是已經有開會了有嗎\n310634\t331413\t其實這個我們一樣是非常嚴厲的譴責這樣的一個情況我們與相關的單位我們有發表的聲明衛福部有發表的聲明部長我不是要你們衛福部發表聲明我的問題是你們有沒有跟剿政署共同來開會提出檢討\n335185\t353929\t我們當時新聞稿是說我們將會與相關的單位好沒關係如果將會齁就不是出國的將會齁我希望你們立刻好不好在最短的時間內不然我跟你講這個醫療體系退出服務是很嚴重對他們受刑人權益也是一個傷害啦可以快一點嗎你們在那邊講個時間點在什麼時候之內你要完成\n362031\t376038\t我們跟矯正單位馬上來進行在檢討整個作業我們本來有一個作業稀之你們是不是兩個禮拜內因為畢竟這件事情已經發生一段時間我們兩個禮拜內就馬上來召開相關的聯繫會議檢討流程然後跟委員報告\n382461\t404780\t那因為根據自由時報的報導這個已經不是單一的事件因為近年來類似醫療暴力的事件在全國各地的這個監所都陸續發生例如在去年台北監獄跟高雄監獄都有類似的案例所以這個問題已經是一個就是說常年發生的問題必須我們要很嚴肅的來看待\n411128\t416720\t我想聚焦在東城監獄這件令人痛心的暴力事件\n419517\t440769\t在這個當然在這個部分剛剛有提到就是說在管理的部分有一個也出現很大的漏洞在監所內對於這個危險物品的管理儲存有這個重大的瑕疵那收容人他如何能夠輕易取得這個\n441710\t467808\t尖尖的這個原子筆作為這個攻擊的工具也反映出說對這個高風險收容的這個風險評估還有這個無預警的機制這個是非常明顯不足的那我想在這個工會的護理師工會的這個訴求當中已經有特別強調就是說制定入監醫療安全指引這個部分那麼\n470034\t494189\t那麼我們再看在特約根據全民健康保險提供的矯正機關醫療服務計畫裡面特約醫療院所必須要承擔來提供醫療服務的責任但是契約的內容幾乎都沒有提到風險保障還有安全協助的具體條款\n495520\t514478\t好那這個在現實執行的這個環境的危險性其實看起來是明顯脫節同時我們在醫療法裡面24條還有106條雖然已經明定這個醫療暴力的刑事責任但是呢在這個矯正機關作為特殊\n516200\t539397\t他們在矯正機關的這個特殊環境執法的保障保護的實際執行顯然是沒有辦法跟上這個法律的規範那我想在五月的時候莊惠雄委員質詢當中也有提出類似醫療暴力事件頻傳也需要法務部跟衛福部進行跨部會的合作跟系統性的解決\n541520\t548550\t從第一個問題看起來你們目前都還沒有聚在一起所以我想我剛剛提的一切的一切希望你們兩個禮拜這個會議可以來啟動好\n555526\t570759\t那再來我想有另外一個兩個問題就是說我們要檢討一下這個現行醫療服務的執行規範有特別矯正機關有要求這個醫療團隊連續三天設診再連續假期\n576664\t597192\t的時候那每天最多分為上午跟下午兩個時段那每個時段呢原則上三個小時並且至少就是說至少就是說間隔半個小時那這項規定本來就是說要確保這個受刑人的醫療需求跟穩定\n598573\t625275\t但是在執行當中也發生了嚴重的問題就是大家想一想連續三天高強度的執勤特別在介護人力有限的情況下顯著增加了醫護人員身心上的負擔也有可能就是說因為連續三天因為疲勞降低警覺性\n625936\t650981\t好 所以從這個間接來提升安全風險那這個部分東城監獄的事件當中我們了解就是說這護理師正處於連續執勤的第三天那或許這個也是他就是說未能及時察覺危險因素的其中之一啦好 所以特別點出這個部分我不知道繳證署是不是也有\n652482\t669738\t針對這三天的這個連續射診的規定有進行系統性的評估因為我想我的這個評估是因為如果有相關數據顯示這樣安排可以提升受診人的醫療品質然後減少疾病惡化然後降低轉診的比例\n670399\t685668\t那當然這個是值得考慮但是就是說你到底有沒有充分的數據來支持能夠證明這項規定的必要性那再反過來看就是說連續執勤那導致這個醫護人員疲勞累積那也會影響這個診斷的這個\n693093\t699562\t準確性跟應變能力所以這個部分我不知道你們是不是有這個數據上的一個研究統計\n702302\t715693\t從我們醫療的角度來看,真的醫院本身就已經業務繁重那在年息假期又要增多這樣的一個服務,其實壓力會非常大,我想連手裡面的介護人員恐怕都\n723806\t740821\t人力都不一定有辦法來配合我們希望在看門診的時候其實在我們覺得應該是不是都要為了保護醫跟護因為醫療暴力零容忍所以如果在這個叫矯正機關裡面的\n746944\t770935\t的人也應該是比較更需要去關心因為他可能情緒不好或怎麼樣所以基本上我以前我們很多學生到監獄裡面去看像雲林在哪裡很多台大醫院訓練也負責很多其實他們都覺得很有意義但是無形中還是潛在的有他危險我聽了那麼久我是聽不到部長你的針對我的問題回答就是說\n775797\t784341\t因為要檢討嘛 你剛剛講這個問題我們都知道啊所以我是不是在這裡 具體檢討我是希望 因為這個是矯正機關矯正機關要求的啦 我想是不是說這個部分對 我剛剛問他嘛 部長搶著回答 我也不知道\n792864\t821550\t医码疲劳啊说明一下针对这个三天以上有连续假期要请这个我们的医事的服务的企业的这些医疗机构来看诊但这个根本的考量也是根据我们的一个目前我们在我想我们不谈需求啦我这里讲你有没有什么应变的方式比如说把现行规定改为这个弹性排班嘛或者是每周轮替的频率增加嘛\n822861\t847812\t好對不對所以或者是你們要根據這個實際的這個醫療需求來做一個整個射診的時段的調整嗎這部分我們會跟外部再研議那目前這個根據是根據我們不得連續三天不得開封不得什麼連續三天不開封不開就是說不開什麼讓他們能夠從設防出來到工廠去洗澡運動\n849033\t876678\t那尤其一到年假像明年的過年有九天的假期你不可能說都不讓他們出來洗澡或是看電視或是這個抽菸幹嘛那趁這個時間的時候因為這時間的假期太長我們也希望安排有醫療看診一定有需求的這樣的一個需求所以我們才會有這樣的一個規範請衛福部或是真的相關的醫療機構對啦現在就是你們不能只考慮到受診人的需求嘛\n877498\t900493\t阿現在就是發生這樣的問題請你們一併檢討我剛剛提供幾個方法然後我已經沒有時間了但我提一個最後最嚴重的問題就是我們現在來就是說壽星人看診欠費的問題你要看一下喔這個欠費截至目前為止總共積欠了1278萬元\n904821\t909326\t這個統計只是現在在裡面的受刑人欠費的統計喔他們一旦畢業出監之後那些數據就\n919520\t941668\t那個一筆勾銷然後全部都要醫院自己想辦法去追討我想這個是非常不合理的醫院已經冒著生命的危險派人去監所裡面去提供服務了然後這些受刑人他無力負擔的時候\n942938\t962508\t你們那出間以後 矯正署說沒有我的事啊這個是這個是天大沒有道理的如果你們這個不改的話我呼籲不用我呼籲啦 我告訴你已經有醫院的院長在跟我們講說我們要全面退出啦看你們怎麼辦啦矯正署關起來了\n965990\t985642\t當然委員剛才講的這個1278萬是到今年4月底為止,就是在間的部分現在只是4月,總計到4月而已那如果這個在間的部分,我們現在目前的一些都有強制在跟他扣款而且積極在扣款,那也有聯繫他的家屬,如果他沒有錢也會聯繫他的家屬來繳款\n987204\t1004466\t另外我們也有請他可以根據相關的健保法來申請這些減免或是要貸款等等的一個補助所以你的意思就是說那個醫院繼續自己去跟這些受刑人然後出監以後繼續去跟他們追討\n1006090\t1020282\t我這樣啦齁我在這邊提出具體的建議第一個要求你們回頭去統計已經出間的就是說積欠的費用到底有多少我們很想看看我們替這些醫院\n1022369\t1038564\t發聲一下到底還有多少錢沒有收回來我想看了以後搞不好都沒有醫院願意進去監鎖了然後我想這個其實是這個部分你們就是說有沒有\n1040576\t1061004\t在這個我提出建議啦就是說矯正署你們研議能否代電受刑人的支付額啦並且針對這個無力支付的這個個案進行後續的追討啦你怎麼不能叫醫院自己去討啊醫院還要忙著救別人對不對難道醫院還要負責討債嗎\n1063035\t1083005\t再來就是說能否在這個醫療服務契約當中增添這個欠費補償的機制保障這個醫療機構的權益我想我就提出這兩個建議剩下的你們就繼續研議我要在你們就是說剛剛都說了種種一切的一切我們兩個禮拜內啟動\n1086171\t1108277\t這樣子的會議衛福部跟矯正署好那你們這個欠費這個我給你們幾個月的時間你們好好去研議好看要修要修哪裡你們的辦法要怎麼修就不要讓醫院進去承受這些風險出去討債你覺得他們會遇到什麼如果有人出去\n1109591\t1129385\t我不知道他們未來是出監以後是什麼樣的狀況那個人頭銷也是很恐怖的好嗎好就那個你的衛福部兩個禮拜啊那個監這個這個矯正署的欠費的一個月好謝謝好謝謝\n","txt":"謝主席麻煩請法部剿政署跟衛福部剿政署還有衛福部要哪位?部長是國建署?沒有\n我想先看一下這個圖這部電影的畫面是1990年已故的金馬影帝陳崧勇主演的電影片名叫我在死牢的日子\n那這個畫面的影片中呢一位死刑犯挾持監所護理師的畫面那雖然這是一部電影但是沒想到這樣的畫面卻真實在監獄裡面上演而且發生在我們台東那這個是\n在这个月的10号东城监狱发生受刑人看诊时勒住护理师的颈部拿笔攻击护理师的新闻这是当天发生事件诊间的示意图我们看一下\n受刑人進入診間之後坐在醫師的左邊當時那隻行兇的筆是放在醫師桌上的右手邊那位受刑人先把醫師右手邊的筆緩緩拿到醫師的左手邊放在桌上\n那後來拿起筆就往護理師方向過去攻擊護理師那當時在那個診間沒有戒護人員發生事件之後診間走道上的兩位戒護人員就立即衝進去壓制受刑人\n整間內這裡有個重點就是說整間內為什麼沒有戒護人員那為什麼放獸型人與這個醫護單獨處在一個空間內那這樣的戒護都沒有疏失嗎 矯正署\n好 主席還有委員 針對剛才委員的一個提問就是針對東城監獄在10號發生這個雙人攻擊這個醫護人員的事件剛才委員提到 當時其實我們在整監其實都有有監護人員在戒護\n但是他介護不是只有單純幾個人他整批帶過去看診大概也有數十個人那可能他站的位置大概當時可能是在這個外面的這個還看診區那真正他實際進入到診間去呢這部分我們一般介護人員並不會就是直接跟著他進去你說診間內有介護人員他另外診間還沒有我說那個看診區的地方他在等待看診區後診區後診區\n好沒有關係我不跟你討論細節啦但是發生的當下整間內或許空間狹小那沒有確實裡面在整間內沒有健護人員在裡面好所以這個部分我在這裡點出來這也是未來你們要要這個檢討的事情那是不是因為那畢竟只有一坪左右大小的空間\n那這樣的一個空間是不是你們要繼續如果發生這樣的事件我想空間的大小也是為了你們要檢討的一個問題那承辦這個業務的醫院其實是非常的憤慨那他們也揚言說如果就是說未來繼續這個樣子都沒有改善的話他們要退出這個服務那根據這個台東縣護理師公會\n在6月15日發表一個最新的聲明他們對這個事件也表達強烈的不滿並且提出4點的具體訴求包括立即要制定入監醫療安全指引建立完善的這個醫療暴力通報與應變處理機制而且要立法將\n第一線醫護人員的納入保護範圍以及這個全面檢討現行矯正機關的醫療服務契約內容以確保這個整個醫護人員的這個執行安全我想這些這些訴求不僅反映了這個基層的這個醫護人員的這個切身的需求更凸顯\n長期以來矯正機關在醫療服務中這個安全保障機制的嚴重不足的這個結構性問題那我不知道說在這邊衛福部是不是在這個事件發生之後已經有立即跟這個矯正署來共同討論檢討如何改進了你們是不是已經有開會了有嗎\n其實這個我們一樣是非常嚴厲的譴責這樣的一個情況我們與相關的單位我們有發表的聲明衛福部有發表的聲明部長我不是要你們衛福部發表聲明我的問題是你們有沒有跟剿政署共同來開會提出檢討\n我們當時新聞稿是說我們將會與相關的單位好沒關係如果將會齁就不是出國的將會齁我希望你們立刻好不好在最短的時間內不然我跟你講這個醫療體系退出服務是很嚴重對他們受刑人權益也是一個傷害啦可以快一點嗎你們在那邊講個時間點在什麼時候之內你要完成\n我們跟矯正單位馬上來進行在檢討整個作業我們本來有一個作業稀之你們是不是兩個禮拜內因為畢竟這件事情已經發生一段時間我們兩個禮拜內就馬上來召開相關的聯繫會議檢討流程然後跟委員報告\n那因為根據自由時報的報導這個已經不是單一的事件因為近年來類似醫療暴力的事件在全國各地的這個監所都陸續發生例如在去年台北監獄跟高雄監獄都有類似的案例所以這個問題已經是一個就是說常年發生的問題必須我們要很嚴肅的來看待\n我想聚焦在東城監獄這件令人痛心的暴力事件\n在這個當然在這個部分剛剛有提到就是說在管理的部分有一個也出現很大的漏洞在監所內對於這個危險物品的管理儲存有這個重大的瑕疵那收容人他如何能夠輕易取得這個\n尖尖的這個原子筆作為這個攻擊的工具也反映出說對這個高風險收容的這個風險評估還有這個無預警的機制這個是非常明顯不足的那我想在這個工會的護理師工會的這個訴求當中已經有特別強調就是說制定入監醫療安全指引這個部分那麼\n那麼我們再看在特約根據全民健康保險提供的矯正機關醫療服務計畫裡面特約醫療院所必須要承擔來提供醫療服務的責任但是契約的內容幾乎都沒有提到風險保障還有安全協助的具體條款\n好那這個在現實執行的這個環境的危險性其實看起來是明顯脫節同時我們在醫療法裡面24條還有106條雖然已經明定這個醫療暴力的刑事責任但是呢在這個矯正機關作為特殊\n他們在矯正機關的這個特殊環境執法的保障保護的實際執行顯然是沒有辦法跟上這個法律的規範那我想在五月的時候莊惠雄委員質詢當中也有提出類似醫療暴力事件頻傳也需要法務部跟衛福部進行跨部會的合作跟系統性的解決\n從第一個問題看起來你們目前都還沒有聚在一起所以我想我剛剛提的一切的一切希望你們兩個禮拜這個會議可以來啟動好\n那再來我想有另外一個兩個問題就是說我們要檢討一下這個現行醫療服務的執行規範有特別矯正機關有要求這個醫療團隊連續三天設診再連續假期\n的時候那每天最多分為上午跟下午兩個時段那每個時段呢原則上三個小時並且至少就是說至少就是說間隔半個小時那這項規定本來就是說要確保這個受刑人的醫療需求跟穩定\n但是在執行當中也發生了嚴重的問題就是大家想一想連續三天高強度的執勤特別在介護人力有限的情況下顯著增加了醫護人員身心上的負擔也有可能就是說因為連續三天因為疲勞降低警覺性\n好 所以從這個間接來提升安全風險那這個部分東城監獄的事件當中我們了解就是說這護理師正處於連續執勤的第三天那或許這個也是他就是說未能及時察覺危險因素的其中之一啦好 所以特別點出這個部分我不知道繳證署是不是也有\n針對這三天的這個連續射診的規定有進行系統性的評估因為我想我的這個評估是因為如果有相關數據顯示這樣安排可以提升受診人的醫療品質然後減少疾病惡化然後降低轉診的比例\n那當然這個是值得考慮但是就是說你到底有沒有充分的數據來支持能夠證明這項規定的必要性那再反過來看就是說連續執勤那導致這個醫護人員疲勞累積那也會影響這個診斷的這個\n準確性跟應變能力所以這個部分我不知道你們是不是有這個數據上的一個研究統計\n從我們醫療的角度來看,真的醫院本身就已經業務繁重那在年息假期又要增多這樣的一個服務,其實壓力會非常大,我想連手裡面的介護人員恐怕都\n人力都不一定有辦法來配合我們希望在看門診的時候其實在我們覺得應該是不是都要為了保護醫跟護因為醫療暴力零容忍所以如果在這個叫矯正機關裡面的\n的人也應該是比較更需要去關心因為他可能情緒不好或怎麼樣所以基本上我以前我們很多學生到監獄裡面去看像雲林在哪裡很多台大醫院訓練也負責很多其實他們都覺得很有意義但是無形中還是潛在的有他危險我聽了那麼久我是聽不到部長你的針對我的問題回答就是說\n因為要檢討嘛 你剛剛講這個問題我們都知道啊所以我是不是在這裡 具體檢討我是希望 因為這個是矯正機關矯正機關要求的啦 我想是不是說這個部分對 我剛剛問他嘛 部長搶著回答 我也不知道\n医码疲劳啊说明一下针对这个三天以上有连续假期要请这个我们的医事的服务的企业的这些医疗机构来看诊但这个根本的考量也是根据我们的一个目前我们在我想我们不谈需求啦我这里讲你有没有什么应变的方式比如说把现行规定改为这个弹性排班嘛或者是每周轮替的频率增加嘛\n好對不對所以或者是你們要根據這個實際的這個醫療需求來做一個整個射診的時段的調整嗎這部分我們會跟外部再研議那目前這個根據是根據我們不得連續三天不得開封不得什麼連續三天不開封不開就是說不開什麼讓他們能夠從設防出來到工廠去洗澡運動\n那尤其一到年假像明年的過年有九天的假期你不可能說都不讓他們出來洗澡或是看電視或是這個抽菸幹嘛那趁這個時間的時候因為這時間的假期太長我們也希望安排有醫療看診一定有需求的這樣的一個需求所以我們才會有這樣的一個規範請衛福部或是真的相關的醫療機構對啦現在就是你們不能只考慮到受診人的需求嘛\n阿現在就是發生這樣的問題請你們一併檢討我剛剛提供幾個方法然後我已經沒有時間了但我提一個最後最嚴重的問題就是我們現在來就是說壽星人看診欠費的問題你要看一下喔這個欠費截至目前為止總共積欠了1278萬元\n這個統計只是現在在裡面的受刑人欠費的統計喔他們一旦畢業出監之後那些數據就\n那個一筆勾銷然後全部都要醫院自己想辦法去追討我想這個是非常不合理的醫院已經冒著生命的危險派人去監所裡面去提供服務了然後這些受刑人他無力負擔的時候\n你們那出間以後 矯正署說沒有我的事啊這個是這個是天大沒有道理的如果你們這個不改的話我呼籲不用我呼籲啦 我告訴你已經有醫院的院長在跟我們講說我們要全面退出啦看你們怎麼辦啦矯正署關起來了\n當然委員剛才講的這個1278萬是到今年4月底為止,就是在間的部分現在只是4月,總計到4月而已那如果這個在間的部分,我們現在目前的一些都有強制在跟他扣款而且積極在扣款,那也有聯繫他的家屬,如果他沒有錢也會聯繫他的家屬來繳款\n另外我們也有請他可以根據相關的健保法來申請這些減免或是要貸款等等的一個補助所以你的意思就是說那個醫院繼續自己去跟這些受刑人然後出監以後繼續去跟他們追討\n我這樣啦齁我在這邊提出具體的建議第一個要求你們回頭去統計已經出間的就是說積欠的費用到底有多少我們很想看看我們替這些醫院\n發聲一下到底還有多少錢沒有收回來我想看了以後搞不好都沒有醫院願意進去監鎖了然後我想這個其實是這個部分你們就是說有沒有\n在這個我提出建議啦就是說矯正署你們研議能否代電受刑人的支付額啦並且針對這個無力支付的這個個案進行後續的追討啦你怎麼不能叫醫院自己去討啊醫院還要忙著救別人對不對難道醫院還要負責討債嗎\n再來就是說能否在這個醫療服務契約當中增添這個欠費補償的機制保障這個醫療機構的權益我想我就提出這兩個建議剩下的你們就繼續研議我要在你們就是說剛剛都說了種種一切的一切我們兩個禮拜內啟動\n這樣子的會議衛福部跟矯正署好那你們這個欠費這個我給你們幾個月的時間你們好好去研議好看要修要修哪裡你們的辦法要怎麼修就不要讓醫院進去承受這些風險出去討債你覺得他們會遇到什麼如果有人出去\n我不知道他們未來是出監以後是什麼樣的狀況那個人頭銷也是很恐怖的好嗎好就那個你的衛福部兩個禮拜啊那個監這個這個矯正署的欠費的一個月好謝謝好謝謝\n","vtt":"WEBVTT\n\n00:10.036 --> 00:18.820\n謝主席麻煩請法部剿政署跟衛福部剿政署還有衛福部要哪位?部長是國建署?沒有\n\n00:27.325 --> 00:30.849\n我想先看一下這個圖這部電影的畫面是1990年已故的金馬影帝陳崧勇主演的電影片名叫我在死牢的日子\n\n00:45.845 --> 01:03.179\n那這個畫面的影片中呢一位死刑犯挾持監所護理師的畫面那雖然這是一部電影但是沒想到這樣的畫面卻真實在監獄裡面上演而且發生在我們台東那這個是\n\n01:05.040 --> 01:20.523\n在这个月的10号东城监狱发生受刑人看诊时勒住护理师的颈部拿笔攻击护理师的新闻这是当天发生事件诊间的示意图我们看一下\n\n01:21.244 --> 01:37.602\n受刑人進入診間之後坐在醫師的左邊當時那隻行兇的筆是放在醫師桌上的右手邊那位受刑人先把醫師右手邊的筆緩緩拿到醫師的左手邊放在桌上\n\n01:38.163 --> 01:56.500\n那後來拿起筆就往護理師方向過去攻擊護理師那當時在那個診間沒有戒護人員發生事件之後診間走道上的兩位戒護人員就立即衝進去壓制受刑人\n\n01:58.181 --> 02:14.366\n整間內這裡有個重點就是說整間內為什麼沒有戒護人員那為什麼放獸型人與這個醫護單獨處在一個空間內那這樣的戒護都沒有疏失嗎矯正署\n\n02:20.165 --> 02:29.371\n好主席還有委員針對剛才委員的一個提問就是針對東城監獄在10號發生這個雙人攻擊這個醫護人員的事件剛才委員提到當時其實我們在整監其實都有有監護人員在戒護\n\n02:38.717 --> 03:04.544\n但是他介護不是只有單純幾個人他整批帶過去看診大概也有數十個人那可能他站的位置大概當時可能是在這個外面的這個還看診區那真正他實際進入到診間去呢這部分我們一般介護人員並不會就是直接跟著他進去你說診間內有介護人員他另外診間還沒有我說那個看診區的地方他在等待看診區後診區後診區\n\n03:07.205 --> 03:33.790\n好沒有關係我不跟你討論細節啦但是發生的當下整間內或許空間狹小那沒有確實裡面在整間內沒有健護人員在裡面好所以這個部分我在這裡點出來這也是未來你們要要這個檢討的事情那是不是因為那畢竟只有一坪左右大小的空間\n\n03:35.190 --> 04:01.102\n那這樣的一個空間是不是你們要繼續如果發生這樣的事件我想空間的大小也是為了你們要檢討的一個問題那承辦這個業務的醫院其實是非常的憤慨那他們也揚言說如果就是說未來繼續這個樣子都沒有改善的話他們要退出這個服務那根據這個台東縣護理師公會\n\n04:05.018 --> 04:23.074\n在6月15日發表一個最新的聲明他們對這個事件也表達強烈的不滿並且提出4點的具體訴求包括立即要制定入監醫療安全指引建立完善的這個醫療暴力通報與應變處理機制而且要立法將\n\n04:23.735 --> 04:31.098\n第一線醫護人員的納入保護範圍以及這個全面檢討現行矯正機關的醫療服務契約內容以確保這個整個醫護人員的這個執行安全我想這些這些訴求不僅反映了這個基層的這個醫護人員的這個切身的需求更凸顯\n\n04:44.644 --> 05:05.259\n長期以來矯正機關在醫療服務中這個安全保障機制的嚴重不足的這個結構性問題那我不知道說在這邊衛福部是不是在這個事件發生之後已經有立即跟這個矯正署來共同討論檢討如何改進了你們是不是已經有開會了有嗎\n\n05:10.634 --> 05:31.413\n其實這個我們一樣是非常嚴厲的譴責這樣的一個情況我們與相關的單位我們有發表的聲明衛福部有發表的聲明部長我不是要你們衛福部發表聲明我的問題是你們有沒有跟剿政署共同來開會提出檢討\n\n05:35.185 --> 05:53.929\n我們當時新聞稿是說我們將會與相關的單位好沒關係如果將會齁就不是出國的將會齁我希望你們立刻好不好在最短的時間內不然我跟你講這個醫療體系退出服務是很嚴重對他們受刑人權益也是一個傷害啦可以快一點嗎你們在那邊講個時間點在什麼時候之內你要完成\n\n06:02.031 --> 06:16.038\n我們跟矯正單位馬上來進行在檢討整個作業我們本來有一個作業稀之你們是不是兩個禮拜內因為畢竟這件事情已經發生一段時間我們兩個禮拜內就馬上來召開相關的聯繫會議檢討流程然後跟委員報告\n\n06:22.461 --> 06:44.780\n那因為根據自由時報的報導這個已經不是單一的事件因為近年來類似醫療暴力的事件在全國各地的這個監所都陸續發生例如在去年台北監獄跟高雄監獄都有類似的案例所以這個問題已經是一個就是說常年發生的問題必須我們要很嚴肅的來看待\n\n06:51.128 --> 06:56.720\n我想聚焦在東城監獄這件令人痛心的暴力事件\n\n06:59.517 --> 07:20.769\n在這個當然在這個部分剛剛有提到就是說在管理的部分有一個也出現很大的漏洞在監所內對於這個危險物品的管理儲存有這個重大的瑕疵那收容人他如何能夠輕易取得這個\n\n07:21.710 --> 07:47.808\n尖尖的這個原子筆作為這個攻擊的工具也反映出說對這個高風險收容的這個風險評估還有這個無預警的機制這個是非常明顯不足的那我想在這個工會的護理師工會的這個訴求當中已經有特別強調就是說制定入監醫療安全指引這個部分那麼\n\n07:50.034 --> 08:14.189\n那麼我們再看在特約根據全民健康保險提供的矯正機關醫療服務計畫裡面特約醫療院所必須要承擔來提供醫療服務的責任但是契約的內容幾乎都沒有提到風險保障還有安全協助的具體條款\n\n08:15.520 --> 08:34.478\n好那這個在現實執行的這個環境的危險性其實看起來是明顯脫節同時我們在醫療法裡面24條還有106條雖然已經明定這個醫療暴力的刑事責任但是呢在這個矯正機關作為特殊\n\n08:36.200 --> 08:59.397\n他們在矯正機關的這個特殊環境執法的保障保護的實際執行顯然是沒有辦法跟上這個法律的規範那我想在五月的時候莊惠雄委員質詢當中也有提出類似醫療暴力事件頻傳也需要法務部跟衛福部進行跨部會的合作跟系統性的解決\n\n09:01.520 --> 09:08.550\n從第一個問題看起來你們目前都還沒有聚在一起所以我想我剛剛提的一切的一切希望你們兩個禮拜這個會議可以來啟動好\n\n09:15.526 --> 09:30.759\n那再來我想有另外一個兩個問題就是說我們要檢討一下這個現行醫療服務的執行規範有特別矯正機關有要求這個醫療團隊連續三天設診再連續假期\n\n09:36.664 --> 09:57.192\n的時候那每天最多分為上午跟下午兩個時段那每個時段呢原則上三個小時並且至少就是說至少就是說間隔半個小時那這項規定本來就是說要確保這個受刑人的醫療需求跟穩定\n\n09:58.573 --> 10:25.275\n但是在執行當中也發生了嚴重的問題就是大家想一想連續三天高強度的執勤特別在介護人力有限的情況下顯著增加了醫護人員身心上的負擔也有可能就是說因為連續三天因為疲勞降低警覺性\n\n10:25.936 --> 10:50.981\n好所以從這個間接來提升安全風險那這個部分東城監獄的事件當中我們了解就是說這護理師正處於連續執勤的第三天那或許這個也是他就是說未能及時察覺危險因素的其中之一啦好所以特別點出這個部分我不知道繳證署是不是也有\n\n10:52.482 --> 11:09.738\n針對這三天的這個連續射診的規定有進行系統性的評估因為我想我的這個評估是因為如果有相關數據顯示這樣安排可以提升受診人的醫療品質然後減少疾病惡化然後降低轉診的比例\n\n11:10.399 --> 11:25.668\n那當然這個是值得考慮但是就是說你到底有沒有充分的數據來支持能夠證明這項規定的必要性那再反過來看就是說連續執勤那導致這個醫護人員疲勞累積那也會影響這個診斷的這個\n\n11:33.093 --> 11:39.562\n準確性跟應變能力所以這個部分我不知道你們是不是有這個數據上的一個研究統計\n\n11:42.302 --> 11:55.693\n從我們醫療的角度來看,真的醫院本身就已經業務繁重那在年息假期又要增多這樣的一個服務,其實壓力會非常大,我想連手裡面的介護人員恐怕都\n\n12:03.806 --> 12:20.821\n人力都不一定有辦法來配合我們希望在看門診的時候其實在我們覺得應該是不是都要為了保護醫跟護因為醫療暴力零容忍所以如果在這個叫矯正機關裡面的\n\n12:26.944 --> 12:50.935\n的人也應該是比較更需要去關心因為他可能情緒不好或怎麼樣所以基本上我以前我們很多學生到監獄裡面去看像雲林在哪裡很多台大醫院訓練也負責很多其實他們都覺得很有意義但是無形中還是潛在的有他危險我聽了那麼久我是聽不到部長你的針對我的問題回答就是說\n\n12:55.797 --> 13:04.341\n因為要檢討嘛你剛剛講這個問題我們都知道啊所以我是不是在這裡具體檢討我是希望因為這個是矯正機關矯正機關要求的啦我想是不是說這個部分對我剛剛問他嘛部長搶著回答我也不知道\n\n13:12.864 --> 13:41.550\n医码疲劳啊说明一下针对这个三天以上有连续假期要请这个我们的医事的服务的企业的这些医疗机构来看诊但这个根本的考量也是根据我们的一个目前我们在我想我们不谈需求啦我这里讲你有没有什么应变的方式比如说把现行规定改为这个弹性排班嘛或者是每周轮替的频率增加嘛\n\n13:42.861 --> 14:07.812\n好對不對所以或者是你們要根據這個實際的這個醫療需求來做一個整個射診的時段的調整嗎這部分我們會跟外部再研議那目前這個根據是根據我們不得連續三天不得開封不得什麼連續三天不開封不開就是說不開什麼讓他們能夠從設防出來到工廠去洗澡運動\n\n14:09.033 --> 14:36.678\n那尤其一到年假像明年的過年有九天的假期你不可能說都不讓他們出來洗澡或是看電視或是這個抽菸幹嘛那趁這個時間的時候因為這時間的假期太長我們也希望安排有醫療看診一定有需求的這樣的一個需求所以我們才會有這樣的一個規範請衛福部或是真的相關的醫療機構對啦現在就是你們不能只考慮到受診人的需求嘛\n\n14:37.498 --> 15:00.493\n阿現在就是發生這樣的問題請你們一併檢討我剛剛提供幾個方法然後我已經沒有時間了但我提一個最後最嚴重的問題就是我們現在來就是說壽星人看診欠費的問題你要看一下喔這個欠費截至目前為止總共積欠了1278萬元\n\n15:04.821 --> 15:09.326\n這個統計只是現在在裡面的受刑人欠費的統計喔他們一旦畢業出監之後那些數據就\n\n15:19.520 --> 15:41.668\n那個一筆勾銷然後全部都要醫院自己想辦法去追討我想這個是非常不合理的醫院已經冒著生命的危險派人去監所裡面去提供服務了然後這些受刑人他無力負擔的時候\n\n15:42.938 --> 16:02.508\n你們那出間以後矯正署說沒有我的事啊這個是這個是天大沒有道理的如果你們這個不改的話我呼籲不用我呼籲啦我告訴你已經有醫院的院長在跟我們講說我們要全面退出啦看你們怎麼辦啦矯正署關起來了\n\n16:05.990 --> 16:25.642\n當然委員剛才講的這個1278萬是到今年4月底為止,就是在間的部分現在只是4月,總計到4月而已那如果這個在間的部分,我們現在目前的一些都有強制在跟他扣款而且積極在扣款,那也有聯繫他的家屬,如果他沒有錢也會聯繫他的家屬來繳款\n\n16:27.204 --> 16:44.466\n另外我們也有請他可以根據相關的健保法來申請這些減免或是要貸款等等的一個補助所以你的意思就是說那個醫院繼續自己去跟這些受刑人然後出監以後繼續去跟他們追討\n\n16:46.090 --> 17:00.282\n我這樣啦齁我在這邊提出具體的建議第一個要求你們回頭去統計已經出間的就是說積欠的費用到底有多少我們很想看看我們替這些醫院\n\n17:02.369 --> 17:18.564\n發聲一下到底還有多少錢沒有收回來我想看了以後搞不好都沒有醫院願意進去監鎖了然後我想這個其實是這個部分你們就是說有沒有\n\n17:20.576 --> 17:41.004\n在這個我提出建議啦就是說矯正署你們研議能否代電受刑人的支付額啦並且針對這個無力支付的這個個案進行後續的追討啦你怎麼不能叫醫院自己去討啊醫院還要忙著救別人對不對難道醫院還要負責討債嗎\n\n17:43.035 --> 18:03.005\n再來就是說能否在這個醫療服務契約當中增添這個欠費補償的機制保障這個醫療機構的權益我想我就提出這兩個建議剩下的你們就繼續研議我要在你們就是說剛剛都說了種種一切的一切我們兩個禮拜內啟動\n\n18:06.171 --> 18:28.277\n這樣子的會議衛福部跟矯正署好那你們這個欠費這個我給你們幾個月的時間你們好好去研議好看要修要修哪裡你們的辦法要怎麼修就不要讓醫院進去承受這些風險出去討債你覺得他們會遇到什麼如果有人出去\n\n18:29.591 --> 18:49.385\n我不知道他們未來是出監以後是什麼樣的狀況那個人頭銷也是很恐怖的好嗎好就那個你的衛福部兩個禮拜啊那個監這個這個矯正署的欠費的一個月好謝謝好謝謝\n\n","segments":[{"start":10.036,"end":18.82,"text":"謝主席麻煩請法部剿政署跟衛福部剿政署還有衛福部要哪位?部長是國建署?沒有"},{"start":27.325,"end":30.849,"text":"我想先看一下這個圖這部電影的畫面是1990年已故的金馬影帝陳崧勇主演的電影片名叫我在死牢的日子"},{"start":45.845,"end":63.179,"text":"那這個畫面的影片中呢一位死刑犯挾持監所護理師的畫面那雖然這是一部電影但是沒想到這樣的畫面卻真實在監獄裡面上演而且發生在我們台東那這個是"},{"start":65.04,"end":80.523,"text":"在这个月的10号东城监狱发生受刑人看诊时勒住护理师的颈部拿笔攻击护理师的新闻这是当天发生事件诊间的示意图我们看一下"},{"start":81.244,"end":97.602,"text":"受刑人進入診間之後坐在醫師的左邊當時那隻行兇的筆是放在醫師桌上的右手邊那位受刑人先把醫師右手邊的筆緩緩拿到醫師的左手邊放在桌上"},{"start":98.163,"end":116.5,"text":"那後來拿起筆就往護理師方向過去攻擊護理師那當時在那個診間沒有戒護人員發生事件之後診間走道上的兩位戒護人員就立即衝進去壓制受刑人"},{"start":118.181,"end":134.366,"text":"整間內這裡有個重點就是說整間內為什麼沒有戒護人員那為什麼放獸型人與這個醫護單獨處在一個空間內那這樣的戒護都沒有疏失嗎 矯正署"},{"start":140.165,"end":149.371,"text":"好 主席還有委員 針對剛才委員的一個提問就是針對東城監獄在10號發生這個雙人攻擊這個醫護人員的事件剛才委員提到 當時其實我們在整監其實都有有監護人員在戒護"},{"start":158.717,"end":184.544,"text":"但是他介護不是只有單純幾個人他整批帶過去看診大概也有數十個人那可能他站的位置大概當時可能是在這個外面的這個還看診區那真正他實際進入到診間去呢這部分我們一般介護人員並不會就是直接跟著他進去你說診間內有介護人員他另外診間還沒有我說那個看診區的地方他在等待看診區後診區後診區"},{"start":187.205,"end":213.79,"text":"好沒有關係我不跟你討論細節啦但是發生的當下整間內或許空間狹小那沒有確實裡面在整間內沒有健護人員在裡面好所以這個部分我在這裡點出來這也是未來你們要要這個檢討的事情那是不是因為那畢竟只有一坪左右大小的空間"},{"start":215.19,"end":241.102,"text":"那這樣的一個空間是不是你們要繼續如果發生這樣的事件我想空間的大小也是為了你們要檢討的一個問題那承辦這個業務的醫院其實是非常的憤慨那他們也揚言說如果就是說未來繼續這個樣子都沒有改善的話他們要退出這個服務那根據這個台東縣護理師公會"},{"start":245.018,"end":263.074,"text":"在6月15日發表一個最新的聲明他們對這個事件也表達強烈的不滿並且提出4點的具體訴求包括立即要制定入監醫療安全指引建立完善的這個醫療暴力通報與應變處理機制而且要立法將"},{"start":263.735,"end":271.098,"text":"第一線醫護人員的納入保護範圍以及這個全面檢討現行矯正機關的醫療服務契約內容以確保這個整個醫護人員的這個執行安全我想這些這些訴求不僅反映了這個基層的這個醫護人員的這個切身的需求更凸顯"},{"start":284.644,"end":305.259,"text":"長期以來矯正機關在醫療服務中這個安全保障機制的嚴重不足的這個結構性問題那我不知道說在這邊衛福部是不是在這個事件發生之後已經有立即跟這個矯正署來共同討論檢討如何改進了你們是不是已經有開會了有嗎"},{"start":310.634,"end":331.413,"text":"其實這個我們一樣是非常嚴厲的譴責這樣的一個情況我們與相關的單位我們有發表的聲明衛福部有發表的聲明部長我不是要你們衛福部發表聲明我的問題是你們有沒有跟剿政署共同來開會提出檢討"},{"start":335.185,"end":353.929,"text":"我們當時新聞稿是說我們將會與相關的單位好沒關係如果將會齁就不是出國的將會齁我希望你們立刻好不好在最短的時間內不然我跟你講這個醫療體系退出服務是很嚴重對他們受刑人權益也是一個傷害啦可以快一點嗎你們在那邊講個時間點在什麼時候之內你要完成"},{"start":362.031,"end":376.038,"text":"我們跟矯正單位馬上來進行在檢討整個作業我們本來有一個作業稀之你們是不是兩個禮拜內因為畢竟這件事情已經發生一段時間我們兩個禮拜內就馬上來召開相關的聯繫會議檢討流程然後跟委員報告"},{"start":382.461,"end":404.78,"text":"那因為根據自由時報的報導這個已經不是單一的事件因為近年來類似醫療暴力的事件在全國各地的這個監所都陸續發生例如在去年台北監獄跟高雄監獄都有類似的案例所以這個問題已經是一個就是說常年發生的問題必須我們要很嚴肅的來看待"},{"start":411.128,"end":416.72,"text":"我想聚焦在東城監獄這件令人痛心的暴力事件"},{"start":419.517,"end":440.769,"text":"在這個當然在這個部分剛剛有提到就是說在管理的部分有一個也出現很大的漏洞在監所內對於這個危險物品的管理儲存有這個重大的瑕疵那收容人他如何能夠輕易取得這個"},{"start":441.71,"end":467.808,"text":"尖尖的這個原子筆作為這個攻擊的工具也反映出說對這個高風險收容的這個風險評估還有這個無預警的機制這個是非常明顯不足的那我想在這個工會的護理師工會的這個訴求當中已經有特別強調就是說制定入監醫療安全指引這個部分那麼"},{"start":470.034,"end":494.189,"text":"那麼我們再看在特約根據全民健康保險提供的矯正機關醫療服務計畫裡面特約醫療院所必須要承擔來提供醫療服務的責任但是契約的內容幾乎都沒有提到風險保障還有安全協助的具體條款"},{"start":495.52,"end":514.478,"text":"好那這個在現實執行的這個環境的危險性其實看起來是明顯脫節同時我們在醫療法裡面24條還有106條雖然已經明定這個醫療暴力的刑事責任但是呢在這個矯正機關作為特殊"},{"start":516.2,"end":539.397,"text":"他們在矯正機關的這個特殊環境執法的保障保護的實際執行顯然是沒有辦法跟上這個法律的規範那我想在五月的時候莊惠雄委員質詢當中也有提出類似醫療暴力事件頻傳也需要法務部跟衛福部進行跨部會的合作跟系統性的解決"},{"start":541.52,"end":548.55,"text":"從第一個問題看起來你們目前都還沒有聚在一起所以我想我剛剛提的一切的一切希望你們兩個禮拜這個會議可以來啟動好"},{"start":555.526,"end":570.759,"text":"那再來我想有另外一個兩個問題就是說我們要檢討一下這個現行醫療服務的執行規範有特別矯正機關有要求這個醫療團隊連續三天設診再連續假期"},{"start":576.664,"end":597.192,"text":"的時候那每天最多分為上午跟下午兩個時段那每個時段呢原則上三個小時並且至少就是說至少就是說間隔半個小時那這項規定本來就是說要確保這個受刑人的醫療需求跟穩定"},{"start":598.573,"end":625.275,"text":"但是在執行當中也發生了嚴重的問題就是大家想一想連續三天高強度的執勤特別在介護人力有限的情況下顯著增加了醫護人員身心上的負擔也有可能就是說因為連續三天因為疲勞降低警覺性"},{"start":625.936,"end":650.981,"text":"好 所以從這個間接來提升安全風險那這個部分東城監獄的事件當中我們了解就是說這護理師正處於連續執勤的第三天那或許這個也是他就是說未能及時察覺危險因素的其中之一啦好 所以特別點出這個部分我不知道繳證署是不是也有"},{"start":652.482,"end":669.738,"text":"針對這三天的這個連續射診的規定有進行系統性的評估因為我想我的這個評估是因為如果有相關數據顯示這樣安排可以提升受診人的醫療品質然後減少疾病惡化然後降低轉診的比例"},{"start":670.399,"end":685.668,"text":"那當然這個是值得考慮但是就是說你到底有沒有充分的數據來支持能夠證明這項規定的必要性那再反過來看就是說連續執勤那導致這個醫護人員疲勞累積那也會影響這個診斷的這個"},{"start":693.093,"end":699.562,"text":"準確性跟應變能力所以這個部分我不知道你們是不是有這個數據上的一個研究統計"},{"start":702.302,"end":715.693,"text":"從我們醫療的角度來看,真的醫院本身就已經業務繁重那在年息假期又要增多這樣的一個服務,其實壓力會非常大,我想連手裡面的介護人員恐怕都"},{"start":723.806,"end":740.821,"text":"人力都不一定有辦法來配合我們希望在看門診的時候其實在我們覺得應該是不是都要為了保護醫跟護因為醫療暴力零容忍所以如果在這個叫矯正機關裡面的"},{"start":746.944,"end":770.935,"text":"的人也應該是比較更需要去關心因為他可能情緒不好或怎麼樣所以基本上我以前我們很多學生到監獄裡面去看像雲林在哪裡很多台大醫院訓練也負責很多其實他們都覺得很有意義但是無形中還是潛在的有他危險我聽了那麼久我是聽不到部長你的針對我的問題回答就是說"},{"start":775.797,"end":784.341,"text":"因為要檢討嘛 你剛剛講這個問題我們都知道啊所以我是不是在這裡 具體檢討我是希望 因為這個是矯正機關矯正機關要求的啦 我想是不是說這個部分對 我剛剛問他嘛 部長搶著回答 我也不知道"},{"start":792.864,"end":821.55,"text":"医码疲劳啊说明一下针对这个三天以上有连续假期要请这个我们的医事的服务的企业的这些医疗机构来看诊但这个根本的考量也是根据我们的一个目前我们在我想我们不谈需求啦我这里讲你有没有什么应变的方式比如说把现行规定改为这个弹性排班嘛或者是每周轮替的频率增加嘛"},{"start":822.861,"end":847.812,"text":"好對不對所以或者是你們要根據這個實際的這個醫療需求來做一個整個射診的時段的調整嗎這部分我們會跟外部再研議那目前這個根據是根據我們不得連續三天不得開封不得什麼連續三天不開封不開就是說不開什麼讓他們能夠從設防出來到工廠去洗澡運動"},{"start":849.033,"end":876.678,"text":"那尤其一到年假像明年的過年有九天的假期你不可能說都不讓他們出來洗澡或是看電視或是這個抽菸幹嘛那趁這個時間的時候因為這時間的假期太長我們也希望安排有醫療看診一定有需求的這樣的一個需求所以我們才會有這樣的一個規範請衛福部或是真的相關的醫療機構對啦現在就是你們不能只考慮到受診人的需求嘛"},{"start":877.498,"end":900.493,"text":"阿現在就是發生這樣的問題請你們一併檢討我剛剛提供幾個方法然後我已經沒有時間了但我提一個最後最嚴重的問題就是我們現在來就是說壽星人看診欠費的問題你要看一下喔這個欠費截至目前為止總共積欠了1278萬元"},{"start":904.821,"end":909.326,"text":"這個統計只是現在在裡面的受刑人欠費的統計喔他們一旦畢業出監之後那些數據就"},{"start":919.52,"end":941.668,"text":"那個一筆勾銷然後全部都要醫院自己想辦法去追討我想這個是非常不合理的醫院已經冒著生命的危險派人去監所裡面去提供服務了然後這些受刑人他無力負擔的時候"},{"start":942.938,"end":962.508,"text":"你們那出間以後 矯正署說沒有我的事啊這個是這個是天大沒有道理的如果你們這個不改的話我呼籲不用我呼籲啦 我告訴你已經有醫院的院長在跟我們講說我們要全面退出啦看你們怎麼辦啦矯正署關起來了"},{"start":965.99,"end":985.642,"text":"當然委員剛才講的這個1278萬是到今年4月底為止,就是在間的部分現在只是4月,總計到4月而已那如果這個在間的部分,我們現在目前的一些都有強制在跟他扣款而且積極在扣款,那也有聯繫他的家屬,如果他沒有錢也會聯繫他的家屬來繳款"},{"start":987.204,"end":1004.466,"text":"另外我們也有請他可以根據相關的健保法來申請這些減免或是要貸款等等的一個補助所以你的意思就是說那個醫院繼續自己去跟這些受刑人然後出監以後繼續去跟他們追討"},{"start":1006.09,"end":1020.282,"text":"我這樣啦齁我在這邊提出具體的建議第一個要求你們回頭去統計已經出間的就是說積欠的費用到底有多少我們很想看看我們替這些醫院"},{"start":1022.369,"end":1038.564,"text":"發聲一下到底還有多少錢沒有收回來我想看了以後搞不好都沒有醫院願意進去監鎖了然後我想這個其實是這個部分你們就是說有沒有"},{"start":1040.576,"end":1061.004,"text":"在這個我提出建議啦就是說矯正署你們研議能否代電受刑人的支付額啦並且針對這個無力支付的這個個案進行後續的追討啦你怎麼不能叫醫院自己去討啊醫院還要忙著救別人對不對難道醫院還要負責討債嗎"},{"start":1063.035,"end":1083.005,"text":"再來就是說能否在這個醫療服務契約當中增添這個欠費補償的機制保障這個醫療機構的權益我想我就提出這兩個建議剩下的你們就繼續研議我要在你們就是說剛剛都說了種種一切的一切我們兩個禮拜內啟動"},{"start":1086.171,"end":1108.277,"text":"這樣子的會議衛福部跟矯正署好那你們這個欠費這個我給你們幾個月的時間你們好好去研議好看要修要修哪裡你們的辦法要怎麼修就不要讓醫院進去承受這些風險出去討債你覺得他們會遇到什麼如果有人出去"},{"start":1109.591,"end":1129.385,"text":"我不知道他們未來是出監以後是什麼樣的狀況那個人頭銷也是很恐怖的好嗎好就那個你的衛福部兩個禮拜啊那個監這個這個矯正署的欠費的一個月好謝謝好謝謝"}]}}},"gazette":{"lineno":1105,"blocks":[["陳委員瑩：（12時44分）謝謝主席，麻煩請法務部矯正署跟衛福部。"],["主席：請矯正署。衛福部要哪位？"],["陳委員瑩：部長。"],["主席：請邱部長。"],["邱部長泰源：委員好。"],["陳委員瑩：部長好。我想先看一下投影片這張圖，這部電影是1990年由已故金馬影帝陳松勇主演的電影，片名叫「我在死牢的日子」，這個影片中的畫面是一位死刑犯挾持監所護理師，雖然這是一部電影，但是沒想到這樣的畫面卻真實在監獄裡面上演，而且發生在我們臺東。","投影片是這個月的10號，東成監獄發生受刑人看診時勒住護理師的頸部，拿筆攻擊護理師的新聞。我們看一下當天發生事件時診間的示意圖，受刑人進入診間之後，坐在醫師的左邊，當時那支行兇的筆是放在醫師桌上的右手邊，那位受刑人先把醫師右手邊的筆緩緩拿到醫師的左手邊放在桌上，後來拿起筆就往護理師方向攻擊護理師，當時在診間沒有戒護人員，事件發生之後，診間走道上的兩位戒護人員就立即衝進去壓制受刑人。這裡有個重點是診間內為什麼沒有戒護人員？矯正署為什麼讓受刑人與醫護單獨處在一個空間內？這樣的戒護都沒有疏失嗎？"],["蘇主任秘書坤銘：主席還有委員。針對剛才委員的一個提問，就是東成監獄在10號發生受刑人攻擊醫護人員的事件，剛才委員提到，我們在診間其實都有戒護人員在戒護，但是他們戒護的不是只有單純幾個人，他整批帶過去看診大概也有數十個人，可能他站的位置當時是在外面的候診區，受刑人實際進入到診間去，這部分我們一般戒護人員並不會就直接跟著……"],["陳委員瑩：你說診間內有戒護人員？"],["蘇主任秘書坤銘：沒有，我是說候診區……"],["陳委員瑩：就走道嘛？沒關係，我不跟你討論細節，但是發生的當下，診間內或許空間狹小，確實沒有戒護人員在裡面，所以這個部分我在這裡點出來，這個也是未來你們要檢討的事情，畢竟只有一坪左右大小的空間，這樣的一個空間，你們是不是要繼續……如果發生這樣的事件，我想空間的大小也是你們未來要檢討的一個問題。"],["蘇主任秘書坤銘：是。"],["陳委員瑩：承辦這個業務的醫院其實非常憤慨，他們也揚言說如果未來繼續這個樣子都沒有改善的話，他們要退出這個服務。","根據台東縣護理師護士公會在6月15日發表的最新聲明，他們對這個事件也表達強烈不滿，並且提出四點具體訴求，包括要立即制定入監醫療安全指引，建立完善的醫療暴力通報與應變處理機制，而且要立法將第一線醫護人員納入保護範圍，以及全面檢討現行矯正機關的醫療服務契約內容，以確保醫護人員的執行安全。我想這些訴求不僅反映了基層的醫護人員切身的需求，更凸顯長期以來矯正機關在醫療服務中，安全保障機制嚴重不足的結構性問題，我不知道衛福部是不是在這個事件發生之後已經有立即跟矯正署共同討論、檢討如何改進了？你們是不是已經有開會了？有嗎？"],["邱部長泰源：其實我們一樣是非常嚴厲地譴責這樣的情況，衛福部也發表了聲明。"],["陳委員瑩：部長，我不是要衛福部發表聲明。我的問題是你們有沒有跟矯正署共同開會提出檢討方案？"],["邱部長泰源：我們當時新聞稿是說我們將會與相關的單位……"],["陳委員瑩：好，沒關係。如果「將會」，就不是唱歌的江蕙，我希望你們立刻，好不好？在最短的時間內。不然我跟你講，醫療體系退出服務是很嚴重的事，對受刑人權益也是一個傷害。"],["邱部長泰源：是、是、是。"],["陳委員瑩：可以快一點嗎？你能不能講個時間點？你要在什麼時候之內完成？"],["邱部長泰源：我們跟矯正單位馬上再檢討，我們本來有一個作業須知，我想……"],["陳委員瑩：你們是不是兩個禮拜內？因為畢竟這件事情已經發生一段時間了。"],["邱部長泰源：好，我們兩個禮拜內就馬上來召開相關的聯繫會議檢討流程，然後跟委員報告。"],["陳委員瑩：好，根據自由時報的報導，這已經不是單一的事件，因為近年來類似醫療暴力的事件，在全國各地的監所都陸續發生。例如去年臺北監獄跟高雄監獄都有類似的案例，所以這個已經是常年發生的問題，我們必須要很嚴肅地來看待。","我想聚焦在東成監獄這件令人痛心的暴力事件，當然在這個部分，剛剛有提到在管理的部分也出現一個很大的漏洞，在監所內對於危險物品的管理、儲存有重大的瑕疵，收容人能夠輕易取得這個尖尖的原子筆作為攻擊的工具，也反映出對高風險收容的風險評估，預警機制也是非常明顯不足的，在護理師公會的訴求當中已經有特別強調制定入監醫療安全指引這個部分。根據全民健康保險提供保險對象收容於矯正機關者醫療服務計畫裡面，特約醫療院所必須要承擔提供醫療服務的責任，但是契約的內容幾乎都沒有提到風險保障還有安全協助的具體條款，這個與現實執行環境的危險性看起來是明顯脫節。同時在醫療法第二十四條，還有第一百零六條，雖然已經明定醫療暴力的刑事責任，但是他們在矯正機關這樣的特殊環境執勤時，實際的保障、保護顯然是沒有辦法跟上法律的規範。5月的時候，莊瑞雄委員在質詢當中也有提出，類似的醫療暴力事件頻傳，也需要法務部與衛福部進行跨部會的合作和系統性的解決。","從第一個問題看起來，你們目前都還沒有聚在一起，所以就我剛剛提的一切，希望你們兩個禮拜內可以來啟動這個會議。"],["邱部長泰源：好。"],["陳委員瑩：另外還有兩個問題，就是我們要檢討一下現行的醫療服務執行規範，特別是矯正機關有要求醫療團隊在3天以上連續假期要設診，每天最多分為上午及下午兩個時段，每個時段原則上3個小時，並且至少要間隔半個小時。這項規定本來是要確保受刑人的醫療需求及穩定，但是在執行當中也發生了嚴重的問題。大家想想，3天以上連續假期要設診的高強度執勤，特別在戒護人力有限的情況下，顯著增加醫護人員身心上的負擔，他們也有可能因為3天以上連續假期要執勤，導致疲勞，降低警覺性，間接提升安全風險。","在東成監獄的事件當中，我們了解，這個護理師正處於連續執勤的第3天，或許這也是他未能及時察覺危險的其中一個因素，所以我特別點出這個部分。我不知道矯正署是不是也有針對這個3天以上連續假期要設診的規定進行系統性的評估？要有這個評估是因為如果有相關數據顯示這樣安排可以提升受刑人的醫療品質、減少疾病惡化、降低轉診的比率，當然這個是值得考慮的，但是你到底有沒有充分的數據能夠支持、證明這項規定的必要性？再反過來看，連續執勤導致醫護人員疲勞累積，也會影響診斷的準確性及應變能力。我不知道這個部分你們是不是有數據上的研究統計？"],["邱部長泰源：報告委員，從醫療的角度來看，醫院本身真的就已經業務繁重，在連續假期又要多增加這樣的服務……"],["陳委員瑩：對，而且害他們都沒有假了。"],["邱部長泰源：其實壓力會非常大，我想連所裡面的戒護人員恐怕人力都不一定有辦法來配合，我們……"],["陳委員瑩：這些都需要檢討。"],["邱部長泰源：我們也希望在看門診的時候都要保護醫及護，因為醫療暴力零容忍……"],["陳委員瑩：沒錯！"],["邱部長泰源：所以矯正機關裡面的人員應該更需要去關心，因為他可能情緒不好或怎麼樣，基本上，以前我們有很多學生到監獄裡面去看診，像雲林等等，臺大醫院分院也負責很多，其實他們都覺得很有意義，但是無形中還是有潛在的危險性。"],["陳委員瑩：對啦！但聽了那麼久，我聽不到部長有針對我的問題回答，因為要檢討，你剛剛講的這個問題我們都知道，所以我是不是在這裡具體……"],["邱部長泰源：要檢討，但因為這個是矯正機關……"],["陳委員瑩：對，我是問矯正機關……"],["邱部長泰源：矯正機關要求的，所以這個部分是不是……"],["陳委員瑩：對，我剛剛是問他們，但部長搶著回答，我也不知道你是怎樣，你也疲勞了！"],["蘇主任秘書坤銘：跟委員說明一下，針對有3天以上連續假期要請我們醫事服務契約的醫療機構來看診，根本的考量也是根據目前我們在……"],["陳委員瑩：我想我們不談需求，我這裡要講的是你有沒有什麼應變的方式，比如把現行規定改為彈性排班，或者是每週輪替的頻率增加，對不對？或者是你們要根據實際的醫療需求來做整個設診時段的調整？"],["蘇主任秘書坤銘：這個部分我們會跟衛福部再來研議，目前這個是根據我們不得連續3天不開封，為了……"],["陳委員瑩：不得什麼？"],["蘇主任秘書坤銘：連續3天不開封。"],["陳委員瑩：不開什麼？"],["蘇主任秘書坤銘：就是讓他們能夠從舍房出來到工廠去洗澡、運動，尤其遇到連假，像明年的過年有9天的假期，我們不可能都不讓他們出來洗澡，或是看電視、抽菸等等，因為這個假期的時間太長，趁這個時間，我們也希望安排醫療看診，一定有這樣的需求，所以我們才會有這樣的規範，請衛福部或是相關的醫療機構來……"],["陳委員瑩：對啦！但你們不能只考慮到受刑人的需求，現在就是發生這樣的問題，請你們一併檢討，我剛剛提供了幾個方法。","我已經沒有時間了，但我提一個最嚴重的問題，就是受刑人看診欠費的問題，截至目前為止，總共積欠了1,278萬元，這個統計只是現在在裡面的受刑人欠費的統計，他們一旦畢業出監之後，那些數據就一筆勾銷，全部都要醫院自己想辦法去追討，我想這個是非常不合理的！醫院已經派人冒著生命危險去監所裡面提供服務了，結果這些受刑人無力負擔，出監以後，矯正署又覺得事不關己。這個是天大的沒有道理！如果你們這個不改的話，我要呼籲，也不用我呼籲，我告訴你，已經有醫院的院長在跟我們講要全面退出，看你們怎麼辦啦！"],["蘇主任秘書坤銘：委員剛才講的這個在監部分的1,278萬是到今年4月底為止。"],["陳委員瑩：現在只是統計到4月而已喔。"],["蘇主任秘書坤銘：有關在監的部分，我們目前都有強制在跟他扣款，而且積極在扣款，也有聯繫他的家屬，如果他沒有錢，也會聯繫他的家屬來繳款。另外，我們也有告訴他可以根據相關的健保法申請這些減免，或是要貸款等等的補助。"],["陳委員瑩：所以，你的意思就是說，受刑人出監以後醫院自己繼續去跟他們追討？我在這邊提出具體的建議，第一個，我要求你們回頭統計已經出監的人積欠的費用到底有多少？我們很想看看，我們替這些醫院發聲一下，到底還有多少錢沒有收回來？我想看了以後搞不好都沒有醫院願意進去監所了。這個部分我提出建議，矯正署研議能否代墊受刑人的自付額，並且針對無力支付的個案進行後續的追討，你總不能叫醫院自己去討啊！醫院還要忙著救別人，對不對？難道醫院還要負責討債嗎？再來，能否在醫療服務契約當中增列欠費補償的機制，保障醫療機構的權益。我提出這兩個建議，剩下的你們就繼續研議。剛剛都說了，種種的一切，我們兩個禮拜內請衛福部跟矯正署啟動這樣的會議，至於欠費這個議題比較傷腦筋，我給你們一個月的時間，你們好好去研議，看要修哪裡以及你們的辦法要怎麼修，不要讓醫院進去承受這些風險，要出去討債，你覺得他們會遇到什麼？如果有人出去，我不知道他們出監以後是什麼樣的狀況，討債也是很恐怖的，好嗎？"],["蘇主任秘書坤銘：好。"],["邱部長泰源：好。"],["陳委員瑩：衛福部就給你們兩個禮拜，矯正署欠費的議題給一個月時間。謝謝。"],["蘇主任秘書坤銘：謝謝委員。"],["邱部長泰源：謝謝。"],["主席：謝謝。","接下來請楊曜委員詢答，請準時啊。"]],"agenda":{"page_end":118,"meet_id":"委員會-11-3-26-18","speakers":["劉建國","陳昭姿","林月琴","陳菁徽","邱鎮軍","王育敏","廖偉翔","蘇清泉","黃秀芳","涂權吉","王正旭","陳培瑜","范雲","陳瑩","楊曜","謝龍介","楊瓊瓔","葉元之"],"page_start":1,"meetingDate":["2025-06-23"],"gazette_id":"1146302","agenda_lcidc_ids":["1146302_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18次全體委員會議紀錄","content":"一、審查(一)委員劉建國等17人擬具「老人福利法第四十八條條文修正草案」案、(二)台灣民眾\n黨黨團擬具「老人福利法第四十八條條文修正草案」案；二、審查( 一) 委員許宇甄等18 人擬具\n「身心障礙者權益保障法第五十三條條文修正草案」案、(二)委員邱鎮軍等19人擬具「身心障礙\n者權益保障法第五十三條條文修正草案」案、(三)委員林月琴等17人擬具「身心障礙者權益保障\n法第五十三條條文修正草案」案、(四)委員陳菁徽等18人擬具「身心障礙者權益保障法第五十三\n條條文修正草案」案、(五)台灣民眾黨黨團擬具「身心障礙者權益保障法第五十三條條文修正草\n案」案、(六)委員范雲等17人擬具「身心障礙者權益保障法第五十三條條文修正草案」案、(七)\n委員邱若華等17人擬具「身心障礙者權益保障法第五十三條條文修正草案」案【提案第11006882\n號】、(八)委員魯明哲等19人擬具「身心障礙者權益保障法第五十三條條文修正草案」案、(九)\n委員傅崐萁等24人擬具「身心障礙者權益保障法第五十三條條文修正草案」案、(十)委員洪孟楷\n等17人擬具「身心障礙者權益保障法第五十三條條文修正草案」案、(十一)委員邱若華等17人擬\n具「身心障礙者權益保障法第五十三條條文修正草案」案【提案第11010755號】；三、審查(一)\n委員范雲等17人擬具「身心障礙者權益保障法部分條文修正草案」案、(二)委員郭昱晴等19人擬\n具「身心障礙者權益保障法第十六條條文修正草案」案、(三)委員何欣純等17人擬具「身心障礙\n者權益保障法部分條文修正草案」案、(四)委員陳冠廷等16人擬具「身心障礙者權益保障法第三\n十八條條文修正草案」案、(五)委員陳冠廷等20人擬具「身心障礙者權益保障法第二條、第五十\n三條及第九十九條條文修正草案」案、(六)委員徐富癸等18人擬具「身心障礙者權益保障法第十\n條條文修正草案」案、(七)委員羅廷瑋等16人擬具「身心障礙者權益保障法部分條文修正草案」\n案、(八)委員黃捷等17人擬具「身心障礙者權益保障法第七十一條條文修正草案」案、(九)委員\n王鴻薇等20人擬具「身心障礙者權益保障法增訂第四十條之一條文草案」案、(十)委員柯志恩等\n18人擬具「身心障礙者權益保障法增訂第四十條之一條文草案」案、(十一)委員柯志恩等17人擬\n具「身心障礙者權益保障法第六十條之一條文修正草案」案、(十二)委員馬文君等19人擬具「身\n心障礙者權益保障法第三十條之一、第五十條及第五十二條條文修正草案」案、(十三)委員廖偉\n翔等21人擬具「身心障礙者權益保障法增訂第五十條之一條文草案」案、(十四)委員廖偉翔等19\n人擬具「身心障礙者權益保障法部分條文修正草案」案、(十五)委員林楚茵等20人擬具「身心障\n礙者權益保障法第十條條文修正草案」案、(十六)委員陳菁徽等16人擬具「身心障礙者權益保障\n法部分條文修正草案」案、(十七)委員洪孟楷等18人擬具「身心障礙者權益保障法增訂第四十條\n之一條文草案」案、(十八)委員羅美玲等16人擬具「身心障礙者權益保障法部分條文修正草案」\n案、(十九)委員陳俊宇等18人擬具「身心障礙者權益保障法第七十一條條文修正草案」案、(二\n十)委員林楚茵等17人擬具「身心障礙者權益保障法第七十一條條文修正草案」案、(二十一)委\n員劉建國等17人擬具「身心障礙者權益保障法第七十一條條文修正草案」案、(二十二)委員邱若\n華等17人擬具「身心障礙者權益保障法第七十一條條文修正草案」案、(二十三)委員劉建國等17\n人擬具「身心障礙者權益保障法部分條文修正草案」案【第一案至第三案採綜合詢答；本日僅處\n理第一案及第二案】","agenda_id":"1146302_00001"}}}