{"error":false,"id":["156392"],"data":{"IVOD_ID":156392,"IVOD_URL":"https://ivod.ly.gov.tw/Play/Clip/1M/156392","日期":"2024-11-04","會議資料":{"會議代碼":"委員會-11-2-26-7","會議代碼:str":"第11屆第2會期社會福利及衛生環境委員會第7次全體委員會議","屆":11,"會期":2,"會次":7,"臨時會會次":null,"種類":"委員會","委員會代碼":[26],"委員會代碼:str":["社會福利及衛生環境委員會"],"標題":"第11屆第2會期社會福利及衛生環境委員會第7次全體委員會議"},"影片種類":"Clip","開始時間":"2024-11-04T10:29:36+08:00","結束時間":"2024-11-04T10:39:51+08:00","影片長度":"00:10:15","支援功能":["ai-transcript","gazette"],"video_url":"https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/4be73137691ca4089c8bf67ea789b2fb570a598ce3c5a946f0f51ee05cf641d9a86133156bd620685ea18f28b6918d91.mp4/playlist.m3u8","委員名稱":"蘇清泉","委員發言時間":"10:29:36 - 10:39:51","會議時間":"2024-11-04T09:00:00+08:00","會議名稱":"立法院第11屆第2會期社會福利及衛生環境委員會第7次全體委員會議（事由：一、繼續處理中華民國113年度中央政府總預算有關衛生福利部主管預算凍結報告案1案。\n二、邀請衛生福利部部長針對「社區精神病患照護優化」進行專題報告，並備質詢。）","transcript":{"pyannote":[{"speaker":"SPEAKER_04","start":0.03096875,"end":2.6634687500000003},{"speaker":"SPEAKER_04","start":3.00096875,"end":3.6590937500000003},{"speaker":"SPEAKER_04","start":3.69284375,"end":7.92846875},{"speaker":"SPEAKER_03","start":9.88596875,"end":20.46659375},{"speaker":"SPEAKER_04","start":18.64409375,"end":19.31909375},{"speaker":"SPEAKER_04","start":20.078468750000003,"end":31.38471875},{"speaker":"SPEAKER_04","start":32.07659375,"end":33.612218750000004},{"speaker":"SPEAKER_04","start":33.86534375,"end":34.70909375},{"speaker":"SPEAKER_04","start":35.36721875,"end":37.392218750000005},{"speaker":"SPEAKER_04","start":37.712843750000005,"end":39.06284375},{"speaker":"SPEAKER_04","start":40.48034375,"end":41.32409375},{"speaker":"SPEAKER_03","start":40.59846875,"end":41.69534375},{"speaker":"SPEAKER_03","start":41.99909375,"end":43.416593750000004},{"speaker":"SPEAKER_04","start":42.150968750000004,"end":43.180343750000006},{"speaker":"SPEAKER_04","start":43.416593750000004,"end":47.02784375},{"speaker":"SPEAKER_03","start":43.68659375,"end":43.78784375},{"speaker":"SPEAKER_04","start":48.86721875,"end":49.424093750000004},{"speaker":"SPEAKER_04","start":50.470343750000005,"end":51.80346875},{"speaker":"SPEAKER_03","start":51.80346875,"end":51.820343750000006},{"speaker":"SPEAKER_04","start":53.102843750000005,"end":53.15346875},{"speaker":"SPEAKER_03","start":53.15346875,"end":53.45721875},{"speaker":"SPEAKER_03","start":56.98409375000001,"end":59.80221875},{"speaker":"SPEAKER_03","start":60.40971875,"end":61.641593750000006},{"speaker":"SPEAKER_04","start":62.23221875,"end":65.53971875},{"speaker":"SPEAKER_04","start":66.09659375000001,"end":73.35284375},{"speaker":"SPEAKER_03","start":70.82159375,"end":71.00721875},{"speaker":"SPEAKER_02","start":73.79159375,"end":74.60159375},{"speaker":"SPEAKER_04","start":74.60159375,"end":76.27221875000001},{"speaker":"SPEAKER_02","start":74.61846875,"end":75.25971875},{"speaker":"SPEAKER_03","start":75.25971875,"end":75.37784375000001},{"speaker":"SPEAKER_02","start":75.37784375000001,"end":75.59721875000001},{"speaker":"SPEAKER_03","start":75.59721875000001,"end":75.98534375},{"speaker":"SPEAKER_04","start":76.57596875,"end":78.14534375000001},{"speaker":"SPEAKER_04","start":78.31409375,"end":79.27596875},{"speaker":"SPEAKER_04","start":79.74846875,"end":80.28846875},{"speaker":"SPEAKER_04","start":80.94659375,"end":83.35971875},{"speaker":"SPEAKER_04","start":84.13596875,"end":85.26659375},{"speaker":"SPEAKER_04","start":86.04284375,"end":88.35471875},{"speaker":"SPEAKER_04","start":89.08034375000001,"end":89.75534375000001},{"speaker":"SPEAKER_04","start":90.46409375,"end":90.59909375000001},{"speaker":"SPEAKER_03","start":90.59909375000001,"end":91.15596875},{"speaker":"SPEAKER_03","start":91.78034375,"end":92.69159375000001},{"speaker":"SPEAKER_03","start":94.14284375000001,"end":94.29471875},{"speaker":"SPEAKER_03","start":95.69534375,"end":101.11221875000001},{"speaker":"SPEAKER_03","start":101.90534375,"end":105.06096875},{"speaker":"SPEAKER_03","start":105.38159375000001,"end":108.03096875},{"speaker":"SPEAKER_04","start":108.48659375000001,"end":117.43034375},{"speaker":"SPEAKER_04","start":118.07159375,"end":119.91096875000001},{"speaker":"SPEAKER_04","start":120.88971875000001,"end":127.01534375000001},{"speaker":"SPEAKER_04","start":127.38659375,"end":129.46221875},{"speaker":"SPEAKER_04","start":129.63096875000002,"end":130.22159375},{"speaker":"SPEAKER_04","start":131.01471875000001,"end":131.70659375},{"speaker":"SPEAKER_02","start":132.36471875,"end":134.67659375},{"speaker":"SPEAKER_04","start":134.87909375,"end":136.11096875},{"speaker":"SPEAKER_02","start":135.26721875,"end":136.38096875000002},{"speaker":"SPEAKER_02","start":136.80284375000002,"end":138.16971875000002},{"speaker":"SPEAKER_04","start":137.83221875,"end":138.08534375000002},{"speaker":"SPEAKER_02","start":138.47346875,"end":162.14909375000002},{"speaker":"SPEAKER_04","start":157.71096875,"end":157.98096875000002},{"speaker":"SPEAKER_04","start":162.23346875000001,"end":169.79346875000002},{"speaker":"SPEAKER_02","start":169.86096875,"end":171.26159375},{"speaker":"SPEAKER_04","start":171.31221875,"end":177.57284375},{"speaker":"SPEAKER_02","start":171.93659375000001,"end":172.12221875},{"speaker":"SPEAKER_02","start":178.02846875,"end":191.02221875},{"speaker":"SPEAKER_02","start":191.14034375,"end":204.55596875},{"speaker":"SPEAKER_04","start":205.56846875000002,"end":216.53721875000002},{"speaker":"SPEAKER_04","start":216.92534375000002,"end":217.48221875000002},{"speaker":"SPEAKER_04","start":217.66784375,"end":222.27471875},{"speaker":"SPEAKER_04","start":222.46034375000002,"end":235.26846875},{"speaker":"SPEAKER_00","start":226.49346875,"end":226.51034375},{"speaker":"SPEAKER_03","start":226.51034375,"end":226.83096875},{"speaker":"SPEAKER_03","start":235.26846875,"end":235.52159375000002},{"speaker":"SPEAKER_04","start":235.85909375000003,"end":237.25971875000002},{"speaker":"SPEAKER_04","start":238.01909375000002,"end":239.77409375000002},{"speaker":"SPEAKER_04","start":240.44909375,"end":241.37721875000003},{"speaker":"SPEAKER_04","start":241.57971875,"end":244.49909375000001},{"speaker":"SPEAKER_04","start":244.66784375,"end":246.18659375000001},{"speaker":"SPEAKER_04","start":246.33846875,"end":247.60409375},{"speaker":"SPEAKER_04","start":247.82346875000002,"end":252.00846875000002},{"speaker":"SPEAKER_04","start":252.12659375,"end":254.47221875000002},{"speaker":"SPEAKER_03","start":254.52284375000002,"end":255.36659375000002},{"speaker":"SPEAKER_04","start":255.36659375000002,"end":256.32846875},{"speaker":"SPEAKER_03","start":255.38346875000002,"end":269.49096875000004},{"speaker":"SPEAKER_03","start":269.84534375000004,"end":275.44784375},{"speaker":"SPEAKER_03","start":275.97096875,"end":278.55284375},{"speaker":"SPEAKER_03","start":279.04221875,"end":281.01659375},{"speaker":"SPEAKER_03","start":281.23596875000004,"end":284.59409375},{"speaker":"SPEAKER_04","start":283.95284375,"end":284.50971875},{"speaker":"SPEAKER_04","start":284.59409375,"end":284.61096875000004},{"speaker":"SPEAKER_03","start":284.61096875000004,"end":284.72909375},{"speaker":"SPEAKER_04","start":285.48846875000004,"end":289.13346875},{"speaker":"SPEAKER_04","start":289.85909375,"end":290.50034375},{"speaker":"SPEAKER_03","start":290.04471875,"end":296.18721875},{"speaker":"SPEAKER_04","start":293.28471875,"end":293.33534375},{"speaker":"SPEAKER_00","start":293.33534375,"end":293.35221875},{"speaker":"SPEAKER_04","start":293.35221875,"end":293.38596875},{"speaker":"SPEAKER_00","start":293.38596875,"end":293.47034375000004},{"speaker":"SPEAKER_04","start":293.47034375000004,"end":293.50409375000004},{"speaker":"SPEAKER_00","start":293.50409375000004,"end":294.21284375000005},{"speaker":"SPEAKER_04","start":294.21284375000005,"end":294.38159375000004},{"speaker":"SPEAKER_00","start":294.38159375000004,"end":294.65159375},{"speaker":"SPEAKER_04","start":294.65159375,"end":295.10721875},{"speaker":"SPEAKER_00","start":295.10721875,"end":325.48221875},{"speaker":"SPEAKER_04","start":325.71846875,"end":330.52784375000005},{"speaker":"SPEAKER_00","start":330.10596875000005,"end":345.54659375},{"speaker":"SPEAKER_04","start":345.63096875,"end":348.14534375},{"speaker":"SPEAKER_00","start":348.24659375000005,"end":354.54096875000005},{"speaker":"SPEAKER_04","start":354.43971875,"end":361.08846875},{"speaker":"SPEAKER_00","start":360.63284375,"end":360.91971875},{"speaker":"SPEAKER_00","start":361.08846875,"end":361.13909375000003},{"speaker":"SPEAKER_00","start":361.20659375,"end":370.67346875000004},{"speaker":"SPEAKER_04","start":370.30221875,"end":373.99784375},{"speaker":"SPEAKER_04","start":374.26784375,"end":376.91721875},{"speaker":"SPEAKER_04","start":377.62596875,"end":379.16159375},{"speaker":"SPEAKER_00","start":379.16159375,"end":379.85346875000005},{"speaker":"SPEAKER_04","start":380.12346875000003,"end":382.08096875},{"speaker":"SPEAKER_04","start":383.39721875000004,"end":384.05534375},{"speaker":"SPEAKER_00","start":384.74721875,"end":390.38346875},{"speaker":"SPEAKER_04","start":390.73784375,"end":392.30721875},{"speaker":"SPEAKER_04","start":392.69534375,"end":394.53471875},{"speaker":"SPEAKER_04","start":395.20971875000004,"end":403.19159375000004},{"speaker":"SPEAKER_04","start":403.52909375,"end":405.18284375},{"speaker":"SPEAKER_04","start":406.06034375,"end":411.27471875000003},{"speaker":"SPEAKER_04","start":411.74721875,"end":414.37971875000005},{"speaker":"SPEAKER_04","start":416.08409375,"end":418.85159375},{"speaker":"SPEAKER_03","start":417.88971875000004,"end":423.86346875000004},{"speaker":"SPEAKER_04","start":423.86346875000004,"end":424.21784375000004},{"speaker":"SPEAKER_04","start":424.60596875000005,"end":447.60659375},{"speaker":"SPEAKER_04","start":448.09596875000005,"end":452.02784375000005},{"speaker":"SPEAKER_04","start":452.88846875,"end":454.05284375},{"speaker":"SPEAKER_03","start":454.76159375000003,"end":456.68534375},{"speaker":"SPEAKER_03","start":456.90471875000003,"end":456.95534375000005},{"speaker":"SPEAKER_04","start":456.95534375000005,"end":457.12409375000004},{"speaker":"SPEAKER_03","start":457.24221875,"end":458.06909375000004},{"speaker":"SPEAKER_03","start":458.20409375,"end":458.28846875000005},{"speaker":"SPEAKER_04","start":458.28846875000005,"end":462.76034375},{"speaker":"SPEAKER_03","start":458.30534375,"end":459.57096875},{"speaker":"SPEAKER_01","start":466.16909375,"end":471.18096875000003},{"speaker":"SPEAKER_04","start":471.19784375,"end":471.87284375},{"speaker":"SPEAKER_04","start":471.97409375,"end":472.02471875000003},{"speaker":"SPEAKER_04","start":472.96971875,"end":473.03721875},{"speaker":"SPEAKER_04","start":473.52659375,"end":476.47971875},{"speaker":"SPEAKER_04","start":478.36971875,"end":479.61846875000003},{"speaker":"SPEAKER_04","start":481.44096875,"end":482.72346875000005},{"speaker":"SPEAKER_04","start":482.97659375,"end":484.36034375},{"speaker":"SPEAKER_04","start":484.93409375000005,"end":494.18159375000005},{"speaker":"SPEAKER_04","start":494.73846875000004,"end":498.56909375000004},{"speaker":"SPEAKER_03","start":499.02471875000003,"end":504.39096875},{"speaker":"SPEAKER_04","start":500.67846875000004,"end":501.74159375000005},{"speaker":"SPEAKER_04","start":504.10409375000006,"end":507.00659375000004},{"speaker":"SPEAKER_03","start":507.61409375000005,"end":508.03596875000005},{"speaker":"SPEAKER_02","start":508.25534375,"end":508.42409375000005},{"speaker":"SPEAKER_02","start":508.69409375000004,"end":526.8515937500001},{"speaker":"SPEAKER_04","start":526.36221875,"end":535.37346875},{"speaker":"SPEAKER_02","start":535.60971875,"end":539.7778437500001},{"speaker":"SPEAKER_04","start":539.82846875,"end":541.5834687500001},{"speaker":"SPEAKER_02","start":541.2122187500001,"end":549.68346875},{"speaker":"SPEAKER_04","start":547.8103437500001,"end":548.58659375},{"speaker":"SPEAKER_04","start":549.39659375,"end":550.81409375},{"speaker":"SPEAKER_04","start":551.77596875,"end":552.0459687499999},{"speaker":"SPEAKER_04","start":553.10909375,"end":556.56846875},{"speaker":"SPEAKER_02","start":556.5009687500001,"end":561.8334687500001},{"speaker":"SPEAKER_04","start":557.14221875,"end":557.5303437499999},{"speaker":"SPEAKER_04","start":561.51284375,"end":563.2509687500001},{"speaker":"SPEAKER_02","start":564.21284375,"end":568.56659375},{"speaker":"SPEAKER_04","start":568.56659375,"end":569.91659375},{"speaker":"SPEAKER_02","start":568.93784375,"end":569.52846875},{"speaker":"SPEAKER_04","start":569.96721875,"end":575.7722187500001},{"speaker":"SPEAKER_04","start":575.9578437499999,"end":579.53534375},{"speaker":"SPEAKER_04","start":579.7547187499999,"end":581.1215937500001},{"speaker":"SPEAKER_04","start":581.6784687500001,"end":589.9640937500001},{"speaker":"SPEAKER_04","start":590.4028437500001,"end":592.27596875},{"speaker":"SPEAKER_04","start":592.44471875,"end":593.40659375},{"speaker":"SPEAKER_04","start":595.68471875,"end":599.19471875},{"speaker":"SPEAKER_03","start":599.76846875,"end":600.6797187500001},{"speaker":"SPEAKER_04","start":600.2578437500001,"end":610.87221875},{"speaker":"SPEAKER_03","start":606.9740937500001,"end":607.07534375},{"speaker":"SPEAKER_03","start":610.3828437500001,"end":613.84221875}],"whisperx":[{"start":0.189,"end":1.99,"text":"社區精神病患照護優化"},{"start":10.792,"end":38.058,"text":"有通過的法案太多了到底那個時候是不是有擔任召委員有擔任7次的召委員所以很多的法案都是我跟大家報告現在有精神相關的官能證的什麼的有就醫有紀錄的差不多100多萬人差不多150、160萬人那裡面有精神疾病娘殘障手冊的是13萬是不是這樣"},{"start":40.498,"end":44.059,"text":"我們現在急慢性的病狀總共有2萬608床"},{"start":62.444,"end":89.557,"text":"那你現在這個新的法是要把這些我們以前叫精神分裂症現在就是失解失調嘛把這些人盡量推回家裡嘛回到社區嘛這是人權的關係那你的人你的輔導啊社工啊這些人看起來還有缺口嘛現在的缺口差不多有兩萬人還是更多"},{"start":90.741,"end":107.79,"text":"應該沒有。我們叫到114人將增加到2489人。所以以現在的努力還,現在還有差1000人。"},{"start":108.53,"end":129.196,"text":"你如果照日本阿加拿大阿他們那種一個人負擔的譬如說訪視員阿什麼你的名稱什麼不管了anyway就是英國差不多1比35阿香港差不多1比50日本是比較誇張日本是1比10啦那我們台灣是1比300還是400"},{"start":132.798,"end":161.967,"text":"那個是4年前4年前現在嗎對跟委員報告跟委員報告您剛提到的1比300那個是在109年的時候那當時我們的關懷訪視員人數的確是比較少當時才100多位那我們現在的關懷訪視員已經來到了500多位將近600位了所以這個案量比到去年為止是1比60所以已經有大幅度的改善那今年到年底的話會應該會降到1比50左右"},{"start":162.988,"end":173.498,"text":"那你這一筆五十是把醫生、心理師、社工師都攬攬做一個在拼這年吧?只有關懷訪視員只有關懷,那所以你的關懷訪視員是訪視的對象是就是這13萬個人"},{"start":178.4,"end":203.913,"text":"各位委員報告您剛剛提到的是領有身心障礙手冊的慢性精神病人那在我們這個全國的精神病人的追蹤關懷系統裡面我們現在追蹤的是9萬5千人那剛剛提到的關懷訪視員這500多位呢其實他是訪視我們在這個9萬多人裡面的第一級跟第二級的個案大概2萬6千人左右所以剛剛的1比60是這樣算出來的"},{"start":205.615,"end":219.75,"text":"因為像屏東在兩、三、兩年多前有一個就是思覺失調的然後在高速箱打一個女電眼黑白手那件事震驚全台灣"},{"start":220.911,"end":236.791,"text":"那在長庚演課幫他開刀的時候是我媳婦給他打開了所以我印象很深那個女孩子也因為失禮也救了大部分都救回來了所以是很不簡單大家都很用心那像這一種的"},{"start":238.232,"end":249.648,"text":"現在是打長效針嘛,打長效針,啊我們打長效針你現在是寬列預算,那一支很有效的耶,那一支很有效的,那煮了之後都頂著頂著齁,啊那支檢報有出嗎?有,那一支是多少支?"},{"start":254.634,"end":257.916,"text":"臺灣很重要的事情,這是唯一留下來的患病跟那個"},{"start":279.228,"end":294.448,"text":"這一個長效針不然其他的都挪到變成來公務預算那一針是可以撐半年還是多久我們請那個原心理健康事件這列中文"},{"start":296.05,"end":323.031,"text":"跟委員報告我們健保其實是針對這個專款專用27億那我們那個時候是比較國際趨勢國際帶思覺失調症或躁鬱症的嚴重患者有打到這個的比例是到20%那我們在前年的施打率是61%去年的施打率是83那今年應該可以過9成這是第一個那也跟委員報告說我們施打以後本土的資料我們施打的病人在住院率是下降15到20%這個是國會院的資料所以也可以解決這個旋轉門效應的問題以上補充謝謝"},{"start":326.653,"end":327.074,"text":"一針可以撐幾個月?"},{"start":348.851,"end":372.007,"text":"一針目前有三種有一個月的、三個月的、六個月的所以最長的甚至可以到六個月以上所以一個人差不多一針是多少六個月一針是健保是多少點那個藥費嘛我們藥費1.1元然後那有不同的廠牌大概是九千多點到一萬出頭多點所以才特別專款專用所以一個人差不多一年要兩萬多塊的藥費"},{"start":374.369,"end":376.751,"text":"我們在去年的這個施打有接受這個施打的是3.2萬人"},{"start":392.809,"end":407.416,"text":"3.2萬所以你的預算是夠的那你健保局很會殺價你就去殺價再去殺啊每一個打啊因為打那個藥我個人觀察是很有效的真的大家處理得乖乖的不然你現在讓他回去家裡溫習的啊"},{"start":409.238,"end":423.459,"text":"這對家屬是一個很沉重的負擔啊家屬大家社區看到這種病人那真的大家不就都該躲當時的這個專業的見解跟我們先母親來努力的方向是一致的"},{"start":424.713,"end":453.863,"text":"所以該打就打啦你是精神科專科你是該打就打啦要把他殺低一點以後這些已經有重大傷病的或是山上所致大家都住處乖乖的這樣就沒問題了不然你有滑滑照不定時炸彈的那是很危險的事情這兩天桃園這個軒然大波是抱一個小孩子嘛我有傷害到那個小孩子嗎有沒有抓到的時候還好"},{"start":458.365,"end":458.966,"text":"那再來就"},{"start":481.488,"end":506.482,"text":"回到家裡之後我們是不是有專家、醫師、團隊組成一個team就好像我們癌症病人這樣是一個teamwork到家裡去訪視那由醫生帶隊還是怎麼樣我們要做這個重點現在是有外展的一個服務嗎如果必要的話是有外展的服務那這個可以做得更完善一點嗎現在"},{"start":508.969,"end":535.098,"text":"跟委員報告其實我們目前對於這個病人的治療方式有非常多種那剛剛委員提到的就是說居家治療就是我們的醫療團隊外展到病人的家裡面那搭配剛剛所提到的長效徵記的話其實效果是會很好的那居家治療這個部分目前也是由健保在做支付那你剛剛講的這些社工員、心理師這個都是正職的公務的缺還是都是約聘的還是外包的"},{"start":536.203,"end":563.079,"text":"這個都是聘用人員是由地方政府來禁用那經費是我們中央政府經費是由中央部分補助但是我們是補助的這個7成以上啦看每個地方政府的一個財力狀況所以待遇是OK不要最最大的那個那個低薪是中央造成的不會的因為他們的這個條薪呢也是跟著公務人員的這個條薪那休假是比照老保"},{"start":564.566,"end":566.126,"text":"我們努力爭取謝謝召委"},{"start":595.768,"end":608.4,"text":"那心理這邊OK嗎?這邊沒問題吧?該寬烈就要寬烈啦,我們不會無理的來刪,我們一定是全力支持啦。不該發的那不要發。好,謝謝,謝謝部長。"}]},"gazette":{"lineno":473,"blocks":[["蘇委員清泉：（10時29分）謝謝主席，我們請邱部長。"],["主席：我們請邱部長。"],["邱部長泰源：召委好。"],["蘇委員清泉：好，部長辛苦了。"],["邱部長泰源：是。"],["蘇委員清泉：精神衛生法，這是你做召委的時候通過的嘛！"],["邱部長泰源：差不多……因為通過的法案太多了，到底那個時候是不是我擔任召委員，因為我當了7次召委，所以很多的法案都是在我……"],["蘇委員清泉：我跟大家報告，現在有精神官能症等相關精神疾病且有就醫紀錄的，差不多150萬、160萬人，裡面有精神疾病且領有殘障手冊的是13萬，是不是這樣？"],["鄭代理司長淑心：對，沒有錯。"],["蘇委員清泉：沒錯啦！"],["邱部長泰源：是、是、是，委員掌握的數據有對。"],["蘇委員清泉：那你說現在急慢性的病床總床數有幾床？"],["邱部長泰源：我們現在急慢性的病床總共有2萬608床。"],["蘇委員清泉：好，你現在這個新的法是要把這些以前叫精神分裂症患者，現在稱為思覺失調症患者儘量推回家裡嘛！"],["鄭代理司長淑心：留在社區。"],["邱部長泰源：留在社區。"],["蘇委員清泉：回到社區嘛！這是人權的關係。那你的輔導員、社工這些人看起來還有缺口，現在的缺口差不多有2萬人，還是更多？"],["鄭代理司長淑心：沒有、沒有、沒有。"],["邱部長泰源：應該沒有，我們到114年將增加到2,489人，所以現在還有差1,000人。"],["蘇委員清泉：你如果比照日本、加拿大那種1個人負擔的，譬如訪視員什麼的，名稱什麼不管，anyway，英國差不多1比35，香港差不多1比50，日本是比較誇張，日本是1比10，我們臺灣是1比300還是400？"],["鄭代理司長淑心：那個是4年前。"],["蘇委員清泉：4年前。現在呢？"],["鄭代理司長淑心：跟委員報告，您剛剛提到的1比300是在109年的時候，當時我們的關懷訪視員人數的確是比較少，當時才一百多位，我們現在的關懷訪視員已經來到了五百多位，將近600位了，所以這個案量比到去年為止是1比60，已經有大幅度的改善，今年到年底的話，應該會降到1比50左右。"],["蘇委員清泉：你這個1比50是把醫生、心理師、社工師都混在一起去做平均的吧！"],["鄭代理司長淑心：只有關懷訪視員。"],["蘇委員清泉：只有關懷訪視員？"],["鄭代理司長淑心：對。"],["蘇委員清泉：所以你的關懷訪視員訪視的對象就是這13萬個人？"],["鄭代理司長淑心：跟委員報告，您剛剛提到的是領有身心障礙手冊的慢性精神病人，在我們全國精神病人的追蹤關懷系統裡面，我們現在追蹤的是9萬5,000人，剛剛提到的關懷訪視員這五百多位其實是訪視這九萬多人裡面第一級和第二級的個案，大概2萬6,000人左右，所以剛剛的1比60是這樣算出來的。"],["蘇委員清泉：二年多前屏東有一個思覺失調的在高樹鄉對一個女店員挖眼睛，那件事震驚全臺灣，因為當時在長庚眼科幫他開刀的是我媳婦，所以我印象很深，那個女孩子視力大部分都救回來了，很不簡單，大家都很用心。像這一種的，現在是打長效針，我們打長效針，你現在是匡列預算，那是很有效的，那真的很有效！那打下去之後，他們都乖乖了，那個錢健保有出吧！"],["邱部長泰源：有。"],["蘇委員清泉：那一針是多少錢？一針是撐多久？"],["邱部長泰源：跟召委報告一下，其實以前有很多公務預算可以來支付的，我們最近都把它清出來，但是我們把這個針特別留在健保專款裡面，因為這個是對臺灣很重要的事情，唯一留下來的是罕病的及這個長效針，其他的都變成挪到公務預算這邊。"],["蘇委員清泉：那個一針是可以撐半年，還是多久？"],["邱部長泰源：我們請原心理健康司的……"],["蘇委員清泉：這是你的專門、這是你的專門。"],["陳副署長亮妤：我現在到健保署了，所以來回答……"],["邱部長泰源：健保署……"],["陳副署長亮妤：跟委員報告，我們健保其實是針對這個專款專用27億，那我們那時候是比較國際趨勢，國際思覺失調症或躁鬱症的嚴重患者有打到這個的比例大概是到20%，我們在前年的施打率是61%，去年的施打率是83%，今年應該可以過九成，這是第一個。也跟委員報告，我們施打以後，據本土的資料，我們施打的病人再住院率是下降15%到20%，這個是國衛院的資料，所以也可以解決這個旋轉門效應的問題。以上補充，謝謝！"],["蘇委員清泉：那怎麼會有說我們這裡的施打率是20%以下？"],["陳副署長亮妤：跟委員報告，那個是前年我們還沒有解封的時候，那個時候5月才解封，所以當時精神病房施打這個長效針劑的比率比較低，我們去年這個專款專用的施用率已經到83%，今年應該可以過九成，以上。"],["蘇委員清泉：那一針是可以撐幾個月？"],["陳副署長亮妤：目前有三種，有1個月的、3個月的、6個月的，所以最長的甚至可以到6個月，以上。"],["蘇委員清泉：6個月，一針6個月的健保是多少點？"],["陳副署長亮妤：那個藥費是1.1元，有不同的廠牌，大概是九千多點到1萬出頭點，所以才特別專款專用，以上。"],["蘇委員清泉：所以一個人差不多1年要二萬多塊的藥費。"],["陳副署長亮妤：是。"],["蘇委員清泉：那有需要施打的有多少人？所以你編了20幾億嘛！"],["陳副署長亮妤：27億。"],["蘇委員清泉：27億，有幾萬人？10萬人？"],["陳副署長亮妤：跟委員報告，去年有接受施打的是3.2萬人。"],["蘇委員清泉：3.2萬。"],["陳副署長亮妤：是。"],["蘇委員清泉：所以你的預算是夠的。"],["陳副署長亮妤：是。"],["蘇委員清泉：健保局很會殺價，你就去殺價，再去殺啊！到時候每一個打啊！因為打那個藥，我個人觀察是很有效，大家打了之後真的都乖乖的，不然你現在讓他回到家裡穩死的，那對家屬是很沉重的負擔，在社區看到這種病人，大家的壓力真的都很大，何時……"],["邱部長泰源：召委這個專業的見解跟我們現在努力的方向是一致的。"],["蘇委員清泉：所以該打的就打，你是精神科專科，該打就打啦！藥價殺低一點，以後這些有重大傷病的或者領有殘障手冊的都在家裡乖乖的，這樣就沒事了，不然你讓他到處亂跑，他是不定時炸彈，那是很危險的事情！像這兩天桃園這個軒然大波，他是抱一個小孩子，有傷害到那個小孩子嗎？有沒有？抓到的時候還好？"],["張司長秀鴛：猥褻。"],["蘇委員清泉：猥褻？"],["張司長秀鴛：是。"],["蘇委員清泉：什麼叫做猥褻？"],["張司長秀鴛：抱他，讓他覺得不舒服，然後有碰擊到重點部位。"],["蘇委員清泉：好，這個定義太多了。","再來，他回到家裡之後，我們是不是有專家、醫師、團隊組成一個team，就好像我們癌症病人這樣，是一個teamwork到家裡去訪視，由醫生帶隊，還是怎麼樣，我們有做這個重點……"],["邱部長泰源：現在是有外展的服務……"],["蘇委員清泉：有在做嘛！"],["邱部長泰源：如果必要的話，是有外展的服務。"],["蘇委員清泉：這個可以做得更完善一點嗎？"],["鄭代理司長淑心：跟委員報告，其實我們目前對於病人的治療方式有非常多種，剛剛委員提到的就是居家治療，是由我們的醫療團隊外展到病人的家裡面，搭配剛剛所提到的長效針劑的話，其實效果是會很好的，居家治療這個部分目前也是由健保在支付。"],["蘇委員清泉：你剛剛講的這些社工員、心理師都是正職的公務缺，還是都是約聘的，還是外包的？"],["鄭代理司長淑心：這個都是聘用人員，是由地方政府來進用。"],["蘇委員清泉：經費是我們中央給它？"],["鄭代理司長淑心：經費是由中央部分補助，我們是補助7成以上，看每個地方政府的財力狀況。"],["蘇委員清泉：7成以上，所以待遇是OK？不要最大的低薪是中央造成的。"],["鄭代理司長淑心：不會的，因為他們的調薪也是跟著公務人員的調薪一起調的。"],["蘇委員清泉：休假是比照勞保？"],["鄭代理司長淑心：他就是比較類似準公務人員的概念。"],["蘇委員清泉：因為像食藥署都找不到人，當稽核員出去會被罵、會被酸，都沒人要做，都找不到人耶！你這裡會找不到人嗎？食藥署常常都找不到人，邊境檢查到處都在缺人，你們那個待遇太差了，壓力太大了，會不會？"],["林副署長金富：我們努力爭取，謝謝召委。"],["蘇委員清泉：心理司這邊也OK，沒問題吧！該匡列就要匡列，我們不會無理的刪，我們一定是全力支持，不該花的當然不要花，好，謝謝部長。"],["邱部長泰源：謝謝召委，謝謝主席。"],["主席：謝謝蘇清泉委員。"],["主席（蘇委員清泉）：接續請涂權吉委員質詢。"]],"agenda":{"page_end":272,"meet_id":"委員會-11-2-26-7","speakers":["蘇清泉","陳昭姿","陳菁徽","林月琴","廖偉翔","邱鎮軍","涂權吉","王正旭","鍾佳濱","林國成","楊瓊瓔","林淑芬","賴士葆","黃秀芳","陳雪生","王育敏","劉建國","牛煦庭","楊曜","陳瑩","黃國昌","盧縣一"],"page_start":199,"meetingDate":["2024-11-04"],"gazette_id":"1139301","agenda_lcidc_ids":["1139301_00004"],"meet_name":"立法院第11屆第2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":"一、繼續處理中華民國113年度中央政府總預算有關衛生福利部主管預算凍結報告案1案；二、邀\n請衛生福利部部長針對「社區精神病患照護優化」進行專題報告，並備質詢","agenda_id":"1139301_00003"}}},"supported_relations":[],"relations":[]}