{"error":false,"id":["165853"],"data":{"IVOD_ID":165853,"IVOD_URL":"https://ivod.ly.gov.tw/Play/Clip/1M/165853","日期":"2025-11-26","會議資料":{"會議代碼":"委員會-11-4-26-13","會議代碼:str":"第11屆第4會期社會福利及衛生環境委員會第13次全體委員會議","屆":11,"會期":4,"會次":13,"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4會期社會福利及衛生環境委員會第13次全體委員會議"},"影片種類":"Clip","開始時間":"2025-11-26T10:17:26+08:00","結束時間":"2025-11-26T10:30:09+08:00","影片長度":"00:12:43","支援功能":["ai-transcript"],"video_url":"https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/f5b16bee5fdcc5c1fc4f92bd7cbcadd6ba7bab90aa47d9990a682b421b74d94e28abf62da49b1b6a5ea18f28b6918d91.mp4/playlist.m3u8","委員名稱":"黃秀芳","委員發言時間":"10:17:26 - 10:30:09","會議時間":"2025-11-26T09:00:00+08:00","會議名稱":"立法院第11屆第4會期社會福利及衛生環境委員會第13次全體委員會議（事由：邀請衛生福利部部長、財政部及環境部就「蘇丹紅化學原料竄臺，政府如何強化進口把關及後市場查驗，以維護國人健康安全」進行專題報告，並備質詢。\n\n邀請衛生福利部部長、司法院、法務部、勞動部及內政部警政署就「國內醫師、護理人力需求及分布暨防止醫療暴力措施及改善情形」進行專題報告，並備質詢。\n\n(討論事項)\n審查\n一、委員柯志恩等17人擬具「醫療法第二十四條及第一百零六條條文修正草案」案。\n二、委員林月琴等17人擬具「醫療法第二十四條及第一百零六條條文修正草案」案。\n三、委員王育敏等16人擬具「醫療法第二十四條及第一百零六條條文修正草案」案。\n四、委員顏寬恒等17人擬具「醫療法第二十四條及第一百零六條條文修正草案」案。\n五、委員萬美玲等16人擬具「醫療法第一百零六條條文修正草案」案。\n六、委員顏寬恒等16人擬具「醫療法第二十四條及第一百零六條條文修正草案」案。\n七、委員邱若華等17人擬具「醫療法第一百零六條條文修正草案」案。\n八、委員陳菁徽等17人擬具「醫療法第二十四條及第一百零六條條文修正草案」案。\n九、委員魯明哲等18人擬具「醫療法第一百零六條條文修正草案」案。\n十、委員王鴻薇等20人擬具「醫療法第二十四條及第一百零六條條文修正草案」案。\n十一、委員林淑芬等25人擬具「醫療法增訂第一百條之一條文草案」案。\n十二、委員盧縣一等16人擬具「醫療法第二十四條及第一百零六條條文修正草案」案。\n十三、委員羅廷瑋等21人擬具「醫療法第二十四條及第一百零六條條文修正草案」案。\n十四、委員廖偉翔等17人擬具「醫療法第二十四條及第一百零六條條文修正草案」案。\n【第十四案，如經復議，則不予審查】【專題報告及討論事項綜合詢答，討論事項僅詢答】）","transcript":{"pyannote":[{"speaker":"SPEAKER_01","start":0.03096875,"end":0.40221875},{"speaker":"SPEAKER_01","start":0.6722187500000001,"end":3.0515937500000003},{"speaker":"SPEAKER_00","start":10.172843750000002,"end":12.51846875},{"speaker":"SPEAKER_01","start":12.771593750000001,"end":13.429718750000003},{"speaker":"SPEAKER_01","start":16.95659375,"end":17.56409375},{"speaker":"SPEAKER_00","start":17.56409375,"end":56.798468750000005},{"speaker":"SPEAKER_01","start":38.657843750000005,"end":38.72534375},{"speaker":"SPEAKER_01","start":38.80971875,"end":38.82659375},{"speaker":"SPEAKER_00","start":57.05159375,"end":74.06159375},{"speaker":"SPEAKER_00","start":74.28096875,"end":121.36221875000001},{"speaker":"SPEAKER_01","start":121.63221875,"end":128.26409375},{"speaker":"SPEAKER_01","start":128.53409375,"end":145.96596875},{"speaker":"SPEAKER_00","start":131.01471875000001,"end":131.55471875},{"speaker":"SPEAKER_01","start":146.37096875,"end":251.89034375000003},{"speaker":"SPEAKER_00","start":180.74534375000002,"end":181.20096875000002},{"speaker":"SPEAKER_00","start":202.59846875000002,"end":202.80096875},{"speaker":"SPEAKER_00","start":206.05784375000002,"end":206.54721875},{"speaker":"SPEAKER_00","start":209.56784375,"end":209.77034375000002},{"speaker":"SPEAKER_00","start":222.15659375,"end":222.44346875000002},{"speaker":"SPEAKER_00","start":234.64409375000002,"end":235.11659375000002},{"speaker":"SPEAKER_00","start":243.23346875000001,"end":243.48659375000003},{"speaker":"SPEAKER_01","start":252.22784375,"end":273.01784375},{"speaker":"SPEAKER_00","start":254.97846875000002,"end":255.50159375},{"speaker":"SPEAKER_00","start":263.34846875,"end":263.82096875},{"speaker":"SPEAKER_00","start":273.01784375,"end":273.77721875000003},{"speaker":"SPEAKER_01","start":273.32159375000003,"end":274.77284375},{"speaker":"SPEAKER_00","start":274.77284375,"end":284.59409375},{"speaker":"SPEAKER_01","start":274.80659375,"end":274.84034375000005},{"speaker":"SPEAKER_01","start":274.87409375000004,"end":274.89096875},{"speaker":"SPEAKER_01","start":281.55659375,"end":281.87721875},{"speaker":"SPEAKER_01","start":281.97846875,"end":282.01221875000005},{"speaker":"SPEAKER_00","start":285.06659375000004,"end":305.87346875000003},{"speaker":"SPEAKER_01","start":288.44159375000004,"end":288.99846875000003},{"speaker":"SPEAKER_01","start":289.26846875,"end":289.40346875},{"speaker":"SPEAKER_01","start":292.98096875000005,"end":293.33534375},{"speaker":"SPEAKER_01","start":305.87346875000003,"end":322.42784375},{"speaker":"SPEAKER_00","start":312.75846875,"end":313.23096875000005},{"speaker":"SPEAKER_00","start":318.15846875,"end":318.59721875},{"speaker":"SPEAKER_01","start":322.64721875000004,"end":326.61284375},{"speaker":"SPEAKER_01","start":326.62971875,"end":335.97846875000005},{"speaker":"SPEAKER_00","start":331.84409375,"end":332.18159375000005},{"speaker":"SPEAKER_00","start":335.30346875000004,"end":348.33096875},{"speaker":"SPEAKER_01","start":344.50034375,"end":345.04034375000003},{"speaker":"SPEAKER_01","start":345.42846875000004,"end":345.63096875},{"speaker":"SPEAKER_00","start":349.30971875,"end":353.79846875000004},{"speaker":"SPEAKER_01","start":350.52471875000003,"end":352.36409375},{"speaker":"SPEAKER_01","start":352.46534375000005,"end":352.81971875000005},{"speaker":"SPEAKER_01","start":353.91659375,"end":401.67284375},{"speaker":"SPEAKER_00","start":358.87784375,"end":359.36721875},{"speaker":"SPEAKER_00","start":363.55221875,"end":363.87284375},{"speaker":"SPEAKER_00","start":372.49596875000003,"end":372.90096875},{"speaker":"SPEAKER_00","start":374.04846875000004,"end":374.38596875},{"speaker":"SPEAKER_00","start":376.63034375,"end":377.84534375000004},{"speaker":"SPEAKER_00","start":380.74784375,"end":381.28784375000004},{"speaker":"SPEAKER_00","start":381.45659375,"end":381.89534375000005},{"speaker":"SPEAKER_00","start":399.91784375000003,"end":400.33971875000003},{"speaker":"SPEAKER_00","start":400.81221875,"end":401.21721875000003},{"speaker":"SPEAKER_00","start":401.75721875000005,"end":411.12284375},{"speaker":"SPEAKER_01","start":409.36784375,"end":409.84034375000005},{"s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我們請部長"},{"start":16.963,"end":44.802,"text":"我今天想要跟部長再討論一下有關我們醫療人力的問題我記得在前陣子也在這個質詢台上面也有詢問過部長那我想請教就是說其實我們看到這個兩個禮拜前部長跟總統都有去參加第78屆的醫師節的慶祝大會那當天總統也有特別提到就是說允諾跟醫界要一起合作"},{"start":45.923,"end":68.171,"text":"提升我们的医疗服务品质解决改善医疗人力的问题还有医疗人力跟工作环境都要改善我想请教部长因为我们看到台大医院在之前就是说他们在招聘住院医师的时候要招11个人只有来7个人"},{"start":69.131,"end":91.971,"text":"那北榮的四位兒科住院醫師也全數離開離職然後去開業所以我不知道就是說這個醫療人力當然就是說衛福部這邊一直有提出一些政策希望能夠將這些醫療人力能夠留在醫院可是我們看到就是說這些醫療人力就一直出去然後自己開業嘛"},{"start":92.972,"end":120.41,"text":"那我們看到就是說你們之前也有特別提到就是說健保的支付的標準有提高還有發放住院的醫師的津貼還有增加輔助人力推動醫療糾紛的相關的一些法案我想請教部長我們提高了我們增加了這些政策有減少就是說讓這些醫師願意留在醫院嗎"},{"start":121.933,"end":145.276,"text":"跟委員說明就是說我們今年的健保的總額是叫去年提升增加了531億然後再加上政府的公務預算一住180億是增加到732億有這麼多那明年我們的成長那麼還會再加比今年的這個總額呢要再成長"},{"start":146.457,"end":171.152,"text":"到597億將近600億的規模所以今年是531億明年會到597億再增加同時又有公務預算199億進來所以明年整個的健保總額會破兆大概是這個概念所以增加了這麼多預算那麼其實總統的指示方向很清楚就是希望改善醫療品質"},{"start":172.293,"end":194.665,"text":"那麼留住急重症的人力所以整個健保也在搭配調整這個支付標準所以一開始就是先從急重症先調所以我們今年就先調了這個急性一般病床的護理費把它調升急診的觀察床的費用啊這個護理費都把它調了所以先調了這個那至於"},{"start":195.825,"end":216.556,"text":"醫師的人力我們看起來的人力是穩定留在醫院的還算穩定但是有一些科別之間確實出現這個住院醫師招收的下降像外科像今年來講招收的就還不錯那但是在這個內科也還可以但是這個兒科的部分就是明顯是比較困難"},{"start":217.276,"end":240.206,"text":"那当然这个儿科的背景是因为我们的少子女化的关系所以整个小孩子的数量下降所以那个儿科医师他的服务对象就下降了所以如果按照过去用这个论量记酬Fee for service的方式来支付就会让他们的收入就会下降所以对于这个未来的前景啊"},{"start":240.626,"end":254.782,"text":"年輕的醫師可能就會卻步所以我們才會在明年的總額用一個特殊的方式就是先框住了一定的預算就是保障這個孩子照顧得好醫師收入不會減少"},{"start":255.603,"end":284.363,"text":"那用这个方式来设计新的支付的模式不再是论量计筹反而是把孩子的预防保健这些健康检查早期疗愈这些事情早点发现导入把孩子照顾健康但是医师收入不减少那朝这个方向来调整那我是不是可以请部长就是说我们推了这么多的一个政策或者是说健保的这个有增加那你们应该也要再去做一个统计那"},{"start":285.183,"end":304.924,"text":"既然這樣子不是像以前的這個論量計酬那就是提高我們的這個醫療兒科的這個醫療品質那如果是這樣的話應該也要再去統計一下那這樣子這個兒科醫師願意留在這個職場裡面的到底他的成效到底好不好我覺得應該也要再去做一個統計"},{"start":306.466,"end":321.919,"text":"跟委員報告我們也有這個方面的數字啦當然就是現在的流向就是開業比較多啦所以我們現在的目標就像委員關心的要留在這個醫院的急重症因為醫院的兒科醫師要值班啊要照顧比較"},{"start":322.84,"end":345.24,"text":"早產的這些困難的科或者是男症 寒病的小孩所以我們也會去搭配的調整這個支付標準讓這個兒科醫師願意留在醫院那當然就是說總統也有提到一個就是說改善醫療人力的問題所以你們現在正在試辦就是假日輕急症中心那這個從試辦到現在"},{"start":351.21,"end":372.006,"text":"四周的時間那你們覺得成效好嗎因為我們一共有13個點在示範那麼在六都來示範那現在看起來成效最好的大概是在台南台南的UCC就是假日的輕急症中心他的人數上都是破百的"},{"start":373.167,"end":401.444,"text":"一天的量两个班就差不多都是破百以上对于那个陈大医院的急诊的舒缓看到数字的下降所以他还是会如果能够宣导的好做的成功的话可以降低这个急诊的负荷让大医院的急诊去处理那些重症的病人那其他的区域的话那个量还在还没有完全上来我们会再努力去做调整"},{"start":401.804,"end":419.334,"text":"部長我想請教就是說這個假日清急症中心他這些醫師是原本就是開業醫然後進來支援的嗎對 為主就是那個開業醫然後進來支援基層的醫師有時候是地區醫院的或者是那個開診所的醫師"},{"start":420.354,"end":437.811,"text":"就是基層的醫師來支援那部長會不會未來會有一個狀況就是說這個原本我們在大醫院的這些醫師他還是希望就是說到外面去開業然後你反而就是說假日的時候來支援賺的更多會不會有這樣的一個狀況"},{"start":438.812,"end":453.54,"text":"不会啦因为他我们要求的是要内科儿科跟这个骨外科啦那这些其实儿科医师刚刚就提到说很多就是目前在基层在职业的可以来帮忙"},{"start":454.5,"end":469.755,"text":"那内科医师其实已经够多了所以不会因为这几个班因为这个班不多啦一个月才四天而已部长我是不是也可以请就是说我们这些大医院的这个医疗人力的福利这些医师福利"},{"start":471.076,"end":494.067,"text":"有一些好譬如說我們中央衛福部這邊補助的應該可以直接進到我們所有的護理人員或者是醫師的這個口袋裡面啦不是又透過醫師這個大醫院再重新去分配不知道可不可以做到這樣子的一個我們現在慢慢的有一些調整支付標準都會要求一定比例要到這個人員的身上 像比如說我們"},{"start":495.328,"end":509.326,"text":"再來明年打算在過年長假期間去增加幾戶增加幾戶我們就會要求這個八成增加的部分都要跟人員給人的出來上班的人"},{"start":510.527,"end":536.29,"text":"那你们有去集合吗就是有请医院这边你们钱下去了之后然后你们有去集合到底他是不是真的把这个你们补助给医院的这些钱是直接进到医师或者是进到护理人员的这个口袋里面当然我们有一个那个申诉平台但就是如果没有拿到的我们尽量把我们这些做法让大家知道大家如果觉得说我们"},{"start":536.75,"end":560.605,"text":"布裡面已經有這樣的措施可是他們都沒有拿到就可以來申訴我們就會去查其實有時候申訴這個基層的員工或者是護理人員或者是醫師其實有的人你要叫他去申訴我覺得他也會有一些壓力我覺得應該你們要更主動一點去稽查到底有沒有把這個你們補助的這些經費是進到這些醫療人員的這個薪資裡面"},{"start":563.346,"end":590.785,"text":"我再請健保也研究一下因為都是健保的費用所以這個應該要有建立一下另外部長因為我這兩天接到很多已經在從事醫美的醫師的一個陳情就是說你們這個特管辦法下來之後他還要去做PGY的一個訓練我想請教就是說有的從事醫美的醫美診所已經開了十幾年"},{"start":591.705,"end":613.275,"text":"那像這樣子他已經在基層這個從事醫美的工作這麼久了那還需要再進到學校或者是再進到這個大醫院裡面去做PGY的這個訓練嗎那我希望就是說這個因為也引起很多目前已經自己開業的這些"},{"start":615.376,"end":632.311,"text":"医美的这个医师的一些呈请所以我希望就是说针对这部分你们应该要再去好好的去沟通跟委员说明今天下午就医事室就有召开一个会议有大概40个团体代表"},{"start":632.952,"end":661.983,"text":"都会来参与那在会上大家再好好的说明把这个执行的细节讲清楚了让大家清楚那看还有什么意见那再来做整合因为其中有一部分你们是要溯及既往是不是应该是这样我们溯及的部分是最主要是针对因为我们学制改变过去呢是医学系毕业要七年最后一年都是完整一整年的实习甚至有的是两年的实习"},{"start":662.628,"end":687.679,"text":"那后来把这个学制缩短了然后把它放在这个毕业后训练所以才有所谓的毕业后一般医学训练这六加二才是一个完整的医师的基本训练才有办法去独立执行业务所以当时候的概念就是这样那他已经在外面已经职业这么久了没有想到有这个状况这个PGY的训练不是"},{"start":688.659,"end":706.392,"text":"现在你做的可能只是专门做同一件事情当然你做的很好但是医疗可能碰到任何不预期的状况所以这些基础的训练是让你在面对一些不预期意外状况的时候你如何处理"},{"start":706.852,"end":723.009,"text":"我們過去看到的幾個案件經常是在發生意外或者醫療不良事件的時候他沒有辦法緊急的處置而造成遺憾所以我們必須去強化這一塊那我是不是可以請就是說衛福部這邊還是要加強溝通"},{"start":724.35,"end":736.709,"text":"要不然其实会让这些人也是你们这个特管办法出来之后就有很多陈情所以我们希望就是说确实要好好的沟通那沟通完之后"},{"start":738.34,"end":760.599,"text":"這個我覺得一方面就是確保這個患者或者是想要去做醫美的這個安全我覺得是安全也是很重要安全是最重要對 安全是最重要所以我覺得說這個溝通你們應該要好好去溝通啦好 避免下一次又大家就是大量的陳情或者是怎樣我覺得這樣也不好會 好不好好 我們來強化溝通好 謝謝委員好 謝謝這個黃昭瑋"}]}},"supported_relations":[],"relations":[]}