President Ma Ying-jeou on the morning of April 26 attended a roundtable discussion with groups representing the interests of the nation's nurses, whom he thanked for protecting the health of the public. The president and the participants discussed topics such as the appropriate ratio of nurses to patients, workplace safety, training, and licensing tests. The president instructed government agencies to formulate comprehensive measures to improve working environments for nurses, so as to ensure their interests and dignity while protecting the health of the public.
In opening remarks, President Ma stated that in order to fulfill a pledge he made during his campaign, he has attended a number of conferences with various civic groups both last year and this year covering judicial affairs, new immigrants, women's affairs, youth affairs, environmental protection, athletics, medical affairs, the aging of society, tourism, pre-schooling, transportation safety, and nuclear energy. These conferences have yielded judicial reforms, improvements in the treatment of new immigrants, and amendments to the Medical Care Act.
President Ma mentioned that Taiwan has superbly skilled physicians and a national health insurance system that is trusted by the public. This system is renowned throughout the world, and constitutes an important source of social stability, he said. Over the past five years, he noted, the financial tsunami and the eurozone debt crisis have put a drag on global economic growth, but fortunately Taiwan's national health insurance system provides a social safety network. Otherwise, social turmoil could have resulted. Nonetheless, changing social conditions and needs have caused a shortage of medical personnel here in five important fields. If this situation is not improved, he stated, it could affect the health of the public in general, and the younger generation in particular.
The president opined that patients require medical professionals who are healthy and willing to provide appropriate care. If physicians are cowed by frivolous litigation, or nurses are overwhelmed by heavy workloads and fall ill, it will be impossible to maintain the quality of medical care, he said. Taiwan's national health system cannot be maintained at the cost of overworked medical professionals, the president remarked.
The government is working actively to come up with solutions, the president noted, pointing out that last September he convened a roundtable discussion that focused on medical malpractice litigation. Before the end of last year (on December 18), the Executive Yuan's Department of Health had submitted to the legislature draft legislation that codifies the mechanism for resolving medical disputes and compensating patients for malpractice, and a draft amendment to Article 82 of the Medical Care Act. The president stated that this demonstrates the government's determination to carry out reform.
As for the shortage of nurses, President Ma further stated, in May of last year the Department of Health began working aggressively to improve working conditions for nurses. By the end of last year, he said, the number of practicing nurses had already increased by 4,592 to 140,000, which is a new high. The president added that this number was maintained as of the end of March of this year, an indication that the government's allocation of funding and appropriate pay increases for nursing staff in specific departments have helped attract people back into nursing.
President Ma pointed out that International Labor Day was coming up on May 1, with International Nurses Day to follow on May 12. The president recognized the hard work and contributions of nurses, who are on the front lines at hospitals and clinics throughout Taiwan working to ensure the health of the public. At the same time, the president asked for one minute of silence to commemorate the seven doctors and nurses who died 10 years ago in the line of duty during the Severe Acute Respiratory Syndrome (SARS) epidemic [Dr. Lin Yongxiang (林永祥), Dr. Lin Zhongwei (林重威), Head Nurse Chen Jingqiu (陳靜秋), Nurse Lin Jialing (林佳鈴), Deputy Director Zheng Xuehui (鄭雪慧), Nurse Hu Guifang (胡貴芳), and Medical Technologist Cai Qiaomiao (蔡巧妙)].
Following his remarks, the president exchanged views with the participants on three major topics: instituting standards to ensure appropriate staffing levels and working hours; creating a safe working environment and providing reasonable benefits and pay; and coordination of education, testing, and employment of nurses.
After listening to the opinions of the participants and compiling the suggestions of the representatives, the president then issued the following directives. First, regarding the ratio of nurses to patients, which is an issue that is being closely watched by the public, the president stated, the nation is working toward a 1:7 ratio, the same as in Japan. According to calculations by the Department of Health, however, to achieve this level Taiwan will require an increase of over 9,200 nurses at a cost of about NT$5.5 billion each year (of this, public hospitals are estimated to require NT$2.2 billion). While this will be difficult to achieve in the short term, the president said, related organizations should first work together and conduct long-term and large-scale research and surveys to confirm Taiwan's exact needs. President Ma also asked the Department of Health and other related agencies to draw up a timetable with the hope that over the next three or four years, public hospitals will be able to achieve this nurse-to-patient ratio during daytime shifts.
As for the education, testing, and employment of nursing staff, the president instructed the Ministry of Examination, the Ministry of Education, and the Department of Health to jointly examine the present situation and identify problems in the systems of five-year nursing colleges and licensing examinations. The president stressed that there is a considerable gap between the numbers of licensed and working nurses. The Department of Health should understand the main reasons why nursing junior college graduates who pass licensing exams decide not to work in the field, he said, adding that solutions should be found to attract nurses back to the profession. For instance, the president noted, last year after the government aggressively worked to improve the working environment for nurses, the number of nurses practicing increased by over 4,000, which immediately helped authorities reach nearly 50% of their goal. The president emphasized that "where there is a will, there is a way." As long as we are determined and work our hardest, he is confident that we can achieve our goals.
As for the shortage of nurses in remote areas, the president stated, the government is implementing a plan to train medical personnel for work in aboriginal or offshore areas. From 2007 to 2011, only 10 nurses were trained under this initiative, he said. Currently, however, the Department of Health is preparing a project to train 200 nurses over the next four years, with the tuition to be picked up by the government, he explained. This, he commented, will hopefully encourage nurses to return to their hometowns to practice. The president asked that the Department of Health make appropriate plans with respect to funding, manpower, and other aspects to ensure the success of this initiative.