Hospital Governance: The Key to the Protection of Labor Rights of Medical Professionals

Abstract

醫師團體爭取勞動基準法的適用已爭論多年，過程中遭遇極大的阻力，雖然衛生福利部終於在日前宣布2019年受僱醫師將全數納入勞基法，但可預期接下來會有許多法令增修實質內容的協商與準備工作。本文目的在於提醒醫師團體及司法體系，「納入勞動基準法」其實只是讓受僱醫師有最基本的法律保障，但「徒法不足以自行」，要真正落實醫事人員勞動權益的保障，還有哪些被忽略的環節？本文嘗試透過實例分析，以目前獲取健保龐大資源的財團法人醫院為例，從國際上漸趨重視的醫院治理、醫療貪腐視角，闡述為何下一個更重要的戰場必須鎖定醫院治理。如果醫院治理失靈，將會嚴重影響醫事人員能否獲得合理的勞動條件與福祉；更重要的是，我們該如何做才能導正並扭轉已經走上歧路的醫院治理模式。

Whether the Labor Standard Law should cover medical doctors or not is a heated debate in Taiwan over the years. Some groups of medical doctors strongly ask for its coverage but to no avail until the end of 2016 when the government declared this Law applies to all employed doctors starting in 2020. It is anticipated that there will be substantial negotiations and regulations to be revised with regard to the working conditions such as working hours, leaves, overtime, etc. in the following three years. This paper aims to remind medical doctors’ groups and judicial system that the coverage of employed doctors into labor standard law, though an overdue motion, is not able to guarantee the labor rights protection of doctors unless the issue of hospital governance is to be addressed.\n\nThere are four types of hospitals, namely public hospitals, private clinics and hospitals, foundational hospitals, and corporate hospitals. Those foundational hospitals are the target of our analysis for its fast development in number and in size, most of them being medical centers, taking up a significant share of insurance resources. Hospital governance has received international attention in the past decade due to the fact the corruption of health system and commercialization of health care services turn the hospital to the direction that cannot fulfill its mission but harm people instead. Studies show that foundational hospitals in Taiwan are turning away from their solemn mission leading to hospital governance as a big concern. The issue of good hospital governance is one of the keys to rescuing hospitals from corruption and functioning as life guarding and quality enhancing units of the society.