省思我國醫院治理法制【本期企劃】 試閱
Reflection on the Law Concerning Hospital Governance in Taiwan
醫院治理應為醫療體系中提升醫療品質、促進病人福祉的重要制度。然而,現行醫療法對於醫療機構組織之規定,主要集中於設置資格與形式,但對於醫院治理的規範,主要集中於醫療法人部分。本文爬梳現行法與行政院2017年提出「醫療法部分條文修正草案」,指出草案雖然針對醫療財團法人,提出設置監察人、設置公益監察人、增加董事會組成多元性、董事長連任限制等,然而借鏡公司治理之學理,草案所提之制度設計,仍有效益不彰或欠缺明確性的問題;而在醫療社團法人部分,現行法也未能釐清一直以來的營運目的疑慮。本文並且借鏡國外研究,提出強化醫院治理的幾個方向,包括保障專業治理、建立監督機制以及落實醫療公共性,以供我國法制與政策參考。
Hospital governance should be a critical part in the healthcare system to enhance medical quality and promote patient welfare. However, the current Medical Care Law mainly focuses on the qualifications and forms of medical institutions. The limited regulations on hospital governance primarily concentrates on the part concerning medical care juridical persons. This article examines the current Medical Care Law and the “Partial Amendment Draft of the Medical Care Act” proposed by the Executive Yuan in 2017, pointing out that although the draft proposes mechanisms to improve the governance of medical care foundations, such as appointing supervisors, establishing public supervisors, increasing the diversity of the board of directors, and restricting the re-election of chairpersons, those institutional designs proposed in the draft still suffer from inefficiency or lack clarity, drawing upon corporate governance principles. Moreover, the current Medical Care Law also fails to clarify the operational purposes of medical care associations, which has been a longstanding issue under the current law. Drawing insights from foreign research, this paper proposes several directions to strengthen hospital governance, including ensuring professional governance, establishing check-and-balance mechanisms, and implementing medical publicness, for reference in our country’s legal system and policies.
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