部立醫院行政法人化之芻議

The transition to non-departmental public bodies -- a preliminary study of hospitals affiliated with Taiwan's Ministry of Health and Welfare (MOHW)

目標：本研究探討署立醫院改制行政法人未成功的原因，以及針對部立醫院（原署立醫院）未來行政法人化提出建議。方法：本研究採用深度訪談，對象包括5位署立醫院高階主管，5位行政院與衛生署官員，1位立法委員。結果：當年行政法人化未成功的主因為：第一，政治氛圍不利於行政法人化；第二，員工抗拒行政法人化；第三，部分醫院擔憂行政法人化後財務更困難。結論：衛生福利部應從行政、法律、政治等面向，個別評估各家部立醫院改制為行政法人的可行性。針對適合行政法人化者，衛生福利部應積極向立法院遊說推動組織法案，以及向醫院員工充份宣導行政法人化的工作權益事項。

Objectives: This study determined the reasons for failed transformation of DOH- affiliated hospitals into non-departmental public bodies (NDPBs). Suggestions are proposed for the future transformation of MOHW-affiliated hospitals into NDPBs. Methods: Five senior officers in DOH-affiliated hospitals, five political appointees and senior officers in the Executive Yuan and the Department of Health, and one member of the Legislative Yuan were interviewed. Results: There are three main reasons for failed transformation of DOH- affiliated hospitals into NDPBs. First, the political atmosphere was unfavorable for the transformation. Second, the hospital staff declined the transformation. Third, some hospitals feared that the transformation might result in a worsening financial condition. Conclusions: We suggest that transforming MOHW-affiliated hospitals into NDPBs can be evaluated individually based on the administrative, legal, and political feasibility by the MOHW. For hospitals which are well-suited for transformation into a NDPB, the MOHW should actively lobby the Organizational Act Reform, and communicate the working benefits of the transformation to the hospital staff.