防疫物資制度相關法律問題檢討

The Legal Study on the System of Materials for Communicable Disease

系所名稱：法律學系 學位別：碩士 畢業學年：100年 指導教授：林桓 為確保國家安全，維護社會安定，並提升防疫物資制度之成效，政府應鑑往知來防疫需求，並完整相關配套措施。機關（構）或事業於決定採購防疫物資時，應事先規劃對策、重點，透過經營策略與產業分析，以有效掌握防疫物資市場短缺及異動風險，並兼顧成本效益。為免浪費及耗損，並使採購品項與數量迅速取得及具彈性，有必要就防疫物資之供給面及需求面仔細評估，以免需求數與採購量產生落差。防疫物資之使用及管理，重在確實掌握預算，而妥善運用經濟訂購量，將有助於降低交易成本與如何決定防疫物資採購量及存貨控制。機關（構）或事業如能建立儲備量檢討準則，並訂定合理之採購量，以及確實掌握持有成本、訂購成本及缺貨成本，且經費支用以實用為優先，充實各項防疫物資，撙節消耗性支出，將可展現資源有限、表現傑出之實務成效。防疫物資之庫存模式、運作模式及儲備品項等，對供應鏈之實務運作具關鍵性影響，如能充分發揮其優點，並以新加坡為鑑，於我國防疫物資管理制度上克服其缺點或使產生之問題減至最低，將能大大提升其成效。因應防疫物資使用及管理面臨之挑戰，亟需有新思維、新方式，以適應防疫物資制度轉型的要求。為達以有效率的資源利用管理方式，滿足防疫物資使用需求之雙贏目標，謹提供建議如下：一、為免多元機關及機構的政策缺乏協調整合，導致各行其事、供過於求及事倍功半之情形持續存在。「傳染病防治法」第二十條第一項規定，建議修正為「中央主管機關應評估、彙整我國防疫物資需要，協調地方主管機關及醫療機構，適當、合理儲備各項防治傳染病之藥品、器材及防護裝備，並適時檢討之。」。二、為適當、合理儲備防疫物資，並避免浪費及耗損。「防疫物資及資源建置實施辦法」第六條規定，建議修正為「醫療機構為因應傳染病大流行之隔離需要，應自行預估防治動員十四天所需求之防疫物資安全儲備量，並將計算基礎及參數報請下列機關核定：一、公立醫療機構，報其主管機關。二、其他醫療機構，報其所在地之地方主管機關。」。三、中央主管機關對於防疫物資之儲備，應加強部會政策橫向聯繫，並發揮內部控制機制或提升其執行成效。四、訂定儲備量檢討準則，運用跨業流通及區域聯防機制，善用防疫物資，節省不必要之資源浪費。五、把關防疫安全，借鏡新加坡。鑑於新加坡之防護裝備儲備模式，可以活化防疫物資安全庫存量，擴大防疫物資的使用涵蓋範圍，有助於降低臺灣防疫物資市場交易成本，另外新加坡以「包裹式契約」互相調合主管機關、供應商、物流業者及醫療機構等四方之間的法律權利義務關係，亦有助於我國防疫物資之儲備、使用及管理，爰建議採用，作為我國防疫物資安全儲備模式重新規劃或調整之參考。六、修正「政府採購法」相關條文，明文授予行政院公共工程委員會訂定共同供應契約相關辦法之權限，以符合授權明確性原則；修正「政府採購法」相關條文補足「中央機關共同供應契約集中採購實施要點」之合法性，並針對臺灣銀行於本要點之特殊地位，檢討其權限之合法性，去除「指定」相關條款，以釐清臺灣銀行採購部與行政院公共工程委員會間之法律關係；調整「共同供應契約」適用公開招標規定，以利採購契約之運作。

To assure national security, to maintain social stability, and to facilitate the effects of the disease control materials system, the government should evaluate the needs of disease control and prepare relevant accompanying measures.When an organization (institution) or enterprise decides to procure disease control materials, they should plan in advance strategies, major issues, and through management strategies and industry analysis, to effectively understand the market and risks of changes of disease control materials, and to consider, at the same time, cost effectiveness. To avoid wastes and loses, and to obtain the items and amount under procurement in good time and with flexibility, it is imperative that the supply sides and demand sides of the disease control materials be carefully evaluated to avoid discrepancies between demands and amounts procured.The use and management of disease control materials depends on the correct control of budget. Through economical ordering, transaction costs can be reduced; it also helps in deciding the amount of disease control materials to be procured and their safety reserves. An organization (institution) or enterprise, if they can establish principles for the review of reserves and decide on the reasonable amount of procurement, they can precisely control the costs of holding, ordering and deficiencies of supplies. Expenditures should be practical to substantiate various disease control materials, and to save consumptive expenditures. In this way, the limited resources can be extended, and the practical performances can be remarkable.The modes of stock, operation and items for storage of disease control materials are a key factor to the practical operation of the supply chains. How to develop their merits, following the case of Singapore, will help overcome deficiencies in our management system of disease control materials or reduce to the lowest the problems thus arise to come up with more outstanding performances.Facing the challenges of the use and management of disease control materials, new ways of thinking, new methods are required to meet changes of the disease control materials systems. To effectively use and manage resources and to meet the goal of the use of disease control materials, the following are suggested:1. To avoid the lack of coordination and integration in policies of many organizations and institutions involved and thus result in supplies exceeding demands and poor outcomes, it is suggested that regulations of Paragraph 1 of Article 20 of the Communicable Disease Control Act be amended to: “The central competent authority shall evaluate, integrate the national needs of disease control materials, coordinate local competent authorities and medical care institutions to adequately and reasonably store various pharmaceuticals, devices and protective facilities for the control of communicable diseases, and review them timely.”2. To adequately and reasonably store disease control materials and to avoid wastes and loses, it is suggested that Article 6 of the “Implementation Regulations Governing Materials for Communicable Disease Control and Establishment of Resources” be amended to: “To meet the isolation needs for large-scale epidemics of communicable diseases, medical care institutions shall estimate by themselves the safety reserves of materials for communicable disease control required for control mobilization for fourteen days, and report the basis of calculation and parameters to the following organizations for approval: 1) for public medical care institutions, report to their respective competent authorities, 2) for other medical care institutions, report to their respective local competent authorities.”3. The central competent authority, for the storage of disease control materials, shall strengthen the horizontal coordination of ministries, and facilitate internal control mechanism or upgrade their effects of performance.4. Principles on amount of reserve should be decided. Use the cross-disciplinary flow and regional joint defense mechanisms to more effectively utilize disease control materials to save unnecessary wastes of resources.5. For disease control safety, examples of Singapore should be followed. The mode of storage of protective facilities in Singapore can activate the storage amount of disease control materials, extend the use of disease control materials, should be helpful in reducing transaction costs of disease control materials market in Taiwan.The “package contracts” method used by Singapore to adjust the legal rights and duties relationships between the four sides of the competent authority, suppliers, commodity dealers and medical institutions should also help Taiwan in the storage, use and management of disease control materials, their application is suggested for reference for Taiwan in the re-planning or adjustment of the safety storage mode of disease control materials.6. The relevant regulations of the Government Procurement Act should be amended. The Public Construction Commission of the Executive Yuan should be authorized to decide authorities of relevant regulations of common supply contracts to be clearer in the area of authorization. The relevant regulations of the Government Procurement Act should be amended to include the justification of the “Implementation Directions Governing the Centralized Procurement of Inter-entity Supply Contract of the Central Competent Authorities”. The special status of the Bank of Taiwan in this set of Directions should be reviewed of its legality in authorization. Articles on designation should be removed to clarify the legal relationship between the Bank of Taiwan and the Public Construction Commission of the Executive Yuan. Regulations concerning open tendering procedures should be so adjusted to apply to the “inter-entity supply contract” to facilitate the operation of the procurement contracts.