照顧服務人力問題之研究─以照顧服務員及外籍看護工為中心

Abstract

隨著老年人口比例逐年上升，如何滿足照護需求者的照顧需求，政府責無旁貸。從憲法基本權及基本國策，皆指出長照制度之建置乃政府的重要任務。而長照服務若要健全運作，勢必需要充足且受過訓練的照顧服務人力支持。惟我國目前的照服人力數量是否足夠，是否皆受過足夠的照顧訓練，似乎仍有待商榷。 為探究我國照服人力現存之問題及解方，本文將以「本國照顧服務員」及「外籍看護工」分別討論。本國照顧服務員方面，為了解決人力不足之問題，政府多年來推出了諸多政策改善照服員的薪資條件及提升工作價值，以吸引民眾加入長照工作的行列，亦有相當之成效，惟因老年人口成長速度過快，尚有待加強之處。而為了提升照顧品質，學界近年極力推動的照顧服務專業人員國家考試及衛福部提出的認證分級制度，亦有許多討論空間。 外籍看護工始終是我國長照服務體系下不可忽視的存在。在外籍移工開放引進後，外籍看護工便擔任支撐我國長照運作的重要角色，雖然外籍看護工之定位已從暫時性補充人力轉變為長照服務主力，其勞動權益仍未獲完善保障。政府近年來擬定法規及政策以吸引良好的外籍看護工長居台灣，惟本文認為唯有改善外籍看護工的勞動條件，確實保障其勞動權益，方能維繫長期照顧的品質，並留下優秀的照顧人才。

With the proportion of elderly population increasing year by year, it is the government's responsibility to meet the care needs of care recipients. From the perspective of fundamental right and the fundamental national policies in Taiwanese Constitution, the establishment of a long-term care system is an important task for the government. To ensure the effective operation of long-term care services, it is crucial to maintain the sufficiency in the human resource concerning well-trained care-givers. However, it remains unanswered as to whether the current number of caregivers in our country is sufficient, and whether these caregivers are adequately trained. In order to study the existing problems and establish possible solutions concerning care-giving human resource in our country, this thesis will look into the current system from two caregiver groups: "domestic nurse aides" and "foreign caregivers". To solve the problem of insufficient domestic nurse aides, the government has implemented many policies, including salary raise and work value enhancement, to boost the incentive in joining the nurse aide career. Although, these policies have been somewhat effective, yet more robust solutions are needed to face the challenge of a rapidly growing elderly population. Meanwhile, the quality of care also demands improvements. Social science scholars have been vigorously promoting policies concerning professional caregiver qualifications via national-level examinations. On the other hand, the Ministry of Health and Welfare has been proposing a certification grading system. All of the above mentioned solutions have much room for discussion. Foreign caregivers have always been an important presence in our country's long-term care service system. After the gates opened for foreign migrant workers, foreign caregivers have been playing an important role in supporting the operation of our country's long-term care services. Despite the transition of foreign caregivers as temporary supplementary human resource to being the main force of long-term care services, they remain inadequately protected by labor rights. In recent years, the government has formulated regulations and policies to incentivize quality foreign caregivers to settle in Taiwan, but this thesis concluded that the long term incentive lies in palpable improvements of working conditions for foreign caregivers. When such improvements actually take place, not only would the quality of long-term care be kept up but quality caregivers would stay.