Sun, May 18, 2003 page2

• Reorganize the medical structure, legislators ask

  • By Fiona Lu / STAFF REPORTER
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  Three DPP lawmakers with clinical-practice experience called for the restructuring of the country's medical system, perceiving a flaw within the existing framework that sparked off the SARS outbreak.

  "The outbreak of the flu-like illness severely hit the country partially because of the long-time neglect of medical research and training at the infectious disease department," Chien Chiao-tung (簡肇棟) said.

  Chien, who held a press conference with his fellow DPP Legislators Lai Ching-te (賴清德) and Chen Chi-mai (陳其邁) on Friday, said that urgent reinforcement of infection technology is needed to halt the spreading disease.

  All three lawmakers are experienced medical professionals.

  The hospital management system must improve its training as well as aid for personnel at the infectious diseases department by doubling the manpower and improving clinical protection for personnel on duty, Chien, formerly a thoracic doctor and a hospital superintendent in Taichung County, said.

  Chien explained that, "the infectious departments are unappreciated in most hospitals in civilized countries because modern society has been far removed from life-threatening epidemic transmissions following the development of more advanced medicines in the 21st century."

  And this demonstrated that, before the pneumonic disease surfaced, hospital administrations tended to treat their infectious departments as secondary subdivisions with the minimum personnel, the least cost accounting and protective measures and even the poorest payment rules within the national health insurance service.

  He said that hospitals around the country usually deploy only one doctor to the infectious department and the maximum nursing staff dispatched to the department is four.

  "The outbreak of SARS undoubtedly created the harshest challenge to the infectious manpower reserve because of their lack of combat capability," Chien said.

  The lawmakers advised enlisting the military forces to help fight the epidemic. The worsening infection was a warning that the civil medical system had been unable to win the battle against the rampant disease on its own, they said.

  The battle against the SARS virus should be upgraded to a mission of biochemical war. Military hospitals should take over the command of centralized medical treatment and hospitalization, while dozens of the DOH-supervised hospitals around the country need to modify their roles in support of the leading general hospital, they said.

  "The military medical forces must contribute to epidemic control with its high-speed mobilization capability and biochemistry training," Chien said.

  They said the Tri-Service General Hospital of Taipei should mastermind the national SARS-prevention and cure scheme and be declared the centralized treatment base for all SARS patients and suspected cases.

  The other 19 army hospitals and clinics scattered around the country can serve as preliminary bases for epidemic sampling tests and temporary centralized infirmaries for cases showing SARS-related symptoms.

  Chen Chi-mai, formerly a doctor in charge at Chang Guan Memorial Hospital, demanded the speeding up of the recruitment of supplemental staff to relieve hard-pressed medical personnel. "The required quarantine for medical personnel having contact with SARS patients increased the workload of the limited amount of frontline doctors and nurses," he noted.

  The administration should inaugurate standard operation procedures (SOP) for treatment of an epidemic, said Lai, who used to be a physician at National Cheng Kung University Hospital, stressing that modifying diagnostic procedures need to on while the government is pushing for a NT$50 billion special budget to curb the illness.
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