配合行政院組織改造,衛生福利部(簡稱衛福部)於2013年7月23日成立,目標為打造以人為中心的衛生福利網,促進全民健康與福祉作為使命。為此,部內人員的核心職能由衛生醫療範圍擴增為社會福利服務的範疇,業務推動具有跨領域與跨專業的特質。衛政與社政兩個體系的整合,是行政院組織改造諸多議題中,被討論最多的組改課題之一。此外,關於衛政與社政服務的整合研究,可以長照政策推動為代表,相關研究建議衛福部成立後,由部長定期召開長照會報,讓兩個專業能有固定溝通管道,促進彼此之間的相互瞭解與信任。為此,本研究有別於跨部門與跨區域的研究,聚焦於專業分歧的跨域,透過文獻檢閱、問卷調查與深度訪談,以及從內部利害關係人的角度,探討在衛福部的組織體系下,衛政與社政專業的互動與運作。研究發現衛福部存在衛政與社政專業的互動與運作困境,由於衛政及社政兩種不同專業背後的思考邏輯不同,形塑不同的文化,形成專業職能分歧的另類跨域治理現象。研究建議透過不同場合或議題,讓中高階人員瞭解並尊重不同專業的多元性與差異性,強化跨專業合作的可能。
Professional Divergence as an Alternative Type of Cross-boundary Governance Issue: A Preliminary Exploration Using the Ministry of Health and Welfare as an Example
I-Chun Liu, Don-Yun Chen, Chao-Yi Lin, I-Hua Lai
Abstract
The Ministry of Health and Welfare was established on July 23, 2013 as part of the organizational reform of the Executive Yuan. The aim was to create an individual-centered health and welfare network to promote the health and well-being of the entire population. To achieve that end, the ministry expanded its staff’s core duties from hygiene and medical issues to the domain of social welfare services. The ministry’s work has both cross-boundary and cross-disciplinary characteristics. The integration of the health system and the social welfare system is one of the most frequently discussed themes among the various issues associated with the organizational reform of the Executive Yuan. Furthermore, research on the integration of the health system and social welfare services has resulted in the promotion of long-term care policies. Relevant studies suggest that after the establishment of the Ministry of Health and Welfare, the minister should hold regular long-term care meetings, so that both professions can share a fixed channel of communication, thereby fostering mutual understanding and trust. In this aspect, this study differs from existing cross-departmental and cross-regional studies, as it focuses on cross-domain professional differences. Through literature reviews, questionnaire surveys, and in-depth interviews, this study was conducted from the perspective of internal dynamics of interests, in order to explore the characteristics of interactional and operating difficulties between the health system and the social welfare system under the organizational framework of the Ministry of Health and Welfare. We found that there were indeed interactional and operating difficulties between the two systems. Owing to the differences in the logic of the two professions, different cultures have formed. The findings of this study suggest that different occasions or issues should be employed to enable middle to senior personnel to understand and respect the diversification and heterogeneity of different professions, which will help to bolster the possibilities for cooperation across disciplines.
Keywords: across boundary governance, interprofession, core competence, competence