Taipei: The Legislature on Friday mandated nurse-to-patient ratios in law, responding to long-standing calls to ease nurses' workloads, and stipulated that hospitals violating the regulation could be made to suspend operations for up to one year.

According to Focus Taiwan, the amendment to the Medical Care Act passed by the Legislature sets nurse-to-patient ratios initially at target levels introduced by the Ministry of Health and Welfare (MOHW) in March 2024. These ratios are subject to review by the MOHW every three years to consider patients' interests and nurses' labor rights, with adjustments as necessary. The amendments, proposed by the opposition Kuomintang (KMT) and supported by the Taiwan People's Party (TPP), received backing from all three major parties, including the ruling Democratic Progressive Party (DPP).

The proposals differed in their approach to determining the ratios. The DPP suggested that an advisory committee, comprising one-third of its members as nurses, should be consulted by the MOHW. In contrast, the TPP proposed that nurses should constitute at least half of the committee. Each version received support only from the proposing party, leading to negotiations before votes were cast.

Outside the Legislature, protests erupted following reports that the proportion of nurses on the advisory committee might be reduced from one-half to one-third. Despite the breakdown of negotiations, lawmakers proceeded with voting on the proposals.

According to the MOHW's 2024 policy, medical centers have nurse-to-patient target ratios set at 1:6 for day shifts, 1:9 for evening shifts, and 1:11 for night shifts. For regional hospitals, the ratios are 1:7, 1:11, and 1:13, while district hospitals have ratios of 1:10, 1:13, and 1:15. Hospitals meeting these standards were eligible for incentives, but previously, there was no legal basis for imposing penalties for noncompliance.

Following the legislative amendments, hospitals failing to adhere to the ratios will face fines ranging from NT$50,000 to NT$250,000 for district hospitals, NT$200,000 to NT$1 million for regional hospitals, and NT$1 million to NT$2 million for medical centers. Persistent noncompliance, with three penalties without adequate improvements, could result in suspension of operations for up to a year.

The MOHW's 2024 introduction of nurse-to-patient ratios came in response to calls from nurses dealing with excessive workloads and staffing shortages, issues believed to contribute to nurses leaving their jobs. TPP lawmaker Chiu Hui-ju stated that Taiwan has about 300,000 licensed nurses, but only approximately 190,000 are currently practicing.