Taipei: The Taiwan Nursing and Medical Industries Union and hospital associations have expressed conflicting views over a proposal by Taiwan's health authority to postpone the enforcement of mandatory nurse-to-patient ratios in hospitals by two years.
According to Focus Taiwan, the disagreement follows the passage of amendments to the Medical Care Act, which mandates three-shift nurse-to-patient ratios introduced by the Ministry of Health and Welfare (MOHW) starting in 2024. However, Health Minister Shih Chung-liang announced that the new regulations would be delayed until May 1, 2028, without specifying when the laws would take effect.
The nursing union criticized the delay, arguing that it favored hospital management interests and accused Minister Shih of neglecting his duties. Union consultant Chen Yu-feng has filed an appeal with the Control Yuan to investigate potential misconduct by Shih. Chen highlighted that the nurse-to-patient ratio issue has been under discussion since 2018, with little progress despite MOHW's promises. The union also intends to file a complaint with prosecutors.
Unions from six hospitals have called for an accelerated implementation of the plan, citing substantial government spending on hospital labor costs and criticizing the lack of auditing mechanisms for hospital-submitted data. They accused the MOHW of disregarding nurses' concerns on the front lines.
Conversely, seven hospital associations issued a joint statement supporting the delay. They argued that a two-year grace period is crucial for a smooth transition, as over 30 percent of medical institutions are currently unable to meet the required ratios. They warned that immediate enforcement could lead to fines or suspension of operations and might force hospitals to reduce bed numbers amidst existing shortages.
The hospital associations emphasized the need for the grace period to enable recruitment, training programs, and smart healthcare initiatives. They noted that newly hired nurses require several months of clinical training to be adequately prepared.
Health Minister Shih echoed concerns about potential bed reductions if immediate enforcement occurs. He reported that compliance rates with nurse-to-patient ratios have increased since 2024. Despite improvements, some smaller hospitals have had to remove beds to comply. During the grace period, the ministry aims to retain nursing staff through measures such as night-shift allowances.
Shih assured that auditing mechanisms are in place to verify staffing data and ensure proper implementation of incentive measures. Under the MOHW's 2024 standards, nurse-to-patient ratios vary for medical centers, regional hospitals, and district hospitals, with legal penalties now possible for non-compliance.