Ezekiel J. Emanuel’s Which Country Has the World’s Best Health Care?, a bestseller in the US published in June, includes a ranking of countries according to the quality of their healthcare services. Although Taiwan does not appear in the ranking, China does, and it is right at the bottom.
However, Emanuel mentions Taiwan, saying that its healthcare provision is different from that in advanced countries.
First, the healthcare environment is crowded, with the public placing high levels of demand on it, he says.
Second, relatives and friends are responsible for providing the patients’ basic daily needs, he says, adding that hospitals expect them to stay by the bedside, look after the inpatient’s daily needs, and perform tasks such as feeding, bathing or changing their drip.
This does not happen in advanced countries. I am pretty sure, that in those places, hospitals do not expect relatives and friends, who have had absolutely no medical training, to perform tasks normally left to the professionals. How can such a system be expected to provide sufficiently high levels of healthcare?
If you only look at specific cases, you would think that the standards of healthcare in Taiwan are extremely high. Think, for example, of the successful operation to separate conjoined twins Chang Chung-jen (張忠仁) and Chang Chung-i (張忠義), the National Health Insurance system or Taiwan’s handling of the COVID-19 pandemic, all of which have received praise internationally.
Yet hospitals around the country are packed with relatives and friends, with a facility of 1,000 beds having twice that number of people staying there, making noise and denying patients a peaceful environment.
I was deputy head of the National Taiwan University Hospital Nursing Department for 10 years, and the head for another nine.
While I was there, patients and their families often complained of the noise levels, saying it would make it impossible to rest. Once, I had a relative complain that the nurses had not shown them how to dress a wound properly. The woman had seen that the gauze on the patient’s wound was bloody, and even though there were fresh wound dressing materials, medical tape and ointment, she dared not dress the wound herself. In fact, a nurse had shown a previous visitor how to do it, but not the woman in question, who had arrived later.
The nation’s hospitals should look at how things are done in advanced countries, where visitors are limited to designated times, and are there to accompany the inpatients, not perform medical work best left to the professionals.
If Taiwan wants its healthcare provision to be on par with that of more advanced societies, and avoid being an international laughing stock, hospitals should implement a comprehensive nursing system, and recruit adequately trained staff, to take care of all the patients’ needs.
Chou Chaw-fang is former head of the Nursing Department at National Taiwan University Hospital.
Translated by Paul Cooper
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