Official Says Three-Shift Nurse-Patient Ratio Excludes Psychiatry Due to Funding - Scholar Criticizes 'One Country, Two Systems' as Discrimination

After long-term advocacy, the three-shift nurse-patient ratio has finally been codified into law with a clear implementation timeline. However, from the beginning of the pilot program on March 1, 2024, official documents from the Ministry of Health and Welfare explicitly excluded psychiatric specialty hospitals, psychiatric teaching hospitals, and acute general psychiatric wards in general hospitals. Even now, with the formal legislation of the three-shift ratio, the regulation only applies to 'acute general wards,' leaving psychiatric units excluded.

In response, Liu Wen-yi of the Psychiatric Nursing Society stated that nurses working in psychiatric units are denied the benefits of the three-shift nurse-patient ratio despite being equally qualified. Hospitals publicly argue that implementation would increase costs and lead to financial hardship, claiming that more psychiatric hospitals would collapse under the new standard. Liu strongly criticizes this rationale, calling it a form of 'one country, two systems' and a clear act of discrimination against psychiatric patients and nursing staff.

Chen Ching-mei, Deputy Director of the Nursing and Health Care Division at the Ministry of Health and Welfare, explained that prior to the March 2024 pilot, a coordination meeting was held where stakeholders acknowledged the significant gap in nursing staffing levels between psychiatric units and general medical or surgical wards. Achieving the higher standard of the three-shift ratio was deemed unrealistic. Moreover, the care model for psychiatric patients fundamentally differs from that of general wards. Therefore, it was decided that including psychiatric units in this phase would be ineffective, even if mandated. The Ministry emphasized that this exclusion is not intended as discrimination against psychiatric care.