聯勸贊助倡議型公益團體推動制度變革之成功案例分享－號召民眾參與發掘社區用藥風險暨監督藥局品質計畫

Successful Cases of United Way Sponsored Advocacy Groups and Campaigns for System Reform: Calling on the Public to get Involved in Disclosing Medication Risks and Pharmacy Quality watch in the Community

劉淑瓊(Joanne S. Liu) ； 朱顯光(H. K. Chu) ； 張銘芳(Ming-Fang Chang)

《聯合勸募論壇》 3期 (2013/09) Pp. 135-143

摘要

聯合勸募多年來在台灣贊助公益團體推動各種直接服務方案、社福產業創新計畫，促成許多社會實質改變與進步。隨著台灣第三部門所展現的社會力蓬勃壯大，不少公益團體進而積極藉由調查揭露、監督及倡議、觸發民意及媒體關注等方式，促成制度與政策改革，以產生更實質的改變以解決社會問題。但這類調查與倡議型的方案，不似直接服務容易支持到社會資源贊助；為維持倡議的獨立與客觀，更不適合接受政府或利益團體補助。因此，透過聯勸資源贊助，往往成為促成社會變革的關鍵力量。醫改會2012年監督藥局方案，就是個成功範例。台灣因缺乏社區用藥把關機制，導致重複用藥及交互作用率偏高，任意購藥、囤積藥品未服用等問題；有心增進社區民眾用藥健康的社區組織與社福機構，也無從有效聯結優質社區藥事資源。為解決此社會問題，醫改會申請聯勸2012年研究與調查補助計畫，採「行動研究法」方式，號召志工及社區民眾以神秘客方式調查藥局品質。結果發現藥局違規率竟達七成三，且四成專業諮詢沒到位。醫改會進而召開「揭露健保藥局五大『藥』命指數」記者會， 計有31家媒體採訪、43則報導，有效引起與論、醫藥團體、立委及政府重視，促成社區藥局評鑑、優良藥局資訊公開及強化違規查核等制度變革；透過媒體大幅報導，也讓大眾更進一步認識聯勸贊助倡議調查的貢獻。醫改會也透過與社福團體召開圓桌論壇、宣導講座、影音網頁，教民眾如何發掘社區用藥風險；相關成果亦可作為聯勸推動「樂齡360高齡服務」參考。

並列摘要

Over the years, United Way has sponsored numerous non-profit organizations to launch direct service programs and innovative development plans for the social welfare industry. Directly and indirectly, United Way has contributed substantially to the progress and growth of the society. The growing social force manifested in the actions of the third sector in Taiwan brought many non-profit organizations to actively investigate, expose, monitor, advocate, and initiate discussions of issues in the society and media system, and such active public attention has brought about substantial changes and resolved social issues in the society through system and policy reform. However, such investigation and advocacy programs do not gain as much support of social resources as direct services. To maintain independence and impartiality, it is also inappropriate for the advocates to receive grants from the government or profit-seeking groups. Therefore, United Way sponsorship often becomes the key force in the campaigns for social reform. The pharmacy watch program initiated by the Taiwan Health Reform Foundation (THRF) in 2012 is a good example of successful advocacy campaign.A checking mechanism has been missing in the community pharmacy system in Taiwan, and therefore the problems of repeated and interfering medication have persistently existed in the communities. People purchase drugs without prescriptions and stock up on drugs. Community/social welfare organizations advocating public health have been unable to connect the public to quality community pharmaceutical resources. To solve this social issue, the THRF made a request to United Way in 2012 for sponsorship to its research and investigation plan. This plan was conducted through action research; in which, volunteers and community residents were engaged as anonymous customers to investigate the quality of the pharmacies.From this research, THRF discovered that 73% of the pharmacies violated relevant regulations and 40% of them did not provide professional consultancy. THRF called for a press conference and disclosed of the five deadly indicators of National Health Insurance pharmacies. This press conference attracted the attention of 31 media and achieved wide exposure of 43 entries of news reports, which effectively initiated public discussion and grabbed the attention of the medical care groups, legislators, and the government. The campaign successful brought about system reform. Public grievances prompted the authorities to set up an accreditation system for community pharmacies, make the information of quality pharmacies available to the public, and strengthen law enforcement to prevent illegal pharmacy practices. In addition, nationwide media reports made the contribution of United Way sponsored advocacy known to the public, and the THRF was given an opportunity to educate the public on how to discover medication risks in the community through round table conferences with social welfare groups, seminars, and website audio/ video resources. The information provided by this research was also used a reference for United Way’s ”LOHAS 360 Service for the Elderly” program.