Taipei: President Lai Ching-te announced on Tuesday that the law mandating nurse-to-patient ratios will now take effect on May 20, 2027, moving up the implementation date from May 21, 2028, as previously stated by Health Minister Shih Chung-liang. Lai disclosed this change during an International Nurses Day event, stating that the policy will be "implemented in phases" to expedite enhancements in nurses' working conditions and patient care quality. His announcement was met with applause from the attending nursing personnel. However, Lai did not clarify what the phased implementation would involve.
According to Focus Taiwan, Health Minister Shih Chung-liang addressed reporters after the event, emphasizing that the ongoing nurse shortage, particularly in smaller and remote hospitals, cannot be resolved instantly. Shih highlighted that acute-care beds face an estimated shortage of 3,000 to 5,000 nurses needed to comply with the mandatory ratios. Despite 4,900 new nurses entering practice in March, with about half working with acute-care beds, Shih believes that the shortfall could be addressed by next year. He noted that advancing the law's implementation by a year necessitates measures to recruit and retain nurses, especially in small and remote hospitals.
Taiwan has long grappled with concerns about nurses being overworked due to high patient numbers. In 2024, the Ministry of Health and Welfare (MOHW) issued an administrative order setting three-shift nurse-to-patient ratios to tackle the issue, but it lacked enforcement penalties for noncompliance. The 2024 standards set target ratios at medical centers at 1:6 for day shifts, 1:9 for evening shifts, and 1:11 for night shifts. Regional hospitals must maintain ratios of 1:7, 1:11, and 1:13, while district hospitals are required to meet ratios of 1:10, 1:13, and 1:15. The ministry reported that about 70 percent of hospitals met these ratios in the latter half of 2025, up from 50 percent earlier that year.
On Friday, the Legislature passed amendments to the Medical Care Act, making nurse-to-patient ratios a legal requirement. The initial standards will reflect those set by the MOHW in 2024, with reviews every three years. Hospitals failing to improve after three penalties could face fines or operational suspension for up to a year. After the amendments' passage, Shih stated the new rules would take effect on May 1, 2028, following extensive discussions with nursing groups, the medical community, and other stakeholders. Nursing groups, preferring a Dec. 31, 2027 start date, protested the May 1, 2028 timeline, arguing it favored hospital management. Shih defended the timeline, warning that immediate enforcement could lead hospitals to reduce bed capacity to comply with the requirements, as increasing nursing staff cannot be achieved overnight.