not improved work conditions by providing a sufficient workforce. As a result, the situation at public health centers continues to worsen, virtually causing public health centers to become sweatshops. (2) As the work items handled by public health centers increases and their service scope expands, the individual workload increases; moreover, a high standard is required for the service. Furthermore, to provide opening hours convenience to the general public, employees at public health centers often work at night or on regular holidays, or may even be requested to meet exigencies and service residents after they return home. In addition to the core services of public health centers, non-nursing public health tasks continue to expand, and nursing professionals often have to handle duties of administrative management, audit, administrative inspection, and purchase of supplies, etc. The heavy workload of employees at public health centers is mainly due to the increase of services without a sufficient workforce to support it. Under excessively long working hours, the working conditions are poor, and the occupational safety and service quality are affected. (3) The Local Health Agency Service Evaluation Plan established by the MOHW involves hundreds of evaluation targets, and its content is complicated. Some targets are impossible to achieve; moreover, many indicators and targets may not meet the principles of policy necessity, concrete and quantifiable, and able to be objectively measured. The MOHW and each Department of Health are using irrational targets as the evaluation mechanisms for unreasonable workloads, in effect transferring the responsibility for community healthcare to the nursing personnel at public health centers, such that personnel at public health centers are under pressure of a heavy workload, and pushed to produce higher “service quantity” instead of improvements in “quality.” Consequently, public health centers cannot be optimally effective in establishing an efficient public healthcare system. (4) Some work tasks of nursing personnel at public health centers involve considerable hazards; however, the MOHW has not established systematic protection mechanisms. It is the responsibility of the managing authorities to make a professional judgment regarding the determination of hazardous labor conditions for the nursing personnel at public health centers. Consequently, the protection of the rights and interests of nursing personnel providing services on the front line at public health centers still needs to be improved. Furthermore, the Ministry of Civil Service (MCS) has not fully grasped the actual conditions of the hazardous work performed by nursing personnel, and the MCS has excluded from consideration the situations that health personnel judge are hazardous work duties; the MCS is thus clearly in disagreement with the opinions of the majority of health departments at the level of counties and cities. The principles and criteria adopted by the MOHW in such determinations are crude and require further improvement. 84