WASHINGTON (AP) — In a scathing appraisal, a review
ordered by President Barack Obama of the troubled Veterans Affairs
health care system concludes that medical care for veterans is beset by
"significant and chronic system failures," substantially verifying
problems raised by whistleblowers and internal and congressional
investigators.
A summary of the review by deputy White House chief
of staff Rob Nabors says the Veterans Health Administration must be
restructured and that a "corrosive culture" has hurt morale and affected
the timeliness of health care. The review also found that a 14-day
standard for scheduling veterans’ medical appointments is unrealistic
and that some employees manipulated the wait times so they would appear
to be shorter.
The review is the latest blistering assessment of
the VA in the wake of reports of patients dying while waiting for
appointments and of treatment delays in VA facilities nationwide. The
White House released a summary of the review following President Barack
Obama’s meeting Friday with Nabors and Acting VA Secretary Sloan Gibson.
The
review offers a series of recommendations, including a need for more
doctors, nurses and trained administrative staff. Those recommendations
are likely to face skepticism among some congressional Republicans who
have blamed the VA’s problems on mismanagement, not lack of resources.
The
White House released the summary after Obama returned from a two-day
trip to Minneapolis and promptly ducked into an Oval Office to get an
update on the administration’s response to the VA troubles from Gibson
and Nabors.
"We know that unacceptable, systemic problems and
cultural issues within our health system prevent veterans from receiving
timely care," Gibson said in a statement following the meeting. "We can
and must solve these problems as we work to earn back the trust of
veterans."
Rep. Jeff Miller, the Republican chairman of the House
Veterans’ Affairs Committee, said the report was a late but welcome
response from the White House and vowed to work with the administration
to fix the system.
"It appears the White House has finally come to
terms with the serious and systemic VA health care problems we’ve been
investigating and documenting for years," he said in a statement.
The
review contains a searing critique of the Veterans Health
Administration, the VA sub-agency responsible for medical care. Earlier
this week the VA announced that Dr. Robert L. Jesse, who has been acting
undersecretary for health and head of the VHA, was resigning. Jesse has
been acting undersecretary for health since May 16, when Robert Petzel
resigned under pressure months before he was set to retire.
Nabors’
report found that the VHA, the country’s biggest health care system,
acts with little transparency or accountability and many recommendations
to improve care are slowly implemented or ignored. The VHA serves
nearly 8.8 million veterans a year in more than 1,700 health care sites.
But the report says concerns raised by the public, monitors or even VA
leadership, the report said, have been dismissed at the VHA as
"exaggerated, unimportant, or ‘will pass.’"
Among Nabors’ other findings:
__
As of June 23, the independent Office of Special Counsel, a government
investigative arm, had more than 50 pending cases that allege threats to
patient health or safety.
— One-fourth of all the whistleblower
cases under review across the federal government come from the VA. The
department "encourages discontent and backlash against employees."
—
The VA’s lack of resources reflects troubles in the health care field
as a whole and in the federal government. But the VA has been unable to
connect its budget needs to specific outcomes.
—The VA needs to
better prepare for changes in the demographic profile of veterans,
including more female veterans, a surge in mental health needs and a
growing number of older veterans.
Obama asked Nabors to stay at the VA temporarily to continue to provide assistance.
The
White House said that over the past month, the VA has contacted 135,000
veterans and scheduled about 182,000 additional appointments. It has
also used more mobile medical units to attend to veterans awaiting care.
Sen.
Bernie Sanders, the Vermont independent who heads the Senate’s
Veterans’ Affairs Committee, said the VA must restructure
decision-making between its headquarters and its regional officials and
that regional and local offices can no longer hide problems when they
surface.
"No organization the size of VA can operate effectively
without a high level of transparency and accountability," he said.
"Clearly that is not the case now at the VA.
"
Since reports
surfaced of treatment delays and of patients dying while on waiting
lists, the VA has been the subject of internal, independent and
congressional investigations. The VA has confirmed that dozens of
veterans died while awaiting appointments at VA facilities in the
Phoenix area, although officials say it’s unclear whether the delays
were the cause of the deaths.
One VA audit found that 10 percent
of veterans seeking medical care at VA hospitals and clinics have to
wait at least 30 days for an appointment. More than 56,000 veterans have
had to wait at least three months for initial appointments, the report
said, and an additional 46,000 veterans who asked for appointments over
the past decade never got them.
This week, the independent Office
of Special Counsel concluded there was "a troubling pattern of deficient
patient care" at the Veterans Affairs that VA officials downplayed.
Among the findings were canceled appointments with no follow up,
contaminated drinking water and improper handling of surgical equipment.
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Associated Press writer Kevin Freking contributed to this report.