The Department of Veterans Affairs’ health network lacks accountability and suffers from a host of other problems, including a “corrosive culture” of employee discontent and management retaliation, according to the two men President Obama appointed to fix the system.
White House adviser Rob Nabors and acting VA Secretary Sloan Gibson said in briefing to Obama on Friday that the Veterans Health Administration “needs to be restructured and reformed,” according to a summary of the findings they presented.
Among their other conclusions, the officials determined that the VA’s goal of scheduling patients within 14 days is “arbitrary, ill-defined and misunderstood,” and that it may have “incentivized inappropriate actions.”
An inspector general’s report last month said VA medical centers nationwide falsified appointment records to hide extensive treatment delays. The problems led to a leadership shakeup that included the resignation of former VA secretary Eric Shinseki and demotion for two top officials.
VA officials have said that outdated scheduling software contributed to the record-keeping issues, but Nabors and Gibson said technology was “secondary” to the need for additional medical staff to help treat patients.
The two officials noted that shortages of health professionals are not unique to the VA, but they said slowness in federal hiring and difficulty competing with private-sector wages have exacerbated the problem for the department.
They also said VA headquarters needs to be more hands-on with field facilities, noting that clinics are generally “not accountable or transparent to veterans, the secretary or the department as a whole.” They added that many employees believe the issues raised by leadership and the public are “exaggerated, unimportant, or ‘will pass.’”
On the other hand, the officials said that the VA culture encourages retaliation against employees who expose wrongdoing. They said one-fourth of all whistleblower cases with the U.S. Office of Special Counsel come from the VA.
The OSC investigates allegations of wrongdoing in the federal workplace and protects employees who report the problems from reprisal. The agency said this month that it is reviewing complaints from 37 VA employees.
Senate Veterans Affairs Committee Chairman Bernard Sanders (I-Vt.) said in a statement on Friday that the VA must do a better job of understanding what is taking place on the ground, adding that regional and local offices have to stop hiding serious problems.
“No organization the size of VA can operate effectively without a high level of transparency and accountability,” Sanders said. “Clearly that is not the case now at the VA. The communication and decision-making between the central office and regional offices must be radically restructured.”
The White House on Friday outlined steps the VA has taken to improve access to care and address the scheduling issues. The actions include contacting veterans who are still waiting for appointments, hiring more staff, expanding the use of non-VA clinics to care for patients, posting twice-monthly updates on access data and directing a review of how the agency treats whistleblowers.