Throwing Money at the VA Will Do Little to Restore Trust and Accountability

In the wake of the devastating scandal within the Department of Veterans Affairs, Congress approved a $16.3 billion appropriations bill to hire more staff members and lease more space for VA medical clinics, attempting to cut down on the long wait times and poor care experienced by veterans. This is in addition to the current $163.9 billion funding for FY2015.

Unfortunately, while more money and an expansion of health care services will certainly help veterans, it will not solve all the problems the VA is facing.

Undersecretary of Veterans Affairs Sloan D. Gibson appeared before the Senate Committee on Veterans Affairs in mid-July, hat in hand, requesting $17.6 billion to combat the rampant dysfunction within the VA’s health care system. The final bill, which was over a billion dollars short, was overwhelmingly approved in a rare instance of bipartisanship.

We understand the seriousness of the problems we face. We own them. We are taking decisive action to begin to resolve them
Sloan D. Gibson, undersecretary of Veterans Affairs
“We understand the seriousness of the problems we face. We own them. We are taking decisive action to begin to resolve them,” Gibson told the Senate panel. “We can turn these challenges into the greatest opportunity for improvement in the history of the department.”

During his testimony, Gibson not only told the committee that the money was vital to getting veterans off of waiting lists and providing them the care they deserve, he said the money was vital to rebuilding the trust that veterans have in the VA.

“The trust that is the foundation of all we do — the trust of the veterans we serve and the trust of the American people and their elected representatives — has eroded,” Gibson said. “We have to earn that trust back through deliberate and decisive action, and by creating an open and transparent approach for dealing with our stakeholders to better serve veterans.”

While the VA’s website and blogs tout how happy veterans are with their care and how excellent the care is, news stories of hundreds of veterans languishing or dying at VA facilities have been plastered across nearly every media outlet in the free world.

While the VA claims that they have reached out to over 160,000 veterans to get them off waiting lists, in several VA clinics, patients are still being told their names will have to go on these waiting lists — never to hear from the VA again. It would seem that even after all the publicity, the VA still can’t seem to pull it together.

During his testimony, Gibson detailed 6 points that he says are key to restoring the trust of veterans:

  1. Get veterans off wait lists and into clinics;
  2. Fix systemic scheduling problems;
  3. Address cultural issues;
  4. Hold people accountable where willful misconduct or management negligence are documented;
  5. Establish regular and ongoing disclosures of information; and,
  6. Quantify the resources needed to consistently deliver timely, high-quality health care.

The culture within the VA is the reasons that more money won’t solve all of the problems.

According to the New York Times, a scathing summary of findings on the state of health care within the VA given to President Obama by his deputy chief of staff, Rob Nabors, said:

“A corrosive culture has led to personnel problems across the department that are seriously impacting morale, and by extension, the timeliness of health care.”

“The VHA leadership structure is marked by a lack of responsiveness and an inability to effectively manage or communicate to employees or veterans,” he added.

Nabors’ report, while not specific, said leadership at the VA was “not prepared to deliver effective day-to-day management.” The report was not specific in recommending changes, simply saying that the department needed to “increase transparency” and that it needed “a better structure.”

Gibson’s testimony and Nabors’ report also addressed the issue of accountability.

An FBI investigation into possible criminal actions at VA health care centers is on-going, so the FBI spokesman could not comment on the specifics of the case. The VA has said that it is taking steps to address accountability by suspending bonuses and sending a memo to all of the VA’s 341,000 employees saying that whistle-blowers are to be protected, not retaliated against.

It would seem, however, that not everyone got that memo, as reports of retaliation against whistle-blowers have surfaced.

Until we eliminate the culture of intimidation and climate of fear, no reforms will be able to turn this broken agency around.
Danielle Brian, executive director of the Project on Government Oversight
In Albany, New York, a nurse manager was forced to resign from her position, forfeit $6,000 in annual salary, and was given another administrative position because she showed compassion for a patient. Her offense was removing a patient from restraints, per VA policy, who had been strapped down for hours, soiled herself, and was under the care of a male attendant, despite the doctors being aware that she had been a victim of sexual trauma and was uncomfortable with a man.

After reporting the poor care that doctors had ordered for the patient, and being told not to worry about it, the problems began, prompting her to retain an attorney. Her case is currently under investigation by the Office of the Inspector General, but it is not unique.

Across the country, reports of retaliation within the VA are common, according to the Project on Government Oversight, and cover much more than just long wait times. Most address the poor quality of health care services.

“A recurring and fundamental theme has become clear: VA employees across the country fear they will face repercussions if they dare to raise a dissenting voice,” the group’s executive director, Danielle Brian, said in an interview. “Until we eliminate the culture of intimidation and climate of fear, no reforms will be able to turn this broken agency around.”

No matter how the problem is examined, there is no way to buy a new culture within the VA. As long as doctors, administrators, and VA leadership put their own interests before the interests of patients, nothing will change and veterans will continue to suffer and die.

To date, 87 VA facilities are under investigation for wrong doing.

Photo Source: AP