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Progress slow in overhaul of veterans’ hospitals

Critics say too few were fired, waiting times still too long

President Obama visited Friday with Army Sergeant First Class Cory Remsburg, who was injured in Afghanistan and moved into a home donated by a veterans’ support group.SAUL LOEB/AFP/GETTY IMAGES

By Michael D. Shear

New York Times

PHOENIX — The nation’s largest hospital system has made only halting progress in hiring new doctors, replacing incompetent supervisors, upgrading computers and rebuilding trust with veterans, nine months after President Obama concluded that a “corrosive culture” had led to systemic problems at the Department of Veterans Affairs.

Patients, veterans groups, and doctors say delays in receiving care are still common, and they accuse VA officials of failing to provide opportunities to see private doctors.

Critics, including Republican lawmakers on Capitol Hill, say far too few senior managers have been held accountable for the mismanagement at the hospital in Phoenix and at others around the country.

Obama on Friday made his first visit to the department’s hospital in Phoenix since reports surfaced that officials there oversaw sham patient waiting lists used to hide long delays in appointments.

Several veterans died waiting for care there. Those delays set off a political crisis last summer that led to the ouster of the department’s chief and raised serious questions about the president’s ability to manage the sprawling VA bureaucracy.

“Very little has changed,” Dr. Sam Foote, an internist who was one of the first whistle-blowers to reveal problems with wait times at the Phoenix hospital, said in an interview Thursday.

The continued problems at the hospitals underscore the grim reality that overhauling a federal department with almost 300,000 employees scattered across the country is a difficult and tedious process. That truth will almost certainly ensure that Obama fails to make good on his 2008 campaign promise to fix the “broken bureaucracy of the VA” before he leaves office.

But administration officials insist that the situation is getting better, if slowly.

In an appearance at the Phoenix hospital Friday, Obama acknowledged the need for more improvement. But he urged lawmakers and other critics of the system not to let the department’s recent problems keep people from recognizing the good work at the hospitals, including significant progress being made by Robert A. McDonald, the department’s new secretary.

“The fact is that there have been a few bad apples, mistakes that have been made, systems that aren’t designed to get the job done,” he said. “I don’t want that to detract from the outstanding work from a lot of people inside this organization.”

Obama held a private discussion with the hospital’s managers, elected officials and staff and closed-door visits with some patients. He said he expected the pace of progress to steadily increase and vowed to hold McDonald accountable for delivering high-quality care.

“We’ve brought in a new team that has been tackling these issues to make sure that wait times for scheduling, access to providers is greatly improved,” the president said in remarks after the closed-door meeting. “But what we know is there is still more work to do.”

Obama said that the episodes of “cooking the books” at the Phoenix medical center and at other facilities had eroded trust among veterans in the hospital system and in the government. But he praised the efforts of the many tens of thousands of department employees working to make the system better.

“Trust is one of those things that you lose real quick and then it takes some time to build,” Obama said. “The good news is that there are outstanding folks here at this VA and all the VAs across the country who are deserving of trust.”

Obama also announced the creation of a new advisory committee made up of representatives from nonprofit organizations, veterans groups and government officials to make recommendations about improving the department.

Republicans who attended the session Friday, including Obama’s one-time presidential rival, Senator John McCain of Arizona, are dismissive of the president’s assertions. They say reforms in the veterans health care system have been sluggish, and many of the leaders who presided over the scandal are still in place.

In a statement after the session, McCain said that the meetings “served more as a photo-op for the president than it did a meaningful discussion of the challenges our veterans continue to face in getting the timely health care they have earned and deserve.”

After firing Eric K. Shinseki, his first VA secretary, Obama selected McDonald, the former president and chief executive of Procter & Gamble, to turn around the troubled department.

The new secretary vowed to act “aggressively” in holding people accountable, but since taking control he has fired fewer employees than his predecessor did in the year before he resigned. McDonald was forced to backtrack in February after saying on NBC’s “Meet the Press” that 60 employees had been fired for manipulating wait times. A spokesman later said it was fewer than 20.

The director of the Phoenix hospital, Sharon Helman, was fired in December for accepting improper gifts, not for her role in the scandal.

Lance Robinson, the associate director, and Brad Curry, the health administration services director, have been on paid leave for nearly a year, and have been issued “notices of proposed removal,” according to a department spokesman. The investigation of them is continuing.

Dr. Darren Deering, the hospital chief of staff who told a Senate committee in September that there were no manipulated wait times, remains in his job.

Officials said that 1,100 employees across the department were terminated in 2014, but that those terminations were not directly related to actions taken as a result of the scandal.