WASHINGTON — The Veterans Health Administration has a corrosive culture that has led to poor management, a history of retaliation toward employees, cumbersome and outdated technology, and a shortage of doctors, nurses and physical space to treat its patients, according to a review presented to President Barack Obama on Friday by one of his top advisers on veterans' issues.
Obama called last month for the review of the Veterans Health Administration, a part of the Department of Veterans Affairs, just days before he accepted the resignation of the Veterans Affairs secretary, Eric Shinseki. The review warns that the department's hospital system is facing a coming surge of new patients from Afghanistan and Iraq that demands an overhaul of the entire system.
"The VHA leadership structure is marked by a lack of responsiveness and an inability to effectively manage or communicate to employees or veterans," Rob Nabors, Obama's deputy chief of staff, said in a summary of his findings. "A corrosive culture has led to personnel problems across the department that are seriously impacting morale, and by extension, the timeliness of health care."
Nabors and Sloan Gibson, the acting secretary of the department, met with Obama for more than an hour Friday. In his report, Nabors offers a grim assessment of a department that has been reeling for weeks from revelations of mismanagement, including reports that employees at some hospitals manipulated waiting lists and delayed office visits.
Obama is expected to name a replacement for Shinseki as early as next week. The report makes clear that the new secretary will face a major management task.
The report does not offer specific new examples of mismanagement at individual hospitals. And the solutions that Nabors recommends are general and vague. He said the department needs "increased transparency" and "a better structure," without saying how those goals should be met.
He also said the department should take "swift and appropriate accountability actions," but does not specify them.
The Veterans Affairs scandal has its roots in a mathematical mismatch: At a time when demand for visits to doctors and nurse practitioners was growing, the Veterans Affairs health care system tightened its own standards on how fast patients should be able to see doctors to, in many cases, within 14 days.