July 22, 2014
Remarks of Acting Secretary Sloan D. Gibson (As Prepared), Veterans of Foreign Wars Annual Convention,
July 22, 2014
The Department of Veterans Affairs is in the midst of its most serious crisis in more than a generation. I know that, and I know you know that.
But here’s something I want to make sure you also know: The Department of Veterans Affairs has before it perhaps its greatest opportunity to enhance care for Veterans in its history.
I’m not the only one who thinks that. Two weeks ago, I met with Dr. Harvey Fineberg, the distinguished clinician and healthcare leader who just completed 12 years as the President of the Institute of Medicine. When I commented that we could accomplish more in the next two-to-three years than we could have in two-to-three decades, he immediately interrupted and corrected me, “No! VA can accomplish things now it never could have accomplished.”
He’s right: We are in an extraordinary position.
VA’s faults are well documented:
All of these problems fall into three categories:
As we begin to tackle these challenges, what are our priorities?
Those are our priorities. Now, here are some of the immediate actions we are already taking to tackle the first one—getting Veterans off wait lists and fixing scheduling problems:
These are just some of the actions we are now taking to meet some of the process challenges. Now, let me take a moment to talk about the leadership challenge.
I’ve been making the rounds of VA medical centers in recent weeks seeking out the “on-the-ground truth.” I’ve heard both good and bad, and what strikes me is the contrast between places like Phoenix and places like San Antonio.
Interestingly, the very next day I went to visit the medical center in San Antonio. It was a whole different story:
I would tell you that, for me, the harder of these two visits was San Antonio. Because everywhere I looked I realized that, but for leadership, that could have been Phoenix. But for leadership.
Since those visits, I’ve challenged VA leaders to explain to me the difference between Phoenix and San Antonio. I have yet to hear an explanation that doesn’t boil down to one thing—leadership—leaders failing to take ownership of the problems, both large and small, facing their employees.
Take, for example, the inoperable X-ray machines in the OR. You know what was wrong? The computers required to operate the machines needed to be updated from Windows XP to Windows 7. How simple a problem to solve. But no one took ownership, and I think that also highlights an unresponsive bureaucracy that frontline staff have simply given up trying to fight.
We’ve created an environment where the opinions of the rank and file—those doing the hard, day-to-day work of caring for our Veterans—are not only not listened to, they are instead punished!
Here’s some of what we’ve done so far:
Let me talk for a moment about accountability. At VA, we depend on the service of employees and leaders who place the interests of Veterans above and beyond self-interest. Accountability, delivering results, and honesty are also key to serving our Veterans.
Those who have not performed and have not delivered results honestly will be held accountable. Where willful misconduct or management negligence is documented, appropriate personnel actions will be taken—this also applies to whistleblower retaliation. We will not tolerate retaliation against whistleblowers.
Leaders make the difference between Phoenix and San Antonio.
So, as you would expect, there are many changes in leadership underway.
First, I’ve named Dr. Carolyn Clancy interim Under Secretary for Health. Dr. Clancy is new to VA—she joined us last August as Assistant Deputy Under Secretary for Health for Quality, Safety, and Value. Before that, she worked at the Department of Health and Human Services, as Director of the Agency for Healthcare Research and Quality. Dr. Clancy is a proven leader and innovator when it comes to healthcare quality and safety. She will spearhead our reform efforts to accelerate access to care and restore trust among our Veterans.
Second, I have appointed Dr. Gerry Cox as the interim director of the Office of the Medical Inspector (OMI), responsible for restructuring the office.Dr. Cox is a 30-year Navy Veteran and former Assistant Inspector General of the Navy for Medical Matters. He will provide new leadership and a fresh perspective to help restructure OMI and ensure a strong internal audit function.
Third, I’ve brought on Dr. Jonathan Perlin for a short tour of duty as a Senior Advisor. Dr. Perlin comes to us on loan from the Hospital Corporation of America, where he is Chief Medical Officer and President for Clinical Services. He is also chairman-elect of the American Hospital Association and a former VA Under Secretary for Health. Dr. Perlin brings a wealth of knowledge and experience to help us bridge the period till we have a confirmed Under Secretary for Health. Incidentally, that selection process is well underway and included participation by VFW Executive Director Bob Wallace on the selection Commission.
Fourth, I’ve also brought back Leigh Bradley for a four-month assignment as Special Counsel to the Secretary. Ms. Bradley is a former General Counsel at VA and, most recently, a senior member of the DoD General Counsel team, with direct responsibility for their ethics portfolio. At VA, she will assist us in taking action against those supervisors and employees accused of wrongdoing or serious management negligence.
Finally, as you all know, the President has nominated former Proctor & Gamble CEO Robert A. McDonald to be the next Secretary of Veterans Affairs. Bob and I have been friends for 40 years beginning during our time together as cadets at West Point. He brings strong leadership and exceptional management skills to this role, and he’s got one of the strongest moral compasses I have ever seen.
This combination of executive skills and values are ideal for VA at this critical time.His confirmation hearing is today, and I hope for a speedy confirmation.
Before, I move to my last topic on healthcare, I want to say a brief word about benefits. Since arriving at VA five months ago, I have been very impressed with the transformation that is underway at VBA. I seriously doubt that any major part of the federal government has transformed so much in the past two-to-three years, and I believe that without this transformation, we would not be on track to eliminate the disability claims backlog in 2015.
Having said that, Veterans still wait too long for decisions, and our quality is still not up to standard. More recently, there have been reports that call into question the accuracy of the data we use to report our progress. Clearly, we have more work to do—faster, more accurate decisions, documented with credible reporting.
The last topic I want to address is resourcing VA to meet the current demand for timely, high-quality healthcare. As I mentioned in my Senate testimony last week, and as I will repeat at my House testimony this week, I believe that the greatest risk to Veterans over the intermediate to long-term is that additional resources are provided only to support increased purchased care in the community and not to materially remedy the historic shortfall in internal VA capacity. Such an outcome would leave VA even more poorly positioned to meet future demand.
Make no mistake: Purchased care plays an important role in extraordinary circumstances:
But purchased care is not a replacement for a strong and vital Veterans’ healthcare system.
Consider these points:
This simple fact explains my statement to Congress last week that we need an additional $17.6 billion in funding over the next three years—making it possible to hire an additional 10,000 clinical staff, provide essential information technology support, make a very small dent in the massive capital project deficit we carry, and fund additional purchased care while we build the internal capability to meet current demand.
These resources are critical if we are to seize on the opportunity before us! VFW has been there for Veterans from the beginning, as the oldest of the major VSO’s.
You have had a hand in every major achievement on behalf of Veterans for the past hundred years: formation of the Veterans Administration and the original GI Bill; advancing VA’s elevation to Cabinet-level status; creation of the new GI Bill; and advocating for recent funding increases and advance appropriations.I know I can count on you to lend a hand, along with your best advice, to make a lasting difference for Veterans.
My thanks to your leadership:
Thank you for all you do for Veterans. I look forward to working with you to seize this historic opportunity to transform VA into THE provider of choice for Veterans’ healthcare.
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