• Persistent trouble at the VA
    May 31,2014
     

    Retired Gen. Eric Shinseki, the departing Veterans Affairs secretary, is a Vietnam veteran, a two-time Purple Heart recipient and a former Army chief of staff who famously crossed swords with past Secretary of Defense Donald Rumsfeld during the lead-up to the 2003 Iraq War, most notably over the number of troops needed to stabilize the country after the initial invasion. For his candor, Shinseki was subsequently marginalized and his replacement as Army chief of staff was announced a year prior to his tenure ending ó which was undoubtedly done to publicly embarrass and further ostracize him.

    I have met him on a couple of occasions, watched him as the commanding general of the 1st Cavalry Division, and my assessment is that Shinseki is a courageous and honorable man. He is intelligent, unselfish and a proven combat leader who undoubtedly cares for veterans deeply.

    He did the honorable thing by resigning Friday. Sadly, after five years at the helm, one must conclude he ultimately failed to suitably lead the VA.

    The problems at the VA are insidious and have plagued the organization for decades, and unfortunately have been ignored by both political parties. So, forgive me if the faux outrage and characteristic Washington kabuki dance doesnít give me cause for great optimism. Having said that, my intent is to identify some of those major challenges that plague the VA and offer potential solutions.

    Leadership and culture: The VA is an unwieldy bureaucracy that employs nearly 314,000 people at more than 1,400 sites. These include Veterans Affairs medical facilities, clinics, nursing homes and benefits offices. An organization this size needs effective leadership at every level; however, at the point of service where strong leadership is critically important, it is most lacking. To remedy this, I recommend that the VA do a comprehensive, painstaking leadership review from top to bottom and then take appropriate action based on the outcome. That may well include firing those who are failing to meet the abysmally low standards that the VA has apparently set for itself.

    My experience as a veteran has been that the medical care you receive by and large is excellent; the clinicians are highly capable. It is the feckless organizational and administrative leadership that is usually the root cause of most of the recurring problems. On this front, Congress should mandate that the VA do a top to bottom review of its hiring practices for both leaders and staff. I have heard numerous stories from my colleagues regarding substandard customer service, treating veterans with casual indifference or downright disrespect. The 9-to-5, ďIím on my lunch break, come back laterĒ culture that permeates the VA must end.

    Now, before every employee of the VA feels compelled to write a letter excoriating me, I know for a fact there are many outstanding leaders and staff members employed by the VA. Some of them are friends of mine. Unfortunately, from my experience and study, there needs to be many more. By way of example: Letís say that only 5 percent of the 314,000 VA employees/leaders are poor. Iíd argue that number is much higher, but letís just say for argumentís sake it is 5 percent; thatís almost 16,000 people who should be looking for another job.

    Poor leadership and a business-as-usual culture have been enduring problems at the VA; 13 years of war have magnified and exacerbated those problems. Frankly, the VA has become a self-licking ice cream cone. When the VA can hire a veteran, chiefly a combat veteran who understands better than anyone what needs to be done and can empathize with the plight of those veterans, especially those wounded warriors, it must absolutely do so. If I could be so bold as to offer President Obama a recommendation of a retired general who has the gravitas and experience to turn the VA around, it would be Gen. Jim Mattis, former Central Command commander and Marine.

    Technology and innovation: The Defense Department and VA spent $1.3 billion to build a joint electronic medical record system for their health-care services. In February, Defense Secretary Chuck Hagel and Secretary Shinseki announced that they were scrapping the effort. This is on top of the more than $2 billion the Defense Department has spent on a failed upgrade to its own electronic medical system. This is intolerable, but it highlights the constant lack of imagination and poor decision-making that have mired the VA in bureaucratic sclerosis. Mavericks and outside-the-box thinkers who desire to replace the antiquated mind-set donít last long.

    Sadly, the attributes embraced in the private sector ó innovation, risk-taking and creativity ó are frowned upon by the VA. Government bureaucracies like the VA have seen little innovation. In many cases, they have gotten worse as more layers of bureaucracy grow on top of the existing systems. The VA may well be the pre-eminent place to start implementing creative thinking because of the scale of its bureaucracy and the scope of its challenges. This is a time when you can instantly make a purchase or conduct a bank transaction online, reserve a room or get money from an ATM worldwide in seconds, yet it takes on average up to 177 days to transition a veteranís records from the Defense Department to the Department of Veterans Affairs. This is embarrassing and unconscionable and needs to change with alacrity.

    Management control: Moreover, the VA must strengthen and broaden its inspector general and management control system. Each major facility should have its own IG office on site as a local, immediate inject point for veteransí and family membersí complaints to guarantee a direct redress of grievances. It would also provide an important outlet for VA employees who can use the inspector general as a sounding board and would provide them immediate whistle-blower protection if they felt that proper procedures were not being followed and had to make a complaint.

    As a former inspector general myself, I know well the power of having an IG on site daily walking the halls, speaking with veterans and employees. It is a powerful antidote to complacency and malfeasance. If the IG route is not feasible, then an ombudsman should be placed at each VA facility. Oftentimes IG or ombudsman early intervention can identify problematic patterns and emerging issues before they become pervasive problems and ultimately ugly embarrassments.

    Finally, Dan Lipinski, a representative from Illinois, has said: ďLet us remember the service of our veterans, and let us renew our national promise to fulfill our sacred obligations to our veterans and their families who have sacrificed so much so that we can live free.Ē

    Veterans answered when the nation called. Now itís time for the U.S. government to do its job and provide the medical services it has promised in a timely manner.



    Lou Bello is a retired U.S. Army lieutenant colonel who lives in Barre Town.

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