REPORTING IN, SIR: In the news, Dismissing Managers not the answer

REPORTING IN, SIR: In the news, Dismissing Managers not the answer

Study the cause not the effect

By Jerry Field

“Reporting in, Sir!” Columnist and Veterans Affairs Editor Jerry Field

The Veteran Administration Hospitals are under a scrutiny after what could be several violations of procedures at the Phoenix, AZ facility. All VA Hospitals are now under investigation.  The effects of these violations have been detailed time and time again, with civic leaders, Veterans’ groups and elected officials calling for firing of managers and setting up committees to detail the effects of this breach of proper procedures, without one mention or action as to finding the cause.

The question that needs to be answered is “What caused the unprofessional procedures and how the cause of this situation could and can be corrected.” Most likely more than one question needs to be answered. Firing experience administrators may not be the only answer although it seems to be a quick fix that does not address long term corrective action.  Long term corrective action is needed, which is amounts to finding the cause.

Not all the facts and details are readily available and often are there are restrictions on some information. There needs to be a reason why it takes more than a few weeks to have an appointment at a VA hospital. In simple terms to have an appointment there needs to be a staff and doctors and other back up employees available to offer the services our military is entitled to receive.  The VA needs to offer all the services needed in an expedited manner. An excellent service takes staff and staff which is a budget item. The managers are judged by reports, reports can be written to shown best practices, but where was the oversight?

Take a look at the total budget for the VA in 2008. The total budget was $87.6 billion dollars. That covers all the VA services: GI Bill, death benefits, services to widows and children and over a hundred other programs.

The budget in 2014-15 was $163.90 billion just a little less than double from 2008. But, and there is always a but, the number of Veterans and their families serviced has more than doubled, it actually appears to have increased over 5 fold. If the figures are correct an increase of almost 5.5 times, according to the figures INN has been able to uncover. Consider that the breakdown of conflicts served in 2013 was: WWII 1.2%; Korean Conflict 2.1%; Vietnam 7.3%; Gulf War 6.5%; Others 5.5%;  for a total of 21,973,000 million Veterans sought services from the VA in 2013 opposed to an estimated  12 million 800 thousand in 2008. Once again the figures are estimates taken from VA files.  Each yearly report is more than 500 pages in length and often difficult to find specific numbers.

There is another factor that needs to be considered. The VA hospitals are serving more Vietnam Vets than military from other theatres of war. The Vietnam treatment is more than likely to be more mental than physical.  An arm or leg with injury can be corrected with surgery, rehabilitation and far less visits than the mental trauma of war. Mental health often requires weekly or bi-weekly visits and a time on task for doctors, scheduling staff and a private room for the standard 50 minute hour.

What we have is less money from Congress, more patients seeking more help and less staff to offer the services needed.   The cause of this problem is somewhat identified. The real correction of the problem which is the case cause of the situation is Congress needs to fund the VA based on patients serviced with special attention to the type of services the Veterans require. The VA need to offer a better breakdown of hospital services by specific anticipated needs, a projection not easy to accomplish with 150 hospitals, 850 clinics, and 300 VA Centers.

There is no harm in trying to eliminate the cause rather than only dealing with the effect. It will offer a better system.