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Secretary Of Embattled VA: 'I Can Reset The Tone'

Nov 10, 2014
Originally published on November 11, 2014 7:22 am

Former Army Ranger and Procter & Gamble CEO Robert McDonald took over as secretary of veterans affairs three months ago, while the department was stained by scandal. The VA for years had falsified documents to conceal the delays veterans faced in getting medical care. One audit found that 13 percent of VA schedulers were told to cook the books.

A few months into his tenure, McDonald has announced an ambitious reorganization plan for the VA. He plans firings and other discipline, but also better ways to serve the department's customers, the veterans.

In a statement released Monday, McDonald promised to create a new framework to help veterans "more easily navigate VA without having to understand our inner structure" and establish veteran advisory councils.

McDonald told NPR's Robert Siegel on Monday that the organization also needs more funding and more doctors.

"I think we need more resources," said McDonald. "If I look back at what's happened over time, we've had a huge increase in demand. We had veterans who'd suffered from Agent Orange, from the Vietnam era. ... We've discovered things like post-traumatic stress. That science then allows veterans of previous wars to get that qualification for our service. So, we've had a huge increase in demand, and we haven't kept up with the supply."

As part of that resource gap, McDonald acknowledged that the VA increasingly will have to partner with other health providers to get veterans the care they need. "The system that we will end up running will be a series of partnerships," said McDonald, "[for patients that are] 40 miles from one of our facilities, or where we don't have technologies, or our wait times are too long. We want to make sure our veterans get the care they deserve."

McDonald said that in the past few months, the VA has already made significant progress. "We've been working hard to improve getting veterans into our hospitals," said McDonald. "We've had over a million more appointments over the last four months. We've driven down disability claims by 60 percent. Homelessness is down of veterans by 33 percent. So it's all about results for the American people."

McDonald said some problems at the VA also plague the overall American health care system, particularly a shortage of doctors. He said during visits to medical schools, he was told the VA isn't the only institution with that need.

"The people ... told me Florida needs 17,000 more doctors. ... Janet Napolitano, who leads the University of California ... said that California needs 22,000 more doctors," he said, adding, "We're not just producing enough doctors."

McDonald admitted that the issue is not one he can fix alone. But in an earlier interview with CNN, McDonald said he's already cleaning house at the VA. The organization has taken disciplinary action against more than 5,000 employees and McDonald's promised that firings will come. McDonald told 60 Minutes that some 1,000 VA personnel should be let go.

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Transcript

ROBERT SIEGEL, HOST:

Robert McDonald took over as secretary of Veterans Affairs three months ago, when the department was stained by scandal. Waiting times for medical appointments at some VA facilities were misrepresented. The books were cooked to conceal the real delays veterans faced for medical care. McDonald is a West Point graduate and former paratrooper who spent a career at Procter & Gamble, rising to CEO there. And he's our guest today. Welcome.

ROBERT MCDONALD: Thank you, Robert. It's great to be with you.

SIEGEL: You have set this Veterans Day as an important milestone as secretary. And you've spoken of three nonnegotiable goals to rebuild trust, improve service deliveries - that, of course, for the long-term. Is, say, the last two years of the Obama administration enough time to achieve those goals?

MCDONALD: Well, the president said in our cabinet meeting last week that he wants to make sure in those two year news that we deliver better customer service to the American people. And that's what we're all about. We've been working hard to improve getting veterans into our hospitals. We've had over a million more appointments over the last four months. We've driven down disability claims by 60 percent. Homelessness is down, of veterans, by 33 percent. So it's all about results for the American people.

SIEGEL: There was a Virginia study released last month that found problems in facilities in that state involving everything from recruitment and financial incentives to outdated telephones and insufficient parking. As someone who came out of the private sector, are you appalled by the level of service in the Department of Veterans Affairs?

MCDONALD: The overarching thing, I would say, is that this is a business about customers. We have 22 million veterans in this country. We have 9 million veterans that use our health care system. It's all about focusing on the customer and customer service. And what I've found is a department that wasn't quite as focused on its customers as it should be.

SIEGEL: You told "60 Minutes" that if you really could hire the medical personnel you need, you would hire 28,000 more people. So explain this to me. During the tenure of your predecessor, Eric Shinseki, when the department was asked, do you lack for money, the answer was typically no. Are the problems at the Department of Veterans Affairs - can they be remedied without more resources? Is it just a matter of inefficiencies and mismanagement? Or do we just have more need for veteran services and we'd better spend a lot more on them?

MCDONALD: Yeah, I think we need more resources. If I look back at what's happened over time, we've had a huge increase in demand. We had veterans who had suffered from Agent Orange...

SIEGEL: From the Vietnam era.

MCDONALD: ...From the Vietnam era that were given conditions to take advantage of the VA. We've discover things like posttraumatic stress. That science, then, allows veterans of previous wars to get that qualification for our service. So we've had a huge increase in demand, and we haven't kept up with the supply.

SIEGEL: Veterans are getting choice cards, a card which someone who lives far away from any veterans' health facility or who has a month-long waiting period for an appointment can go to an approved provider to get care from. Do you see that as just a temporary patch, or is this going to be a permanent feature of care?

MCDONALD: Well, I think in the grand scheme of things, Robert, the system that we will end up running will be a series of partnerships. So I think private, public partnerships will exist in the future. And you're right on the conditions. Forty miles from one of our facilities, or where we don't have technology or where wait times are too long, we want to make sure our veterans get the care they deserve.

SIEGEL: Even if it were well-managed and efficient, the number of health care professionals and the hours they can put into service, all the veterans who need medical care from the DVA - you don't have enough.

MCDONALD: That's right. We are the canary in the coal mine. I was in Florida. I visited the University of Central Florida medical school, University of South Florida medical school. The people there told me Florida needs 17,000 more doctors. I was in California. Janet Napolitano, who leads the University of California, she said that California needs 22,000 more doctors. So we are demonstrating to the American public the problems that the American medical system has seen. We're just not producing enough doctors.

SIEGEL: Given the shortages that you've described, not just for VA facilities but generally, of doctors, how can you actually find those 28,000 more doctors and nurses that you need?

MCDONALD: To me, the only answer is personal initiative and personal leadership.

SIEGEL: But you can't personally recruit 28,000 people.

MCDONALD: Well, no, but I can reset the tone. The reason this came up was when I was traveling to Phoenix on my first trip to the area where the crisis began, I had an individual - a gentleman - sitting behind me. And as we landed, he said, are you - you know, are you with the VA? And I said yes. And he said, well, he had been in the Air Force for 22 years. He was now part of Lockheed Martin. He had a daughter going to medical school. He talked to her about working for the VA. And she said, dad, haven't you been listening to the radio - or don't you know what's going on? Why would I want to work for the VA? I knew immediately I had to change the tenor. So I have to get out there. And I've got to tell the positive stories about what the VA does.

SIEGEL: Well, Bob McDonald, thanks a lot for talking with us today.

MCDONALD: Thank you, Robert. It's been great to be with you today.

SIEGEL: Mr. McDonald is the secretary of the Department of Veterans Affairs. Transcript provided by NPR, Copyright NPR.