VA Clinic Leadership 'Reform' Really Just Shifting Managers Around

Reupholstering the deck chairs on a sinking ship


Bob McDonald

According to a USA Today investigation, The Department of Veterans Affairs (VA) is solving its management crisis the way government institutions have since time immemorial: They're moving staff around rather than dumping people and replacing them.

In the wake of its massive scandal where veterans were dying while sitting on wait lists and unable to get medical care, VA Secretary Bob McDonald promised new leadership at medical centers. He is correct in a very literal sense. Two-thirds of the VA medical centers have new directors, 92 since McDonald took office. The problem? Only eight of these new directors are from outside the VA administration. Many others have been simply shifted from facility to facility.

The administration's response is essentially, "This is fine":

President Obama has echoed McDonald's pride in the VA's transformation, saying on a recent CNN forum that "we have, in fact, fired a whole bunch of people who are in charge of these facilities." In fact, the VA only moved to fire seven medical center directors. One of them quit and another retired first.

Of the 69 permanent directors installed since McDonald took over, 49 transferred from a different VA medical center, while 12 came from different jobs within the same hospital. The moves included promotions, for instance from associate director to director of a medical center.

In 22 cases, the VA moved directors from one center to another, sometimes to more complex hospitals, but at other times, to less complex facilities. In Ohio, directors in Chillicothe and Columbus simply switched places.

Some of the directors came from facilities where they faced issues ranging from low-ranking quality of care to wait-time falsification to mismanagement identified by outside investigators.

Reporter Donovan Slack notes further the specific problems and misbehaviors by a handful of these directors. But certainly they must have learned their lessons, right?

Why can't they bring in more outsiders? The VA administration claims money is an issue. Salaries for directors are about half of what they can make in the private sector, and they blame Congress for failing to raise the salary cap.

Of course, the problem with that argument is that the VA has a history of blowing money it's given, and that has increased congressional skepticism of giving them more. The VA got $15 billion in funds but that didn't improve veterans care. And over the course of a decade the agency spent millions on artwork while care languished.

A representative for the agency also noted that the hiring process is very slow and heavily favors applicants with federal experience. This system, of course, is a result of decades of self-serving government employee influence and power. It will resist reform and change, and there's very little to suggest in USA Today's reporting that it will be coming from this administration (and possibly not the next one either).

Read more here.