The regional director for veterans hospitals across New England faced criticism Monday as a congressional subcommittee began examining problems at the Manchester VA Medical Center.
The House Veterans' Affairs Subcommittee on Oversight and Investigation's field hearing came two months after a Boston Globe report highlighted allegations of substandard conditions and treatment at New Hampshire's only veterans hospital. The report detailed complaints from whistleblowers who described a fly-infested operating room, surgical instruments that weren't always sterilized and patients whose conditions were ignored.
One of the whistleblowers, Dr. Ed Kois, told the panel that he spent nearly two years trying to bring the problems to the attention of VA officials. Dr. Carolyn Clancy, a deputy VA undersecretary, said that's unacceptable.
"The part of story here that I find most disturbing is Dr. Kois saying for two years he tried but wasn't effective. That's the piece we need to get to," she said.
U.S. Rep. Jack Bergman, the subcommittee's chairman, took aim at Dr. Michael Mayo-Smith, the regional director, reminding him of his responsibilities as a leader. Beyond whatever improvements are made to patient care and infrastructure in Manchester, Bergman said better oversight and management at the regional and national level also are needed.
"As the subcommittee chairman and a veteran, I'm very concerned about leadership failures and deficiencies that existed in Manchester and had been allowed to compound for too many years. It was also very clear that there was no sense of urgency within the (regional network) to address these problems," said Bergman, a Michigan Republican. "It should not take a news report or a congressional hearing for VA leadership to respond to veterans' and employees concerns."
Mayo-Smith said officials are undertaking a "deep dive" to identify and fix any problems with how the regional networks respond to such concerns.
"This is going to be done," he said. "This is something I've been an advocate for, that we take lessons learned when things go wrong at one medical center, and we share them among the network directors so we can be a learning organization and make improvements."
In response to the Globe report, Secretary of Veterans Affairs David Shulkin immediately removed three top officials and ordered an investigation. Shulkin visited the hospital in August, and said a task force would explore bringing a full-service veterans hospital to New Hampshire, teaming up with other hospitals in the state or forming a public-private partnership to improve care.
But Democratic U.S. Rep. Annie Kuster, said partnering with community providers may be challenging given the problems with the VA's Veterans Choice program, which allows veterans to seek care outside the VA system. Patients have long complained about difficulty getting appointments, while providers complain about not getting paid. One New Hampshire hospital is owed $3 million, she said.
"How can we ask our community hospitals to step up and care for our veterans when they're owed $3 million?" she said. "That's real money where I come from."
And while VA officials noted that a newly created Office of Community Care successfully cleared a backlog of 3,300 pending requests for appointments through the choice program, Kuster, a Democrat, questioned how the backlog grew so large in the first place. Mayo-Smith responded his office was getting inaccurate data about the pending cases.
The hearing was called by Kuster, the panel's ranking member, and included questioning and New Hampshire's Democratic U.S. senators, Jeanne Shaheen and Maggie Hassan.
Kois said the problems detailed by the Globe aren't unique to New Hampshire.
"Unless we get a handle on really what's happening in the VA system, this is going to continue," he said. "We have really dedicated people who work in the system, but we have a bureaucracy that is so top heavy and so slow to react, it's problematic."
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