Veterans' health care: a call of duty

Abstract

Last week saw the US Department of Veterans Affairs (VA) hit by yet another health-care scandal. On Sept 2, the VA's Office of Inspector General (OIG) published its report reviewing alleged mismanagement at the Veterans Health Administration's Health Eligibility Center. In response to a whistle-blower's claims, it investigated whether the centre had more than 850 000 health-care applications in a pending status, whether more than 47 000 veterans had died while their applications were pending, whether 10 000 health records were purged or deleted, and whether thousands of unprocessed applications, spanning a 3-year period, were discovered in January, 2013. On all four counts, the OIG found the VA guilty. The report calls for the provision of guidance by the VA's Under Secretary for Health on timeliness metrics and assignment of an accountable senior executive to develop a project management plan to correct data integrity issues. The OIG notes that all the report's recommendations have been accepted by the VA and corrective actions plans have been submitted; the OIG will monitor implementation. 8·9 million of the 22 million veterans in the USA are enrolled in the VA's health benefits programme. 6 million receive treatment every year in 151 VA medical centres and other facilities. Major problems in the system have come to light in recent years. In 2011, the VA was taken to court for failing to provide adequate mental health care for veterans returning from active service. The appeals court ordered a drastic overhaul to correct “unchecked incompetence” in the system. In 2014, the OIG investigated claims of long delays, falsified waiting lists, and poor quality of care and found substantial evidence to support them. These revelations point to gross mismanagement and lack of oversight within the Veterans Health Administration. The VA's problems run wide and deep. They will certainly need presidential level and bipartisan commitment in Congress to be solved. If countries are going to deploy people into active service abroad, they have a duty to plan for, and provide, the highest possible standard of care for those returning home. Call to duty revisitedAs longserving surgeons in the Veterans Health Administration (VHA) system, we found the Editorial1 about the VHA both disturbing and misleading. In view of the fact that the UK does not have a specific agency devoted to veterans, this critique of the VHA is unwarranted and non-specific. The Editorial is another gratuitous example of piling on criticism in response to news of admittedly egregious administrative wrongdoing in the misreporting of waiting times for access to primary care in the VHA health-care system. Full-Text PDF