'Corrosive culture' at VA has led to significant failures in health care, White House review finds

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New report details poor management and care at VA

Sen. Coburn sounds off

The troubled Veterans Affairs health care system is plagued by a "corrosive culture" of mismanagement and distrust that has had significant negative impacts on medical treatment for veterans, according to a White House review.

A summary of the review, which was done by deputy White House chief of staff Rob Nabors and released Friday, says the environment within the Veterans Health Administration hurt morale and affected the timeliness of health care, and the division of the department must be restructured.

The review came in the wake of reports of lengthy wait times for appointments and treatment delays in VA facilities nationwide.

The review offers a series of recommendations, including a need for more doctors, nurses and trained administrative staff. Those recommendations are likely to face skepticism among some congressional Republicans who have blamed the VA's problems on mismanagement, not lack of resources.

The White House released the summary after Obama returned from a two-day trip to Minneapolis and promptly ducked into an Oval Office to get an update on the administration's response to the VA troubles from Acting VA Secretary Sloan Gibson and Nabors.

"We know that unacceptable, systemic problems and cultural issues within our health system prevent veterans from receiving timely care," Gibson said in a statement following the meeting. "We can and must solve these problems as we work to earn back the trust of veterans."

Among Nabors' findings:

-- The VA acts with little transparency or accountability and many recommendations to improve care are slowly implemented or ignored. Concerns raised by the public, monitors or even VA leadership are viewed by those responsible for VA's health care delivery as "exaggerated, unimportant, or `will pass."'

-- The VA's lack of resources is widespread in the health care field as a whole and in the federal government. But the VA has been unable to connect its budget needs to specific outcomes.

--The VA needs to better prepare for changes in the demographic profile of veterans, including more female veterans, a surge in mental health needs and a growing number of older veterans.

Since reports surfaced of treatment delays and of patients dying while on waiting lists, the VA has been the subject of internal, independent and congressional investigations. The VA has confirmed that dozens of veterans died while awaiting appointments at VA facilities in the Phoenix area, although officials say it's unclear whether the delays were the cause of the deaths.

One VA audit found that 10 percent of veterans seeking medical care at VA hospitals and clinics have to wait at least 30 days for an appointment. More than 56,000 veterans have had to wait at least three months for initial appointments, the report said, and an additional 46,000 veterans who asked for appointments over the past decade never got them.

This week, the independent Office of Special Counsel concluded there was "a troubling pattern of deficient patient care" at the Veterans Affairs that VA officials downplayed.  Among the findings were canceled appointments with no follow up, contaminated drinking water and improper handling of surgical equipment.

The Associated Press contributed to this report