WASHINGTON • U.S. House members, troubled by medical safety lapses, on Tuesday accused Veterans Affairs of carelessness and a lack of accountability in treating patients at the John Cochran VA Medical Center in St. Louis and other VA facilities.
In a House Veterans Affairs Committee hearing, a top VA official heard a bipartisan chorus of withering criticism of his agency's leadership, its secretive policies and a workplace culture that discourages employees from speaking out about problems.
Also, the Government Accountability Office released a new report concluding that the VA policies for overseeing medical supplies threaten veterans' safety.
Randall Williamson, the GAO's director of health care, testified that until the VA makes improvements, "veterans may continue to be at risk."
The House Veterans Affairs hearing was called to respond to medical sanitation problems that have showed up at VA facilities in St. Louis, Miami and Dayton, Ohio. In Dayton, the VA facility was rocked by disclosure recently that a dentist routinely failed to clean instruments between patients.
In St. Louis, the Cochran operating rooms were temporarily shuttered in February because of discoloration on surgical equipment. A VA official insisted at the hearing that the equipment in question was sterile.
Last year, Cochran belatedly advised more than 1,800 patients that they might have been exposed to viruses after dental tools were found to be improperly cleaned.
"We may have the best scientific procedures there are in the world," Rep. Russ Carnahan, D-St. Louis, said at the hearing, "but if it doesn't affect the human impact on veterans, it's not a good system."
Rep. William Lacy Clay, D-St. Louis, suggested that the government consider providing St. Louis-area veterans with vouchers to obtain care at local hospitals.
"If you cannot do the job for people who deserve it, perhaps we ought to look at another system to deliver medical care to them," Clay said.
The timing — and the method — of informing St. Louis-area veterans about problems were among points of contention.
"Why did it take eight weeks in St. Louis to decide that we have almost 2,000 people possibly infected with HIV?" asked Rep. Bob Filner, of California, the committee's ranking Democrat.
Dr. Robert Petzel, the VA's undersecretary for health, replied that his agency proceeds cautiously. He raised the ire of Filner and others in the room when he testified that "every single one" of the St. Louis-area veterans received phone calls about the potential problem.
Committee members recalled that veterans received a form letter that resembled a traffic citation.
"I will have to go back and review my recollection of it," Petzel responded.
"I am right and that is the way it happened," countered Carnahan.
John Daigh, the VA's assistant inspector general, testified that even though he believes his agency provides high-quality care, recent incidents "naturally would shake the faith of those who receive care from the VA."
Daigh said some of the problems resulted from improper handling of equipment "and others were the result of of leadership failing to act when presented information of serious breaches of infection control protocols."
Despite harsh partisanship over other issues on Capitol Hill, Democrats and Republicans were unified in their negative assessments of VA performance.
They contended that VA officials routinely shun responsibility, hide behind arcane policies and fail to provide requested documents even to Congress.
"Accountability and leadership at the helm is lacking," aserted committee's chairman, Rep. Jeff Miller, R-Fla.
Petzel apologized to veterans, arguing that improvements have been made.
"What's developing in St. Louis is an atmosphere where people can come to the management," he contended. "There's very good evidence that things are changing in St. Louis."