Full-service VA Hospital still possible in New Hampshire

After a Boston Globe Spotlight report in July on the poor state of care at the Manchester, N.H., VA Medical Center, the Veteran’s Administration reacted swiftly to address issues. Within 24 hours of the report, which included “whistle-blower” accounts from current and former staff members, VA Secretary David Shulkin removed two top officials and sent in the Office of Medical Inspector and the Office of Accountability and Whistleblower Protection to investigate.

The issues outlined in the Globe article included non-sterile operating equipment, a fly infestation in one OR, equipment issues and patients whose care resulted in what specialists have said was avoidable permanent spinal damage and paralysis.

The VA, under the direction of newly-appointed Shulkin, took the accusations seriously, meeting with the whistle-blowers; holding over a dozen employee town halls; hosting a mental health summit with 130 community partners; establishing partnerships with a local hospital and providers across the state; and creating a task force to address issues, among other steps.

The quick response to the Globe report were in direct contrast to the reaction that the whistle blowers claimed they had received from administrators and the head of VA New England Health Systems, which oversees the New Hampshire facility.

According to Andrea Amodeo-Vickery, a Manchester-based lawyer who worked with the 11 whistle-blowers, the center’s chief of medicine, Stewart Levenson, M.D. and William “Ed” Kois, M.D., head of the Manchester VA spinal cord clinic, had attempted to draw attention to the issues for some time.

“The head of VA New England, Dr. Michael Mayo-Smith, had been told for at least two years prior to the article,” said Amodeo-Vickery.

Amodeo-Vickery explained that, after the group brought their concerns about the task force to the New Hampshire delegation of senators and representatives, who then conveyed the message to Shulkin, Mayo-Smith was replaced on the task force.

U.S. Senators Jean Shaheen (D) and Maggie Hassan (D), along with Rep. Ann Kuster (D), raised concern over the official written announcement of the task force. The wording, they felt, went away from a comment made by Shulkin in August that New Hampshire needs a full-service VA hospital and instead called for a “future vision of what the VA must do to best meet the needs of New Hampshire’s veterans.” New Hampshire has the fifth-highest ratio of veterans in the country, yet it is the only state in the contiguous 48 states without a full-service medical center.

“Senator Hassan has repeatedly pushed Secretary Shulkin to prioritize establishing a full-service VA hospital in New Hampshire so that our veterans receive the full service of high-quality care that they deserve,” said Ricki Eshman, Senator Hassan’s press secretary.

The VA, in response to the legislators’ concerns, sought to reassure New Hampshire vets that the task force will still look at bringing a full-service hospital to the state.

“VA New England Director Mayo-Smith [then head of the task force] met with Sen. Hassan to assure her that the language was not meant to assume that a full-service hospital is not being considered,” said Maureen Heard, chief communications officer at VA New England Health Systems. “All things are on the table.”

The whistle-blower group, said Amodeo-Vickery, are hopeful that the January report from the task force will address the many issues at the medical center. In the meantime, since the secondary tier of administrative staff has not changed, the atmosphere and mood at the facility have not noticeably improved, she said.

“In terms of the day-to-day, some things have improved but the corporate culture is still in place and there is still a disconnect between the bureaucracy in the building and the providers,” she said. “We are hopeful about the January report, though.”