The Department of Veterans Affairs Health Care division has had bureaucratic management problems going back decades. Why is it that the VA simply has not been able to correct its problems. Some problems exist in nearly every Government Bureaucracy but in the VA the problems seam to be worse.
Bureaucratic Managers especially those that are Directors of large medical facilities such as the VA are under tremendous pressure to show leadership especially leadership that purports to be efficient saving the Department of Veterans Affairs money. The Director in turn receives a significant bonus just for appearing to be doing something needed by the Department. The pressures of increased numbers of patients in recent years and an agency with a limited budget caused the Directors of most of the VA Medical facilities to falsify patient schedules. If current VA funding had gone to hire the doctors and staff needed there would have been no funds available for Management bonuses.
Here is why I believe the VA bureaucratic Management has failed:
The management tools for proper management simply do not exist in bureaucratic government. The reason for this is that knowing the cost of a simple process with enough precision to apply the tools of management does not exist. Most companies in private industry know what it costs to manufacture an item or the cost of providing a service. Budgets in private industry to a large extent reflect actual costs while in Government Bureaucracies most budgets are negotiated based on the previous years expenditures and no one knows what the real costs should be.
Not knowing what each process in the Facility should cost means that VA Directors and Managers are unable to know which operations are operating efficiently and which need to be scrutinized and made more efficient. The inability to make this important distinction causes inept managers to apply pressure on all processes scolding and congealing employees to be more efficient. At the lower levels of the agency this leads to bullying of employees and the natural obstinacy of employees.
Sharon Helman suspended director of the VA’s Phoenix Medical Facility is an example of a Director that will do almost anything to make her directorship appear to Veterans Affairs in Washington DC that she is doing an excellent job and deserves the lucrative bonuses that she has received. Unable to actually make her directorship efficient through actual cost data she resorted to a number of tricks to reduce budget. The firing of managers and leaving the post open, the closing of parts of the hospital shutting off services to Vets etc. all were done to make Director Helman appear to be reducing costs while actually causing extreme chaos in the facility. The following article by Sheila Hager highlights the problems.
Suspended Phoenix VA director had problems in Walla Walla
By Sheila Hagar Thursday, May 22, 2014 UnionBulletin.com#WALLA WALLA — A director placed on administrative leave last week at a Phoenix Veterans Affairs medical center had a troubled run here, as well.
#Sharon Helman served as director of the Jonathan M. Wainwright Memorial VA Medical Center after coming from a VA in Roseberg, Ore in January 2007. In June 2008, she transferred to Spokane’s VA medical center.
#Veterans Affairs Secretary Eric K. Shinseki announced on May 1 he had placed Helman, Associate Director Lance Robinson and a third unidentified employee on administrative leave “until further notice,” stemming from a wide-reaching scandal brought on by whistle-blowers accusing the Phoenix VA of keeping a secret waiting list to hide delays in treatment, according to a Los Angeles Times story.
#Helman said she respected Shineski’s decision and was “fully supportive of any decision that ensures we have a thorough review by the Office of the Inspector General.”
#By the end of her tenure in Walla Walla eight years ago, Helman had drawn the ire of VA employees and veterans, according to a Union-Bulletin story.
#In summer of 2008 a group gathered to meet with Sen. Patty Murray’s staff and John Lee, then director of Washington state Department of Veteran Affairs. The discussion, held at the National Guard Armory in Walla Walla, centered on employee morale and quality of medical services during Helman’s tenure.
#Former employee James Bernasconi was vice president of local chapter of the American Federation of Government Employees union at the time. He had recently retired from a 33 year career as a budget analyst for the Walla Walla VA.
#The atmosphere and morale at the medical center was toxic, Bernasconi said at the meeting, covered by the Union-Bulletin.
#In 2007, the mental-health unit at the local VA was considered by some in management to be one of the best in the nation. A year later many believed it to be slated for closure, he explained.
#Bernasconi said it began with the arrival of Helman.
#“They brought Sharon Helman in to quiet the community,” he said. “She had no management skills, but she quieted things down.”
#Under Helman’s reorganization in July 2007, department chiefs were taken out of their positions and departments were left to “intentionally fail,” Bernasconi said in 2008.
#Others at the meeting spoke of the rapid shut down of the Community Living Center, the VA’s nursing home unit, that July. The maneuver took three days and put at least one patient in crisis, those at the meeting said.
#“It seems like a brilliant plan,” said veteran Russ Acord said then. “Blow it up from the inside and blame it on the staff.”
#Acord said he blamed Dennis “Max” Lewis, then Veterans Affairs regional network director, and Helman for “pulling this VA apart as quickly as possible, but they are simply following orders and being paid well to do so.”
#One former employee at the meeting who did not want to be identified in the newspaper told Murray’s staff that managers with long, commendable work histories were fired under Helman as scapegoats, while others fled the situation by quitting. Staff members displaced from other areas had been slotted into spots they weren’t qualified for, she said.
#Sheila Hagar can be reached at sheilahagar@wwub.com or 526-8322.
Comment by Lawrence Rosier Principal Consultant
This is over the top incompetent Management without a clue as to how to actually make an organization more efficient. Please peruse the following articles:
Article 55. Obtaining Maximum Patient Throughput with The Highest Effectiveness
Article 58. Reinventing the VA
Article 61. Why the Federal Government is Unlikely to fix the VA
Article 64. Bureaucratic “Stone Walling”, Whistle Blowers and a Fix for the problem
Article 65. Why the General Reform Model Works
Article 66. 'Bonus Culture' at VA Scrutinized by House Committee
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