Gates Puts Punch Behind Fixing Wounded Warrior Care

Defense Secretary Robert M. Gates, left, conducts a press conference with former Secretary of the Army and Veterans Affairs Togo West, center, and former Secretary of the Army John Marsh, at the Pentagon, May 2, 2007. West and Marsh discussed the findings of the Independent Review Group on patient care at Walter Reed Army Medical Center and Bethesda hospital. Defense Dept. photo by Cherie A. Thurlby   (Click photo for screen-resolution image);high-resolution image available.

The group’s findings and recommendations were presented in a 129-page report to the Defense Department April 19, and Gates met with the group today.

Flanked by the group’s co-chairs, former Army secretaries Togo D. West Jr. and John O. Marsh Jr., Gates said the oversight group will ensure the recommendations of the IRG, the president’s Commission on Care for Returning Wounded Warriors, and the Interagency Task Force are promptly and properly integrated, implemented, coordinated and resourced. Other members of the group attended the briefing, along with a handful of senior Defense Department civilian officials.

“Apart from the war, this department and I have no higher priority” than to ensure wounded servicemembers have the best care and facilities and ample assistance navigating the next step in their lives, Gates said.

“That is what we intend to give them,” he said.

Senior military and civilian officials will make up the oversight committee, including all of the service chiefs or vice chiefs, the chairman or vice chairman of the Joint Chiefs of Staff, and senior civilian leadership from the department’s personnel and readiness and health affairs functions, Gates said.

The committee will meet weekly.

Defense Department Health Affairs and the Army have already begun implementing changes recommended by the nine-member panel charged with assessing care for servicemembers at Walter Reed Army Medical Center here and the National Naval Medical Center, Bethesda, Md. The group held public meetings, established a hotline to receive comments and visited 10 military medical centers across the country.

“Though we perceive ourselves as a nation that is grateful, (that) is honored by the service of its wounded veterans and servicemembers … our review suggests that our servicemembers and their families have not always seen it that way,” said West.

West said the group found that inpatient care was “excellent” but that problems began when the servicemember was transferred to outpatient care.

Among the recommendations were more caseworkers and better training, more physicians to coordinate patient care, and an improvement of attitude in general, said West.

Also, West said, the Base Realignment and Closure and A76 cost-comparison processes at Walter Reed caused uncertainty among the personnel at the center. He called for a review to examine how the processes affect medical centers.

The group, however, did not recommend that the aging D.C. hospital campus be taken off of the BRAC list, but instead recommended that the process be expedited and preparations be made faster at the National Naval Medical Center and at Fort Belvoir, Va., to receive those functions.

The report also calls for establishing a center of excellence that focuses on traumatic brain injuries and post traumatic stress disorder.

The medical evaluation process is “lengthy and segmented” and needs to be consolidated into one process involving all related departments, the report recommends.

“For those in the departments who understand how it works, it all seems logical,” West said. “For vulnerable servicemembers and their families, it seems a contradictory mass of sequential reviews, of several sequential decisions, compounded by confusing regulations at a time when they are most vulnerable and least able to follow them.”

Marsh said a breakdown in the system of reporting complaints caused reports of substandard care not to be heard quickly enough. The group recommended establishing an oversight system to field complaints and elevate them to senior leadership.

Army officials said the service has resolved, or is resolving, 24 of the 26 findings of the review group. The remaining two findings require efforts by the Defense or Veterans Affairs departments, they said.