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Army Works to Repair Medical Center, Reputation

February 21, 2007 at 1:50 PM EST
Army officials toured Walter Reed Army Medical Center on Wednesday to inspect and monitor repairs at the facility, which has been criticized for poor conditions and patient care. The Army's surgeon general and a veterans advocate debate the medical center's future.
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JUDY WOODRUFF: The U.S. Army rushed today to respond to a Washington Post series on poor patient treatment and rundown buildings at its largest medical facility, Walter Reed Army Medical Center in Washington, D.C.

Soldiers and contract workers spackled holes in ceilings this afternoon and repainted rooms where moldy wallpaper and carpets have been removed from Building 18, part of the focus of the Post report.

Building 18 is one five buildings attached to Walter Reed and home to 76 recovering soldiers. They make up about 10 percent of the nearly 700 outpatients at the facility.

The Post’s report quoted soldiers charging neglect and frustration in the extreme at Walter Reed. It highlighted problems with the outpatients’ housing, including rodent infestation, holes in the walls and ceilings, and moldy carpets and wallpaper.

At a Pentagon briefing this morning, top officials said they had been surprised by the Post report.

GEN. RICHARD CODY, Army Vice Chief of Staff: I am disappointed that I had to learn about the conditions of that building through media reports.

JUDY WOODRUFF: Army Vice Chief of Staff Richard Cody said there had been a breakdown in leadership.

GEN. RICHARD CODY: I’ll take responsibility for this, and I’ll make sure that it’s fixed. But I’m not here today to lay out at what level.

We know what level. I’ve had meetings with those people, and the appropriate actions have been taken. I will personally oversee the plan to upgrade Building 18, and we’ll soon change the name of it. Referring to a place where our soldiers stay as Building 18 is not appropriate.

We own that building, and we’re going to take charge of it. And other facilities, I will oversee and ensure that our soldiers and their families, who have sacrificed so much, receive the care and the housing they so deserve as they go on their road to recovery.

JOURNALIST: General, you said appropriate action has been taken. Has anyone been relieved of command or fired?

GEN. RICHARD CODY: No. We will do the right thing across the board, as we continue to assess where the leadership failure and breakdowns were.

In some cases, I’ll just say it as plainly as I can: We had people that were put in charge that did not have, in my mind, in my experience, the right rank and the right experience and the authority to be able to execute some of the missions that was required.

JUDY WOODRUFF: Dr. William Winkenwerder, the assistant secretary of defense for health affairs, insisted that any failures were not in the quality of medical care.

DR. WILLIAM WINKENWERDER, Assistant Secretary of Defense: The concerns that have been raised are not about the quality of the medical care or about the care and professionalism of the medical staff at Walter Reed. That is not the issue.

This is not a resource issue. There are resources to do all the things we need to do to take care of people. So, at the end of the day, I think this matter is about trust and the trust that we all have with the service members and their families.

The trust has taken a hit here. And I think it’s our job to repair that trust and to re-earn that trust, and that’s what we’re going to do.

JUDY WOODRUFF: Winkenwerder also said an independent review would look into the breakdown and would examine the military’s other major East Coast medical facility, the National Naval Medical Center in Bethesda, Maryland.

The Post’s report also sparked outrage from Democrats and Republicans in Congress. Chairman of the House Veterans Affairs Committee, Congressman Bob Filner, said, quote, “We need to bring the Army people in and say, ‘What the hell is going on?’”

And Democratic Congressman Chris Van Hollen of Maryland told the NewsHour Congress will conduct its own investigation.

REP. CHRIS VAN HOLLEN (D), Maryland: Clearly the system failed our veterans at Walter Reed. And it’s very important that we get in there right away, have an investigation, clean up the mess, and make sure that our veterans who have sacrificed so much, and their families, are treated with the dignity that they deserve.

JUDY WOODRUFF: Several members of Congress have also called for new legislation to deal with problems raised in the report.

Determining responsibility

Steve Robinson
Veterans for America
Nobody wants to call for anybody's head, but everybody at Walter Reed who was in charge at the lowest level has somebody that's in charge of them and has a responsibility... So I don't want to see it get placed just on junior NCOs.

JUDY WOODRUFF: Lieutenant General Kevin Kiley is the Army's surgeon general and commander of U.S. Army Medical Command. As the army's top doctor, he is responsible for all of the Army medical facilities. He served as the commander of Walter Reed Medical Center from 2002 to 2004.

Steve Robinson is director of veterans affairs at Veterans for America, an advocacy and humanitarian organization. He had a 20-year career in the Army and retired as a senior noncommissioned officer.

Gentlemen, thank you very much for being with us.

General Kiley, let me begin with you. The secretary of the Army, Francis Harvey, said today that the failure lies with some noncommissioned officers -- I think he called them garrison leaders -- who were not doing their job. Do you agree with that?

LT. GEN. KEVIN KILEY, Army Surgeon General: Well, I think the analysis that we're doing as we speak over where the breakdown was, in terms of identifying and fixing those issues, particularly in Building 18, which is what I think the secretary was referring to, are also accurately portrayed by the vice chief of staff, who articulated we had young leaders who felt that accountability and responsibility to take care of problems, but didn't necessarily either feel they had the authority or the experience to properly take care of these issues, as small and as few as some of them are.

So we're very aggressively correcting. And you saw and the news has reported that we're in the process of repairing things as we speak.

JUDY WOODRUFF: So my question is, is that as high as the responsibility goes with these noncommissioned officers?

LT. GEN. KEVIN KILEY: Well, I would not identify the noncommissioned officers yet. I share the vice chief of staff's opinion that we need to do an analysis of this, and that's ongoing right now. And then, if appropriate, appropriate action will be taken.

JUDY WOODRUFF: How high do you think the responsibility does go?

LT. GEN. KEVIN KILEY: I really can't say. I've asked General Weightman to take a look at this, and I'm waiting for his report. I don't want to influence him in terms of who or what he thinks may be in...

JUDY WOODRUFF: Steve Robinson, do you have a view of responsibility here?

STEPHEN ROBINSON, Veterans for America: I do. I've been going to Walter Reed since the war started and since I got out of the military. And, you know, ultimately, we start with the president. We then turn to the secretary of defense. We turn to Dr. William Winkenwerder.

We've seen people, when this news story broke, punt all the way down to the lowest-level NCO at Walter Reed. And nobody wants to call for anybody's head, but everybody at Walter Reed who was in charge at the lowest level has somebody that's in charge of them and has a responsibility.

The span of control in the military is three to five people. So I don't want to see it get placed just on junior NCOs. And -- go ahead.

JUDY WOODRUFF: Could that happen, General Kiley? Could that happen?

LT. GEN. KEVIN KILEY: Well, you know, you heard in the press conference the vice chief of staff say he's accountable. I'm accountable, as commander of MEDCOM. So I don't want to speculate on who will be held accountable and at what level they'll be.

Is the system broken?

Lt. Gen. Kevin Kiley
Surgeon General, U.S. Army
We've had problems over the last three years that we've recognized and we've made significant improvements. We've got more we need to do; there's no question about that...But it is a very large, complex process.

JUDY WOODRUFF: Steve Robinson, you've told my colleagues today that you've been trying to get, as you put it, Army higher-ups to pay attention to this problem for the last three years. Can you tell us who you met with and when?

STEPHEN ROBINSON: Actually, I've spoken with General Kiley before when I came to Walter Reed, to talk about soldier issues, people who were in the barracks, waiting extremely long periods of time to get their medical processing completed so that they could get out.

I've met with Deputy Surgeon General DeKoning. I've met with a lot of people, and we've had a good conversation with the Office of the Surgeon General. And with the new mental health care task force, they're out there, they're identifying these problems.

But, to me, this issue isn't about mold and mice. There's a larger, systemic problem about capacity and case managers who are in the hospital addressing the individual needs of every servicemember and their family that come through that facility.

JUDY WOODRUFF: General Kiley, you just heard Mr. Robinson saying he met with you, he met with others in your office, and, yet, the officials were saying today that they didn't know this was going on. Can you square that for us?

LT. GEN. KEVIN KILEY: Well, you've got to look at the time lines and what we meant. I don't disagree with Mr. Robinson that the challenges that the leadership at Walter Reed have had -- frankly, since I took command in 2002 -- in support of the global war on terrorism and taking care of soldiers has required us to continually reevaluate how we care for soldiers, how we process the MEB-PEB process, the medical boarding process.

Our ratio of case managers, we've improved that from 100-1 -- to 129-1 to 30. We're re-looking to see if maybe we ought to go lower.

This is a very complex set of problems, because the soldiers have got complex issues, mental, and emotional, and physical. And they require a long time to recover from that, and that lends to some issues that Mr. Robinson is alluding to.

STEPHEN ROBINSON: Well, we did. I mean, as far back as 2003, my organization and in other capacities, in other organizations that I've been in, have seen stories about the long wait times to be out-processed.

There is no doubt -- let there be no doubt that there is state-of-the-art care going on at Walter Reed and that they're taking care of people in the operating rooms, they're giving them state-of-the-art prosthetics.

But the bureaucracy of getting out of Walter Reed, and getting back home, and reintegrating back to your family is broke. There is no seamless transition out of the military and into the V.A. health care system.

JUDY WOODRUFF: Do you agree it's broken?

LT. GEN. KEVIN KILEY: I would not agree that it's broken. I would agree that it's a challenge; and I agree that we've had problems over the last three years that we've recognized and we've made significant improvements.

We've got more we need to do; there's no question about that. We want to make a better transition from inpatient to outpatient, from outpatient returning home to the units, or being returned from -- released from active duty or medically retired.

But it is a very large, complex process. And that, as Mr. Robinson is alluding to, is the challenge.

Army's awareness of problems

Steve Robinson
Veterans for America
There are some problems with some facilities, and that's being addressed...But the real story is that there's a bureaucracy that people have to go through that is extremely frustrating when you come back from war, that needs immediate attention.

JUDY WOODRUFF: Your colleagues at the Pentagon today were saying, among other things, that they were surprised. They didn't know this was going on. My question is, where did you think those 700 or 800 or 900 outpatients were? And what kind of care did you think they were getting?

LT. GEN. KEVIN KILEY: I think they're getting outstanding care. It's the same set of doctors and nurses that take care of our inpatients who are taking care of our outpatients.

I would take exception with claims that the medical care that our soldiers are getting is inferior. I think there have been issues in the bureaucracy about may be perceived as timely appointments, but we work very hard to take care of those soldiers.

And if the capacity is exceeded, we have options within Walter Reed to bring more resources to bear to take care of them.

JUDY WOODRUFF: Is that your sense?

STEPHEN ROBINSON: Well, I'm shaking my head yes, they're getting good medical care, but the continuum of care extends beyond the operation that they get in the hospital, and it extends to out-processing them.

JUDY WOODRUFF: Because they're surviving...

STEPHEN ROBINSON: That's right.

JUDY WOODRUFF: ... the acute care that they get in the hospital.

STEPHEN ROBINSON: That's right, and they're living there for sometimes up to a year-and-a-half, and waiting to be discharged to return home.

And I don't think anybody is saying that there aren't good doctors at Walter Reed. What they're saying is, is that there are some problems with some facilities, and that's being addressed, and that got the headlines. But the real story is that there's a bureaucracy that people have to go through that is extremely frustrating when you come back from war that needs immediate attention.

JUDY WOODRUFF: Were you aware, Steve Robinson, that the conditions were what have been laid out by the Post?

STEPHEN ROBINSON: Yes, I have been in that facility before.

JUDY WOODRUFF: Well, General Kiley, if someone like Mr. Robinson, who is not in the military, but in a veterans organization, was aware, how is it that the military itself was not aware?

LT. GEN. KEVIN KILEY: Well, I think it's not that we weren't aware that that building needs and requires continued maintenance and upkeep. And since 2001, we've had two overhauls and one major renovation.

In the last year, we've done over 200 what we call "work orders" to fix things that were, again, reported in the paper. It's an old building. You can walk into it today, and if you walk into it six months from now, you're going to find issues.

Senior leaders, platoon sergeants, company commanders, brigade commanders should be walking through those facilities at least on some kind of a periodic basis. But, remember, more than half the rooms were actually perfectly OK.

And those that are problems like mold, there were only about seven of them that had that. The mice and cockroach issue was something that, in fact, the command did address last year, and that was due to soldiers leaving food in their rooms. We policed that up, and the rodent problem and cockroach problem has been corrected.

JUDY WOODRUFF: But the problem still existed as of this week.

LT. GEN. KEVIN KILEY: Well, I'm not sure about mice. I'm not sure about rodents. I think mold recurs. The HVAC system and the plumbing system in that building are old. They probably need to be replaced, and that's our intent to do those things.

Fixing the problems

Lt. Gen. Kevin Kiley
Surgeon General, U.S. Army
We're going to get on this right away, get it fixed. I do not think that the paper accurately reflects the emotional, physical and intellectual commitment to taking care of these soldiers. We are not abandoning them.

JUDY WOODRUFF: And what is your sense, both of you, of how deeper this problem goes? Does this exist at other medical facilities, military medical facilities?

STEPHEN ROBINSON: Absolutely. I mean, and I don't want to say it's an epidemic, but what we really need is to have an entire review of how we're caring for our soldiers that come home from war, at every military medical facility, to ensure that we're delivering to them state-of-the-art care, in comfortable environments that allow them to heal, and with case managers that will be there for them to handle the issues that arise.

JUDY WOODRUFF: And this discharge process, can it be speeded up, General?

LT. GEN. KEVIN KILEY: I think it can, but I want to differentiate between the discharge process, the MEB-PEB process, which I've already alluded to as complex and can take time, from the very long time that soldiers often require to heal to the maximum benefit of the therapy.

And so if you talk to a soldier who's been at Walter Reed for 12 months or 18 months, they haven't been waiting 12 to 18 months to process out of the Army. They've been healing. They've been recovering, some often from traumatic brain injury, recovering from PTSD, and of course all the orthopedic and other physical ailments.

And at the point where we think they're healed, we start this process, which we'd like to see -- in fact, in the last three years, we've improved the time lines on that. So I want to differentiate between the administrative process and the healing, convalescing process.

JUDY WOODRUFF: How do you feel about all this?

LT. GEN. KEVIN KILEY: Well, I will tell you that I continue to be extremely proud of Walter Reed, the staff. As I said this morning at a town hall meeting, I jog around the compound in the morning, and the staff are there at 5:00 and 5:30 in the morning ready to take care of patients.

I think, as the vice has said, we're going to get on this right away, get it fixed. I do not think that the paper accurately reflects the emotional, physical and intellectual commitment to taking care of these soldiers. We are not abandoning them.

JUDY WOODRUFF: General Kevin Kiley, surgeon general, Steve Robinson of Veterans of America, thank you both. Appreciate it.

LT. GEN. KEVIN KILEY: Thank you.

STEPHEN ROBINSON: Thank you.