The task force looking at the future of VA health care for New Hampshire veterans wrapped up two days of meetings Thursday. For the most part, these meetings are calm deliberations. Task force members listen to presentations, ask questions, and discuss VA issues.
But a heated exchange at yesterday's meeting highlights the simmering tensions between VA whistleblowers, who went public with their concerns, and VA leadership.
The comment that kicked off the conflict came from Dr. Michael Mayo-Smith. He's the network director for the VA New England Healthcare System, and he was invited by the task force to talk about culture change.
As part of that discussion, he shared the results of an employee survey, which showed a significant drop in satisfaction at the Manchester VA earlier this year.
"In 2017, the all employee survey was administered about one week after The Boston Globe article was published," said Mayo-Smith.
The article came out in July and continues to make waves. It detailed allegations by VA whistleblowers of dangerous delays in care that caused some veterans harm. It caught national attention, and Mayo-Smith said it "very likely had an influence on the results at the time."
That statement didn't sit well with Dr. Ed Kois. He's the leader of the dozen whistleblowers and a frequent critic of the way Mayo-Smith allegedly handled complaints about bad patient care....years before they became public. Kois stood up at the meeting.
"To blame it at the Globe's article one week earlier I think completely misses the point. We had a very toxic environment here. It was not working. We have seven or eight section chiefs leave because they could not work with Dr. Schlosser and Danielle Ocker."
James Schlosser and Danielle Ocker were removed from their positions by VA Secretary David Shulkin a day after The Boston Globe's report.
Kois said the problem was bad leadership, not the Globe's article.
"You had 12 dedicated professionals go to the federal agency to become whistleblowers and put their careers and our lives on the line," Kois said. "It wasn't because of a Boston Globe article one week earlier. For you to ignore that shows you're missing the whole picture."
Mayo-Smith responded to Kois.
"Well, let me reword it then, because you're absolutely...you know...you're raising another perspective, and that's, you know, many possible explanations. And certainly I respect your perspective on that."
The fact that Mayo-Smith was even speaking at this task force meeting bothers some of the whistleblowers.
In October, Mayo-Smith was removed as co-chair and as a member of the task force. Whistleblowers had been calling him complicit in the problems in Manchester, saying he didn't do enough to fix them.
In removing Mayo-Smith, officials in D.C. said, “it’s important to have the panel remain independent of his views." Yet Kois says it's bizarre that Mayo-Smith still offers presentations and weighs in while sitting behind the task force members.
"So I don't understand how they can say he's been removed from the task force. He's actually right in the fray," says Kois.
And that's how this small argument underscores a bigger rift between the whistleblowers and VA leadership. The VA announced that Mayo-Smith wouldn't have influence on the task force, but whistle blowers say he still does.
Mayo-Smith says it's absolutely appropriate to continue participating as he has. In a statement, VA spokesman Curt Cashour says the task force is "made up of adults and respected professionals" who can decide what unsolicited comments they can use or disregard.
Meanwhile, some whistleblowers have told NHPR that things aren't getting better at the VA. For example, they say problems persist in geriatric medicine. And now some community care bills are not getting paid in a timely manner.
But Ed Kois says interim Manchester VA director Al Montoya deserves credit for, among other things, soothing an anxious workforce.
As for how new leadership at the Manchester VA would affect next year's employee satisfaction survey, Mayo-Smith is clear. "Hopefully in a positive way," he says. "That's our goal."
The task force now has until March to come up with recommendations on how to best deliver VA health care to New Hampshire's veterans.