As The Secretary Was Out We Wait

As The Secretary Was Out We Wait

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Published August 26, 2014 at 4:00 PM CDT

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For more on the VA Inspector General's report and the department's response, I am joined now by the Deputy Secretary of Veterans Affairs, Sloan Gibson. Welcome to the program.
SLOAN GIBSON: Melissa, thank you very much. It's good to be here.
BLOCK: Let's start with that conclusion. The reports says it cannot conclusively prove that the absence of timely quality care caused the deaths of these veterans. But even so, it's quite clear that a wait time of seven - eight months for an appointment presented health and safety risks for these patients. Do you acknowledge that the conclusion here is that this shows a widespread failure of care within the VA?
GIBSON: Absolutely, yes. I would say on the one hand I'm relieved that they did not conclude that the delays caused deaths, but they're still unexcusable - inexcusable. We owe our veterans there and around the country, and we owe the American people an apology.
BLOCK: Well, apart from an apology, I want to ask about what action might be taken...
BLOCK: ...Because this of course is not a new problem. The report today says there have been 20 reports on wait times and access to care within the VA since 2005. Here's a quote from the report - "VA has been resistant to change." So why should veterans expect anything to be different now?
GIBSON: Well, I think what veterans should be doing is watching our actions. What you have a new leaders inside the organization. What you've got is an environment of openness and transparency that's being created. We're pushing detailed wait time information out the door twice a month - detailed care quality and patient safety information out the door. So I think what we're trying to do is to - is to be very open and very transparent and demonstrate accountability, but at the end of the day we have to earn that trust back.
BLOCK: When you think about the - the existing system - part of the problem has been with these long wait times - that the VA has not enough doctors, especially in primary care. Under the new reform bill, there is now billions of dollars to spend on private care outside the VA system. Do you see that as a long-term fix, as opposed to bringing more doctors within the VA itself?
GIBSON: I think purchase care is design for extraordinary demand, extraordinary technology or extraordinary geography. But it's not intended to be replacement for a strong and vital and effective veterans healthcare system. In my testimony both to the Senate and to the House, I noted that I thought the greatest risk in the intermediate term was that funding would only be provided to provide more care -to deliver more care in the community and not to make up for the shortfall in clinicians you've mentioned, as well as in space. We - oftentimes when I'm out visiting medical centers, I find that spaces is one of the key constraints for access to care.
BLOCK: When you think about benchmarks for success - you've talked about earning back the trust of veterans - what metrics do you use for that? I mean, when you think about the original 14 day for appointments that led to this whole system of lying about wait times to meet that goal - what's your new measure of success and how do you ensure it doesn't backfire?
GIBSON: Well, I think what we will - we will work towards - we are already building much more robust, continuous measures of patient satisfaction - veteran satisfaction. And I think that becomes the single most important set of metrics that we use to gauge our - our success by. It's - it's the success as viewed from the veteran's perspective.
BLOCK: Is there some benchmark for an appropriate wait time that you have in mind that would tell you we are - we are hitting our target here, we are - we are where we need to be?
GIBSON: Well, one of the things that I've learned - I'm now six months at the VA - one of the things I've learned is - is you won't find a large, integrated healthcare systems are using a single wait time metric as the basis for judging access to care, because there's no clinical relevance for a single wait time. For some veterans that need to be seen today - even the old 14-day standard failed miserably. And so basically that's why I think we get back to looking at - at veteran satisfaction and patient satisfaction. So that - so that we are asking the veteran - did we see you timely? Were you able to get that that appointment scheduled when you wanted to be seen? And so for the veteran that doesn't need to be seen - doesn't care about being seen in three or four weeks - that's fine. For the veteran that needs to be seen today, we see that veteran today.
BLOCK: Sloan Gibson is the Deputy Secretary of Veterans Affairs. Thanks for being with us.
GIBSON: Thank you very much, Melissa. Thanks for the opportunity. Transcript provided by NPR, Copyright NPR.

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ECW: Why is education a priority in emergencies and protracted crises?
António Guterres:  The COVID-19 pandemic has upended societies and created the largest-ever disruption of education systems, affecting more than 1.5 billion students. While remote solutions were rolled out, 1 in 3 children missed out on such opportunities, exposing and exacerbating inequalities and vulnerabilities, especially for those in crisis situations. In such circumstances, education protects girls and boys from sexual violence and exploitation, trafficking, early pregnancy and child marriage, forced recruitment into armed groups and child labour. It also ensures that they continue learning, offering them hope for the future. As we enter 2021, education must be at the core of pandemic response and recovery efforts. Without resolute political commitment by global leaders, as well as additional resources for Education Cannot Wait, and its UN and civil society partners, millions of girls and boys may never return to school. Investing in the education of these vulnerable children and youth is an investment in peace, prosperity and resilience for generations to come – and a priority for the United Nations.
ECW: Why is it important to facilitate more collaboration between humanitarian and development actors in crisis contexts?
António Guterres: With the intensification of conflicts, climate change-related disasters, forced displacement reaching record levels and crises lasting longer than ever, humanitarian needs keep outpacing the response despite the generosity of aid donors. Partnerships are crucial to transform the aid system, end silos and ensure that aid is more efficient and cost-effective. Whole-of-child education programmes offer a proven pathway for stakeholders to collaborate in enabling vulnerable children and youth to access quality education in safe learning environments so they can achieve their full potential.
ECW: What message would you like to share with crisis-affected girls and boys whose right to education is not yet being realized?
António Guterres:  Above all, I pay tribute to their resilience and I commit to working with governments, civil society and all partners to overcome both the pandemic and the crises that have been such profound setbacks in their lives. We must also step up our efforts to reimagine education – training teachers, bridging the digital divide and rethinking curricula to equip learners with the skills and knowledge to flourish in our rapidly changing world.
ECW: As a secondary student in Portugal, you won the ‘Prémio Nacional dos Liceus’ as the best student in the country. After completing your university studies in engineering, you started a career as a teacher. Can you tell us what education personally means to you?
António Guterres:  Long before I served at the United Nations or held public office, I was a teacher. In the slums of Lisbon, I saw that education is an engine for poverty eradication and a force for peace. Today, education is at the heart of the Sustainable Development Goals. We need education to reduce inequalities, achieve gender equality, protect our planet, fight hate speech and nurture global citizenship. Upholding our pledge to leave no one behind starts with education.
ECW: Following the turbulence of 2020, what is your message to the world as we enter 2021?
António Guterres:  2020 brought us tragedy and peril. 2021 must be the year to change gear and put the world on track. The pandemic has brought us to a pivotal moment. We can move from an annus horribilis to make 2021 an “annus possibilitatis” – a year of possibility and hope. We must make it happen — together.
Background on UN Secretary-General António Guterres
António Guterres, the ninth Secretary-General of the United Nations, took office on 1st January 2017.
Having witnessed the suffering of the most vulnerable people on earth, in refugee camps and in war zones, the Secretary-General is determined to make human dignity the core of his work, and to serve as a peace broker, a bridge-builder and a promoter of reform and innovation.
Prior to his appointment as Secretary-General, Mr. Guterres served as United Nations High Commissioner for Refugees from June 2005 to December 2015, heading one of the world’s foremost humanitarian organizations during some of the most serious displacement crises in decades. The conflicts in Syria and Iraq, and the crises in South Sudan, the Central African Republic and Yemen, led to a huge rise in UNHCR’s activities as the number of people displaced by conflict and persecution rose from 38 million in 2005 to over 60 million in 2015.
Before joining UNHCR, Mr. Guterres spent more than 20 years in government and public service. He served as prime minister of Portugal from 1995 to 2002, during which time he was heavily involved in the international effort to resolve the crisis in East Timor.
As president of the European Council in early 2000, he led the adoption of the Lisbon Agenda for growth and jobs, and co-chaired the first European Union-Africa summit. He was a member of the Portuguese Council of State from 1991 to 2002. Learn more about Mr. Guterres .

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United Nations Secretary General António Guterres appointed Martin Griffiths of the United Kingdom as Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator in May 2021.

Mr. Griffiths brings extensive experience in humanitarian affairs. Since 2018 he served as the Secretary-General’s Special Envoy for Yemen. Between 2014 and 2018, he served as the first Executive Director of the European Institute of Peace. Between 2012 and 2014, he served as an adviser to all three Special Envoys of the Secretary-General for Syria, and Deputy Head of the United Nations Supervision Mission in Syria (UNSMIS). From 1999 to 2010, Mr. Griffiths was the founding Director of the Centre for Humanitarian Dialogue in Geneva.
He also worked in the British diplomatic service and for various international humanitarian organizations, including UNICEF, Save the Children and Action Aid. In 1994 he became the Director of the Department of Humanitarian Affairs in Geneva and, from 1998 to 1999, served as Deputy to the United Nations Emergency Relief Coordinator in New York. He has also served as United Nations Regional Humanitarian Coordinator for the Great Lakes and in the Balkans.
Mr. Griffiths holds a master’s degree in Southeast Asian studies from the School of Oriental and African Studies at the University of London and is a qualified barrister.
ECW: The United Nations Office for the Coordination of Humanitarian Affairs ( OCHA ) has been a trusted partner since ECW’s establishment in 2016. As we look forward to ECW’s High-Level Financing Conference in February 2023 through the #222MillionDreams campaign, how can we best engage partners across the humanitarian-development-peace nexus and enhance coordinated actions?
Martin Griffiths: I am hard-pressed to think of anything more important than ensuring the education of our children. It is fundamental for the progre
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As The Secretary Was Out We Wait

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