Distrust at Togus

Of course officials of Togus medical center can tell veterans as they did this week that 9 percent of staff positions can be cut without changing the level of services there: Plenty of veterans aren’t receiving the services they need now and they won’t in the future. No change, but an unacceptable situation.

Just about all medical centers nationwide are experiencing the crunch between limited budgets and the rising costs of health care. Mostly, people understand that hospitals are in a difficult situation and trust that hospital administrators are acting appropriately. Not so at Togus, where a lack of faith in the officials there is the most widespread and pernicious disease the medical center encounters. It is only made worse by the announcement this week that 77 positions — 25 of them in direct medical services — would disappear but that efficiencies would eliminate any loss of quality.

Veterans can be excused for not quite believing that. Not only are too many vets on waiting lists for both basic and specialized care, but the information the VA has handed out over the last few years is confusing, often contradictory and anything but reassuring. Just last August, Togus received an additional $5.5 million to ensure adequate services, with Dr. Thomas Garthwaite, the VA’s undersecretary of health, promising that, No mission changes are being considered. Earlier this year, a long-awaited report by the VA inspector general concluded that Togus needed to give greater attention to hiring permanent and temporary staff. How does eliminating positions meet that requirement or maintain the mission?

Most frustrating in this latest announcement was the manner in which it was presented. Togus administrators may have worked hard on this plan and it may even be a reasonable response given the budget restrictions, but veterans groups were not brought in on these discussions and the plan was simply offered as a done deal — which, without the VA’s approval, it certainly is not. The fact that an acting director of the VA for New England announced it didn’t help either. He will soon by gone from his temporary position, the new person will claim no responsibility for the cuts and veterans will once again get stuck with inadequate services.

The acting director, Dr. Fred Malphurs, may have unintentionally made matters worse by emphasizing the region’s relatively high health care costs, brought on by the fact that its veterans are, on average, the oldest in the country. He said that issue needs to be addressed. How? New England has older veterans because the region is older generally than the rest of the nation. The simple fact is that older people need more services, the nation committed itself to providing those services and now it must do so.

Veterans who have been following the changes in health care at every level understand that the old system is gone and is not coming back. What they do not know is where their health care system will end up. They are properly angry beciase they have been left out of the long-term plan is for delivering these vital services. Instead, they get one jolt after another of budget shortfalls, interim plans and cutbacks. They deserve better. They deserve the health care they were promised.