In 2014, the Phoenix branch of the Department of Veterans Affairs became ground zero for the national health care rationing wait list scandal that rocked the federal agency. In response, both President Obama and the department’s bureaucrats pledged to implement reforms that would fix the problems that led to thousands of the nation’s veterans being denied timely medical treatment, where hundreds died waiting for appointments without ever receiving any care.

This summer, Steve Cooper, a 45 year old veteran seeking care for Stage 4 prostate cancer, secretly recorded his encounter with VA medical staff at a recently opened regional branch of the VA in the greater Phoenix metropolitan area. Local NBC affiliate PNNX 12 News provides a transcript for some of the more remarkable statements that came out in the recording.

The most notable moments throughout the 30 minutes of recorded conversations include the following:

– A nurse calls the patient phone scheduling system “a nightmare,” admitting that even as an employee she can’t get a person on the phone line.

– The doctor who saw Cooper admitted he’s “not a fan of the VA” and complained his patient load doesn’t allow him enough time with patients.

– The doctor said that, as a new employee, he is still trying to understand how the “Choice” program works.

– The doctor expressed a desire to check Cooper’s heart and lungs but said he misplaced his stethoscope. The doctor ended up not using a stethoscope at all, but nonetheless stated that “key exam findings” on Cooper were negative.

“I especially have a problem with it because earlier the nurse said my blood pressure was high,” Cooper said in an interview with 12 News. “And the excuse that a doctor says he can’t find his stethoscope just doesn’t work when you’re a doctor making six figures working for the Phoenix VA.”

Cooper says he believes the audio reflects ongoing issues at the Phoenix VA Healthcare System first identified two years ago.

“Post two-years since the crisis broke, the audio is valuable. It’s valuable to hear from the employees themselves that the system doesn’t work because of the infrastructure,” Cooper said during an interview with 12 News.

KPNX 12 News‘ report came out on August 23, 2016. In the report, Phoenix VA medical director Diana Amdur indicated that the agency would address the allegations and take appropriate actions.

Nine days later, while visiting the Phoenix branch of the VA, the Department of Veterans Affairs’ second highest ranking official, Sloan Gibson, agreed with the statements in the recording and described the VA’s patient scheduling system as a “nightmare”. KPNX 12 News reports:

“I don’t want anyone to think that we’re hanging up a ‘Mission Accomplished’ banner,” Gibson said. “We’re not. We’ve got a lot of work left to do but the simple fact of the matter is a vast amount has changed.”…

Regarding a 12 News report last week about secret audio recordings at a VA clinic, Gibson said he agreed with a nurse who said the patient scheduling system was “a nightmare.”

Gibson vowed that a “contact center” will be established at every VA medical center nationwide by the end of the year to handle issues such as scheduling.

“I’ve directed today the executive in charge of that program to come here on the ground, for him to do an assessment,” Gibson said. “To figure out what resources do we need to bring to bare so when a veteran calls somebody answers the phone and provides the help they need.”

Gibson has been one of the VA’s few bright spots in the bureaucracy’s response to its systemic problems. He will also soon be in a position to more directly influence the lack of effective implementation of reforms uncovered at the Phoenix branch of the VA through a change in its leadership, since VA medical director Diana Amdur announced several days earlier that she will be stepping down from her position for health reasons after being on the job for just nine months.

Gibson attributed the high stress of the job as being a contributing factor to Amdur’s health condition.

Meanwhile, President Obama is rejecting a recommendation of the independent Commission on Care to reform the governance structure of the VA’s hospital network. The Washington Free Beacon reports:

President Obama is disputing a recommendation to change the governance structure of the Department of Veterans Affairs network of hospitals, saying it would undermine the authority of bureaucrats overseeing the agency-run facilities.

The proposal was one of several included in the final report of the Commission on Care, an independent panel established by Congress to examine the VA’s hospital network after veterans were found to have died waiting for care as agency employees kept secret lists to conceal long appointment waits in 2014….

In its final report, which outlined a plan for “far-reaching organizational transformation” at the VA, the commission cited “weak governance” as one of the root causes of the Phoenix VA wait list scandal uncovered more than two years ago. As a solution, the panel recommended that Congress provide for the formation of an 11-member board of directors, accountable to the president, that would be “responsible for overall VHA Care System governance” and would have “decision-making authority to direct the transformation process and set long-term strategy.” The board would also not be subject to the Federal Advisory Committee Act, under the commission’s recommendations.

“The governance limitations made evident in the Phoenix scandal have profound implications for the long term,” the commission’s report stated. “The Commission believes [the Veterans Health Administration] must institute a far-reaching transformation of both its care delivery system and the management processes supporting it.”

It’s hard to see how any of that can happen without substantial reform of the VA’s bureaucracy and management structure.