Monday, April 23, 2012. Chaos and violence continue, Nouri gets tight(er) with Tehran, Nouri continues to have problems/make problems with Turkey, Barzani calls for caution on the F-16 deal with the US, Senator Patty Murray gets documentation that the VA wait times are as feared (and will address the topic in a Wednesday hearing), and more.
Starting in the US, the Senate Veterans Affairs Committee will hold a hearing Wednesday on "VA Mental Health Care: Evaulating Access and Accessing Care" starting at 9:30 am EST in the Senate Dirksen Office Building, Room 138. Senator Patty Murray is the Chair of the Senate Veterans Affairs Committee. Her office issued the following today:
FOR IMMEDIATE RELEASE
Monday, April 23, 2012
Contact: Murray Press Office
(202) 224 - 2834
Murray Statement on IG Report Showing Major Delays in VA Mental Health Care
(Washington, D.C.) -- Today, U.S. Senator Patty Murray, Chairman of the Senate Veterans' Affairs Committee, released the following statement after the Department of Veterans Affairs Inspector General released a report that she had requested on the time it takes the VA to complete mental health care appointments for our nation's veterans. The report concludes, as Sen. Murray has repeatedly warned, that the wait times faced by many veterans far exceeded that which the VA has previously reported and the time the VA mandates. Murray will hold a hearing on Wednesday, April 25th to seek answers to these problems. The VA Inspector General will testify at that hearing.
"This report confirms what we have long been hearing, that our veterans are waiting far too long to get the mental health care they so desperately need. It is deeply disturbing and demands actions from the VA. The report shows the huge gulf between the time VA says it takes to get veterans mental health care and the reality of how long it actually takes veterans to get seen at facilities across the country.
"Getting our veterans timely mental health care can quite frankly often be the difference between life and death. It's the critical period, not unlike the 'golden hour' immediately after a traumatic physical injury. Yet this report clearly shows that the VA is failing to meet their own mandates for timeliness. Clearly the VA scheduling system needs a major overhaul. The VA also needs to get serious about hiring new mental health professionals in every corner of the country.
"What's particularly disappointing is that this report shows that the VA is failing many of those who have been brave enough to seek care. It is hard enough to get veterans into the VA system to receive mental health care. Once a veteran takes the step to reach out for help we need to knock down every potential barrier to care. Providing timely mental health care is a cost of the decade-long wars our veterans have fought and it is a cost that Congress and the American people are willing to meet."
A number of e-mails came in wanting the Petzel VA issue included in today's snapshot. If there's room, it'll be at the end in full, if there's not room, it'll be edited. I'll try to keep in the points that veterans and veterans' family members e-mailed saying they wanted included in the snapshot.
BAGHDAD, 23 April 2012 -- UNICEF condemns an attack that took place yesterday on a secondary school that killed two children and injured one near the northern Iraqi city of Tikrit.
"UNICEF condemns this attack in the strongest terms" said Maria Calivis, UNICEF Regional Director for the Middle East and North Africa. "The killing of children is unacceptable. Attacks on schools, which are meant to provide a safe learning environment, is a grave violation of children's rights."
According to several reports, five armed men stormed into the school, two are said to have entered a 4th grade class and opened fire on the students, killing 16-year-old and 17-year-old boys and injuring a third aged 16.
UNICEF calls on the Government of Iraq to take the necessary measures to bring to justice those responsible for this attack and take swift action to ensure that measures are put in place to guarantee the safe access to schools to all children in Iraq.
The violence never ends in Iraq. Alsumaria notes an attack to the northeast of Baquba in which unknown assailants shot two police officers leaving them injured and they note that 2 intelligence service officers were shot dead (pistols had silencers), a Salah al-Din roadside bombing left a police major and a police captain injured and a roadside bombing west of Samarra left 1 person dead.
Meanwhile how bad are things between Iraq and the US currently? So bad that the White House is really trying to spin. In other words, the administration finally gets that portraying Iraq and Iran as close friends doesn't work for the Barack Obama re-election campaign.
In desperate need of an answer to "What the hell is going on?" -- a question, please note, not asked by the timid press, but by those concerned with national security -- the White House tried to turn a minor meeting into an event. First, they issued a press release noting that a low-level Iraqi deputy (Huassain al-Shahristani) had met with Daniel Poneman (US Deputy Secretary of Energy) and Carlos Pascual (Special Envoy and Cooridinator for International Energy Affairs). Some will wrongly tell you that he's the former Minister of Energy. No, he wasn't. To have that post, he would have to be confirmed by the Parliament. He was never confirmed for that post. he did previously serve as the Minister of Oil. He was nominated for that post by Nouri and the Parliament voted him into that post. From Minister to one of many deupties, that's a demotion. And that demotion took place despite the fact that al-Shahristani has been loyal to Nouri and is a member of Nouri's political slate State of Law.
The US bragged about spending (since 2003) $6.7 billion to help Iraqi energy production ("$4.6 billion to the power sector and $2.1 billion to the oil sector"). They then sent all three officials out for a photo-op and press briefing. Again, the whole thing took place, this sudden 'event' because of the fact that the White House is facing tough questions from national security types and they have no answers.
Let's go to the weekend and then come back. Over the weekend, Nouri went to Iran to dialogue with officials in Tehran. That included the country's President Mahmoud Ahmadinejad. The Iran Independent News Agency notes, "Iraq no longer needs any help from the United States, Iranian President Mahmoud Ahmadinejad told visiting Iraqi Prime Minister Nuri al-Maliki on Sunday as he offered to strengthen ties between the two neighbouring countries, which were once at war." Pakistan's The Nation adds:
Iraqi Prime Minister Nuri al-Maliki met Iranian President Mahmoud Ahmadinejad on Sunday at the start of a two-day visit to boost relations between their Muslim states. "If Tehran and Baghdad are strong, the region will have no place for the United States and the Zionist regime," Ahmadinejad said, quoted by state news agency IRNA, in reference to Tehran's arch-foe Israel. He said there was "no limit to the strengthening of political, economic and cultural ties" between them. Such moves would serve to "boost stability and security in the region," chimed in Maliki, who also held talks with parliament speaker Ali Larijani.Maliki was also to see Iran's chief nuclear negotiator Saeed Jalili.
Dar Addustour notes the public remarks Ahmadinejad made with Nouri by his side about how the region was no place for enemies of freedom like the US and Israel. TheTehran Times has Ahmadinejad calling the US and Israel enemies of the free world. (It's "Zionist regime," but he's referring to Israel.) RTT News observes, "Observers believe Iranian leaders intend to enhance their influence in Iraq after the pullout of U.S. troops by strengthening ties with Prime Minister Maliki who, like a majority of Iranians, is also a Shia Muslim."
Generally speaking, the US government doesn't reward that sort of behavior. Call it petty or pin it on vanity, but US leaders don't usually reward (or ignore) that sort of public display. Now the official reason from the administration is "Iraq's going to help us with Iran on the nuclear thing!" That's nonsense. Iran's no where near building a nuclear weapon. That's the talk of serial fabulists, But to briefly inhabit the world so many in the administration do, let's pretend that they are on the verge. There's nothing Iran's going to do that it doesn't want to do. That's true today, that will be true when May 23rd rolls around as well. I spoke today to two who gave Barack's 2008 campaign the 'gravitas' it so sorely needed. They'd discussed this with the White House, Nouri's shoulder-to-shoulder as the US is verbally attacked. They explained that the White House's actions are seen as pushing Iraq into the arms of Iran. They explained how vulnerable Barack still is on foreign policy issues.
Because of those conversations (and there were others raising the issue with the administration today), a minor non-meeting was pimped as an event. It wasn't an event, it wasn't significant. It took place today. Friday, did the US State Dept's press briefing note the scheduled meeting? Nope. In fact, Iraq wasn't even mentioned on Friday.
The State Dept has a regular press briefing today. Did Victoria Nuland raise the meeting in the press briefing? Nope. We'll note the Iraq section -- reporters did ask about Iraq -- later in the snapshot but this meeting was noted or brought up. Because it was a minor, do-nothing meeting. It got inflated and pimped because repeat complaints to various members of the administration today made clear to them that they have an image problem that could hurt the 2012 election. Please note, they're convinced that getting Nouri to meet with Iran for the nuclear talks is a great thing for knowledge. But the complaints made them see there was political fallout so this minor meet-up was promoted as an event to try to say, "We're still close!"
Marina Ottaway: Finally -- and this is the last comment that I want to make in terms of agency -- you also have to look at the neighboring countries. And here I -- and here I truly disagree with the previous speaker. I think the situation in the region is going to make the -- is going to aggravate the internal problem that Iraq is facing -- because, like it or not, the regional -- the politics of the region is moving in the direction of sectarian -- of sectarian conflict. The -- talk about the -- you know, the Iran, Iraq, Syria -- one should say, Hizbollah, more than Lebanon -- sort of arc, if you want; the Shia crescent of which King Abdullah of Jordan spoke at one points -- which is coming back with a vengeance. And I would argue that the polices of most countries -- of neighboring countries towards Iraq are colored, and are determined essentially, by this -- by the sectarian perspective. The Gulf countries have resisted embracing the new government in -- essentially embracing Iraq, because they are perceiving Iraq as being a pawn of Iran. Whether or not it is true, they are certainly contributing to pushing -- to pushing Iraq in the arms of Iran. But there is no doubt that the policies of the Gulf countries towards Iran -- excuse me, towards Iraq -- are driven by this perception of what is the relationship between Iran and Iraq.
That's Carnegie Endowment For International Peace's Marina Ottaway speaking at The State Of Iraq conference last February. If she's correct (and she quite often is), the weekend love-fest really didn't help Iraq draw closer to all their other neighbors.
And it's not like Iraq doesn't have problems with its other neighbors. UPI notes, "Iraqi officials announced Monday they summoned Turkey's ambassador in Baghdad in reaction to disparaging remarks made last week by the Turkish prime minister." What's going on?
Friday, Nouri al-Maliki abandoned his brief 13 day attempt to be nice. He lashed out declaring Turkey to be an "enemy state" of Iraq. Saturday Ayla Jean Yacklery (Reuters) reported, "Turkish Prime Minister Tayyip Erdogan on Saturday regjected charges he sought to inflame sectarian divisions in Iraq with recent criticism of its government and accused his Iraqi counterpart of trying to gain 'prestige' in an escalating war of words between the neighbours." Al Jazeera added:
"We don't differentiate between Sunnis or Shias. Arab, Kurd or Turkmen, they are all our brothers," Erdogan told reporters in comments reported by the NTV news channel. "If we respond to Mr. Maliki, we give him the opportunity to show off there. There is no need to allow him to gain prestige." Turkey, which is majority Sunni, has been seen as a key ally and even a role model for Iraq, because of its secular constitution and close relations with the West, including membership in NATO. Iraq is Turkey's second largest trading partner after Germany, with trade reaching $12 billion last year, more than half of which was with the semi-autonomous Kurdistan region.
With everything else Iraq is facing, you'd think Nouri al-Maliki would have the brains not to also antagonize one of its neighbors.
QUESTION: Toria, just a quick follow-up to this, but Maliki had really harsh words for Turkey. And now both of them are your allies, you have invested a great deal in Iraq. I mean, they're -- he's pushing the envelopes. You don't have any comment on that?
MS. NULAND: We have, for almost a decade now, encouraged increased dialogue, increased direct contacts between Iraq and Turkey. There are mechanisms for them to work through their issues together which we have endeavored to facilitate, and we encourage them to continue to use them to work through the issues that they have.
Middle East observers are expressing concern that the row between the two neighbors is a sign of growing Sunni-Shiite tension in the region, as predominantly Sunni Turkey lines up against Maliki, Iran and Bashar al-Assad's violent suppression of Syria's mainly Sunni population.
Mehmet Seyfettin Erol, head of Ankara's International Strategic and Security Research Center (USGAM), says that Maliki's recent comments must be viewed in the context of his government's alliance with the Shiite regime in Iran. Maliki, who is currently on an official visit to Tehran, "is paying lip-service to Iran, which is trying to implement Shiite political dominance in the region," Erol told Turkish daily Today's Zaman. In response, he said, Turkey is being forced to protect Sunni rights in the region.
Let's go back to Carnegie Endowment For International Peace's Marina Ottaway speaking at The State Of Iraq conference last February.
Marina Ottaway: In Iraq today, I think it's becoming more and more appropriate to speak not of the Iraqi government, or even of a Shia-dominated government, or even a Dawa-dominated government -- but rather of a Maliki regime. This is the newly dominant force in Iraqi politics; these are the Malikists. They're an analog to the Saddamists in many way -- or the Saddamiyoon, as Iraqis knew them. And so I'd like to coin the term today, the "Malikiyoon." I think this is something that Iraqis will recongize. And these are the officials and the operators who have enabled Prime Minister Maliki to consolidate control of state power and gradually marginalize the other political blocs as they've done it -- while neutralizing, one by one, the checks and balances that the Iraqi constitution was meant to contain on just such a consolidation of power. So I'd like to talk a little bit -- to dig down a little bit and talk some about where we can find the "Malikiyoon," who they are, how they behave and what policies they'll follow, and what that will mean for Iraq and the rest of us, my best guess. So, first in aquiring power in Iraq, the "Malikiyoon" have focused on the security and intelligence apparatus, the coercive arms of the state. And this is where you can most easily find them. You can find them at the top of the ministry of defense, at the top of the ministry of the interior, at the top of the intelligence services. You will find them in control of the Iraqi special operations forces and in the police commandos. And any forces that can -- that, really, they have coalesced into a new sort of coup-proofing set of forces -- almost a new Special Repbulican Guard. Now, next, who are they individually? Well, individually they are not really the Dawa party. This is not really the Dawa party. They are at the center. They're Maliki's family, including his son and son-in-law most significantly. They're his personal advisers, both official and unofficial -- so those that are in the prime minister's office and those that are -- that are in Maliki's house, you know, in the diwan late at night making decisions.
Aswat al-Iraq reports, "Kurdish region president Masoud Barzani returned yesterday night to Arbil province at the end of his external visit to Bulgaria, USA, Hungary and Turkey, sources said here. Barzani discussed with the Turkish president Abdulla Gul the relations between Kurdistan and Turkey, as well as the situation in Iraq and Syria."
The visit was a success for Barzani. It became an embarrassment for Nouri al-Maliki who first attacked Barzani early last week and cattily insisted that Barzani had Kurds who 'speak ill of him.' Alsumaria reports that Barzani has declared he could meet with Nouri to dicuss the political crisis 100 times and it would change nothing. In addition, he states that the Kurdistan Region is in danger and that he is going to begin talks immediately with Kurdish parties and Iraq President Jalal Talabani on the topic of independence. Rudaw speaks with Barzani and reports:
"I have met with Maliki many times. I don't have any personal problems with him. I have respect for him. But my experience with Maliki is that even if I met him 100 more times, it wouldn't bear any fruit because he has not implemented any of his promises," said Barzani in response to a question by Rudaw.
"Nothing but dictatorship threatens the territorial integrity of Iraq,"" warned Barzani, speaking to journalists in his office in Salahaddin, a resort town northeast of Erbil.
Relations between the Kurdistan Regional Government (KRG) and Baghdad authorities have been tense recently over a range of issues, especially the unsettled oil and gas disputes.
"If all the people of Iraq are happy with this situation, they can do as they please. If the people of Kurdistan and all Kurdistani parties are content with the current situation and don't see any threat, I have no personal problems. But I must clear my conscience with my people," Barzani said about his recent strong remarks against Baghdad authorities, especially PM Maliki.
QUESTION: About the -- just a follow-up about an oil agreement made by Exxon-Mobil and KRG. Since it's an American company, the Exxon-Mobil, this agreement is excluding Baghdad Government's role in the use of oil in KRG region. Do you have any comment? How do you see this agreement? Is it threatening to unity of Iraq, or how do you see Exxon-Mobil and KRG oil agreement?
MS. NULAND: We've talked about this issue many times. Our position on it has not changed, that we think the lack of a comprehensive oil agreement is holding Iraq back, that we've called on all sides to continue to work through what is necessary to come up with a national oil policy. And we also regularly counsel our companies, including Exxon, about the fact that there isn't such an agreement. So I think we'll have a little bit more to say on the issues of Iraq and energy later today. We're going to have -- we have the U.S.-Iraqi energy dialogue going on, and we'll have some folks briefing later this afternoon on those things.
Thursday the International Crisis Group noted that Iraq still had no oil & gas law and the need for one in a typical ICG report -- meaning one-sided with lots of bowing and scraping to Nouri (that's a nasty habit of ICG's). From the Executive Summary of "Iraq and the Kurds: The High-States Hydrocarbons Gambit:"
But the Kurds face a problem. While they pursue an independent oil policy and have taken important steps toward that end by drafting their own oil law in 2007 and signing over 40 contracts with foreign oil companies without Baghdad's input or approval, they lack the means to export their oil without Baghdad's help and therefore its permission. To date, the federal government has used its control over the national pipeline network, as well as its hold on the treasury and budget, to rein in the Kurds' ambitions.
Hemmed in by Baghdad and anxious to become economically self-sufficient, Erbil is turning its eyes to another potential outlet for its oil: Turkey. Masoud Barzani, the Kurdish region's president, reportedly told foreign visitors to his mountain redoubt that if Maliki remains in power beyond the 2014 parliamentary elections, the Kurds would go their own way. Not coincidentally, 2014 is when the Kurdish region expects to complete construction of its own strategic oil pipeline, one that skirts (federal government) Iraqi territory before reaching the border with Turkey. For Kurdish leaders, economic dependency on a democratic neighbour with an attractive window on the West is far preferable to a continued chokehold by a regime displaying authoritarian tendencies -- all of which raises the question of what Ankara would do if the Kurds ask it to take their oil without Baghdad's approval.
For the record, Nouri's making no moves on resolving the disputed territories. Article 140 of the Iraqi Constitution calls for him too but he ignored that call in his first term as prime minister. I would assume the Kurds are being advised to take action and, more importantly, advised that if they do not, with the issue being unresolved and no action on the Kurds part, there is a strong possibility that an outside body would award the region to the central-government based in Baghdad. Legally that could happen. I would assume the Kurds are familiar with this -- I know they're familiar with the repeated calls over the year for an international body to step in and resolve the issue -- and that this is what's prompting them to act. But the ICG always sides with whom they see to hold power and they're not usually very skilled in the law.
Today, AFP reported that Barzani has also stated that he opposes the US sale of F-16 fighter planes to Nouri and that, "The F-16 must not reach the hand of this man. We must either prevent him from having these weapons, or if he has them, he should not stay in his position." The value of the F-16s on the world stage includes the fact that the US and its allies are the ones who know how they work. Nouri's close relationship with Tehran should be seriously factored in before the sale moves forward. If Nouri has F-16s, it's a pretty good conclusion that Tehran then has all knowledge of F-16s. The issue of Barzani and the F-16s was the first of three issues the press raised at today's US State Dept press briefing.
QUESTION: On Iraq, KRG President Maliki criticized an arms sales which will be made by U.S. to Baghdad Government -- about the F-16 sales. And he said to freeze the sales until there will be a solution between KRG and Baghdad Government because he's suspicious that the Maliki government can use this F-16 against KRG. Do you have any comment on that?
MS. NULAND: I'm sorry. Who made these initial comments?
QUESTION: President Barzani.
MS. NULAND: Yeah.
QUESTION: KRG president.
MS. NULAND: I'm not going to get into the middle of intramural efforts between the various Iraqis. I think you know where we are on this, that we want to see the disagreements that they have with each other also settled through dialogue and through a big roundtable process that they've all pledged to join but that still needs to get off the ground.
QUESTION: Is that F-16 sales will go on?
MS. NULAND: I don't think there's any change in our policy.
Intramural? Well that's about how serious the State Dept takes the issue.
Last week, Gretchen Gavett (PBS' Frontline) discovered the issue of the VA's decision to employ an additional 1,900 workers for mental health and she cited the Undersecretary of Health Robert Petzel. She didn't know, apparently, that the House and Senate Veterans Affairs Committees had repeatedly urged and suggested more workers and were repeatedly told that there were enough -- this took place over and over in open hearings. Nor did she grasp, apparently, that Petzel wasn't suddenly doing something because he'd realized there was a shortage, he was doing it as a result of the actions of Senator Patty Murray who chairs the Senate Veterans Affairs Committee. As her office noted last week in a press release:
Today, U.S. Senator Patty Murray, Chairman of the Senate Veterans' Affairs Committee, made the following statement after the VA announced that it would be moving to hire 1,600 mental health care professionals. The announcement comes just days before the findings of a major VA Inspector General report that Senator Murray requested on long wait times for VA mental health care are expected to be announced. VA's action is welcome news to Senator Murray who has held multiple hearings over the past year on overcoming barriers to VA mental health care. Murray will hold a third hearing on this subject in order to hear the Inspector General's findings on Wednesday, April 25th.
Robert Petzel isn't someone worth citing -- as a number of members of the US Congress have learned. I count 18 members who have strongly called him out in public hearings since 2009.
He's been called out for his management or 'management' and he's been called out for his testimony. The House Veterans Affairs Committee held a hearing May 3, 2011 about the VA infecting veterans who came in to be treated. This was a very serious issue. We're noting this exchange between Petzel and Ranking Member Bob Filner and we're noting it in full because it was a serious issue -- veterans going to a VA facility for care were at risk of illness or disease (including AIDS).
Ranking Member Bob Filner: Dr. Petzel, you're here as the representative of the VA. We've gone through this before, sir. It seems to me your job here should have been -- and we have Congress people from all the districts that have been effected -- was to begin to restore some trust and confidence in your institution. I'd hate to take a poll. If I did, and I said, "How many people now have confidence everything is fine in your VA hospital?," I doubt if anyone would raise their hand. You said everything is fine. It's not true. Simply not true. You talk about all of these transparent procedures and these-these Journal -- New England Journal best practices, and yet every time something happens, we have disaster. We don't have a way of communicating. We don't have a way of dealing with the personal concerns. We don't have any knowledge that anybody's been reprimanded. Now you've got three. We've been going over this for years and now we've got three. And we still -- You have never told this committee those figures before as far as I know. But, Dr. Petzel, we've gone through this before. We've raised concerns in our opening statements. You read your opening statement as if we never said anything. So you never addressed issues of accountability, you never addressed issues of communication -- whether within your agency or with veterans or with this Committee. I-I-I-I've gone through the time lines with almost every one of these [Congress] members here and their hospitals. You say panels get together to decide "should we disclose, what should we disclose, who should we --?" It looks to many of us like they get together to decide "What do we keep secret from our" -- You know, you keep shaking your head "no." But why did it take 8 weeks at St. Louis -- where Mr. Carnahan will raise the issues -- why did it take 8 weeks for that panel to decide, we're going to tell people that we have almost 2,000 people infected -- possibly infected with HIV? It took two months before you guys decided that. I would have -- And the Secretary [of the VA, Eric Shinseki] wasn't notified, as far as I know, in his words to me, in that whole period of time. So it sounds like you're sitting there deciding, "What's the minimal amount of information that we can give out so people don't get upset with us?" Rather than the maximum. I would have -- that first day -- I would have had the Secretary had a press conference that said, you know, "We have a possibility of X-hundred or thousands of people, we're going to get to you right away, we want to make sure this is happening." And put pressure on yourselves to become public. Because there's no pressure for you to do anything. We didn't know anything. The Secretary didn't know anything. I don't know if you knew anything. Because these guys are going, "How do we keep this secret for as long as possible? Maybe we don't have to disclose at all?" Because your question was: "Should we disclose?" Not how to do it. And then, as I said, your whole disclosure process is as if everybody knows all your acronyms and your-your initials for everything, all these SPDs and RMEs, as if the patients know what's going on. They get a letter. I've seen these letters. It says basically -- it's not this bald, but almost -- "You may have HIV." They get a letter. It may have even gone to a wrong address. For 1500 people, as I said to you earlier at a hearing, you should have had 1500 of your 250,000 employees, assigned each one to somebody, call them, call them, go visit them, find out where can they come back, when can they get their blood tests, treat them as if they may have HIV. And they're scared to death they're going to die and you send them a letter. And there's no one there necessarily to answer a phone call when they call back cause you don't have people working this like case managers and one person to five people. I think you should do one-on-one. But what you described as this open, transparent process does not come through. And everyone of these people [points to members of Congress] has constituents which I bet confirm what I just said. And even if it's perception and not reality, that, that's just as bad. That you took forever, you weren't very personal in your notification, you weren't very clear about what it is that they might have, you didn't follow up in a way that was very quick and then we don't know anything about accountability. We know nothing from basically what you said today. And you guys have got to develop a new system. Whether it's talk -- You know, we just killed Osama bin Laden and they notified 8 members of Congress and the Committee and they kept that. Well maybe you should notify all the Chair and Ranking Member of the Veterans Committees about what you're doing about your personnel. But there is no sense that you have done anything. And we don't know -- Nobody in Dayton, nobody in St. Louis, nobody in Miami, nobody in New Jersey, nobody in Tennessee knows anything about that accountability. And I doubt anybody in the system knows anything about it, so they don't think there's any accountability. So I wish you would address these issues. We've gone over them for several years. You and I have gone over these exact issues several times in hearings and you do the exact same thing. You give me a prepared statement. 'Everything's fine.' You move the discussion into these arcane things about SPDs and RMEs and you neglect the basic issues of communications and accountability that are at the heart of the confidence that our people have in your system. You may comment in any way you want.
Dr. Robert Petzel: Uh, thank you, Mr. Filner. The, uhm . . . What I want to do is, uh, first talk about our, uh, notification process. The, uh, the process by which we determine who ought to be notified or who might be at risk, as I said before, is an industry standard. I will stand by that process under any circumstance. It takes some time but it is transparent and it is weighted heavily in the favor of --
Ranking Member Bob Filner: Nobody knew about St. Louis for 8 weeks.
Dr. Robert Petzel: I'm --
Ranking Member Bob Filner: Eight weeks.
Robert Petzel: Sir.
Ranking Member Bob Filner: And I'm if that's industry standard, we shouldn't be following industry standard.
Dr. Robert Petzel: Sir, I'm not talking about the communication, I'm talking about the process that we go through. It is very thorough and it's weighted on the side of being abundantly cautious to be sure that we take into account every possible risk. The process by which we disclose to patients involves letters, phone calls and case managers. Particularly in the instance of St. Louis, every single individual that was effected was called, they were offered a case manager, there was a case manager that involved -- in fact, in some instances, the leadership of the medical center. I will admit that we've learned figuratively since --
Ranking Member Bob Filner: Sir, that conflicts exactly with what you said to me at St. Louis. The Chairman was there, Mr. Carnahan was there, Mr. Lacy -- Clay [US House Rep William Lacy Clay] was there, sorry, sir. Mr. [John] Shimkus was there. You never mentioned the word case manager, you never mentioned mentioned that they were called. Is that right, Russ? [Carnahan nods his head in agreement.] We-we went through this discussion with you. The first word I said to you was case manager. I said to you, "Why don't you have case managers?" You said, "Yeah, we'll look at that." We're both going to review your testimony in St. Louis because it's contrary to what you just said now.
US House Rep Phil Roe is also (medical) Doctor Roe. This is part of what he had to say in that hearing:
US House Rep Phil Roe: One of the things that we have to sell in medicine is trust. Our patients need to trust us. They need to trust the VA that that's where the quality of care and transparency, Mr. Filner is absolutely 100% correct. I can assure you that when I had a problem go wrong in my shop when I practiced medicine, not the clerk that answered the phone made the call to the patient, I made the call to the patient. I called them up. I explained to them. I had them come in and tell them what was going on. And I can tell you, with 1500 people, that could have been in a large institution with multiple people, I would have had the highest level people contacting someone when they think they have HIV or a potential life threatening condition.
And the numbers aren't really going down. At some point, department heads are going to need to tie in accountability. They're going to need to set goals and they're going to need to fire those -- at the top the deputies -- who cannot meet those goals because the American people are sick of this across the board. In fact, if Barack Obama or anyone else wanted a winning talking point, that's what they could propose. It would probably work better for a Mitt Romney, Jill Stein or Ron Paul or anyone else who hasn't been president for the last four years, but it would work for Barack as well.