questions as most of you know congressman bill young and his wife beverly and i visit the military hospitals almost every week in fact just two weeks ago i've traveled to brook army hospital in san antonio navy's balboa hospital in san diego and also to wilford hall which is the air force hospital in texas each each time i go to the military hospitals i ask what do you need what can we do for you and do you have any shortfalls and i'm sure bill asked the same questions when he goes i talk to the troops and our families i encourage all the doctors and nurses to make sure that the soldiers hospitals for as long as they need to be in order to get the physical and mental care that they need often all find problems and need be addressed at landstuhl in germany i found the hospital had no air conditioning recently have there's a field hospital in baghdad hospital needed stretchers and you'll find a missile metal money for the modern stretchers that they need in order to help the troops move the people around in the hospitals themselves i also recently learned of the need to provide care for the caregivers i always ask do we do the caregivers do in our right it bothers me when i go to the hospital i mean it gets to me and one guy said i get drunk every night well he was kidding but the point was it's stressful for them and so stress management other types of care needed by the doctor's nurse who deal with desk disfigurement on a daily basis and again i'm proposing that the supplemental include work my impression is that the military was constrained even intimidated from telling me and other congressional members about the real problems and the real needs and i have to wonder is the administration policy not to inform congress and this is not a simple matter when i when i see the casualty figures when i see all the casualties and the t v and all the public sees that and i say to myself how is it possible that we didn't pay more attention to this this issue the scandal at west point is not just about leadership or money or about the chain of command it's about individual lives lives that have been forever changed by war and families who must deal with the consequences of caring for the handicapped or terribly injured soldiers and communities must bear the financial and social burdens walter who read a hospital should be the crown jewel of our family medical military system yet doctors have told me that memorial hospital which is about the same size start of about the same time just around one thousand nine hundred is actually more modern and well equipped as well equipped as walter reed and despite the fact that congress under the leadership of bill young has provided hundreds of millions of dollars to support all reach program that's the doctors tell me that even worse we have outpatient at walter reed living into squalor and both of you know that's unacceptable this in large part i believe this is a failure at walter reed the failure at walter reed is yet another reflection of the thing this characterized this war in iraq from its very beginning that the failure by this administration to plan for the occupation and on asli addressed the real cost of the war the administration insisted on closing walter reed at a time of war there was no consideration that casually would increase the man's on a medical system would grow because as a sector rumsfeld testify we would virtually be out of iraq in six months from the start of the war i testified the base closure commission against a proposal to close walter i voted against it and i stand by that testimony today the consequence of failing to address the needs at walter reed are no different than the shortages of body armor  summer of two thousand and three i found the shortage of trained personnel guarding a blue grab that resulted in the who are we on covered there the shortage personnel and equipment that is be deviled our ground forces here at home causing them we have a low state o vietnam the shortage of oversight that has led to billions of reconstruction dollars have been squandered in iraq i can't even find out from g a o and from from the the specter general rock how many people we that are contractors in iraq they ask us to help them by don't know how many contractors the shortage of oversight that has led to billions or reconstruction dollars being squandered in iraq the shortage of funds for the war because the ministration refused ask for them all told the congress on the leadership the bill young as added one hundred forty five billion of funds for the war in iraq and afghanistan the administration did not request and we couldn't get a justification  good justification for the money these funds were provided for critical programs including medical programs at walter reed what's equally disturbing is even after the funds are provided red tape and department gets in the guardsmen young and i support an additional ten million for walter reed amputee center and it took three years to get to prove our program off the ground i went out to the intrepid a fifty eight million dollar privately funded building marvelous technology everything modern took i'm eighteen months to get it done and yet three years later we still don't have the amputee center finish that at walter reed we supported an increase of thirty million dollars to modernize walter reed and  i have in my notes are no accounting well i just got to the accounting for that to staff just gave me the accounting and it's all for equipment none for infrastructure at all and what i worry about is the brac and i've heard people say bragg made no difference i am absolutely convinced brac was part of the failure because we didn't want to put money into our walter reed didn't put money into the renovation the need to be done that was a mistake to close to say we're going to close because and we knew it bill young jerry lewis and i knew that this would be a problem that's why every year we put money in i think it goes beyond general kiley i think it goes beyond i think it goes to dr chu dr chu is tried to arbitrarily cut medical funds and thinks that will keep the cost down that doesn't keep the cost down it also goes to the former secretary of defense who said we'll do with whatever we have in order to get by so not as a responsibility lie here it lies with the administration appointees who in my estimation made a lot of serious mistakes i have a note that i read today there's a five hundred billion dollars shortfall in infrastructure throughout the whole army i don't know if that's an accurate figure but it gives you an indication of the problems we're going to have down the road trying to get infrastructure straightened out  ask mr young if he has a stay mr chairman thank you very much and i do have a statement and i want to complet compliment you for holding this hearing and always been postponed several times because of being preempted by other committee hearings but when you were first chairman you were my chairman i recall that you began many very serious efforts to improve medical care and do additional medical research that through the military when i became chairman you and i teamed up together on that and now that you're chairman again we're back at it and during mr lewis this time we also made a strong emphasis on military medicine and we do that because a war even war fighter told us at a hearing one time some quite some time ago that a real war stopper would be not having adequate medical care for the soldiers on the battlefield and so we set about to do that we'll talk about that as we go through the day but my part of today's hearing is going to take two paths one my offish your role as a member of congress the other what my wife and i do is volunteers wanting to help and support individual wounded soldiers and their families today's hearing was scheduled for monday but the hearing with the committee on government oversight preempted ours but i watched that hearing on closed circuit t v and during that hearing general kiley you testified that congress had given you everything you asked for and we tried to do that we tried to make sure that we provided whatever we could identify that was needed speaking of hearings i discussed hearings with a reporter i discussed with a reporter some of the individual situations that beverly and i witnessed at walter reed army medical center and i was asked if i held a hearing on the situation is my response was no i would not hold hearings on patients problems and violate their privacy but we'll discuss this further as i get my face two of my  program today however this committee held regular hearings on military medical care the armed services committee held hearings and the committee on government operations held hearings and general kiley as you said in monday's hearing congress gave you everything you asked for congress also went beyond the formal hearings as mr murtha said many of our members visited other hospitals in the military system as well as well at walter reed i learned that the cath lab needed replaced with up to date equipment and technology and we did it we'll discuss the cab cath lab further when we get the face to and evans hospital at fort carson i learned of a telephone system that was so old that patients would have to wait hours just to get through to make their appointments we fixed it at another hospital identified the need for a new hematology lab we fixed it as mr murtha did i went to the air force hospital ascendant brooke ospital in texas landstuhl hospital at ramstein air force base also to a relocatable hospital in kosovo as well as the hospital ship comfort and mercy and we fix problems that appropriations could fix but appropriations alone cannot solve all problems it takes more takes skill takes experience takes determination and it takes attitude that we get to walter reed army hospital what problems and general kiley you testified that you didn't even know about these problems even though you're the top of the army medicine chain of command and again you testified that congress provided everything us for walter reed as many outstanding doctors and medical professionals who provide great medical care to our wounded heroes and i have been beverly and i have both seen miracles performed at walter re medically and it's too bad that these fine folks have to experience the effect of such bad news but let's discuss some of the individual problems of beverly and i saw walter reed and i would remind you that beverly and i a mostly beverly since my work here in the capitol as the other members and in the districts we represent is very time demanding but together my wife and i we have spent not hundreds of hours but hundreds of days in our military hospitals as private citizen volunteers to help with our wounded heroes and their family if i wasn't there with beverly she was there with a staff member she never went alone just a few of the many examples that we brought to light some were fixed some we fixed and we'll get to face to some we're not fixed some soldiers didn't have the appropriate clothing at the hospital because their personal belongings were left behind on the battlefield so we bought them clothes and sweat suits so the be comfortable in their beds we found soldiers doing rehab in the bloody boots they wore when they were injured so we bought them proper shoes we found kids in housing whose parents were feeding them crackers and peanut butter because they had the save money since the armies for d m money had not arrived so we bought them food provided money for the long term needs no general kiley we did not go public with these concerns because we did not want to undermine the confidence of the patients and their families and give the army a black eye while fighting a war therefore we work person to person directly with civilian and military leaders to solve the individual problems without casting blame on the many good functions at walter reed this is are we work with the staff at bethesda where many of our suggestions and observations have helped improve the quality of care sailors and marines this is how we work with the staff of our department of veterans affairs hospital hospitals that service poly trauma unit for injured service members who have left but those and walter reed and are receiving their care closer to home general screw maker knows this and he knows that that's how we've tried to work because one of the very first meetings that i had with him soon after he became chief of staff was when beverly and i went to his office in two thousand and three to discuss some of our concerns about matters at walter reed and i know that the general will remember this meeting because beverly talk to you but the boots you were where you explain why why was part of the uniform for a person in your particular role in the military but all that said this committee has conducted has conducted regular hearings on military medical care as have the other committee s that i mentioned earlier general testified in a number of those hearings and again reported all was well and that we provided everything that was asked for obviously this wasn't true what i can understand is knowing that there were problems  didn't you just level with us why didn't you tell us what the situation really was if you knew rather than continue to suggest that everything was ok this committee's been a partner in insuring all the services who had what they needed and more to provide the best in military medicine all you had to do was ask for help and not rebuff us when we tried to offer help we would have been there we've always been there for our soldiers sailors airmen and marines general you've testified over the past two days that congress has provided all the necessary resources yet doctors and staff tell us that there are many many unmet needs in staffing mr chairman a gentleman i want to apologize ahead of time because i'm supposed to be right now on another meeting concerning iraq so i'm going to have to leave as soon as i finish my statement but the number of questions which i would like to see to it that you answer for the record i would very much appreciate getting those answers within two weeks we're talking today not just about failures of military hospitals we also have the other related problem of the failure of the v a health care system to meet the needs of  hundreds of thousands of our vet turns and we get complaints each day about that problem as well as the problem that we're talking about more specifically today my wife for a number of years was a medical social worker working in a hospital setting and she certainly understood that in that kind of situation it's not just good enough to take care of the patient itself you also have to deal with the needs of the patient's family and i think it's important that that we remember that because while we're talking about patients today primarily we have to recognize that there's a broader responsibility because it isn't just a person in uniform who bears some of the scars either physical or emotional from from some of these incidents it's it's their entire family and their entire  support system walter reed as chairman murtha says or to be the flagship i think the american people every time they hear the term walter reed they believe it is almost a symbol of what people perceive to be casual indifference and if there's anything that it is important for government to avoid it is that indifferen e franklin roosevelt said once better the casual mistake of a government that cares then the then the omissions of a government frozen in the ice of its own indifference and that's what i think rankles so many people across the country when they see this story it is one thing for an average citizen to get hassled by a government agency or two or to get lost in the government bureaucracy american taxpayers experience that all the time they don't like it they get angry about it but i think the country gets especially angry about it when it happens to someone who has worn the uniform of the united states and made the sacrifices that they have made especially when in the context of this war so few others in the society are making any real sacrifices and that's why i think it pains every member of the subcommittee to be here today i don't know of anybody who cares more about military personnel than mr young and mr murtha and obviously mr young's wife has performed  incredible service to people at that institution but i really hope that the military will use this occasion to scrub their entire system to establish outside reviewers so that they can review what the shortcomings are in the system i for one would like to know what kind of a system you have in place so that patients or their families if they feel that they are getting substandard care if they feel that there's another problem so that they feel that they can freely raise that with someone who has an institutional responsibility to raise hell on behalf of patients  from people in the military who feel that they have unfairly been been rated very lowly with respect to their disability it seems to me that it is in the interest of the regular military even if those personnel have left the service it seems to me that it's that it's in the interests of the regular military to see to what that system fairly treats each and every person who comes before it because if it doesn't  i would think it would be a significant impediment to recruitment and a significant loss of public confidence in the way the military and the government does business  i have a series of questions i'd like to ask you with respect to that and i would appreciate it if you could get back to me as quickly as possible i would also like to ask a series of questions about the transition that occurs when someone leaves the military hospital system and and transfers to v a system because it's certainly my impression that there are many gaps that people fall into and i would hope that we would have a renewed effort to it to avoid that it makes me especially frustrated when i read in the washington post of two cases where a military personnel received what they considered to be a much lower disability rankings than that than they felt they were entitled to and that the and that they were adjusted significantly after they had contacted someone who served on a congressional committee and then congressional committee got involved people shouldn't have to go to a congressional committee to get a correct disability rating in the system and i would like to know what the what you intend to do to try to influence the fixing of that problem even though it is in some ways your direct responsibility so those are some of the questions i'd like to ask i appreciate your both being here today and i appreciate mr murtha's running the hearing and i apologize for having to leave but we've got some other problems that we're wrestling with as well thank you mr chairman without objection soldiers in some very interesting ways when you consider why we're here more than once i urged my own colleagues who are going to such a facility for their own medical care to be very careful about going to they ought to consider going to walter reed because the actual medical care receives there was as good as you can get it i had doubts about the medical care at the other facility and saw the results that cause we had doubts i spent some time there myself in trips to the episode i remember more than once looking at what i now know to be building eighteen and i wondered what is there what's this housing project doing here i did it was a d c housing project that was silly obviously needed a lot better attention than d c normally is to their housing projects now having said that i'm going to make a comment about my own district that very much relates to what i think maybe the heart of our difficulty here in the past i had my own staff pretend they were family members of veterans going to our very elaborate v a medical facility veteran's hospital in  california they went and carried folders in their arms like our veterans were asked to do going from place to place to get their service we actually wanted my staff to experience the way they were treated because the mind your own business this is not your problem we run this hospital people are standing in line at the drug facility people who are losing their own files because for god's sakes a better and wandering around was x age is go its files and nobody was willing to respond to them in a personalized way that recognized that well after we had that session the director did make some changes that allowed the real world the computer to be a part of that v hospital i regret to tell you that that same director still a director today he made improvements but the original buck stopped at his door and nobody ever either opened or closed that door i'm very concerned about the fact that my colleague bill young on more than one occasion as talk to me about what has been going on with our soldiers and specifically about walter reed and the path they've been told it out of our you know this is not your business will take care of owning this hospital the buck doesn't stop with you it stops with me well frankly one of the good news items that i'm i understand from the newspapers about is that there is a fellow who has name similar to one of our witnesses today who may be running that facility out here shortly if he's not already if indeed he is a similar name i hope to hell he's ha if that's the case we may straighten this out so those are my interruption remarks and i appreciate your having this hearing thank you very much mr lewis charles i don't have a lengthy statement but i would like to make a few points and i know you've heard me say this before that i'm the senior military officer in the army and i am accountable for this situation it's inexcusable you know to say i'm disappointed is an understatement i've been very angry over there were deep into fixing it and therefore turning my energies from anger and into some results while we're doing this i think it's very very important and i think several of you have made t statement that we should not forget that there are some real heroes at walter reed and other medical facilities all over the world that just like these family members are barren scars medical professionals they deal in twenty four seven but some of the most horrendous that you can imagine and i'm afraid that sometimes some of this rhetoric sticks to them in a way that is not conducive to you know to their health and so i just ask facilities and i've been for i think with this committee in the past about the status of readiness and funding and except for in the army that's not an excuse for anything but there are some reasons why some things are the way they are but i would ask you to to remember that the real issue here the people that are doing this are they're extraordinary and i want to make sure that they know how much all of us appreciate what they do now we have made some changes that we're not shifting around you know plenty of people putting together commissions are going to look the fort dietrich up there with our special research that goes on up there to defend against biological hazard i say all this because i know him very well and i know he's going to do a great job and i know he's committed to doing the right guy not as my brother because he is going to bring such energy now we're going to give him a brigadier general as a deputy that is not a medical person but a combat arms officer that has served in the fight and it's led the soldiers that where all rest of the that's required we've established a hotline one eight hundred number where people will be able to call directly into the army operation center which means that it is formalized from the time in the army operation center when they're called receive and include a major move out of out of this information building eighteen into the kind of the shelters that soldiers should be and we're not calling the building by numbers anymore because that's another which named after reporter chief alarming nurse corps building eleven formally building eleven out there and so the only building that's going to have a numbers eighteen and then it's not quite so i'm telling you that we're very serious about title thirty eight is what the v a operates under the disability rating system and d o d is not the same as it is in the v a we can show you examples where somebody might be rated forty percent of the o t system and go to seventy percent of the v so there's all kinds of stuff that needs to happen to get this done and it's going to take a lot of a lot of help to do that so i appreciate your offer to help appreciate the fact that you've called us to to lay these things out in front of you and i supplemental which we're we're working on i'm recommending tuesday the subcommittee actually goes the full committee four hundred fifty million dollars for brain injury and counseling and four hundred fifty million dollars for post traumatic stress i think you're right it is more of a problem the transition is a big problem i talked to the a b c commentator that had head injuries and i was out of did but does it just happen to see him he his brother walked out of the room and and look just like i said who is this and i thought he was dead from the appearances face was swollen his body was all torn apart i never thought he'd make it and i met with him this past saturday with two staffers and i said what did you go through what kind of real did you have because he had to have intensive rehabilitation carolyn mccarthy who's a member of congress who's a nurse her husband was killed and her son was hurt badly and brain damaged and she said she had two hours three hours a day she had to help him get through this transition we want to make sure our people who are making this sacrifice said that same kind of care so i some feel people out there that can go and ask questions and go into these buildings look at them and make damn sure that we have the kind of curate we need i know will fix this problem working together we have to know the problem general that's that's the thing and and it was money we can help but we can't help but if nobody tells us what the problem is stress think if you'd allow me just for an alibi here i think this whole issue of traumatic brain injury and post traumatic stress syndrome all is there's a lot we don't know about all this that medical people are telling us that we're learning every day and that we're going to smarter about a cultural thing and overcome i think we are come over come some of it but i think the downstream issue here is a big one and i think that that we've got to really pay attention to this that if i could just tell you i looked at some figures yesterday and i'm doing this off the top of my head i could get it to you for the record but i think we evacuated some thirty one thousand soldiers since two thousand and one out of theater about little over four thousand of those problem but forty five hundred more battle injuries about nine thousand about twice that number were  care that we can give them but i think it gives you an order of magnitude of what the real alan jones here because what we really have is every one of these soldiers and families as an individual situation and as a go through this administrative process in the healing process the admin process and all rest of it we cannot come up with just a cookie cutter solution that's going to paint over and we have to have a system that allows us to deal with this with the issues that really exist and i think in listening you have to have more compatibility between the better to ministration law and the military law if there's a difference we need to know what congress needs to do to fix that because you know i'd be more of an authorizing committee problem but we need to know about it so we can work it out i'm not sure there's not even a problem or a different law under social security and medicare just i think i think there are three different public laws that cover all and colleague probably cover but i i just tell you i  hope it's kind of like build an egg tain it's got to mold in that stuff in it but it's because the roof leaks and we fixed it three times but the roof do leaks if we don't fix the roof it's just going to come back and that's a metaphor for the big problem personally and professionally sorry that this has happened and i've offered my apologies to soldiers and their families to the military and the leadership the department particularly to the congress in this committee which has been such great supporters of wal reed and military medicine and the american people and by also like to add my personal apology congressman mrs young for for any failure to recognize the magnificent contributions that the congressman makes as do you chairman the rest this committee in your professional roles but also the volunteer work that the youngs have done at walter reed for years i personally appreciate that the staff knew knows the youngs very well and love to see them come and i i am sorry that we have somehow lost that relationship and would be very interested in regaining that there are other issues to include the complexity of managing these injured warriors and heroes and it needs to be simplification and we're going to take that on we're going to fix some of the brick and mortar simple issues at walter reed particular building eighteen the last soldier should be out of that building tonight we've got systems ready to start renovating that we've got all the soldiers on the post but we've got other issues about their wellness and their healing that we have to take on and nothing can allow us to be in a position where the soldiers on the battlefield have lost confidence in this as a medical system and we're going to regain that confidence immediately  it is a complex and confusing system for the medical board and physical evaluation board and it's confrontation it's adversarial i don't think anybody working inside it is intending it to be that way but it is and it creates a sense that the soldiers are not respected for their contributions and their sacrifice we got to get out that i'm going to get out that we're working on that right now we really need to reinvent the whole process and i'm committed to it as you all know the two we've got a great health care system from the battlefield back to walter reed and that's because of the great staff over half the medical personnel they met of deployed at least once in combat we've got brand new technology that's making a big difference on the battlefield and we have had the unwavering support of you in particular in the congress in general and as congressman young as noted i have said that everything i've asked for the congress has provided i need to do a better job of finding out what i need and asking for and i'm taking that on it's unfortunate the washington post said bring these things to light i need to do a better job of knowing what's going on inside organizations particularly relates to middle over and met hold in the soldiers and the transfer to the a in an outpatient basis or an inpatient basis i mean i'm a soldier and a physician for thirty years in our military to serve the nation and to serve our soldiers i'm proud to continue to lead your medical department and i am prepare to answer your questions thank you mr first let me ask general school marker about walter reed i've been against closing walter reed i think was a tragic mistake too to brac walter reed in the first place you see how do you see the bracton how it reed sure i think they i think there are several things not just brac that i think when you when you announce that you're going to close something that has an impact on the people that manage and so i think when people take a lead downstream they make personal decisions professional decisions based upon whether or not they think they're going to move well read is not going to go away it's just coming in another place the issue is where do people see themselves and well at other place have the same heart and souls and the people that are in the current one the other piece of this that hadn't talked about too much is a seventy six action that took place out there you know in two thousand and one i don't know what but this was where the the the mill that d p w out at walter reed had to compete justifying competition why there might not be a commercial alternative and that thing went on for six years where it was appealed and back and forth back and forth and they impact of that was that there was a decline from some three hundred i guess down to about sixty of the people that were involved in the maintenance  because of because of that action now you know unfortunately wants something like that starts because of the legal ramifications of such a thing and up kind of on this bus to abilene and a way that i think kind of came in under the radar scope quite frankly of things so i think there was a series of things that when you come together these aren't excuses but they are part of the reasons why you know what we're going to try to reverse that decision general because we don't think that there should be any question about the way the money spent out there in new we can give them the best care they possibly need to be authorizing committee has a jurisdiction over this but i've talked to the chairman and the subcommittee chairman and bill young and i both agree this is this was a mistake during war to close this place out there won't reach secondly we must take advantage of some of the kinds of things with the uniform health university and their research and all the rest of it the flows to sort make some sense but what i think some of us are concerned about is how we go about doing this and not losing the capacity that is there during this long war i mean that that is that is what's at issue here in my view and i know there's a lot to it i'm not suggesting that we reopen iraq at all but there might be ways in which we we shift our weight here on this thing in such a way that we don't put ourselves at risk we're going to or we're going to reopen that portion of brac in the authorizer committee and i think you'll see the support for putting this off until at least until the war is over but  agree with you about belvoir we need to do something to modernize that we'll find the money to do that we just need to get to direction change  what i'm about to do is go is making me real happy it is not but i also know that if we don't identify the problems we can't fix them so i'm going to call attention to a few problems and i've got some questions about how they were treated and why they were not treated in my opinion as i said in my opening statement besides skill and commitment determination attitude is very important we're talking about three cases that are not hearsay ones that i know about personally that either i or beverly or member of my staff joining with us know about i've had a number of calls from parents wives asking me to talk about their problems but these people asked me to identify their names except for one one actually authorized me to use name and i wouldn't because it would be very embarrassing to the soldier and i would not want to embarrass a soldier and this is a case of a soldier at walter reed who beverly and i had visited with a number of times and she went in to see him one on one of her visits and we got she got to the door of the room he said mrs young please don't come in and there was another lady with beverly at the time and i will also discuss her beverly said why not he says because i smell really bad she said well i'm going to come in anyway and that's her he sort of pushy and she went in anyway and what she found was a soldier lying on a mattress no cover no blanket no sheet just a black plastic mattress lying in a pool of urine with a puddle of urine under is bed she complained about to a person who was supposedly in charge of the area and she got nothing but attitude she was told this is war we have a lot of casualties we don't have enough sheets and blankets to go around the soldier deserves better than this i'm curious with anything ever done to the people that were were treating  responsible for the soldier responsible for that that type of treatment that he got incidentally beverly went out and she found some some sheets and she threw a couple of them on the floor to soak up the urine that was on the floor and she cleaned up the bed i'm not happy about reporting that but i'd like to know if anything was ever done and i know this was reported to the command anything ever done to the people with that kind of an attitude and if not why not that's totally unacceptable behavior congressman not should not be tolerated i'm sitting here i keep giving answering take for the record check i concur with you that should never happen and if we have a problem with that attitude in any one of our medical facilities we need to change it right now well i would i can understand why you might not have an answer to that and it happened quite a while ago when i would the lady who was with my wife at the time was named wilma d joshua dunlop was in the helicopter that had a very hard landing early in the war when the when the troops were going off for some r and r helicopter was shot down they did a hard landing and he suffered a very severe traumatic brain injury just d and he they have asked me that his mother asked me to use his name dunlop had a severe traumatic brain injury and josh dunlop was in the intensive care unit at walter reed and josh dunlop fell out of his bed on his head that had already been injured in the helicopter  his mother wasn't there when that happened but someone at the hospital called and said asked her to come in because her son had fallen out of bed his forehead was all red from the injury and she cried and i can understand why she might cry she called beverly and told her about this and said what do i do she said well go tell somebody and beverly went down sheikh went down to meet her and they went they told somebody nothing happened because a couple of days later it happened again he fell out of bed again on his head a kid with a traumatic brain injury this is done a lot called beverly again she went down to the hospital at the time and they went to see general kiley you remember that and they mrs dunlop didn't feel like she had a good attitude at that meeting and it must not have because a few days later this is dunlop calls again hysterical mice son in intensive care just fell out of bed for the third time why why command knew about it why it was jo a traumatic brain injury soldier allowed to fall out of bed in intensive care three times and the answer no sir totally unacceptable where both standard general you were told about it twice or yes sir and i failed to get that thing right till the third times i remember and i spent a long time with her and it's no excuse well the third time you did you did post a specialist to sit in the room to make sure it didn't happen again and it didn't happen again that was freed three times and that was all without the last case and this is one that i don't really want to bring up but the parents of this soldier and the wife of the soldier asked me to please bring up this case we got into this case the family has serious problems will you please go to the hospital find the family and do what you can to help and she said of course i will and that's what she did that's what we did this was a long drawn out case the soldier's name is staff sergeant william late them staff sergeant leatham was injured in iraq when he was blowing in a door the explosion came back into his face and his head and he was cause severe damage never really regained consciousness until a couple of weeks later at walter reed hospital this is a long story and i'll make it very short god became quite ill he did show signs of being conscious he asked his father at one point what happened dead so we know that he regained consciousness least briefly medical corps cat walter reed made a decision that sergeant staff sergeant leatham needed some emergency surgery to fix the aneurism in his brain before it killed him the camp lab that i talked about in my opening statement was malfunctioning wasn't running wasn't working i couldn't hardly believe that so i asked my staff assistant who is also an attorney i s down to the kath lab and find out what's going on and he did and he went down with it with the hospital commander and came back and said you know it's broken doesn't work beverl she went to donna arthur met him in his office explained the cases to what was happening with staff sergeant will lay them he talked to general kiley and he said we can fix this we have the equipment it is up and running we'll send an ambulance and we'll bring you over admiral arthur says that he was told that we're not going to do that  we can take care of our own and we think it's too dangerous to move him maybe it was very dangerous but the next morning a respiratory therapist came to the room of staff sergeant staff sergeant les thumbs wife who is now is widow said i don't know that you should be doing that he has this leaking retore therapist went out to the hall checked the chart came back and said there is no mention on the chart over an aneurism and the directions are to do physical therapy the family saw what was happening the latents had three kids back at home melissa knew that it was all over at that point she asked beverly if she would stay with will three died and she did and he died a few days later maybe he will died anyway i don't know maybe if we would have taken him to bethesda maybe he would have survived i don't know that either i'm not a medical person my wife has great training as a medic she was a medic and she got her training at an army hospital by the way so she knows a little bit about ari procedures and army medicine these things should not happen in a first class hospital with first class people who are doctors and nurses and it's just something that this is it on my mind for a long time and i have never been willing to go public with it because i wouldn't without the permission of the parents and the wife in this case when they knew they were doing this hearing they asked me to do that so i don't know if you want to comment on that or not but i think that is a is a tragic experience for everybody involved so our role here or my role as a member of this congress and this committee our role is to fix what needs to be fixed to guarantee that our soldiers our heroes our people who are doing what they've been sent to do on the battlefield that they are getting the type of care that they deserve and they deserve the best medical care that we have available and as i said if we don't identify the problem we don't fix it i just identified three problems were the parents asked me to do so mr chairman thank you very  much and looking at the situation at walter reed and we have a situation out in our state at madigan army hospital i was one of those i'm most proud of in my career was working with senator jackson to get the new  army hospital built at night again and i think it's a great facility and i think it's great care is in most cases rendered there but the comparison that i see between the situation is once they get through the hospital and they've been treated then they go into these medical holding units and this is where the general this is where the process seems to breakdown in my judgment and you know the one point i think in the story about walter reed they said they had one sergeant for a hundred and twenty five soldiers and now they've got this down to one sergeant for twenty five to thirty and this was changed in two thousand and six which is about a year ago this holding unit thing regularly but there is a small percentage who have problems and who feel very strongly that the army is not in there advocating for them that whoever their person is their case advocate that that person is more interested in trying to move or not move the case along or if they move the case along in a way that the the soldier feels is adverse to their best interest and that they're treated the case so what do we do about this how do we fix this part of it this is where i think the breakdown occurred and and obviously we don't i don't believe that out there but i've been told by people who have been there that we don't have the kind of molder bad conditions at that we have building eighteen out of our hospital and fort lewis but how do we fix this holding unit thing how do we get this thing right so that these people don't that someone a there's nobody there who cares about their case how do we train these people better to get them to be advocates for the for the for the soldier who's been injured either in combat or through other accidents i think what i would do is let general kiley in a moment talk about the specifics of how this should work but i think there's a lot of misunderstanding and i certainly never really understood all of the nuances of this system until many years ago when i was a system division commander of the first cavalry division of fort hood and we took a look at at how long i mean we had people in this process for two hundred  fifty two hundred seventy days and it was very difficult to understand what the problem is and the problem is that maybe the medical evaluation board process in the in the p s the physical evaluation board don't start until after treatment that treatment can go on for years they're not in that process and so they're either inpatient or outpatient and it's been during this pull period of time i think that we need to help people much more especially if they're outpatients not under you know the obvious you know in a slow healing process where there's a lot of misunderstanding then if you do once they get through the healing process if it's determined that they have to go through this board process if you do it perfectly i mean this is dishes how bureaucratic assess if you did it perfectly and you never missed an appointment and you never appeal anything it would take one hundred eighty is conducted which determines if they're going to medically retired and all of the rest of this is under title ten which is different than of age and show tech this is one of the big points that was made by one of the doctors out of matt again  that like on post traumatic stress syndrome the army has one standard for evaluation of that individual the a has a different standard and you could you could get one of the i was not an army because of the way the rules are set there and go over to the v a and typically get a higher rating and so there is this so it makes it look like the army is less sympathetic and they're building it making you build a much stronger case for having post traumatic even if the army system works perfectly on the writing what do we need to do about it well i mean again i i'm way out of my league here i'm just i'm talking as a lay person about my frustration as a commander in the past or trying to understand the system because you see all of these soldiers are still in the army and they count against our roles and they're there are non deployable soldiers that are being that are in the system that we that we should and must take care of to a very high standard but they are not available like to take that question in the sense that i have some things that we can do inside army and working with the physical disability agency and our medcom medics doing the medical board the physical disability doing the physical disability assessment i do think there are d o d i's instructions to do that we need to reexamine very quickly i think you're exactly right and one of the things that i fail to realize the significance of with a larger and larger number of soldiers this adversarial piece the concern that soldiers are not being recognized and appreciated that the condition that makes them unfit for service on i'm sure that's a good term to use under forty five or one my regulation does is the only condition that the department will recognize for disability in the vice chief of staff or to the so you could you could lose an eye you could be disable and not be eligible to stay in the army you could have other things like and like t v ad that the department of defense's disability process wouldn't recognize and then the soldier walks over to the v a has a much larger disability and the soldiers say well how come the da do didn't know so we've got some things we're looking at right now with the g one of the army to see what we can do and if we find things that we need statutory sport on we'll be right back in time the gentleman has expired but let me say dr choose god's responsibility here i mean this guy is gotten scott free blame everybody else he wants a set are the first thing i heard from them and bill young and jerry and i were in a meeting he said we're going to cut tri care back substantially in ted stevens and all four of the said that as long as the laws are  it fully now it looks like to me military medicine but underfunded and he got some responsibility for that because and we're going to have him before the committee at some point mr chairman just on just to make a point i will to stop ok i'm told by staff that each military service has their own does ability process and different standards is that correct i know they have their own disability i have not stopped to look at the other services standards i am told that the other services have a higher rate of permanent disability rating i e the thirty percent rule than the army has said that we have not looked at what the navy and the air force are doing and we need to do that also to see if they're doing a better very much one more time i want to tell you how much i appreciate this hearing and it's very important to our soldiers but also very important terms of this committee for years has worked as a nonpartisan  committee members are concerned about our soldiers as they spend a very big part of our discretionary money to carry on our force for peace in the world but this goes right to the heart of why many of us are here general kiley you were the commander a walter reed or you not during what pretty time two thousand to two thousand and four if i'm not mistaken the home or the location where the commander of that facility li kind of over looks the wing eighteen is it not sir it's on the post there are two general sir flag officer delay on the post that are across the street from eating and can you tell me why you could live there for like the time they did not look at that building and wonder what the hell was going on when i was a commander there i did not have patients in that building that had soldiers in the building had very severed from patients good soldiers in that building that looked like the  housing project i talked about in d c that wasn't good enough for soldiers you know so i was not aware that there were significant problems in that building my girls and commander came to me at one time during my command so we need to put new carpets and curtains in there and i have the resources the money to do to that commanders walk through the building we had permanent student detachment there but i did not walk through that building unlike the other buildings like the malone house the long haul abrams hall was closed for  renovation that was the twenty five million dollars that congress gave us to bring films haul up to standards you know recently my bride and i was in the audience had a little problem in our home and california seeing that there was a rat up in the the attic and i spent some considerable energy trying to get that baby out without killing them i found that you use snicker bars instead of milky ways and the cage i was using they don't like milky ways but in the meantime it takes a while and a lot of not attention for rats to get in your attic and were away from our home a lot and thereby i guess that's how that occurred that but there are rats around building eighteen and that doesn't happen  overnight and and your liver was in charge there who talked about carpeting and and drapes must have known there were rats around and i'm wondering why the hell he let that go on that way because it didn't get there overnight that's not our standard sir and  when they discovered mice and cockroaches we we the commander sent his pm teams in the preventive medicine teams and we took steps to remove him and i agree that it's unacceptable to you when you have patients and are absolutely unacceptable and i wondering whether the condition of that building is a reflection of the condition of buildings around the facility in general that lead to a brac commission is suggest the baby ought to be closed my there are lots of buildings that need serious attention  so i haven't run a survey there are old buildings on the campus the new will to read is thirty years old and needs run evasion fundamental renovation i suspect that some of those factors went into the empathetic and that only in the back brac commission is delicate to say the least but that doesn't mean that it's untouchable by the congress in the meantime if we're going to have a building up facility at fo belvoir we're going to be building up expanded facility at bethesda doing joint work there whatever which i frankly are not excited about the thought of in view of what i said earlier about but that is that i'm very concerned about the length of time it would take for that transition and the amount of money it would take to redo just of the sillies that need work right now and they are your people the plan for not just a team but redoing those existing buildings if we're going to if it's going to be five years before we make that transition so we have a plan for routine maintenance and upkeep of the buildings walter reed my understanding is that there are some limits to the amount of full renovation for example building eighteen was going to an office building the patient living is just about completed a renovation that was authorized and started before the brac decisions but since the brac decisions we had to come back to congress for example to build a ten million dollar entity center which the congressman reference which will be completed this fall and have to take for the record what the rules are about renovation versus simple maintenance and upkeep well it's very apparent general generals that hospital and the director still be in there eventually the buck stop somewhere in the in the fact that that guy still there i can't tell you how it angers me because people still stand in line to get their  pending closure of it as a result of the brac process secondly there was a policy carried out to contract out support services that has had an adverse effect in the third is an attitude no one of leadership with regard to brac i'm glad that fort belvoir is in my district but it's not going to be completed by september fifteenth two thousand and eleven now you will not acknowledge that general because you're told not to acknowledge it  but my concern is that there is no contingency plan for walter reed when you do not meet the deadline for dewitt you know it's a little like when general pace was asked what's plan b for the surge plan a is the surge plan b is to make it work well that's the kind of response i'm getting with regard to walter reed if de witt is not ready by september fifteenth two thousand and eleven do you have a plan to sustain w be up and functioning by september fifteenth two thousand and seven i represent that history i'm just telling you now i mean nobody's going to remember five years from now it's not going to be ready by two thousand and eleven i'm concerned you know in general we're underfunded for the  was a substantial reduction in the number of people available for support staff as a result of the fact that they were privatized as a seventy six process they were required to go through what you went from what was the number you set it of your own free hundred three hundred and went from three hundred down to sixty support staff and the attitude at the pentagon was that that didn't matter we were saving money that is a major reason why we were dealing with this today and i want to know from you are you under any requirements from the department of defense to privatized a certain percentage of jobs a one and then it went one way a decision which made it and then it was repealed and it went in and it was back and forth back and forth through a six year period but the pentagon won general and that's why you have sixty support staff instead of the appeals and review by the army already to see and they since about the fourth of february this year they are managing garrison contracted support to include maintenance and upkeep of the building where you'd given a goal of a certain percentage of jobs that needed to be privatized at walter reed and serve if i can remember i know that there was or i'm not sure that it was a particular number of jobs i think the original percent target was a percentage take for the record and see see what my records show that we worked through that process from two thousand to two thousand and four at which time we let the bids and then the first decision was that the government had won the bid and then there was an appeal by the contractor and then further delays which is what created some trouble for walter reed i believe and right i don't know who the contractor is i don't want to know because i probably represent them and no other projects here but the the reality is the government  n and then the pentagon said no we're not going to accept that result and they insisted that it be contracted out to a private contractor and that's and they're saving money but it's at the expense of quality care now the last thing it's it's attitude of you know we wouldn't be here either if there hadn't been those washington post articles we would have had these hearings you wouldn't have gone through the nightmarish week that you've gone through over the last week certainly not to the media and yet that's the only way this was uncovered has any retaliatory action been taken against any soldier who has communicated with the media not to my knowledge congressman and i would army times that reference that i called the brigade commander who had talked to the soldiers and asked them look please come to us we want to help you if you've got issues come to us and he said he had not prohibited but i don't i don't know that someone is a lot let me make it clear it's are you saying you told him don't go to the media go to us no sir i didn't say anything to the soldiers i didn't sing so i asked him for a gig commander if if he had talked to the soldiers and he had and his comment to them was to reassure them that he had an open door policy and that he would be willing to hear any of their issues there was never a comment that he that i know of for sure that that the leadership knew of that we told soldiers you can't go to the media that's that's inappropriate in my opinion i think the chain of command when general last night last night there was a soldier on the base and a person on television was trying to interview them another soldier came and said you know not to be talking to the media and took them away in front of the cameras out and i don't agree that was well i like we can find out that's an immaterial because they were following the policy that and they act on their own initiative and the soldiers have told us that they w to talk and the reason why they did talk is because they felt when they did go to your brigade command they didn't get any response and the gentleman yield for just a second please on the same subject so when we went to visit your soldiers in the hospital we always asked if it was ok on the part of the soldier or the family we were told by several soldiers th had been told that the young those were troublemakers and they ought not to see us so that's unacceptable i certainly never said that i would never you know how i felt about how you and this  this the fact that noncommissioned officers have been blamed in these hearings for not doing their jobs the army announced it is taken disciplinary action against several lower level soldiers at walter reed what is that investigation right now investigating officer to the entire chain of command i thought my impression is that general weight men felt he needed to take action based on his in the in the chain of command assessment of not not necessarily building a team but but the leadership in the unit time as a general has a part let me say this secrecy thing i had the inspector general defense department in my office two months ago three months ago but  remembers a special forces football player who was in that challenge that the family's been looking for the detail also that thing for over three or four years whatever whenever he was killed lofgren who just represents that family said they still don't have the details they told me months ago they would have the details of exactly what happened secrecy doesn't work we've got to work together for going to solve this problem this is unacceptable to think that a family can't find the details when they look through this think specter jenner said a lot of mistakes were made and they said we're going to tell them i would hope general you would get to the army inspector general tell him to release that information to the family or at a department of defen inspector general is the one that you're talking about they're the ones that investigated this i i wish questions by them and my understanding yours is they they are briefing their findings well i just found is out today i'll go back to them again and find out why it took two months to do something i said we're going to right away but what the secret what i'm getting at is the secrecy thing telling the soldiers not to talk to us telling the soldiers not not to come to to the  wrong if it was wrong which it appears that it was why did that person come in there and do that why don't they listen i don't know anybody out there can answer that can you answer that's or you're the surgeon general the army your question is  saying when someone is asked about some questions about the treatment of a person well he's only a reservist and frankly as a former national guard i resent that and i've always resented that there is a difference historically clark you've tried to work to change this but it's still there and your statement mentions two types of medical holding units one for the acting component soldiers and one for the reserve computers component soldiers one of the different since that nest necessitates two separate can you can you explain that first first of all congressman i grew up you should be no difference in the standard of care there is some administrative difference between the two groups of soldiers as it relates to personnel actions finance actions etc and i believe that we break the soldiers into those two units types to keep that clear to improve the efficiency and the support we're attempting to bring to the soldier when it comes to care i don't think there should be any different agree or levels a soldier is a soldier they deserve the dignity of the uniform that they serve and this country and it shouldn't be any different and i you know four is that is that your statement no sir i found a lot of problems between two thousand and two two thousand and four work very hard to work them yes sir i stablished the medical family assistance center i stood up at weekly med fact meetings i renovated there was a lot of stuff that didn't happen because it could of all have a tween two thousand and four today and the attitudes are there could change because you live right across the street you communicate with these people  affected seventy six affected some of the things that you do because i have found him very difficult when it comes to personnel matters dealing with people and human factor on this and it's not  numbers one of the things when i did military construction one of the things that was most important was to make sure that the soldiers had dignity in the where they live because they were happy with their lives their families were happy they stayed in the service the army absolute worst housing of all the soldiers it's not true today because we made some significant changes in the forces they were still here he'd tell you  his bases are better for goods a lot better today than it was but this the treatment of these soldiers and the stories that are here we all hear we hear it back home now there's another problem that we're not getting today but there is a problem because tri care is now their contract with the v a and some of the v a people haven't signed up and haven't got these things right kids coming back to the service  me his marines are you know they were going to tell me and i thought it took me about three months to found it took me four days to fix it in my local v a but there there is transitional problems at all this today as we change the system and the army sir needs to work with the v a to make sure that this is seamless people shouldn't be put they got enough trauma coming back we should make their lives more difficult when they go to get services and john connelly so i'm accountable i'm in command sixt i  a command sergeant major various companies and sufficient noncommissioned officers to do what they're done and we relieved a major general two star general who commanded walter reed he had been there about seven months she's a great doctor you are going to be here sir you're going to red or whatever color pickup truck it is you're going west sure there's continuity in the army the vice chief of staff of the army will be there there be a new chief of staff of the army the standard to continue on i mean there's  we've got an action planned to go on with this and that is measurable and i believe that that will get after it but i agree with you i think this is a bigger thing you've heard me before i mean i'm chief of staff of the army why come back into the army recall from retired status dealing with all the stuff you're talking about and believe me you know i said yesterday just like running in the swamp and hip it just sucks the energy out of you the bigger ocracy is in this government the attention i mean how long have we worked things that ought to be simple and are expected i mean all of us y i didn't call my congressman i mean we fixed it but you know the thing is this is a fancy finance and accounting system doesn't talk to each other the v a doesn't talk to you know the west i mean there are problems here that cannot be fixed by pushing a new from the bottom up h things are huge and must be lashed together in a smart way it still took them almost six months to get my pay right i'm a four star general been one for almost ten years and then show you can imagine what's happening down there and it angers me iraq i had units from my district that found burned iraqi children and they went to undersecretary through me to under secretary chu to try to get medical medical kits down into the units so they could treat the kids that were hurt in iraq if we're trying to win the hearts and minds the people least we can do is heal those that we end up hurting and they were i was told by secretary chu in my office sorry congresswoman send him to the baghdad hospital where he knew darn well there were no supplies there were no medical supplies and i said well mr secretary what if we set up tiny little field tents out there he goes a couldn't do that congresswoman we couldn't protect him so i had that experience with under secretary chu myself my remarks today i dedicate to sergeant matthew kyle of toledo ohio in fort collins colorado who's lying over it walter reed right now with a rifle shot through the neck with very very major spinal cord injury and yesterday coming out of his sleep he tried to raise his hand to make a salute and his father tells me he is one tenth of one percent chance to use his limbs so i dedicate my remarks today to him i am probing whether the bush administration's push to outsource and privatized medical and administrative support responsibilities at walter reed may be responsible for the recent conditions at that facility we all here fully know it's not just walter reed but in january two thousand and six a five year one hundred twenty million dollar contract was awarded to a company called sere barris hedge  would hedge fund which is a subsidiary excuse me they have a subsidiary called i a p t worldwide services for the operation and administrative support at that facility what it meant is mr moran said it was a reduction in the number of persons who would be taking care of medical and support responsibilities at the facility and the i a p corporation is led by former health burton official named al and he f f g e n i want the record to show and i really say this as an american because this is something we have to solve together but i want this on the record ethics disclosures reveal that in two thousand one former defense secretary donald rumsfeld was an investor in this same unregulated wall street hedge fund sir beareth in two thousand dan quayle a former u s vice president to george bush sr who served in the white coterminous with current vice president dick cheney while he was serving as secretary of defense back in the first bush administration joined the board of sir barracks hedge fund and rose to chair its advisory committee and surv subsidiary that got the contract i a p t its board of directors includes former vice president dan quayle a former commandant of the marine corps and a former vice chief of staff of the air force the way i look at it is the revolving door in this town working in the worst way and my questions will deal with the manner in which this contract was let who was involved in the decisions and how the original group that applied for the contract for the services comprised of people who work in th majority of whom were veterans lost the contract through a strange administrative proceeding very strange administrative proceeding because they won the contract initially and then it went up to the army dispute resolution administrative appeal board who added seven million dollars to the contract neither like to know who did that who was involved and then they awarded it to ip and took it away from the people who had won it originally and those individuals were told that they could not by law they were not permitted to proceed with the appeal because of a seventy six proceedings and by january two thousand six all big protests had been solved in a favre you will not have a chance to answer my questions today but i'm going to submit to the record who sat on the army dispute resolution administrative appeals board that made this contract decision who made appointments to that board who could have influenced the decision and i would like if not yourself general the inspector general to provide all t committee why was the in house federal work force bid raised wrote the revisions to the contract what was the specific reason the bid was raised by seven million dollars who met with the army audit agency personnel who developed the revised in house employee contract before during and after the revisions were made did any representatives from i p participate in the changes in the contract and why did the number of personnel drop by two hundred forty people in twelve months is the workload at the facility began to increase rapidly and conditions at buildings on the walter reed complex continue to deteriorate rapidly we had a letter from general wait man in charge of the facility begging for additional help i have that somewhere here in my notes was a back in september and he said we're going to have mission failure out here nothing happened personnel continue to leave they were never replaced rather than having three hundred people there were fifty people  less i think there forty seven or something like that we have to get into this contract as a tip of the iceberg and what's going wrong currently now let me just say this because i have very very great  respect for general schumacher i don't know general kiley that well but i've been in this congress twenty five years as i listen to this today it's an emotional rollercoaster because i served for well over a decade on the veterans committee actually almost two decades and now on this very respected subcommittee but if we'd been doing it right before for half the homeless in america wouldn't be veterans it isn't seven hundred veterans who are homeless it isn't seven thousand it isn't seventy thousand it is one hundred seventy thousand we have a seven hundred thousand people in this country who are homeless and half of those are veterans now we never get the help we need there has been a dysfunction general between d system what you've said trying to figure out how to work together brilliant we need to do that maybe this is our opening maybe this is the way we could really be helpful to the future but let me tell you how bad we're talking about walter reed in ohio the ohio commander the military order the purple hearts came to see me two weeks ago he's fifty nine years old a vietnam vet not associated with any base or any major hospital like walter reed he's fifty percent disabled he has tonight is from shelling he has serious of p t s d and two of his buddies just committed suicide ok we know we've lost more from the vietnam war and suicide than in the war itself the v a told him he has to wait six months to get his paperwork together to get the appointment he says he's just had a stroke yes to wait six months so this is going on across our country mr chairman i would urge you and i know how deeply you've lived your life for this this is a moment we have where if we can get the d o d in the v a to work together to address many of these concerns as these young men and women come back to us maybe we can do better for them than we did for our generation and for the one before it but it isn't demick in the system with somebody just said to me as i was walking into this hearing somebody they have a lot of respect where he goes congresswoman i'm not even going in there because you know why it's a class issue reason we don't take care of the people in those v a hospitals and the d o d hospitals because they're not from the only they never took care of my brother they're not they take care of the kids there today i believe america can do better i believe america must do better and i hope working together we can make that happen thank you joe what has expired i've asked a staff of the very things he's talking about we're going to have the s and i staff look into this too i mean it's this walter reed to do their job and do an excellent job each and every day and i'm they are very veritable miracle workers those doctors and surgeons social workers especially the rehab people who deal with the and petey's i've been out there a number of times announced an unannounced and it seemed incredible work that's done there but i've also been privy to what one might characterize as the other walter reed and that's characterize chairman gives him the liberty i'd like to read excerpts of some ongoing e mail sent by one of my constituents to senior army leaders inside and outside the city members of the command structure at walter reed and congressional staff including my staff january sixteenth two thousand and six the drinking problem by outpatient soldiers needs to be addressed these men do not sit and have a beer or two they drink pure alcohol by the bottle night and day and they take pain medicine they are allowed not doctors and getting into fights seems these people who are in charge of the med hold should be handling the soldiers far better than they do feb ninth two thousand and six the dirty linen fat five days in the linen cart took four days to get the floor claimed i just special request toilet paper twice it's frustrating february eleventh two thousand and six i'm so naaman worn out from fighting these people every day the dirty linen is still accumulated for two to five days before it's emptied i went into his room yesterday and there were pills lying on his tray that were not given so i went to his day nurse and he said i didn't do it i don't give told it was a pipes that froze now it's mental build up on the coils not one person has come to the floor on this issue and i do not know i do know it is not burnt turned in by the change nurse every day march fifteenth last week's issue of my son's receiving somebody else's medicine is still unresolved the blood on the floor is still there june thirteenth two thousand and six they tried to start the medical board without even asking even talking to us just scheduled all kinds of appointments which class with the schedule already set up june eleventh two thousand and six thought things improved a little but guess not the drinking is getting worse every night they actually bring in beer wine and hard liquor by the carloads friday night we had to tolerate it until five five o'clock in the morning june twentieth it was an eighteen or nineteen year old sexually assaulted this week after we left and they said she was drunk as could be that another then another night a young man was stabbed can almost bet the drinking was involved in that one too this will get july fifth two thousand  secretary of the army came to see him yesterday he came in early and my son was just getting up and started to eat the nurse came in and took his food away and told his girlfriend to clean him up in the meantime the nurse threw out all of his medical supplies and anything that was on his tray she has orders that there can't be any clatter to take his food away the boy barely just now i feel my son's health is far more important than appearance and lastly the floor has not been mopped in ten days this is september fourteenth two thousand and six he's been in the room slept only by the door and have never clean the bathroom the toilet leak when flushed garbage was not picked up today and this will get you there is a young man and ward forty six it had that asked his mom for one thing being a texan he wanted a texas yellow rose the mother had a plant made up for him and had a card on it with his nickname saying love mom well he had surgery two weeks ago and had to spend twenty four hours in i c u the plant seemed to have found its way to the nurse's station and then disappeared the mother was she would have to ask the different staff members yourself and then file a police report she doesn't want the money she wants her son's gift back january twelfth two thousand and seven there were four of us sitting around the lobby visiting the subject came up about people calling us back when we left messages absolutely everyone agreed that it does not happen when we're dealing with clinics manholes caseworkers social workers tri care everybody giggled return a phone call you must be kidding mother one mother said she left twenty two messages and trying to figure out a problem and did not get one single phone call this is the other walter reed we thank you generals i'm bewildered it what i'm hearing today i'm new to this subcommittee but since i've been on the appropriations committee i've been on the veterans affairs committee and one of the more heartbreaking things that we have to endure as members of congress are veterans that are trying to maneuver through the system and trying to survive at the same time but today we're talking about a system failure in this case it's a d o d system failure it's a it's a veterans system failure it may be a service to service system failure as well and we've got to listen to it that way general school mike or you talked about the problems at walter reed as an outpatient problem  hope it sounded to me like you were trivializing the problems that were there at walter reed that's part of the problem we don't have an outpatient system our system does not deal with the housing of soldiers housing of soldiers after they were released from the hospital do we have a complete and funded plan for returning soldiers from the combat zone to home have we a health care system that can meet the needs of the growing population of injured soldiers we don't have a uniform medical computer system we have a personnel system and you've heard my colleagues talk about the way the personnel contract at walter reed was completed and i want to address that issue as well and i don't know if we'll have time for me to let you have a response at all but as congresswoman kaptur and and mr moran indicated this process of considering walter reed for this a seventy six competition began in the year two thousand and at first it was determined that the in house federal workforce at walter reed could perform support services there at a lower cost than the bid received then that's when the system got fuzzier a p this company that was referred to protested this determination then it sounds to me like with the help of the army the army audit agency they withdrew its certification of the employee bid and unilaterally raised the bid by seven million dollars thereby making the employee bid higher than the contractor bid which makes it sound like to me that was a way of manipulating the system so that they could award the contractor a p the army reversed his determination and sure enough resolved a seventy six process in favor of i this took a number of years and i he took over this contract in february of zero seven but because of the number of years that the employees endured this they started leaving there and so i think we had an infectious system there or a system for the benefit of the people trying to provide services to the to the soldiers that were there that was almost a guarantee that the that the staff levels would be were reduced and reduced dramatically and in fact they were when i took over this contract they were down to fifty sixty contracts or they had fifty or sixty people to to deal with their this is the same company that's been the subject of congressional examination for problems it encountered in the delivery of ice to the gulf coast region following hurricane katrina so this is a problem we've got to work with together what bewilders me is you've had such a supportive relationship from this subcommittee and from the congress itself and to hear then chairman young and his wife treated the way they were treated at the hospital as they were attempting to intervene on behalf of the of the wounded soldiers there is just incredible to me it's almost as if we're part of the problem rather than wanting to be a partner with you in the problem so you can imagine how overwhelming this is to us there's got to be a better way for us to work together in general kali i have to say to you this is one hell of a way for veterans and their families to get an apology from you and that's that's just the beginning of what we need to do i congratulate these family members for stepping forward maybe contrary to the pressure that was on them within the system and having the courage to come in and tell their stories i've been in a hospital sitting with a loved one that was dying or likely to die  the end you're you're at your most vulnerable when you're in that situation and we should not treat our young men and women and their families this way at all gruesome there's congressman if i could have a moment just to respond to you first of all here i'm not be and i'm very angry about this and i'm very sincere about it like you like everybody that share i've had hundreds and hundreds and hundreds of contacts with the soldiers all over the world in hospital lot from walter reed ma'am she two weeks ago i mean you know top of the soldiers and their families and i ask them questions and i do not hear these things they have a perfect opportunity with the chief of staff of the me things are screwed up and they don't tell me that they're writing to some of you but i would suspect there's some of the others of you that have not heard their stuff like this and so what's the what's the problem base is clear we've got a problem  that's what bothers me because this is all built on trust and obligation and all kinds of things it's got to do with respect for the soldiers and so i part of what i'm angry about is as hard as we have worked i have personally worked the show proof that these kinds of things are shown me totally or anything else by family members or by schildt i'm just not just going to tell you what the problem is i've heard sergeants say they were afraid to speak up because of secretary rumsfeld's position that anybody this spoke out against anything that was going on was going to be fired i've heard officers say the same thing when general shinseki was fired for all tense and purposes when he went eighteen months when somebody  successor was named that's the problem we had they were afraid to speak out to us to you we've got to change that we've got to have them telling us what the hell a problem is so we can straighten it out i absolutely agree with you and but let me let me make it very clear i'm sure chief jeff the army because i want to be not because i have to be i can leave like we've talked about any day i'd be very easy to walk out of here and leave right now but i think we've got to fix this and i'm committed to fictional decision about i'm not afraid of rumsfeld or anybody else have never have been and i've been very clear with you all appearing you have been great partners of stuff so i think that you know this isn't something we can push this move up here i think we've got to have a comprehensive fix for how we won't take care of it and i think the problem is a lot bigger i'm not talking about the anecdotal deals i'm talking about the systemic problem is huge and it's expensive and we're going to have to and by the way look you've all worked very hard i've just about how many times have i testified already last thirty days or so before you all were six months into this fiscal year and don't have the a bill we don't have a milk on bill and we don't have a br i know you've all worked very hard to make that occur but there we sat in the in the brac deal right now and you know we're two billion dollars short of executing that matters and the energy that all of us are spending on this is the energy that ought to be focused on solving some of these problems but there is nothing easy about anything that i'm asked to do every day we're talking about contractual things you know that's not even in spite of anything i've dated  done and in the army contracting services which is under acquisition and as a uniform guy i don't have to do that so you know i can't answer you about seventy six problem or any of the rest that that isn't what i should i don't know that that isn't what i'm asking you to answer or if i want to nate's or wherever you have to go to get their army will get you an answer but i'm telling you i can't sit here and give you even a half answer because i i know your character that you would be open to that but the point i'm trying to alison's the soldiers talk to me all the time but they don't tell me their stuff they tell me all kinds other stuff that's broken and we fiction and i see that but i also think that downstream from somebody knows someone is not doing about anything about it and general kiley i want to get back to the dunlap case as i understood congress young you were told about that three times or you learned about it on the third  time i don't remember i would take congressman young's word that i was told about it i believe was it after the second time congressman you found it absolutely unacceptable actually so you were told about it three times and two of those were in your office has ms and dunlop how she felt about the way she was treated he said he really sucks but she didn't like you very much general i have a you know twenty staffers and they really do a good job and everywhere they go all over southeast georgia they're wearing my name they're speaking for me and often i have a problem being too hard on them and not grateful enough but if something like that happen on my little old organization i would jump all over them because that's my fault if my staff or three times has created a problem which i'm told about and in this situation it would seem to me unbelievable that because it's a red flag it's not just about done let there's another hundred dunlap's that never got to you for some reason and you know the only death but they're sure that there had to be other cases in between but somewhere along the line those staffers have decided that they can selectively address problems not address problems and if you had three opportunities it really seems like a good i'll take names and kick tail opportunity was there and and it's disappointing that that wasn't handled that well i agree that it's very disappointing that it happened to him and in retrospect i probably should take a more aggressive steps as a congressman mention put somebody in this room for the first case well you know i don't think you know to me your general i don't want you walking through building eighteen if you don't have people under you can want to build an eighteen and tell you everything's good then they are a lot of the fire chewed out or kicked or whatever but if you find that building a team isn't that to snuff and they haven't been telling you it would appear to me and i'm sure you are outraged and somebody somebody needs to really should have been the reason why how many others are out there let me say also my good friend mr moran and i have a disagreement on the private sector or the contractors  said does need to be investigated on how that contract was changed i joined them i want to know more details about that however where i would differ from my good friends from ohio and virginia as i think the problem is government i think is just inept government bureaucracy that somehow the army or whatever has fostered i think the private sector could be part of the solution here and i may be wrong but i hope in this myriad of new investigations and new blue ribbon committees that that is part of because to me given more bureaucratic to solve problems of bureaucracy is just going to hurt our had great success in contract support and well you know might be wrong on it they may be right they may be wrong about the right somewhere in between there i think that that has to be part of the solution and  mischief i think what the gentleman is saying all of us agree we have contractors we just have to make sure it's done with jim lee and there's nothing that has happened is not legitimate in his process and we'll certainly look into it and hopefully you folks who do the same thing will get an answer to one of the things that that i know that we got to do out of this is sort of reinvent the system or fix the system so that it works i think one of the important ingredients is oversight and given that i would tell you  that private sector and government hospitals are subject to inspections and accreditation by group called the j c h i assume you know what the j c h o s or it has the authority to issue corrective action o and may be reviewed on a random basis if there's a complaint my questions are this understand that j c h oh did a surprise visit to walter reed after the washington post story broke  before that visit when was the last j c show visit and what did the reports found i have several more questions on the i believe the last inspection was about seventeen months ago and i don't have the specific details of the findings but as i remember it it was a very good report considering the size and complexity the medicals could you get the details of that we could provide that meeting or the any general or the any special hoops to jump through for  time in many ways and the army medical facilities have responded and have done extremely well across the board and through time earlier you could get scores from one hundred two hundred being perfect in our hospitals and some are medical centers we're getting under that they've changed it now but we're very aware acutely aware of instinct gaged in in that sort of case process internally your rules are that the inspections come how frequently the inspections come and at the frequency directed by jake owen and it used to be every three to five years and i don't see don't know i don't believe it's every year now i think it's slightly more random than that but i can get that information and there are no special hoops to jump through to get to for that inspection team to come oh no that's really it least in the past the last time i looked at this it was a or it was a schedule of events we participate with jayco and we say we've got these hospitals and clinics and we want you to come in your convenience so it's not a function of any kind of bureaucratic obstacles for us to your patients generally have knowledge that they can report these kind of essence to jacka i don't know that i know that is where we reid leadership know who made that complaint i don't know but i don't think so i think it's an anonymous for if we could get the sales of those specific i'll be glad provide those questions and in writing mr chairman thank you very thousand and three you became aware problems at the outpatient facility there no i well in early two thousand and three we began ground operations in iraq and very quickly started getting significant casualties coming in they were coming in from iraq problems with the particularly with how we were going to help family members how we were going to how soldiers because we knew that they had to stay around for amputee work that we needed to further increase our technology and our skills and our abilities in dealing amputees general with regards to the problems that you discovered when you were in command did you when you left you convinced that you had completely addressed each and every one of those problems i don't think we ever completely address the problems we find new problems we find new issues that's what i asked or general asked were you convinced that you had solved all the problems that you had become aware of no i don't think so ok after that time did you follow up on the problems that you admit that you had not completed i routinely had consultation with the commander of walter reed and informed him that i stood ready to his assist him in any way if he had problems that he could not resolve at his level and that was part of my management command style with all of my commanders well with regard to management command style my understanding is that there were two additional individuals in charge of walter reed after you three actually i don't know their ranks and i apologize to them farmer gilman and then wait a minute that correct sir no sir general farmer replaced me as the walter reed army medical center commander a north atlantic regional commander and my commander john jeff and colonel jeff of the hospital was replaced by then colonel gilman for a year and he was promoted to brigadier and was reassigned it was farm and wait yes and in your management style when did you communicate with the farmer and wait men about the matters very least that you knew had not been completely addressed when you finished your command of hospital when i can communicate with those commanders was about the same issues that i felt we faced across all of our hospitals which was a growing number of medical hold it i remember did you ever take a tour of the hospital after you left the commanding officer doesn't for you know how many times you did that i don't remember but it was fairly routinely that i go up and and say hi to soldiers on the ward in the center t p t section and did you ever hear any of the horror stories that you've heard today while you were at any time at from two thousand and four until all of these revelations in the washington post i certainly was unaware of anything that was a problem with building eighteen i knew that the malone house was and the line the hall was a separate housing system was not appropriated funds and that their managers had abilities to repair  facilities the commanders would brief me on the numbers of soldiers that they had met hold over but no specific that i remember somebody was specifically come to me and say i have a specific issue about this and if i did i go to the commander general and in hindsight  d knowing now we're beginning to have all these revelations come forth right what would you change if anything about your command style or your style of leadership  that would fail safe these problems not coming to your attention excellent question and i did fail i did not more closely monitor my subordinate commanders more actively engage in these issues but  it's more a function of my role as a surgeon general commander medcom was a strict is has strategic implications and strategic responsibilities and i trust my subordinate commanders to keep me informed of problems to ask me for help and resources when they need it so the fact that they didn't for such an extended period of time medicates a real problem with your model of leadership and how have you addressed that in terms of changes to your model of leader we're in a process of fixing it now and i'm accountable for this and i'm held accountable for his chief and i get this and if i may make a suggestion i can't imagine why we need to reinvent the wheel there are so many hospitals across the country private hospitals and public ospital that have best practices that have seen situations like this they sued for millions of dollars and paid them out millions of dollars for these kinds of errors so i can i can imagine that the army doesn't have to find this out and it's only you know that that they used to say a million dollars hammer when you could have gone to the hardware store and bought it for for a dollar or less where as is so in the general american hospital system structure all these lessons has been learned and procedures and best practices put into place i would imagine that that would be a significant resource for you and your organization so you don't have to reinvent the wheel and we have we have best practices insert our medical p wounded troops brought to your hospitals only four thousand five hundred were injured in battle if i'm paraphrasing you correctly if not please correct me i wonder why you mention that figure a also what's the figure for those of our returning military folks who have post traumatic stress disorder i don't think we know i think is it in the so you're talking about how many general kiley well i mean if you if you use a figure of say five hundred thousand troops that have been involved in combat operations many of them for a couple of times we're talking to two thousand troops could fifty thousand four thousand one hundred five for thirteen percent of that total non battle injuries eight thousand eight hundred forty three or twenty eight percent diseased eighteen thousand six hundred thirty three or fifty nine percent and that accounts for that thirty one thousand five hundred eighty one of that population in patients were about eight thousand eight hundred forty three and out patients about twenty two thousand seven hundred thirty eight and that accounts for that total population in terms of how they're distributed ospital the point here is  this is a significant number of people that are being dealt with in their system that is already a layer of  on let me just say you know that's a reason we can't reduce the capacity at walter reed during a period like this we can see many of the problems came from this whole problem of reducing capacity and all of the things you're going through so we're going to work that way i would i would be concerned about even having a mass casualty incident or some kind of a spike in things that that even puts more pressure on the ship the mother to have absolutely i absolutely agree with  logistics planning for both the outpatient housing and not quite so much for the medical care but it's a very detailed document and then you and then and then i reviewed the recommendations of the colonel spencer in the chief and we were proved his request for resources well which which did not solve his problem general  has a great deal to do with the implementation and the attitude of the subordinates i can recall at least two years ago when i requested a meeting with you in your  y as surgeon general the army to come and talk to me about the healthy troops act and the need for hands on preamp ost deployment examinations for soldiers that were being deployed to iraq afghanistan and the army was not complying with the request of congress with the law that was fast back on with that they have these hands on physicals rather than less examinations that we were in general in medicine because of costs we were moving toward a trend to have fewer examinations and it wasn't really necessary and that's that's why was looking into you and was discussing your management style and your history and you were described as people by people who had served under your command as being very a dog and an aggressive leader  constantly career meant it and focused on personal success and that you would be utterly ruthless in approaching a problem but from what i am given understand by someone else who served on your command that your last concern was for the patient and that you were really driven by a desire to stick to the budget and increase productivity while sacrificing care now i don't know if that is true and from what i've heard general weightman was only in the position as commander assumed command for and if all of these things had been done i don't think we would be here today at least talking about the problems so my question is whether or not that's something that permeates the leadership goes all the way up to the top and surgeon general's office that would have resulted in a laissez faire attitude toward the care of these soldiers circumstances in the situation that they've been allowed to  anted to do the seven to six who wanted to pursue the brac who wanted to downsize walter reed and who did not want to put the resources that were requested at least as far back as september about the garrison commander walter reed i would take exception to the characterization my leadership but i understand that's that's part of the issue i would like to reiterate that that i made available to colonel europol the the resources that he asked for that i have grave concern about the quality health care the seventy six and current job always challenges were in those garrison city manager support activities but i think we've already identified that a seventy six study along with the bra process clearly in retrospect from my perspective and general waymouth told me this recently as a couple weeks ago that clearly impacted on the morale of the staff it made it very difficult to hire people even if i had given had existed and had exact become exacerbated over a six year period which would have been the middle of your command as the commander of walter reed the six year period was a six year history of the a seventy six which started in two thousand responsible fortunate because as i said earlier he is a fine man he's a great doctor and he's somebody that i have a great deal of respect for but he was accountable for this situation sir with all due respect looking at this memo which is pretty exhaustive and land some pretty serious problems i'm not certain of the way that the bureaucracy operates with the congress operates that these things could have been