A leading voice on policy and governmental accountability, Donald Gainsborough is the head of Government Curated. His expertise offers a crucial lens through which to understand a recent, troubling report from the Veterans Affairs watchdog, which revealed a systemic failure to track millions of patient calls, leaving vulnerable veterans at risk. We sat down with him to discuss the profound implications of this breakdown in communication, exploring the gap between the VA’s stated goals and the frustrating reality for those it serves, the erosion of trust caused by these failures, and the necessary steps toward meaningful reform.
Reports indicate that at some VA facilities, nearly half of 2.1 million calls went untracked, many for high-risk services like radiology and mental health. What specific system failures lead to this gap, and could you share an example of how this directly impacts a veteran needing critical care?
The core failure is a staggering lack of a standardized, functional system to simply capture performance data. We’re not talking about a minor glitch; in the facilities reviewed, nearly half of 2.1 million calls vanished into a black hole. The auditors found that a shocking 45% of those untracked calls were to high-risk clinics like radiology and mental health, which is precisely where you need the most seamless access. The human cost of this is devastating. The report detailed a veteran’s spouse trying desperately to schedule a radiology appointment for her husband whose cancer may have spread. She was met with nothing but voicemail and silence, despite promises of a 24-hour callback. That’s not just an inconvenience; that’s a potentially life-altering delay caused by a system that isn’t even aware it’s failing.
In 2023, the VA set a clear goal to answer 80% of calls within 30 seconds. Given that basic data like wait times are not being universally collected, what practical, step-by-step changes are needed to first measure performance, let alone meet this ambitious target?
That 2023 directive is a classic case of putting the cart before the horse. Setting a target to answer 80% of calls within 30 seconds is meaningless if you have no mechanism to track if you’re answering one call or a million. The first, non-negotiable step is to implement a universal data collection system across all facilities and clinics, especially the specialty ones that are currently operating blind. Step two is mandating its use and training staff on it, because technology alone solves nothing. Only then, once you have a reliable baseline of data—caller hang-up rates, answer rates, average wait times—can you begin to manage performance. Without that foundational data, the 80% goal isn’t a policy; it’s a press release.
We’re seeing instances of veterans resorting to driving to facilities just to schedule appointments. Beyond the obvious frustration, how does this breakdown in phone communication erode trust, and what are the unseen costs for veterans in terms of time, money, and health outcomes?
Every time a veteran has to get in their car and drive to a clinic just to make an appointment, a fundamental promise is broken. This isn’t just about frustration; it’s a profound erosion of trust in the very system designed to care for them. The unseen costs are significant. You have the direct financial burden of gas and taking time off work. More importantly, you have the health cost of delayed care. For a veteran needing mental health support or a critical radiology scan, that delay can be catastrophic. It creates a barrier to care that disproportionately affects elderly, disabled, or rural veterans. This failure communicates that their time is not valued and their health is not a priority, which is an incredibly damaging message to send.
An IT official confirmed the VA lacks a system to capture call data for specialty clinics, and some facilities reportedly have no plans to address this. What explains this inaction, and what technology or process improvements could be implemented quickly to start closing this data gap?
The inaction is deeply concerning and points to a combination of bureaucratic inertia and a decentralized structure where there’s a lack of top-down enforcement. When seven of the 13 failing facilities report having no plans to fix the problem, it signals a cultural issue, not just a technical one. The admission from an IT official that the department simply lacks a system for specialty clinics is damning. In today’s world, off-the-shelf call center software that tracks every metric imaginable is widely available and affordable. Implementing a cloud-based Voice over IP (VoIP) system with integrated analytics dashboards could be a relatively quick technical fix to start capturing this data. But the key is leadership making it an urgent, non-negotiable priority for every single facility.
The VA has reported short mental health wait times, yet these numbers are disputed while the department has lost 1,500 schedulers. How does this staffing shortage impact the reality of scheduling care, and what explains the disconnect between official metrics and the veteran experience?
The disconnect is explained by the difference between curated data and lived reality. The VA can boast that mental health wait times are under six days for established patients, but that number means nothing if a veteran can’t get through on the phone to make the appointment in the first place. The loss of 1,500 schedulers is a massive blow to the front lines of veteran care. These are the people who navigate the system, and their absence creates a huge bottleneck. This staffing crisis, combined with the untracked call data, is how you get a situation where official metrics look positive while veterans are driving to clinics in desperation. The official numbers are measuring one small piece of the puzzle, while ignoring the collapsing infrastructure required to even get to that point.
What is your forecast for the VA’s ability to resolve these communication and data-tracking issues?
My forecast is cautiously pessimistic in the short term but hopeful if there’s sustained pressure. The release of this “advisory memorandum” by the Inspector General before the full audit is a clear signal of urgency, a shot across the bow to force action. Real change won’t happen because of a single report; it will happen if Congress, veteran advocacy groups, and the public demand accountability. The technology to fix this is available. The real challenge is overcoming the institutional inertia and ensuring that the VA’s leadership makes transparent, accessible communication an absolute top priority, not just an item on a checklist. Without that relentless oversight, we risk seeing this same problem surface again in a few years.
