AFGE.
More than a few VA hospitals, for years, were ‘training’ hospitals for foreign medical grads wanting to work in the US. Some were very good, some were not - in part because they didn't want to work as hard as the US residency programs traditionally had US medical school graduates work back then. When these VA training programs were taken over and amalgamated with US medical school-based training programs, things got better.
The problem is that it's a government-run system, and as such incompetence gets rewarded, people don't get fired, and problems are often dealt with by ‘promoting’ people out of the positions in which they were not doing a good job. I've spent time at several VA hospitals over the years that were affiliated with universities I was at. I've seen some very committed people, including young enthusiastic nurses, be ‘shot down’ by those who had grown comfortable in a lesser pace of work.
It's kind of ironic to me that after years of some really horrendous care at some VA hospitals, without any scrutiny, they are now getting the scrutiny that was sorely needed years ago.
The VA hospital system has, over the years, done a wonderful job in specific areas - such as spinal cord injury patients, the blind, and care of those who have lost limbs. They fell flat in several other areas.
The secret waiting lists are appalling. This is something I never saw at the VA hospitals I spent time at. We, as a country, made a pact with those who put their lives on the line to protect us and our way of life. We promised to provide them with quality health care. This is a promise that must be kept.