Anatomy of Ne­glect

A Pen­tagon panel re­ports on Wal­ter Reed.

The Washington Post Sunday - - Letters To The Editor -

IT’S OF­FI­CIAL: Poor out­pa­tient care at Wal­ter Reed Army Med­i­cal Cen­ter was de­liv­ered by an in­ad­e­quately sized staff suf­fer­ing from “ com­pas­sion fa­tigue”; ne­glected by lead­ers who “ should have been aware of the poor liv­ing con­di­tions and ad­min­is­tra­tive hur­dles” and yet “ failed to pro­vide clear di­rec­tion, or place proper pri­or­ity, on the man­age­ment of out­pa­tients”; and wors­ened by “ desta­bi­liz­ing” work­force changes and out­dated poli­cies on de­bil­i­tat­ing wounds. The fail­ures were both sys­temic and spe­cific, and there is plenty of blame to go around.

For any­one who read The Post’s se­ries on out­pa­tient care at Wal­ter Reed and fol­lowed the sub­se­quent re­ac­tion, none of th­ese rev­e­la­tions should be sur­pris­ing. What is no­table is that they came from a De­fense De­part­ment- sanc­tioned panel con­vened by Sec­re­tary Robert M. Gates. Last week the panel re­leased a se­ries of draft find­ings and rec­om­men­da­tions that was a thor­ough ac­knowl­edg­ment of un­ac­cept­able, wide- rang­ing fail­ure at prac­ti­cally ev­ery level of re­spon­si­bil­ity.

Of par­tic­u­lar note are the sec­tions that deal frankly with the hu­man costs of com­bat in Iraq and Afghanistan. The draft stresses that the mil­i­tary med­i­cal es­tab­lish­ment has not fo­cused enough on the care of trau­matic brain in­juries, blast in­juries and post- trau- matic stress dis­or­der. It rec­om­mends that burn vic­tims who have lost the use of limbs should re­ceive ben­e­fits sim­i­lar to those of am­putees. It also dis­cusses the bu­reau­cratic mess of the dis­abil­ity rat­ing sys­tem used to ad­ju­di­cate ben­e­fit pack­ages and calls for the re­view of cer­tain dis­abil­ity eval­u­a­tions. The De­fense De­part­ment was ill- pre­pared for the phys­i­cal and fi­nan­cial con­se­quences of war.

There are dozens of de­tails that pol­i­cy­mak­ers have to sort out fol­low­ing the re­lease of the draft, which con­tains a num­ber of mostly good rec­om­men­da­tions. Al­ready, a bat­tle is brew­ing over when to close the ex­ist­ing Wal­ter Reed cam­pus. Op­er­a­tions were sched­uled to move to new fa­cil­i­ties in the area in 2011 as part of a cost- sav­ing re­align­ment, but some law­mak­ers want to de­lay the move in­def­i­nitely. The re­port, on the other hand, rec­om­mends clos­ing the fa­cil­ity as soon as pos­si­ble and ac­cel­er­at­ing work on new build­ings at the Na­tional Naval Med­i­cal Cen­ter in Bethesda to ac­com­mo­date the dis­placed pa­tients.

Nei­ther de­lay nor short- cir­cuit­ing en­vi­ron­men­tal re­view at the new site makes much sense. What is im­per­a­tive is im­prov­ing con­di­tions at the cur­rent Wal­ter Reed cam­pus and en­sur­ing that the even­tual re­align­ment oc­curs smoothly.

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