house side and that's we have either gone past the 30-day established by the va or they live outside of 40 miles from any va facility, be it clinic, outpatient facility or major medical facility that it would exceed by $7 billion on an annual basis what we spend for the entire delivery system for our nation's veterans. to my colleagues, this is ludicrous. this is impossible for us to even start an intelligent discussion on what we put in legislation and when we have got number that is are this so go's thing grotesquely out of line. let me give you a few other references. va estimated that of the 8 million veterans eligible for va but not enrolled, that if we passed this legislation they would automatically drop whatever coverage they have

today. be it medicare, tri-care, private insurance, fehpb for those federal employees and when they dropped that they would immediately go into the va system for two years. i want to ask you to stop and think about that for just a second. to a veteran on medicare, they're going to drop their medicare, go into the va for two years? and then pay the penalty to get back into part "b" medicare? for an employee who has private insurance, they're going to drop their insurance and leave their spouse uncovered because they see some advantage to being on va? it's estimated that 90% of those veteran who is are eligible but not enrolled in va have less than 50% disability rating. the threshold to where it's va care comes without a co-pay. these are individuals who have already made a determination

that the coverage they're under is the best coverage they could have. if not, they would be enrolled in the va today. so, the fact that cbo now says with just the execution of this minor reform legislation it would trigger 8 milliillion peo in the system that exist and don't enroll is just as ludicrous as $35 billion or $44 billion price tag that cbo has put on the bill. cbo determined as you would imagine that only 3% of their cost is attributed to the 40-mile trigger that we put in the senate legislation. in other words, there are very few veterans around the country living more than 40 miles from a va facility but like i have heard some of my colleagues say, when you've got something that makes as much common sense as this, that it's less expensive to let them get local care than

it is to pay their reimbursement to a va facility, can't we accommodate the veterans once? his needs and the taxpayer's fiduciary responsibility to come out cheaper by doing it. this is the only place within the cbo score that they actually agreed that the impact is minimal from a standpoint of the number of people that are affected. so, it leaves one thing. how could cbo come to the conclusion that the va was at a point where it couldn't add any more enroll lees without a masse increase in providers? in other words, the va's full. don't knock. don't come. well, let me suggest to you that the va just on one matrix and that's primary care panels sees 1,200 patients when non-va providers see 2,500 patients. the va sees 1,200 patients on a

primary care panel when the non-va providers see 2,500 patients. when we talk about systemic problems, talking about cultural changes, this is not targeted at folks that veterans don't see every day. it's targeted at providers that for whatever reasons within the va don't conduct themselves at the same rate that non-va providers, in fact, experience. so, i say to my colleagues, i hope that the chairman and the ranking members will challenge cbo on the score to start this process we need to know exactly what it is that happens when we begin to move the dials one way or the other and to start at the point we have started because of

that score is, in fact, more challenging than anything i could ever think of. i thank the patience of the chairman. >> congressman? >> thank you. i would like to thank the chairman and ranking members of the house and senate va committees for the leadership on this issue. it's a real honor to be a member of this conference committee and i look forward to working with you all. the last of transparency at the va and the very nature of data manipulation and secret wait lists have made it very difficult to expose the true nature of the problems facing our veterans. there are almost 100,000 veterans living in my district. in an effort to find out a they're seeing, i've held conference leaders with local leaders, spoken with the facility directors in denver and colorado springs to evaluate the quality of care and i've put out a call to veterans to call my office. we have subpoenaed documents and testimony, heard from numerous witnesses from the va. i've sent multiple letters demanding answers as i'm sure all of us and supported

legislation to expand fee basis care and to give va leadership more flexibility to fire negligent employees. at first, the va attempted to down play the significance and extent of the problem. only through the efforts of whistle-blowers, brave individuals from across the country that have taken great risk to expose the truth, has the depth of the issues at the va come to light. subsequently, the interim va office of ig validated the claims and labeled them systemic. yesterday, the va's bimonthly access data said the electronic wait list in denver had more than doubled since their last report just two weeks ago. this problem is not getting better. it is getting worse. we cannot kick this can down the road. we can't simply seek to create an assembly line to get veterans in and out faster without regard to the quality of care. ultimately, we must focus on changes that yield better health

care outcomes for the veterans through timely access to quality care. in order to achieve this and ensure that these solutions are lasting, there are multiple items that have to be addressed. obviously, we must pave the way for the va to use non-va care to expand veteran access and clear the current backlog. but we can't just fix the problem by simply throwing more money at it. the va has had more medical care funding than it could spend during each of the last four fiscal years. to include $1.4 billion as recently as 2010 and was set to carry over $450 million this year before dipping into those funds for the current accelerated access to care initiative. this is led to multiple testimonies by both va and non-va witnesses who have noted that the biggest issue is not a lack of funding but a welcome of accountability. for this reason, the legislation that we mold must hold individuals accountable who fail to meet performance standards and oversee mismanagement and

neglect. the perverse incentives that led to the manipulation of scheduling data and secret lists must be eliminated. any incentives going forward must have an impact on improving patient satisfaction, outcomes and productivity. finally, the ultimate product must protect whistle-blowers that step forward to share the truth. the last thing they should face for standing up for the veterans is retaliatioretaliation. we can't seek to create a sy semibring line for veterans getting in and out faster. the efforts must lead to changes that yield better health care outcomes for our veterans. that's more important than metrics. this is what our veterans have earned and they deserve nothing less. thank you, flchmr. chairman, i d back the balance of my time. >> thank you. senator rockefeller. >> i thank both chairmen very much as well as ranking members. it has been 15 years since we

did this which is not a very happy statement in and of itself. it's a long time. anybody here remember the name jennings randolph? anybody? >> yes. >> you do? good. >> served with you. >> yeah. no. i took his position on this committee. in 1985. and i've been here ever since. i became chairman in 1993 and i want to give a little bit of context to this, too. how we've tortured our way along. i resolved to do anything that any chairman would resolve to do. we were faced immediately with unresolved illness questions coming out of the persian gulf. and so we had -- started having hearings on gulf war illness, and the soldiers were told, men

and women, to take something called predastitic bromide and not approved by the fda for animals much less united states military personnel. we had a lot of meetings and fights and still going on and nothing is totally resolved. at that time veterans told and some extent pretty much are and they're in their head and take an aprint and go home and sleep it off. it's amazing to me that the government could allow something like that to happen. that was gulf war. and it was a very special, painful experience for a lot of us. then we moved on, actually began with -- first thing i did when i got here is atomic veterans dying from radiation in terms of

exploding bombs in various places for the second world war. during the second world war. later we worked on veterans suff suffering from the effects of agent orange and i think we all remember the powerful testimony of admiral zimwold and how that testimony virtually turned the entire argument around as his son had contracted cancer from agent orange. and then, since 9/11, we have heard from soldiers exposed to burn pits and sodium dicromate. so everything has a history and everything is hard. i don't think anything underscores the vital need for services today and the veterans administration more than ptsd. it's a simple word, so vastly complex. so vastly attacked. we make progress in cancer. we don't seem to be able to make enough progress in ptsd and

people suffer horribly. you go back home and you listen, no press, no staff. and you listen to veterans. at first it was veterans wives when the iraq war was just starting up. and then veterans themselves. and the sheer terror of explaining their experiences, the advantage of a nobody except you and eight ptsd sufferers. discussing what they found that they had found themselves doing in horror, pushing children, sitting on the laps softly away from them so they wouldn't hurt them. not being sure what their reaction would be. i mean, the hurt is just -- it's so astounding and so heartbreaking and yet we're still working on it. actually, there's very good work being done. some of it in vermont on ptsd. and i had a cousin who was killed recently very much a part of that.

obviously, all of this is unacceptable but i want to be absolutely clear in what i'm saying, we need to improve the va, not tear it down. when the gentleman indicated we need accountability more than we need money, we need both. we need both. you can't get pediatricians, you can't get clinical psychologists or anybody else to come and serve their nation the way the veterans that they would treat, the mental health issue is overwhelming and not well understood. it's so deep because unless you've, you know, gone through what john mccain did, how do you possibly understand all of this? if i eve learned anything, it's that we need to listen to veterans. we need to respond simply to what their needs are. in some ways, it is not that complicated. and i just don't want us to do

what we have done to so many other generations of veterans with complaints who have died, the guy in the wheelchair sitting before us at my very first veterans hearing talking about what it was like to die from cancer, that he got because he went into a radiation area. this conference is a very important conference i need to say. thank you. >> thank you very much, senator rockefeller. senator roe. >> thank the chairman very much and would like to thank everyone in the room for their dedication to serving veterans on the respective committees. as i said last night in the hearing i think for the veterans who can get in there, they can get good care but the committee has an opportunity to elevate that to great care for all veterans. i think that's one of the goals. i see two problems. one, the backlog easily fizzible. the other is the culture of the va which is going to be much more difficult to fix. i find it almost

incomprehensible that people would place people, veterans, any patient, in a delayed status and then gain financially which is what happened in phoenix, arizona. it is unbelievable we let that happen and set up a system where that could happen and reward people for doing that. i am a veteran. i served in the second united states infantry division, 1973 and '74 in korea and senator mccain, thank you and the other veterans around this table for your service and i spent about two weeks ago about 30 minutes in the hanoi hilton. that was enough for me. i also trained at a va medical center. i'm a physician, i was in the medical corps and practiced in the private sector over 30 years a eni believe i have the unique capacity of a hospital to operate efficiently and we need to look at best practices on both sides and streamline efficiencies to allow doctors to see more patients. as was stated by mr. lamborn, each doctor should be seeing as

many as we saw on the private system and there are systems that stepped up at a call yesterday from memphis, tennessee, that in 72 hours, seeing any veteran on a primary care or a specialty consult, 72 hours. it took them less than a week to do that. our practice is right now ready to do the same thing. another xamplt of the amount of time for veteran, i was at my ophthalmologist yesterday getting examined and saw here in washington, d.c. a veteran in january who needed to be seen, didn't get seen and five months later, gets seen. has a retinal tear and probably going to lose some of the vision in the eye because of this delayed care. we all have heard stories like this. no matter how much the private sector wants to help, they can't do it unless they get prompt payment from the va. and sometimes i've talked to providers taken a year to get paid for services they provide. the va is that slow in providing the services and can't expect the private sector to really

shore up the va if you don't pay them for it. there's a simple way to do this. you allow and i think senator mccain had this idea several years ago. allow veteran to go out and see me as a patient, as a medicare patient. very simple. it's not a complicated deal at all. if the veteran is low income and can't pay the co-pay, the va covers it and medicare covers the rest. we can do this for our veterans very, very easily. and but i think also for this bill to be fiscally responsible we have to be sure and careful who we open va care up to. i don't need to be on the va care right now. i have adequate health insurance as a veteran. i don't need to be in line in front of a needy veteran and millions of us that feel the same way so i don't think we can afford to expand coverage to every veteran. right now. and i really truly believe this. bottom of my heart that throwing more money at a system that's behaving like this would be the

wrong thing to do. i think we have to change this system the way it's currently working or we're going to just make the problem worse. the backlog we can fix. we've got to change the culture. i said this a couple of weeks ago. if you ask anyone that works on a va campus who they work for, they'll tell you the va. the right answer to that answer should be i work for veterans. that's who -- that's the answer that should be. that's not what you will get on most va campuses so i've -- really appreciate this opportunity that everyone around this table has. we have been given a unique opportunity to change a va system for decades to come and we need to do this right and i certainly look forward to working with each and every one of you to do that. with that i yield back my time. >> thank you. senator isakson. >> thank you, appreciate what everybody's done. i want to particularly acknowledge senator mccain, a

committed person to veterans that rolled up the sleeves in the senate, worked as chairman sanders and saw to it a product out of there and senator coburn who's a practicing physician and an absolutely committed oversight member of the senate with solutions included in the senate version and hopefully in the final product. i very much support the accountability. i very much support the choice. but i also think we all need to recognize that while it is an emergency, chairman sanders, over time the solutions are permanent. and they're going to cost permanently and we have to be sure we're paying for them. i think senator burr is absolutely right. i made the comment at a dinner the other night i've always been mad at cbo not doing dynamic scoring in terms of positive revenues from positive tax policy. this is dynamic expenses in the way they scored this and, chairman burr, ranking member burr made excellent observations we need to work on. the improvements in this bill are great. the veterans need them but we need to make sure we're

committed as members of the united states congress and united states senate to do the oversight so culture of corruption is culture of accountability and account tonight the veterans that served and because of their service we are all here today in this committee. my personal experience with accountability and oversight and the va and i'll hush after this, took place in august of last year when i called a hearing in atlanta because of the three suicides that had taken place. we had a hearing. the doctor was there. everybody but secretary shinseki. fox care railroried it on tv an changed. a recent report i called on the ig for six months ago just relowe'sed on friday showing the marked improvement of atlanta in terms of accountability, in terms of transferring people not doing the job, tracking the veterans, particularly those in mental health and the security necessary in the hospital to see to it the drug overdoses happening in the past no longer happened again and that specimens taken for the purpose

of diagnostic had the type of security we have in most hospitals you see and certainly the clinic here in the united states capitol. change can take place and take a culture of corruption and make it a culture of excellence if you know somebody's looking over the shoulder so as we finish this conference committee, make a report to the congress and pass a bill that hopefully deals directly with the problems, make sure we don't go home, turn off the light and say we have another job next week. we have the job of oversight to see to it veterans health care the best it can be not just today but every day with authority in the united states house and senate. thank you, mr. chairman. >> thank you, senator. congressman takano. >> good afternoon, co-chair sanders and co-chair miller. thank you for the work you have been doing and also thank the ranking members. it is an honor to serve on this conference committee. in the wake of reports of misconduct within the va learning so many of our veterans aren't receiving the care they need in a timely manner and

allegations some veterans died as a result of long wait times and the deaths may have been covered up, i look forward to us all working together to pass a bill that will give us -- that will give our veterans access to the health care they need and deserve. it is clear that any solution must include accountability mshls for va employees, improve vha scheduling practices for appointments and prevent future abuse and provide our veterans with timely access to quality care. it is also clear especially in light of yesterday's allegations about cover-ups at the phoenix va that we need to re-evaluate the culture at the va and take steps to ensure that the department truly is veteran centered. our goal should be to strengthen the va health care system, not dismantle it. by and large, once they're in the va, health care system, veterans say they're happy with the care. our final legislation should break down the barriers to entry. we have learned about in our

hearings. we must also remember that what works for one region of the country won't necessarily work for all. giving veterans the opportunity to seek non-va health care may be a solution in areas where private care is plentiful. in districts such as mine with a shortage of health care providers, i don't know how much a difference it will make. every member of this conference has service areas, populations or health facilities designat i as professional shortage areas by the depth of health and human services. for primary care that means the physician to people ratio is 1 to more than 3,500. for mental health, a specialty we know is critical for veteran population, that psychology is 1 psychiatrist to 30,000. further more, the va's internal audit found front line staff members said the single biggest

barrier to care is lack of provider slots and that's why i believe increasing capacity should be a key component to the final legislation. yesterday, i joined representatives titus and o'rourke, fellow members of the house veterans affairs committee introducing legislation to increase slots at va medical facilities by 2,000. i hope that this committee's final legislation will include modified language from the amendments section on health care recruitment and appointment based on the bill to establish new residency positions at va hospitals. finally, as we expand choice for our veterans to non-va providers, we must ensure that there is continuity of care. the non-va providers should maintain electronic health records through a system interoperable with the va system and at least encourage that inner opinionerability.

we know the problems with the electronic health record systems. i don't want to see that mistake repeated as we encourage more non-va care. thank you, mr. chairman. i yield back. >> thank you. senator murray. >> thank you very much, mr. chairman. i believe that when it comes to caring for our nation's heroes we can't accept anything less than excellence. so while the department generally offers very high quality health care and does many things well or as well or better than the private sector, i'm very frustrated to be here once again talking about these deeply disturbing issues and allegations. it is extremely disappointing that the department has repeatedly failed to address wait times for health care. jao and the inspector general reported on the problems many times over the years and last congress we did a great deal of work around wait times, particularly for mental health care. we learned then that the va has no reliable or accurate way of knowing if they're providing

timely access to mental health care and i think the va is starting to see that business as usual is not acceptable. so i'm very glad to be serving on this conference committee. calling for a formal conference committee is rare step on veterans issues and i think shows how severe the problems facing the va are and how serious members are about fixing them. there have been major bipartisan efforts in both the house and the senate to move legislation addressing these probables. many of the members here have been part of those efforts and i commend them all for their commitment to bipartisanship and putting the needs of our yvette rans first. i personally want to thank chairman sanders and senator mccain for work they did over the last few weeks to get us here. i appreciated working with you over those weeks and look forward to where we can make compromises to pass a bill and ensure that the veterans get the care they need and deserve. i also want to commend chairman sanders and chairman miller for

bringing this conference together. as it shows how serious the two of you are about getting to the heart of this matter and addressing this critical issue. working with both of you over the last years i know how dedicated both of you are when it comes to taking care of our veterans and i appreciate it. now it's vit ral to build on the bipartisan momentum to address the concerns plaguing the va and fix its deep-seeded structural and cultural changes. bills before us have some important provisions to help address the very complex problems. first and foremost, caring for our veterans is a commitment we make as a nation when we go to war. our service members have sacrificed much and we need to make sure that their country is there for them when they come home, no matter what it takes. i know memberless here have a wide change of concerns and helicopter to work with everyone here to address the concerns responsibly and in a way to put the veterans first and give it

is va the tools they need to address the challenges that we face. that means building and strengthening the va system so it delivers the best care over the long term. so it is very important for us to act quickly to start making these changes. and as more problems are uncovered and as the investigations proceed, we will need more action from the va, from the administration and from this congress. because the government made a promise to the men and women who answered the call of duty and one of the most important ways we uphold that is making sure the veterans access the health care they need and deserve so thank you very much, mr. chairman. >> thank you, senator. congressman florez. >> thank you for calling this committ committee. i thank each of the members for joining us in this important cause. i'm humbled to serve working to finalize legislation to help our nation's veterans. when our military men and women return to civilian life we owe it to them to keep the promise and provide them with the best

health care services and benefits as possible. the va health care system is plagued with poor performance and an unresponsive bureaucracy. over 57,000 veterans have had to wait over 3 months to receive their first medical appointment. and additionally, nearly 64,000 veterans never receive the requested appointments. having just one veteran denied an appointment or waiting longer than necessary for care is unacceptable. we must focus on creating a more accountable va with a smaller bureaucracy. as original co-sponsor, i'm pleased to see the legislation come closer to reality. this legislation provides those veterans waiting for care the ability to see a doctor, health care provider outside the va health care system immediately. it will make sure that fewer veterans suffer as a result of va's inability to provide timely care. it's been disheartening to learn the va is failing to do the

primary job and veterans suffering because of va's misconduct and mismanagement. also look forward to a positive resolution on the bipartisan bicam real language of accountability for va management. i believe the new va secretary will need the tools to cut through the mounds of red tape to discipline and remove senior leaders that cultivated a culture of sub standard behavior. the culture lost the way and need of leadership to restore focus toward the core values of integrity, commitment, respect and excellence. it is time to put the interest of americans veterans ahead of the interests of federal bureaucrats to keep our promises to the brave men and women that provided freedom and liberty. the department is failing to do the primary job for the best health care and benefit services to the veterans. it is time that the underperforming senior leaders are fired or disciplined opposed to status quo of ignoring mismanagement and rewarding

misconduct. the nation's heroes deserve better. i look forward to coming together to iron out the differences between the respective bills to ensure that our veterans receiving proper, timely care. longer term, we in congress need to chart a path to build a va for the 21st century. a va that is focused upon putting veterans first and following the core values. this new va should be smaller, more agile, less bureaucratic, more responsive to america's veterans and a better value to hard working american taxpayers. we need to adopt a moon shot approach to do this in the near future. thank you. i yield back. >> thank you. senator brown. >> thank you, mr. chairman. chairman miller, thank you. it's an honor to serve on the committee and thanks to senator mccain and senator sanders for their work in shepherding a very good bill through the united states senate. i've served on this committee for eight years in the senate and never seen anything but

people in both parties, ranking members, chairs, whatever, that always put veterans first in both parties and we should all be commended for that. congressman roe said something i thought was particularly apt. it's the care, once in the va, the care has been very good for the 6.5 million american veterans who have been in that system. it's access to that system that's the problem. we have veterans waiting too long for care. we need to fix that. we have a culture at far too many facilities problems were hidden. that's why we're here today. for the so-called choice card, we have seen this before. in september of 1993, president clinton addressed a joibt session of congress. several of you were there that day. for those that weren't or don't remember, let me remind you. the president talked about reshaping the country's health care and holding up a card that looks like the card that we will see, a choice card. he said every american would receive a health care security card for a comprehensive package

of benefits over the course of an entire lifetime. instead of privatization schemes, we should make the va simply make the va better. va provide care and services unmatched in the private sector. there are questions of diverting money from care to profits. there are significant questions of medical privacy as veterans would be shuffled between the va and the private sector. and we know what happened in the last ten years. a dozen years ago, we went to war without paying for it. a dozen years ago when we went to war we failed to scale up veteran services and ensuing decade we have seen because of agent orange, presumpbltive eligibility, hundreds of thousands of more people demanding and earning services from the veterans administration. some of have launched an un -- what i think is an unfair attack on the vast majority of va employees who are dedicated public servants to the nation and the veterans. these employees chose a career serving veterans, many, many of

these employees as you know and each of your districts and states are veterans themselves. these employees whether it's a police officer at the dayton va, whether it's a claims of -- it's a claims processor at the cleveland's va or whether it's a nurse at the toledo community-based outpatient clinic, these employees are on the front line of care, their ones reducing the backlog, they're helping to eliminate veterans homelessness. they're the one senator isakson talks about trying to prevent suicide and create new ways to serve the veterans. 6.5 million veterans used the veteran health care system in 2013. 85 million patient visits. we shouldn't castigate those innocent and condemn va employees at large for the wrongs for a few and same time make everybody at the va accountable. thank you, mr. chairman. >> thank you, senator.

congresswoman brimly. >> thank you, mr. chairman. as the proud representative of ventura county, in california, home to naval base ventura county and prouder representative of the 40,000 veterans who live in my district, i want to get this right. we must get this right and i know my colleagues here today also want to get this right. problems at the va are not new. they have spanned decades. congress has promised to take care of our veterans, the american people want us to take care of our veterans and our veterans and their families have earned and deserve to be taken care of. they have sacrificed for our country and now our country must sacrifice for them. we are here today at a pivotal moment for the va and for our veterans. we must act decisively and fix what must be fixed. as i sit here with my colleagues both republican and democrat, i

know all of you care deeply about our veterans and i know that all of you truly want to fix the problems currently plaguing the va. i also know that what happened in phoenix was intolerable. that the va must undergo a complete cultural and systemic transformation. and that individuals at the va should and must be held accountable for their actions. but i also see this terrible tragedy as an opportunity to make real changes. an opportunity we must seize. an opportunity for this congress to show the american people that it is not -- that it not only has the will but the way forward to make the va better, to provide the resources our veterans not only need but have earned and to live up to our purpose. our purpose to serve our constituents, to serve our

country, and to serve those who have served us. our veterans deserve no less. the american people expect no less. and we can do no less. i look forward to working with all of you in good faith and to put aside ideology and partisanship so that we may find the courage to do whatever it takes to seize this moment, this opportunity, this purpose for which we are all here. and that is, to put it very simply, to help our veterans receive quality care in a timely manner. it is not too much to ask. i yield back the balance of my time. >> thank you. senator mccain. >> well, i thank you, mr. chairman. i thank you for your kind words and those of other members. i'm very appreciative of that and i would like to thank you for the very vigorous discussions and compromise that we we reached.

i would like to thank senator bure for his work and senator coburn. in fact literally every member of this committee had a role to play in bringing about this legislation. i think other members have described, i think in moving terms the dimensions of this scandal and this include just today we learned of allegations in the phoenix, that records of dead veterans were altered to make the wait times look better. frankly, i don't think that's the last shoe to drop.

i'm afraid there's more, and i think it gives you a great you are sense of urgency to act. i would like to just for a minute say somebody about the cbo scoring. i think if anybody looks at that scoring in a rational viewpoint that it is wildly inaccurate, and i think it's important for all members on both sides of the aisle to really understand how that is a totally unrealistic estimation of the costs involved here, and i think we ought to look for ways that we can pay for the -- these expenses. but i would also argue that if there's ever such a thing as an emergency, it is this issue. i don't know any other obligation that we have to any of our citizens that's greater.

so i appreciate especially the work that dr. coburn did that's available today. it's a report that he's releasing called friendly fire, death, delay and dismay at the v.a. an in-depth study of some of the additional problems he has overcome. so i guess finally i would ask my colleagues. we are all going to be going out of session here the end of this week. i hope we can as a minimum lay off the parameters of what needs to be resolved. i don't think this issue can wait, and i appreciate the participation of all members who are here today, and i thank my colleagues. >> thank you, senator mccain congressman benishek? >> thank you, chairman and fellow members.

at we have an opportunity -- the things we can accomplish here will mean the world for the veterans. together we have to fight for them and help ensure they have the access to the care they have earned and deserve. the reform bills passed by the house and senate represent a historic assault on the culture of complacency and mismanagement. as a doctor who served at the v.a. in iron mountain for 20 years and as a father of a veteran, i take this issue personally. our veterans deserve much better than what they've been receiving from this v.a. whatever you're differences may be, i believe i'm saying in say we all believe the v.a. must emerge from this process much more responsive to the needs of our veterans. i believe we have two chief responsibilities on this committee. first we have to give the v.a. the tools it needs to succeed and institute real, lasting accountability. second, we have to provide for the immediate care of all our

veterans, who have been forced to wait too long, as well as those who have lived long distances from v.a. facilities. we need to put the v.a. on a path to permanent success. this cannot happen without a detailed look at what exactly went wrong. and a strong plan for accountability moving forward. we know that many of the front line care providers are some of the best out there. and we know that layers upon layers of bureaucracy are keeping these care providers from doing their job. but much more is yet to be uncovered. a key component of the house bill lays out a detailed independent assessment to be carried out by a private sector contractor. this contractor must have the knowledge of the v.a. system, and most importantly a best health care delivery practices in the private sector. we should be tapping the best health care minds that we have

in this country to go step by step through the vha system and write us a blueprint for the lean, smart 21st century v.a. that serves our veterans. >> the isolated records have been done in the past, parsing out specific problems, this reform should be an historic opportunity to look at the veterans health administration as a whole and compare it directly to the highest performers in the private sector. there is much we need to know. we need to know exactly why past attempts at implementing physician staffing standards have failed. we need to understand the big reasons for making improvements and as new opportunities for veterans to receive care outside the traditional system emessage, we knee to ensure the v.a. will properly collect the resources owed to them, not continue to leave money on the table that could be reinvested in veteran care. the house language helps address these issues, but more needs to

be done. i'm just not confident we will get the information we need and the goals accomplished if we don't look outside the v.a. too proven leaders in the health care industry. before we get to planning for the future, however, immediate steps need to be taken to get or veteran off waiting lists and into exam rooms. on this basic point both of house and senate agree. i believe we can do this in a responsible and effective way. i don't want veterans having to jump through hoops to qualify to see their local doctor. our veterans have been through enough. no longer should they return from fighting the enemy just to find themselves in a brawl with the v.a. bureaucracy. the language is written so that veterans need to wait for the v.a. to first put them on an actual waitlist and wait 13 or 14 days before they're eligible to even begin looking for private sector care, then we haven't done our job here. if the authority we grant the

v.a. looks eerily similar to the authority they have, but choose not to use, we could be risking being in this situation all over again. the authority has to be specific and clear. veterans can't be allowed to wait endlessly on lists anymore form the v.a. has to be forced to stream did not line this process. of course both the items i brought up this afternoon will only be effect i have been if the v.a. is held accountable in the future. i futurely support the accountability provision for ses employees and appreciate the senate bill leans in that direction as well, though there are more questions to answer. when the v.a. concurs with an inspector general recommendation, who is responsible for following through? what action is taken when a manager fails to address the issues raised by the iismt g? why are they still getting bon uses if they don't comply? thank you, mr. chairman, and

both i thank you for your continued leadership and look forward to working with you. >> thank you. senator testa. >> i would like to thank everybody on this committee, as everyone has said, it truly is an -- i go back to montana, where the per capita is second highest in the country only second to alaska, with the veterans, and they give me an earful every weekend i go back, and they're upset for all the reasons stated today, but i also like what was said. one member said improve the v.a., don't tear it down. another member said deal with the back did log and deal with the culture. thank you for that. deal with best practices. they should be givens, and prompt payment for private sector providers is critically important or we won't get it done. but i also think we need to be careful. we will not be able to increase recruitment unless we put something on the line.

i think we ought to be taking caps off student loan programs for nurses and doctors, and no doubt about it, recruitment is a problem. i can tell you the private providers don't have docs either, so we have to figure out how to solve this problem. i think removing the caps is one that can help with that commitment. project arch, which is mentioned by the ranks member on the house side, is a program that senator mccain supports and i do, too. i hoe we can fund that program. it's been a program that worked very very well. we need to make it real. i want to talk about the 40-mile access rule in the bills. i think that we talk about the number of patients that are seen in the v.a. versus the private sector, and i would say this -- we've got to be careful not to make this an assembly line. many of these folks have issues that the private sector patients do not have, and they need time.

i think if we're running them in and out like cattle through a squeeze chute, we're going to create a big problem and we're not going to have the health care that they need. when it comes to mental health, providers, i think we have one east of billings to the border. that's about 250 miles, and there's a lot of veterans in there. so the private sector doesn't have any providers, either. so we've got to figure out ways to meet they needs, because we all know that mental health issues are the number one injury coming out of iraq and now afghanistan. the last thing and it's very, very important, is we need to continually analyze, if we do this program, its effectiveness not only to the veterans, but the effectiveness for the taxpayer. there is no ifs, ands or buts about that. if it costs more money and that treatment isn't significantly better, we have a problem. i want to thank the chairman and ravening members once again, and i yield my time. >> thank you.

congresswoman kirkpatrick. thank you, chair sanders and miller. i want to thank our senior senator mccain for his hard work on this issue. my colleagues on the house veterans affairs committee have heard about so many issue that is plague the v.a. in hearing after hearing. the latest report from the office of special counsel, the reports of additional cover-ups in the phoenix v.a., and reports of retaliation against whistle-blowers are damning. and only increase the urgency for this committee to act quickly and adopt a version of the senate's expansive reform legislation. we can address these issues now by agrees to an expansive reform rather than piecemeal legislation that only addresses some of the problems. we can enact comprehensive legislation that does more. sweeping reform of the v.a. can start today. last night i asked our v.a.

witness if the v.a. was capable of innovation. they want yes. we must demand innovation in the v.a. by passing comprehensive reforming. we can solve the patient access problem, stop the deceptive appointment scheduling practices, mandate transparency, and hold the v.a. employees accountable by adopting comprehensive reforms. we can empower the v.a. to transform itself into a world-class health care system. my top priority is solving the v.a. access to care crisis. our veterans must receive timely world-class care now and in the future, so that we never again face another patient access crisis in the v.a. we can do this in two ways, by solving the v.a.'s own access and capacity problems, and by expanding access to non-v.a. care. first, the v.a. must have the authority to expedite hiring of

health care professionals, so that the v.a. facilities are adequately staffed to meet the growing number of veterans in need of care. second, the v.a. must have the authorization to lease more facilities so that the providers have the space to care for veterans, and so that facilities exist closer to our veterans. senator tester, i represent a very large rural district in arizona, and everyone has trouble getting access to health care. you're right about that. >> clinics must be fully staffed. phoenix arizona needs another community-based outpatient clinic. third, well-must expand access to care for, and for veterans who have waited too long for care. it only makes sense to give veterans a choice card that allows veterans to receive their health care through medicare providers, and at federal health care facilities if they live too far away or have waited too long.

we must strengthen the partnership between the v.a. and the indian health services, a partnership that is working on the navajo nation in my district. the senate proposal does just that, and it is also less expensive than the house's version by $16 billion. i highlight only a smart part of the senate's v.a. overwhat you will legislation will do to help our veterans. i urge all my colleagues on the committee to championship sweeping reform of the v.a. today. the v.a.'s reformings good for my district, and veterans across the country. thank you, and i yield back. >> thank you. senat senator begich. >> thank you.

i know we have all talked about the systematic problems. i want to be very clear, as we work through this, i want to see a piece of legislation that ensures accountability and restores public trust in the v.a. system. my state is one fifth of the size of the mass of the united states. 0% of our communities are not accessible by roads. we have no v.a. hospital. we have a clinic in seabox, and we have the highest per capita of veterans in the nation. we have a unique situation in trying to create access. once people get into the system, they like their doctors, but access is one of the biggest problems. in alaska, it is more apparent the problem. veterans in alaska have unique needs. the sheer size of the states creates challenges of delivering health care and many live off the road system. with air transportation as their own system, which is heavily dependent on weather conditions. most of them do not get their

care needs they also knew we needed to take care of veterans in places that did not have a v.a. or private doctors. we did that by working directly with the secretary shinseki anded tribal health providers. each provider has a unique agreement with the v.a., with the goal of provides care to veterans who sometimes travel thousands of miles. to date there are 25 agreements with alaska tribal health providers, and agreement with the federally qualified health centers. alaska v.a. has made great progress. in the last four years by expanding outreach, tele medicine, and reducing wait times, sometimes in just less than a week. in our private facilities that are tribal health providers and our federally qualified health centers, if they're on the list,

they get service the same day. given alaska's unique challenges of making health care accessible, i believe alaska serves as a unique model as we try to resolve access. we have in our tribal health provider system, we have an internationally recognized system, which is designed to deliver health care with results, not just processing people through the system. for the purpose of this conference, the committee i would like to put forward the model of alaska hero card, expanding the rural areas around the country. if it works this alaska, as i tell people, can can work anywhere in the country. as for the shortage of providers such as wasilla, where there was no primary care physicians, the alaska v.a. worked on an agreement with the veterans who choose to now access and go across the street to a brand-new clinic run by the tribal provider and get their primary care with no wait time. for mental health my bill with the co-sponsor, would authorize

the v.a. to recruit a select number of psychiatrists with 50% being from rural areas by offering loan repayment incentives. according to the president's fiscal year 2015 budget, requests more than 1.4 million veterans received specialized help. initial more than 55% of the post-9/11 veterans have a mental health diagnosis, and nearly 6,000 veterans commit suicide each year. the need was for more psychiatrists to meet the mental health and substance abuse treatment needs of our veterans. as for construction, i know this bills looks at construction to look for a way to build v.a. buildings and that facilities for future buildings, and to ensure that they are built on time, within their budget, and save taxpayer money.

a it's not perfect, but we are an extreme rural frontier, so to deliver health care in alaska is a great effort, but

start reading and join others to discuss the book in our chat room at booktv.org. booktv, television for serious readers. >> and now live to london for british prime minister question type it each week the house of commons is in session we bring you prime minister david cameron taking questions from the members of house of commons live up wednesday morning here on c-span2. we invite your participation

using hashtag pmqs. prior to question type members are finishing up other business. now live to the floor of the british house of commons. >> the right thing for me to do is write to them with a detailed answer. [laughter] >> order. before i call mr. damian collins at the start of questions for the trimester, i wish to inform the house how i will be applying the house rules to in the exchanges on the case. i asked the house for some forbearance as is important for members and those outside the house that the position is clear. the house will no that mr. coulson has been convicted on a charge of conspiracy to intercept communications. the court has not yet sentenced mr. coulson. there hasn't yet been no verdict

on two charges against him of conspiracy to commit misconduct in public office your the rules of the house resolution from which the house rightly expects me to enforce, applying to criminal cases which are active, they cease to be active when, and i quote, they are concluded by verdict and sentence. so they apply in this case. at the same time the house resolution gives the chair discretion in applying the rules. i have taken appropriate advice as the house would expect, and, indeed, being in receipt of unsolicited advice -- [laughter] -- for which i am of course grateful. in the light of all the circumstances i have decided, one, to allow reference to mr. coulson's conviction, 2, not to

allow reference to his sentencing by the court such as speculation on the nature of that sentence, and three, not to allow reference to those charges on which the verdict is awaiting. i relied upon honorable members to exercise restraint, but if that proves unabated i will of course intervene. i hope that that is helpful for the house. questions to the prime minister. mr. damian collins. >> here, here. >> thank you, mr. speaker. thank you, mr. speaker. this morning i had meetings with ministerial colleagues and others, and in addition to my duties in this house, i shall have further such meetings later today. >> andy coulson conviction shows that the parliamentary inquiry was consistently misled by -- at the expense of the knowledge of

phone hacking. so does the prime minister agree with me that our first concern should be to regress the victims of phone hacking and also to all the democratic freedom of a free press? >> i think my friend is right. the first thing is that we should remember the victims, people who have their privacy wrecked and we should ensure that that cannot happen again. as we do so we must as he says cherish a free and vibrant press in our country. i said yesterday and the sake and today i take full responsibility for employing andy coulson. i did sell the basis of assurances that i received but also the select committee received but i always said if those assurances turned out to be wrong i would apologize fully and, frankly, to this house of commons, and i do so again today. i am sorry. this was the wrong decision, but i think it's right that we that a public inquiry in this country and it is right with proper

investigations. yesterday once again showed that no one is above the law in our country. >> ed miliband. [shouting] >> mr. speaker, today we know that for four years the trend threes handpicked, closest adviseadvisor was a criminal. and brought disgrace to downing street. we now also know that the prime minister willfully ignored multiple warnings about him. on the eighth of july 2009 "the guardian" published evidence of phone hacking on an industrial scale while andy coulson was editor of the "news of the world." at that time andy coulson was his director of communication. what action did he take? >> as i said a moment ago the assurances i sought and received with the same assurances received by the press complaints

commission, by select committee of the south and by police investigation. they were also thoroughly gone into by the leveson inquiry, and inquiry he supported. specifically, and he talks about warnings, specifically on the warnings from "the guardian," leveson had to say this. the editor of "the guardian" did not raise the issue with mr. cameron at meetings both in the months after the article was published in the following year. and he says this, he says this, and audible members want to hear, there can be no criticism of mr. cameron for not raising the issue here we have an exhaustive inquiry. i know we didn't will write the results that he should accept them. >> mr. speaker. that was a long winded way of saying what is gained andy coulson he just didn't want to know the editor. first warned and ignored. let's move on to me 2010.

the deputy prime minister warned him in person about is deeply concerned about andy coulson. so he was warned by his deputy. what action did he take? >> every single one of these issues was dealt with by the leveson inquiry. >> order, order. order. mr. lucas, calm yourself. i am trying to offer you on a weekly basis therapeutic guidance but there's a long way to go and you need to be calm on both sides of the house. the prime minister. >> every one of these issues was dealt with exhaustively by the leveson inquiry. the terms of reference of the leveson inquiry were agreed by the right honorable gentleman and they included, i quote, the extent to which there was a failure to act on previous warnings about media misconduct. that is what leveson looked into. he looked into all of these questions about the warnings i was given and the response i

gave and he made no criticism of my conduct. now i know the right honorable gentleman was disappointed by the leveson inquiry that he called for. it took place and he should heed what it said. >> ed miliband. >> no, mr. speaker. this is about his character, his judgment and the warning he ignored, including from the deputy prime minister. warnings number two ignored. then in september 2010 "the new york times" published a front-page investigation detailing andy coulson's extensive knowledge of phone hacking, clothing one former editor is that i think there are dozens if not hundreds of these with andy when the subject came up. what action did he take? >> all of these issues, every single morning was dealt with by the leveson inquiry. and inquiry he called for calm and inquiry whose terms of reference he agreed, and they know he can't bear it but leveson made no criticism of my

conduct in this regard whatsoever. now you can the call for a judgment of inquiry, participate in a judge-led inquiry, write the terms of reference of a judge-led inquiry and didn't ignore what it has to say but i have to say, mr. speaker, all of the questions he's raising today are not new. they are the questions dealt with by the leveson inquiry. i know -- >> the primus is offering an answer and it must be heard. order. it must be heard by the house. old sides must be heard by the house and that will happen as it always does however long this session has to be run. let us be absolutely clear, the prime minister spent i can quite understand why does want to listen to it eighth month-long inquiry that cost 5 million pounds, that into the people under oath, that was led by a judge but that is what he asked for. that is what was delivered and

it did not criticize my conduct in this regard at all. so instead of casting aspersions about that he should accept the inquiry that he supported. >> no answer -- [shouting] no answer on any of the questions. no answer why didn't act on "the guardian." don't have to wait didn't act on the deputy prime minister. know and why didn't act on the new times. now let's come to -- mr. speaker, amidst all of those warnings the very least he should -- >> order, order. there is the usual ranting from the usual suspects. be quiet. if you can't be quiet, leave the chamber. we can perfectly well manage without you. mr. ed miliband. >> amidst all of those warnings the very least he should have done is insisted any of the on coming to office at andy coulson should have the highest level of security -- as his six

predecessors over the previous 14 years. why did he insist on it? >> again, leveson in his inquiry was directly into this issue. thank you and this is what he found. [shouting] this is what he found. leveson concluded this, the level of security clearance was not the decision of either mr. cameron or mr. coulson. it was the decision of the civil service. and those are -- those are the correct procedures, and those are the correct procedures, but if -- if the leader of the opposition's contention, if the leader of the opposition's contention is that direct venting would've got to the bottom of mr. coulson's conduct at the "news of the world," then he should be very clear about what leveson found, and he found this. and he found this. the process of considering mr.

coulson would not have involved a detailed investigation of phone hacking at the "news of the world." that undermines the entire case that labour has been tried to make this morning. [shouting] i know you don't agree with it. i know that he is so desperate not to talk about the economy, not to talk about unemployment, not to talk about the deficit, but you can't rerun and inquiry that has already taken place. >> ed miliband. >> mr. speaker, so now it is clear from the prime minister, now it is clear from -- i'll tell him, it is failing to stand up for doing the right thing. so now we know, now we know the rule of this prime minister is the buck doesn't stop here and he blames the civil service. now, on the civil service, can he assure -- >> order. sometimes one has to repeat the things if people don't get it

first time. if there is quiet we will continue. if people are trying to shout other people down against the principles of british democracy, they will be stopped in their trucks. it's very simple and i would've thought pretty clear. ed miliband. >> on the civil service can he assure the house that at no time did the then cabinet secretary or any civil servant raise concerns with him or his office about hiring andy coulson? >> he made it very clear any evidence he gave to the inquiry and, indeed, on the issue of that income on the issue of adding it absolutely clear that the decision about embedding is with the permanent secretary at number 10 surgery hayward, someone who has served labour government with impeccable service as well as coalition government led by conservative prime minister to. with right honorable gentleman is trying to do is go through all of the old questions that were answered by the leveson inquiry. he didn't like the answer

because he wanted to try and prove some cooked up conspiracy between the conservatives and news international. he cannot manage to do it because the leveson inquiry can't find it. now, he asked a minute ago what is week. i will pay what is weak, attacking murdoch and then standing up with a copy of "the sun" newspaper only to apologize a few hours later. [shouting] >> ed miliband. >> mr. speaker, mr. speaker, the prime minister said in his previous answer that he was asked what he was raise concerns with him or his office about andy coulson but he was not asked that question and the leveson inquiry. there is now a very important question which the whole country will want an attitude about whether, about whether sir gus o'donnell our senior civil

servants raised concern within or his office about andy coulson and the truth about this is the charge against the prime minister or is not one o of the great. it is willful negligence. and at the heart of the scandal are thousands of innocent victims of phone hacking he didn't stand up for. the prime minister will always be remembered as being the first ever occupant of his office who brought a criminal into the heart of downing street. [shouting] >> he brought up the issue of the warning from "the guardian." i totally disproved him using the evidence. he brought up the idea of direct venting but i've totally disproved them by using the evidence. he cannot do the fact that an eight-month inquiry that he hopes is going to pin the blame on me found that i had behaved correctly throughout. that is the case. all of these issues were examined for all of these issues were examined by the leveson inquiry, but if he wants to

debate the cause we make and the leadership we give, i'm happy to any time because it is leadership that is got by this economy moving. [shouting] it is leadership that is cut our deficit down. it is leadership that is putting britain back to work, and it is the total absence of leadership from the labour party that shows that nothing to say about britain's economic future. [shouting] >> jacob barrie. mr. carrey. not here. >> thank you, mr. speaker. after many months of the anti-arena record from the government, and now certain change of heart, does the prime minister believed that the

enemy's enemy is my friend charles all else? >> no, i don't believe there. i think we should judge every regime and every organization on its commitment to human rights, the rule of law and building pluralistic societies. so we should engage with the iranians, but as i said with a very clear i am a very hard, hard. we shouldn't forget what happened to our embassy. we shouldn't forget the things that they are responsible for of around the world but we should start to build a dialogue with them in the way the foreign secretary set out. >> on a friday my honorable friend and myself jumped from a plane 13,000 feet over the countryside. fortunately we had a parachute. [laughter] and training from the tiger army parachute display team.

as we approach armed forces day, will be prime minister pay tribute to our armed forces and of those charities in the generosity of the british people who do so much to support those who give such commitments to queen and country? and will he reinforce the fact that this parliament will never ever underestimate the constitution of the armed forces of this country? >> i possibly support what my honorable friend has said at a commend them for jumping out of an airplane with a parachute. not only should we commit our armed forces but it's right that we put the armed forces covenant, the military coming into the law of the land. i think armed forces day is now an important part of our national calendar on remembrance sunday we remember those absurd and those who have fallen but on armed forces day it's an opportunity to celebrate all those who serve the day, to to thank them, to thank their families, to celebrate the values that they live by and although they bring to our country.

>> does the prime minister realize he has made history by employing a crude -- bankrupt in number 10 speakers i've given a full answer to this but obviously i regret the decision to employ andy coulson on the basis of the assurances that i was given. but what i would say is that no one made any complaint about the conduct of andy coulson while he was at number 10. and that does stand in quite a contrast to the conduct of damian mcbride, to the conduct of joe moore, to the conduct of alastair campbell. but we had from the previous government was bad news and smearing members of parliament. >> sir mick harvey. >> mr. speaker, the firefighters dispute continue with some worrying consequences and no sign that resident of resolution but mr. speaker, back before easter ministers got the

government actuaries -- was ready to put to its members. will the prime minister look back at the proposal even now and consider what it might still have some useful part to play in bringing and into this dispute? >> i'm very happy to look at what my right honorable friend suggests. i know that the measure in the local government department has been working extremely hard on this issue. i think it's important that we listen to what the firefighters say but also at the same time recognize that the pensions they have access to would actually require the building of half million pound pop for anyone else in the country and we should bear that in mind and the taxpayers contribution at the same time. >> does the prime minister except that -- proves that jake on lost more than 50 terrible years in prison and anguish of his fathers torment due to the

injustice from layers of this state as well as championing against injustice -- [inaudible] and secondly, notwithstanding the egregious 75 years in debt and put in other papers jury was promised access -- [inaudible] will the prime minister assured that the vanquished of an innocent man is on a? >> first of all i'm grateful to the honorable jennifer raising this in the way in which he does but it is hard to think what 15 years in prison when your you're innocent of a crime you've been convicted for what to do somebody. and i think it is absolutely right that the previous prime minister to apologize as fulsomely as he did when this

came to pass. i'm very happy to look at the specific request about the requisite cute which hasn't been put to me before and perhaps contact the honorable gentleman about that issue. >> peter bone. >> mr. speaker, unemployment in north northamptonshire is down by a third. last week this conservative led government approved the rushton lakes development, 2000 new jobs, major retail department, a fantastic letter facility. could the prime minister explain how we have that success? could it be down-to-earth long-term economic plan? >> well, i'm grateful to my honorable friend perdita and what is happening in northamptonshire in terms of the extra jobs and the development. i think what it proves is that we do have an entrepreneur economy, particularly in northamptonshire but we do need t. departments to go ahead to help unlock the jobs, the growth and investment we need for our

country. >> the prime minister said yesterday that he was just getting andy coulson a second chance. that means that the prime minister new that there was a first offense and he knew from the very beginning that he was taking a criminal into downing street and then refused to sack him coming yesterday and again today he was busy praising andy coulson. what message does that send it to the victims? isn't the truth of the matter that the prime minister's is only sorry because he got caught? >> i'm afraid that on this issue the honorable gentleman has got it wrong time and time and time again. what i said about giving someone, what i said about giving someone a second chance is because the individual in question had resigned as the editor of the "news of the world" it does what had happened. but let me just refer him to what he said in this house of commons. he said there's no doubt that there was a deal secure between

the conservative party and news international before the general election. that is what he said after eight months of an inquiry that cost 5 million pounds. that was found to be complete and utter rubbish. and yet have we ever heard one word of retraction from the honorable gentleman? as ever, not a word. >> may i congratulate my right honorable friend on his judgment and resolution in standing up for britain's national interest over the question of the eu commission. and can i put it to him that he is in tune with the concern of the public right across europe how i like so of our continental partners. spent i think it's important on this issue to stand up and speak for what you believe in. i believe that the european commission president should be chosen by the elected heads of government and heads of state on the european council. that is the right approach and it is wrong to sign up to this power grab by the parties of

europe and the european parliament. i also think it's important that the people involved understand that we need reform in europe and it doesn't matter how hard i have to push this case, i will take it all the way to the end. >> mr. speaker, -- had tea at number 10 and a dancing with the business secretary. but still businesses and shortages in the city cannot get superfast broadband. this is not a national embarrassment. what's the prime minister going to do? >> we have put a huge amount of money into expanding superfast broadband. we are now doing better than other european countries in terms of the rollout of our network and the speeds that are available. my right honorable friend the culture secretary's working very hard to do with those areas of the country that don't have superfast broadband and i make sure he puts hackney firmly on his list. >> the prime minister recruited andy coulson in 2007.

in 2009, nick davis from "the guardian" came to the select committee and said i have never seen a piece of paper that directly links andy coulson to any of activity we are discussing a by the country in february 2010 the select committee on which i served concluded with all support we have seen no evidence or andy coulson nude of phone hacking was taking place. with the prime minister agree with me that those who now claim he knew he was in 2007 which includes the leader of the opposition should explain why they didn't pass this information onto the police or the select committee or are they trying to rewrite history for their own leadership shortcomings? [shouting] >> i think, i think my honorable friend put it rather better than i did. thank you. [laughter] >> thank you, mr. speaker.

i'm sure that prime minister and the whole house will join with me in welcoming a very successful visit on her majesty, the queen and the duke of edinburgh for north of ireland this week. will the prime minister also join with me in condemning the approach to reform, which is not attacking the vulnerable in northern ireland but is costing the northern ireland executive 5 million pounds per month in fines? >> well, i agree with the honorable gentleman on both counts. the queen's visit to northern ireland has been a huge success and i think it has highlighted the economic renaissance that is taking place with over 800 for investors northern ireland is now one of the top uk destination for investment and knesset i'm jealous of her majesty being able to meet the cast of games of phone which do

one of the most successful television production anywhere in the world, hosted in northern ireland. but he is also right, he is also right about welfare reform. the point of welfare reform is help people get back to work rather than just to cut budgets and when he displayed all the parties in northern ireland that we should be engaging in welfare reform to help get people back to work. >> thank you, mr. speaker. on this side of the house we have a long-term economic plan. with education funding at its heart and both as a consequence which is seen as enhance 269 pounds per pupil funding that all schools in north will receive next april. does the prime minister agree that we need to continue that program on education funding so that as the plan takes effect we get fair funding for all the schools in this country to? >> my honorable friend is absolutely right that education and better schools and skills are absolutely the heart of our long-term economic plan. he should note we are spending 18 rebounds of school buildings

in the department which is more than labour spent in the first two terms combined but specifically on the issue of international funding formula we have made some progress as he says by allocating 350 million pounds to the lisa fairly funded local authorities, and that will make a real difference in the coming year. >> thank you, mr. speaker. on monday morning -- [inaudible] their main concern was the detail that was the point, i government applying for h.r. in c. could be prime minister usher those members that there are no such plans under his watch? >> that plans we have for h.r. mc is to make more efficient and more effective at collecting

taxes are people who should be paying them. that's the plan. >> andrew stephenson. it in one. on sunday 17 year-old james burch of tragically drowned in a lake pick his death has left his family, friends and the local community in shock. as this week is drowning prevention week, what can the prime minister due to raise awareness of the dangers of open water and improve water state, particularly turn such a warm summer that we are having at the moment. speed my heart goes out to the family that he mentioned and he's right to raise this issue for anyone to lose a son and to lose one in such a tragic what is this. it is heartbreaking. i think we do need to spread better information about the dangers of swimming in open water. i think we need to do more to teach swimming in schools, to teach lifesaving skills and i also think that the heroism bill that we're bringing forward of the people who want to do good and rescue people will also in a small way help as well.

>> hundreds of young british men and some women are now fighting in syria and now with isis in iraq but some of them will come back to united kingdom radicalized and ready to attack. our prevent programs have been cut by 70 million pounds and the funding for local authorities to do the essential long-term community work as all but disappeared. will be prime minister undertaken urgent review of the prevent strategy to make sure that we have the plans and the resources to protect our young people? >> i have great respect for the right honorable played on this issue because she's always will concluded about the need to confront not just violent extremism but all forms of extremism. what we've done in this government is to make sure that the prevent program is properly focused and works in a way where you're targeting those at most risk of being radicalized as well as doing that we need to make sure we shift resources in our intelligence security and policing services to target

those were potential returning from syria or iraq so that they're properly covered and dealt with. we have made a large number of arrests, confiscated passports, taken all the action necessary to keep our country safe. >> thank you, mr. speaker. -- currently giving up the search with university into the impact of short rate on family relationship it will be prime minister give higher priority to the funding of short rates as an investor save measure? >> i agreed with my honorable friend about this issue. anyone bring it up a severely disabled child knows when you find one of these hospices and i'll never forget finding helen house in oxford which was the first children's hospice i think anywhere in the country that is a complete lifesaver for families and carries out brilliant work. that's what we've committed over 800 million for local afford to invest in short rates for

disabled children and it sure this research will help inform our work in the future. >> thank you, mr. speaker. i wonder if the prime minister is aware of the alleged mr. big of cashback by government power and to political campaign -- one of the uk's largest utility companies -- [inaudible] i wonder if you would be prepared to meet me and a delegation to get to the truth of the meta? >> i commend the gentleman for raising this issue. of course, this device over a decade ago and it was looked at at the time by the then department of trade and industry but in light of the concerns that exist for members of the public about the outcome of the liquidation of dr. kirch the gentleman it is not done so already to give the business department all the new information has come to light and i will fix a meeting or him with the business sector and members of the all party group so we can try to get to the bottom of this issue.

>> my constituent installed cctv in his brothers plant because she's a dementia suffer and be recorded on this a brutal assault on her by her care. unbelievably to me that cbs has refused to prosecute because they said it is not in the public interest. would my right honorable friend agree with me that as a society we should be totally intolerant of all a tax on gullible people with dementia? >> on the specific case of course it wouldn't be right for me to comment on the decision but on the general point about is it right that we are intolerant of breaches of care and against elderly people, particularly those with dementia who are reliant on us, yes, we should be intolerant to that. are dementia strategy is all about not just increasing the research in trying to tackle dementia but making sure our care homes and hospitals and, indeed, communities become more dementia friendly. >> mr. speaker, --

[inaudible] >> a number of senior civil servants gave evidence to the love this inquiry and were closely questioned by leveson. the whole process of the employment of andy coulson, andy coulson's arrival at number 10 downing street, the vetting of andy coulson, the warnings that were given, each and every single one were dealt with by the investigation. that the right honorable gentleman supported from the position of leader of the opposition, but he cannot bear the fact that an independent judge-led inquiry came to that conclusion. is the first bit of the opposition not able to ask for an independent judicial inquiry because he's already had one. >> thank you, mr. speaker. although the world cup football results may not be quite what we want in england we have got the 2015 world cup rugby to look

forward to. my right honorable friend knows that there will be 14 teams playing in my constituency. would you agree with me that this is a great opportunity to use the chancellors new brownfield aside fund plus perhaps a new city deal of d.c. lg to make sure that the regeneration of small cities is ready for the world cup 2015? >> my honorable friend is right that after the disappointment of the football and also the disappointment of that stunning head match where we lost on the second last ball i think it is time for us to look to rugby to provide us with something to lift our spirits. [inaudible] the average rent for a two-bedroom home is 12 pounds a month. will be prime minister back my call for a living wage commission to bring rent back in

line? >> well, there's a debate or shortly on the private renters sector and now we get more houses and more competitive rent. what i would say is of course we want to see more competitive rent but one of look at the policies of her party, it looks like you never building houses anywhere for anyone and as a result the rent will go up. >> order. >> here on c-span2 we will now leave the british house of commons as members move on to other business. you been watching prime mr. 's question time aired live wednesday when parliament is in session. a reminder that you can see this week's session again sunday nights at nine eastern and pacific on c-span. and for more information go to c-span.org and click on series to get every program with aired from the british house of commons since october 1989. we invite your comments about prime minister is questions via twitter using hashtag pmqs.

>> c-span to providing live coverage of the u.s. senate floor proceedings and key public policy defense and every weekend booktv now for 15 years the only television network devoted to nonfiction books and authors. c-span2 created by the cable tv industry and brought to you as a public service by local cable or satellite provider. watch us in hd. like us on facebook and follow us on twitter. >> the white house on monday posted a summit on working families, focusing on an employer policies and government actions to help parents. the president highlighted proposals to increase the minimum wage and provide for paid family leave. other speakers at the summit include labor secretary thomas perez, vice president biden and first lady michelle obama. this is two hours.

>> please welcome senior advisor to the present and chair of the white house council on women and girls, valerie jarrett, u.s. secretary of labor, thomas e. perez, and the president of the center for american progress, neera tanden. [cheers and applause] >> well, good morning. good morning, everybody. good morning. let us hear from you. wow, i can't believe you all showed up. i am delighted to be here with my cohosts tom and neera, who you'll hear from shortly to welcome you to the first ever white house summit on working families. [applause] >> so the president's goals are simple. he wants to make sure that every hard-working american gets a chance to get ahead.

and he also wants to make sure that our 21st century workplace reflects the needs of those 21st century families. and as we know, the demographics have changed over the decades. now we know that women make up know the half of the workforce. 40 -- yes, indeed. you can clap whenever you want. [applause] 40% of moms are either single bread makers or the sole primary bread earner for the family. so that's a major change in her demographics. the majority of our children live in families where both parents work. so what we need to do is to make sure that our workplace changes both in policy and in culture to reflect those changes, isn't that right? [applause] >> and so over the course of the last couple of months, we've traveled around the country from the president in orlando, florida, to san francisco to

seattle to boston, new york, my hometown of chicago, virginia. we have talked to workers and business leaders and union leaders and academics and deans and stakeholders from around the country, all helping us figure out what we do to change that paradigm and reflected in this room and watching us online are all of you who have contributed to the agenda for today, and also the announcements that will be making. so thank you very much. [applause] >> we have listened to your stories, and everybody has stories. and so of course since i have the podium on going to tell you a couple of mine. i remember very vividly, i'm not going to tell you exactly how many years ago, maybe i will. 28 years ago, and some change, i was sitting around a conference table at 2:00 a.m., eight and a half months pregnant.

and i kept trying to slip my swollen feet up onto a chair where nobody would notice. and for the women in the audience who have been pregnant, you will know that i could actually sit there for more than about half an hour when the getting up and taking a little departure. but i was too embarrassed to tell anybody i had to go to the basket. so i made of all kinds of excuses for why i was leaving them. i needed to get some papers, i need to make a phone call, i needed to do this, i needed to do that. i needed to pee. [laughter] i felt like i was alone and i was in a room full of men and ended -- i didn't think anybody was going to what i was going to. so one of our big messages today is that you are not alone. that's another thing that today is all about. [applause] >> fast-forward a few years later in a different job, and my daughter is a toddler, and i had a client who was extremely demanding. and i love my client and she was one of my first mentors.

what i needed to get though because i would wake up in more and try to figure out what i did on my bedtime. you know what that's like. so i told her, i love to cook. why don't you come over to my house and i'll make dinner? i don't actually love to cook. she would come over every night and i would make dinner and then i get a chance to say goodnight to my daughter. all these years later i look back and i'm not so sure she actually thought i'd like to cook much like those meals and she was willing to accommodate my schedule so that i could be home by bedtime. a terrific mentor and a great client. and my final story that i will share with you is when i told very, very often, and this is about employers who get it. i was sitting in the conference are working for mayor daley, a little intimidating character for those who have ever met him. and i just been promoted and it was when my first meetings in his office and i was sitting across the table from susan, who used to be the first lady's chief of staff. susan and i both had children in second grade. we kept looking at each other and looking at each other and looking at each other. finally, the mayor realized we weren't paying any attention.

so he said where is it you need to go that's more important? and so in a moment of complete, i don't know, horror, terror, truth, i said to him, the halloween parade starts in 20 minutes. [laughter] we are 25 minutes away. and he said, and this is really important, then what are you doing here? and i am telling you from that moment he had my loyalty, he had my work. i worked twice as hard. i was determined to be worthy of that. [applause] >> and so as we have heard from all of you, what we have heard is for hard-working folks who are trying to make ends meet, we need to raise the minimum wage, point number one. [applause] >> we have heard that everybody should get to go to the holloween parade, so workplace flexibility is important. [applause]

>> paid leave is important one of the only countries that doesn't have paid leave. [applause] childcare is important. [applause] for a while now we've talked about the glass ceiling, but, you know, what? it is that sticky for that is the problem for so many minimum-wage workers who can't get that break to get ahead. [applause] these are the issues that we've heard from you. and so if you are that single mom who sends your kid to school with a little bit of a fever because you don't have any childcare -- i've done that. if you are that dad who would love to stay home with her children and your company has a policy that allows you to stay home but nobody in the culture of a company takes advantage of that policy. if you're a parent who never has been able to attend a parent-teacher conference, let alone a concert or a play in your school because your employer has rigid hours, if you're a company who wants to do the right things by your

employees but simply doesn't know what to do, well then, let me tell you something. you are not alone and this day is for all of you. [applause] >> so we are excited to be here. we are going to learn, we will have announcements to make, we'll have a conversation with one another, but the most important thing i also want you to remember is that this is an important moment but it's not just a moment. it's a movement. it's a movement and we are going forward from this day forward. [applause] >> so with that, i want you to welcome my partner in this, without whom this conference would simply not have been possible, who is an advocate for workers around the country each and every single day please join me in welcoming secretary tom perez. [applause] >> thank you. good morning. all right. good morning.

you know, on cue valerie announced that this was a movement, and general rosa delauro walks in and takes her seat. did you notice that, y'all? hello, general. great to see you. it's an honor to be here, and i want to say thank you to valerie, to tina, to our partners in the white house, to our remarkable partners at the center for american progress, neera, and her wonderful team. and i must take a moment to say thank you to our folks in the women's bureau. where are you? doing great work. right here. you know, these regional summits have been remarkably productive and instructive. and here's what we've learned. we learned two sets of things from these regional summits because we've been asking people the following thing. what's keeping you up at night? what are your biggest sources as a working family, as a working parent, as a single parent? what are your biggest sources of fear and concern? the first thing we hear is that i'm working harder and falling

further behind. what keeps me up at night is my second job. because i can't afford to make ends meet. what keeps me up at night is the sense that i want to put food on the table but i also want to be home to eat at the table with my family. because the most important family value is time spent with your family. [applause] >> and i don't enjoy that luxury. i don't enjoy that luxury because the minimum wage has decreased in value 20% from where it was 30 years ago. i don't enjoy that luxury because my wages have been flat, even though i'm working 50, 60 hours a week. i don't want to be on food stamps, i'm told, we are told with regularity, but i can't afford not to be on food stamps. and that is why the president is so focused on wage fairness, making sure that a fair days work pays a fair day's wage, making sure that nobody in this

country who works a full-time job should have to live in poverty. [applause] >> and that is why, in addition to fighting for harkin-miller, the president is using his pen and his phone to make sure we use every regulatory tool in our arsenal to help working families, for instance, the president helped to make sure that 2 million home health workers have access to minimum-wage and overtime protection. [applause] as you know, 90% women, 50% people of color, 40-45% on some form of public assistance. these people are doing gods work, and they deserve a fair wage and overtime benefits. [applause] and so we will continue to fight for wage fairness because we've heard that throughout our six

visits to the various regional summits. but we've also heard something else which is, we need to make sure, as valerie correctly pointed out, that we have the flexibility we need to make sure that i can go take my kid to the doctor, i can take my mother or my father to the doctor. you know, we have such a here. we see the nature of the family has changed, the nature of work has changed. we are living in the modern family society but we are still stuck with leave it to beaver rules. that's the world we're living in and we've got to change that. [applause] >> you know, too many people as valerie correctly points out have to choose between the job that they need and the family that they love. that's a choice that no one should have to make. i heard neera say with great, you know, remarkable passion that you shouldn't have to win the boss lottery to be able to take two hours off, to take your

kid to the doctor. president clinton did a great thing when he passed the family and medical leave act of for millions of americans who are either not covered by family and medical leave act or who are nominally covered but, in fact, are not covered because they simply can't afford to take the time off, we need the next frontier of workplace fairness. we need the next frontier of flexibility. we need to make sure that we are no longer in the company of three or four nations on the planet who were the only nations on the planet who don't have some form of paid leave. that's not who we are as a nation. [applause] >> and that's why we are fighting for this. that's why we've been working so hard and that's why the president continues to support grants year after year of state

paid leave funds because states are demonstrating that you can do this. employers are demonstrating that you can do this. and it's the right thing to do and it's the smart thing to do. employers to pay minimum wage, employers who pay above the minimum wage, employers who have flexible leave policies, they are creating a competitive disadvantage, competitive advantage for themselves and for their shareholders and that's what we are fighting to do this. that's why i'm so proud to announce today that we are investing in critical new research to understand the benefits of paid leave and will be investing in new grants to support the creation of state paid leave programs. [applause] and by the way, speaking of the xml i, we believe that all families deserve protections and that's why we have proposed new rule changes just last week to realize the promise of windsor

and to give all our lgbt brothers and sisters and legal same-sex marriages the same rights that every family has. [applause] you know, i'm a labor lawyer and a civil rights lawyer. as valerie said, progress does not roll in on wheels of inevitability. it takes everybody in this room and in this nation but it takes coalition building, civil rights act of 1964 we're celebrating the 50 year anniversary. that was first introduced in 1948. it was all about persistence. this workplace flexibility, we have the fmla. it is done well. we need to take the next frontier but what the president is committed to that. we have partners are committed to the. i am confident that we will indeed build this movement because we've got generals like rosa delauro, valerie jarrett. we have the general in chief barack obama and joe biden and

everyone else, and with my partner right here, the nonprofit leader, the president for the center of american progress and my friends, neera tanden. neera. [applause] >> that was great. so, i have to say, what a great partners. we should be able to make a lot of change with this team. and i want to some have for the center of american progress we've been really thrilled to have a fantastic partnership over months and months and months waiting for the conference. valerie at the white is an entire white house team, and the department of labor which has had a fantastic team. valerie is right, we all have stories, everyone in this room, and the people you represent, thousands upon thousands of people have a story. i have my own story, which is that when i had two young children, and i had a son who was a year and a half, doctor

was for and have, took a very high pressure job, was a lot of time commitment for the job and i had a boss at that time who saw that i was struggling a little bit. and she rescheduled meetings around me, made sure she changed her schedule so i could have my responsibilities, old as a parent and as a worker. she changed around the entire work culture to accommodate parents. and as secretary perez said, i really felt like i won a boss lottery. but that's a real problem in this country. you shouldn't have to win the boss lottery. we should all have work situations where people recognize that when we are good workers and good parents, that's the bottom line. and that's why -- [applause] and that so much of what today is about and the white house has

a fantastic report out today making the case for how improving our working conditions for families is best for the bottom line. we have fantastic partners from around the country. most importantly we have women, parents here today who are struggling with the challenges of making those terrible choices. when we've heard these voices in the events leading up to today, we have heard from parents who had to put sick children on a bus because it was that or making their rent. with her parents struggling with the decision about going to work when they know they should be at home. parents talking about how they anxiously waited until 5:00 and then dashed home because they knew they didn't have child care. that is what is motivated today. again, today is not just about changing the conversation. it's openly about changing the

country. and we're going to do that with everyone here. [applause] , everyone here is being commit and we fantastic academics, advocates people and business leaders who recognize how critical it is to have the workplace rule that will help them compete in the 21st century. i want to just say a few things to a few of our partners to help support us in putting this conference together. tonia milstein, the ford foundation, the sloan foundation, deloitte, brighter bison, all of these people are leaders -- >> all of these leaders, all of these people are leaders who bring together diverse viewpoints and sure that we can maintain. we have to learn from those models, have a great day today but today is just the beginning

but will have to roll up our sleeves and make change at the local state and ultimately federal level to improve the quality of life for all our families and ultimately for our economy. so it's my great honor and privilege to introduce jill biden and vice president biden, because these are two people who work every day to improve working families and who we are so thrilled to start at the conference chairman.

[cheers and applause] >> good morning, everyone. >> good morning spent i think i need some of what tom perez is drinking. he really have the energy, didn't he? it's wonderful to welcome you all here to this important discussion and thanks to neera for that kind introduction. everyone here knows the challenges facing working families. i myself can vividly recall teaching full-time, getting a masters degree and raising three young children. even though i had a lot of support and resources, it was still a lot at once. and those kinds of challenges have only increased for today's working family. today, and three quarters of families, all parents work whether it's a single parent family or both parents working. women are nearly half of our

work force, but too many women still earn less than men, and often face advanced barriers to and on top of an already complicated childcare schedule and community obligations, many working families are also caregivers for aging parents. more and more companies know that they need to find ways to address those challenges so that they can attract and retain talent. they also know that people now choose one job over another because it is in the best interest of their family. last month i was in seattle for a discussion with business leaders and employees to hear more about some of the creative ways that they are addressing these challenges and attracting and retaining top talent at what i heard there was pretty simple. employers need to take more than just the eight hours a day an

employee sitting at his or her job. they should also think about the stresses that employees face outside of work. childcare, aging parents, long commutes. if an employer can find creative ways to ease some of those stresses, employees can be more productive with the time they are at work. ..