can be a lever of state power. but all of these are with the benefit of hindsight. what we've spent much of the last 25 years doing is genuinely and sincerely trying to draw russia by stages into the international community. and i think at one stage, we all felt that that was being pretty successful, that russia was becoming normalized, if you like, learning to play by the rules, becoming increasingly engaged in the international economy. and increasingly, a country we could do business with. now, i think we should also emphasize that we have no dispute with the russian people. when you and i were growing up, the russian people were a mystery to us. now, you know, everybody knows plenty of russian people that live in london, across europe, people visit russia, do business in russia. it's no longer the great mystery it was. and we have no dispute with the

russian people. but we do have a disagreement with mr. putin's view of the world, and more particularly, with his ideas about what is acceptable in going about achieving his objectives. >> i think we should be reading the doctrines. and that leads me to my next question. and that is, how is it that -- are we underestimating the risk here? the former u.s. ambassador to moscow said, british diplomacy toward russia and elsewhere has suffered because of a loss of language skills, particularly in the foreign office. now, we know the opening of the language, that's a good thing, but we're not committing -- or have not committed enough resources to eastern europe and russia. is that your take on things? do we need to invest now more?

>> i think we are reinvesting in russia and eastern europe now. but there is no doubt that this is well trodden ground, over a decade or more the uk lost traction. and my predecessor spent a lot of time and energy rebuilding that engagement with the world, and that is included making investment, for example, in language capacity. i checked before we came in here, and we have 156 personnel who are registered as having russian language skills. that's probably fewer than we would like, but a lot more than we will have had at the bottom of the curve. >> i'm not sure you're saying

this, it's not just about the language skills. >> of course not. >> it's about the understanding of the region and the peoples and so forth. what many of us on the committee are concerned about is over the recent decade, there's been a sort of failure of skills of management consultants at the expense of more traditional skills, for example, understanding the region and people, et cetera, that helps us increase the understanding of the problems at large. would you accept that? and can you be more specific as to what extra resource you're putting into this? it's all right saying, we're putting extra resource in. but that's a vague term. can we have some detail? >> again, with the benefit of hindsight, of course, we would like to have more russia and east europe focused resources. but i think if you look at how we have managed, a diplomatic footprint over the last decade or so, and look at how some of our other major allies have done

it, we have degraded our russia capability rather less than some of our allies. i'm going to ask simon to comment on this. >> i would just like to add, i think it's been overemphasized. if you look at the ambassador in moscow, or pakistan, or ukraine, and a number of other places, they're all absolutely stuped in the former soviet union. they have huge amounts of expertise. they all speak excellent russian. it's not just the language, but that's an indication of the thought process. i don't resist the notion that expertise in the area is not what it was in 1990, but of course, the fact that you mention eastern europe, along with russia, tells part of the story. in the 1980s, we had a much bigger pool. if you were based in warsaw, or based in a number of other european countries that's what

you spent a lot of time thinking about, but that is not the case now. >> i accept that expertise is there, but the fact is, we fundamentally misunderstood, did not read the intentions behind president putin's stated objectives. why did we get it wrong? >> i think to be fair, successive governments have been transactional over the years, and that we believe in some community of values. it is true that russia was playing a different role on the world stage in different areas, where in cases of our interests collided. you have to go back to the yenko case, which was a clear indication in the way in which these things can evolve and the measures which the then government took a response to that. i would resist the notion we've been completely naive about russia. i don't think that is accurate. >> this is a comparative game. if you look across europe, that's how different countries

have handled their relationship with russia. i think with the benefit of hindsight, we've done rather better than some. >> thank you. >> secretary, how is the relations between nato and the federation? should it be revealed? and should restraints on the location of nato troops be lifted? >> first of all, the russians have clearly breached the founding act. in our judgment, the reassurance measures that we wish to take can be delivered without breaching the restrictions in the founding act on the basing of substantial troop formations in the new member countries. >> is there any reason why we shouldn't --

>> well, the first is, that from a purely military point of view, looking at what we want to do, the efficient utilization of military forces, it is to rotate relatively small numbers of troops through for training purposes, to create pre-positioned stocks of equipment for deployment hubs that we've deployed to in an emergency. all of these things can be done within the restrictions of the founding act. and the judgment that we have made is that if there is no practical need to breach the restrictions in the founding act, there is value in maintaining the moral high ground, and continuing to observe the rules-based system that the founding act put in place. and to continue to remind the russians that they have breached

it. >> what we discussed at the nato summit? >> the reassurance that we discussed with the spearhead forces, the way they'll operate in eastern europe. there are no nato members, and certainly not in the uk, certainly not in the united states, who wish to position significant numbers of troops on a static basis in eastern europe. that wouldn't fit with the model we have of the way we train and use our forces to be highly mobile, highly flexible forces. it's a cold war type of model that just doesn't fit the way we do things anymore. >> okay. well, there are some among the member states, where article 5 could have been invoked in crimea, or anybody else in ukraine. as a result of the russian involvement, if ukraine had been

a nato member, and it seems like cyber attack, you can make stabilization, psychological warfare, use of troops, and soldiers certainly get lost in eastern ukraine. i mean, a lot of what russia's done really couldn't be pinned down. and lithuania, they could be in a very different situation. how do you respond to that? >> well, ukraine is, of course, not a nato member, and article 5 does not apply. never at any time has it come into the equation. the baltic states are nato members. and they benefit from the collective guarantee that article 5 offers. and you are, of course, right. and i have sat in this very chair discussing with the defense committee on a number of occasions, the challenges that

emerging technologies like cyber present to the definition, the various legal definitions that are involved around war fighting and military operations. and in many countries, including the uk, there is an active debate going on about how to address cyber in particular, but also the other areas you mentioned in the context of where the boundary lines are drawn in the international legal system, which governs permissible responses to aggression. >> but we need a bit more debate if president putin can say to mr. basso over the phone, i'm sure they could be in latvia or lithuania in four, five, even six weeks. now, some of the techniques may be used prior to an entry to

latvia or lithuania. a debate in the next few weeks isn't going to solve that. don't we need a quick change, a quick reappraisal of article 5 in order to stop what we see in ukraine? >> no, we don't need any reappraisal of article 5 at all. what we do have to do, though, and this won't be the first time we've done it, as military technology, the technology of war changes, we need to keep our thinking up to date. and this is true in any field, any legal field. but the legal thinking has to keep pace with the reality of the technology. we have a whole new domain of warfare now called cyber, which didn't exist a decade, perhaps a half a decade ago. there is a process that is under way of thinking through how these different legal doctrines apply in the domain of cyber. >> i think in speaking about the domain of cyber, which i believe

can be considerably more clear-cut, but i mentioned psychological, economic, use of volunteers, you know, retired soldiers, i mean, these are gray areas showing that -- >> well, they are gray areas. and this kind of russian called hybrid warfare is a challenge to us. and again, i covered it in my former role. one of the challenges for the west, nato, is that we are a grouping of democratic and open societies. we can't do deniable warfare proxy wars, veterans fighting campaigns, we cannot do that kind of thing. we have to find a different way to respond to the tools that russia is using. russia is using its relative advantages. one of the advantages it has is that it can do nontransparent

stuff. we have to use -- >> what are we going to do about it? >> we have to use the relative strength that we have. and we have demonstrated them in respect to the ukraine, our big comparative strength is the resilience of our collective economy in the west. which is far stronger, far bigger, far more resilient than the russian economy, which suffers from significant structural weaknesses. >> will it stop the annexation of eastern ukraine? >> i said that i don't think we have enough evidence to know, to speculate on whether annexation of eastern ukraine is an objective of the kremlin or not. but i can confidently say that we have an asymmetric capability in the application of economic, and particularly financial sanctions where russia is not

able to respond in a symmetrical way, because of the difference of the structural strength and size of our economy. >> okay. thank you. >> while we're talking about article 5, could you give us an update of what's going on in estonia at the moment? >> we are in touch with our estonian colleagues. there is more than what's been published on the news media. the estonian official remains in custody in russia, and we're continuing to negotiate with the russians to get him released and returned to their custody. >> militia came over the border in a way that they had done in ukraine. might that invoke article 5? >> article 5 would allow a member state to call upon the

other member states, under article 5, if there were a military threat to its territory. and that's been indicated in my last set of questions. there will, of course, be a large number of lawyers poring over the specific circumstances of any particular threat to identify whether or not it meets the criteria for triggering article 5. >> mike gates? >> at the nato summit last week, there were discussions about providing weaponry to the ukrainian government. the prime minister's statement yesterday mentioned that some nato partners were providing weaponry to ukraine. and i saw a list of five or six countries. uk was not amongst them.

why not? >> the uk doesn't believe that there can be a military solution to the conflict in the ukraine. ukrainian forces made significant gains over a period of weeks after the mh-17 incident, but we saw over the last two weeks that russia will not allow those gains to stand. and that they were an imperric victory. they were simply met with a response of a further illegal incursion by formed russian units. we don't want to encourage the ukrainians to believe that there could be a military solution to this conflict. >> but other nato partners, norway, the united states, france i think, other countries plan to give? >> this is a bilateral issue. it's not a nato decision,

bilateral decision. the uk takes the view that it would not be able to supply military equipment, given our own very stringent export controls on military equipment in the current circumstances. it is a conflict there. >> other review member states are taking part in this. >> i'm aware of other eu member states who are certainly talking about the possibility of supplying equipment to the ukrainian armed forces. i think we should distinguish between the supply of equipment immediately during the period of conflict and discussions about supply contracts that would -- where delivery would take place at some point in the future. >> why has it taken us so long and proved so difficult to get agreement within the european union on effective sanctions,

and action against russia over ukraine? >> well, i'm not an experienced hand after the eu negotiations. but those that are tell me that this has been a lightning speed response of the eu particularly galvanized after mh-17 has moved rather swiftly, to impose sanctions. but frankly, they were far stronger and more effective than many were predicting. and i think the signals, as we read them, are far stronger and more effective than the kremlin ever expected. >> isn't it the case, though, that several european countries have said that they would be shooting themselves in the foot, to quote the hungarian minister, to bring in sanctions against russia because of dependence on gas and oil and trade with

russia? and on the other hand, we ourselves have got their money in our bank accounts in london? >> of course, you can't impose economic sanctions without inflicting some pain on yourself. and we've been upfront about that from the beginning. that it will cause some pain. and the financial sanctions in particular will impose some cost on the financial markets in london. different eu countries have a different tolerance level for absorbing that pain. but i think you've also put your finger on a very important strategic point. i think both sides have learned a lesson over the last few weeks. europe has been reminded of how vulnerable it is in certain areas to russia. particularly in terms of energy

supply. and there is a lot of talk at the moment about the need of the strategic agenda, not over the next weeks or months, or even a couple of years, but over a decade or more to have a clear and effective program to reduce our dependence on -- collective dependence on russia as a supplier of energy. but also, it is clear that the russians have been taken aback by their dependence on western economic systems, and in particular, things like our payments clearance systems. and they, too, have resolved in the heat of the moment to take -- to invest whatever it takes to reduce their dependence on the west -- their economic dependence on the west in the future. so i think we've both been reminded of that

interdependence. and certainly i would advocate that the eu should, as an important strategic agenda, seek to reduce dependence of eu countries on russian gas. not because we don't want to buy russian gas, but because at the moment we have a dangerous overdependence on a single source of supply that could be disrupted by design, but could also be disrupted by technical problems or some other event happening within russia. >> are there new lessons to be learned, both by the european union and by our own government about the way the issue of the relations with ukraine over the eu association agreement developed last year, and the -- an underestimation of the hostility of the russian putin administration towards not just ukraine signing the association,

but prior to that his effective scuffling of the armenian association agreement? isn't that a warning that we could have taken them on board at that time? >> i think it's important that we put this in context. these negotiations started six, seven years ago. and russia didn't raise objections to them at the time when yanukovych was in control in the ukraine. and if you remember, the sequence of events, we got right to the point where yanukovych was contemplating signing an agreement with the eu, when events began to spiral. so i think it would be wrong to see this as the west having failed -- or europe having failed to read the signals. i don't think russia was sending

any signals during those years of the negotiations. >> but isn't it true in 2013, they made enormous efforts by offering lots of money to armenia, for example, so they could change their position over one weekend, without even consulting his government or his parliament. and then did exactly the same pressure, the arrangement with ukraine. wasn't that clearly something that happened with regards to putin's attitude? what was that? >> yes, but i don't know what it was. i'm afraid i can't control, or have access to what goes on in mr. putin's mind. >> would you like to speculate as to why the russians took that position? >> what i would say is this. the eu entered in good faith into negotiations with the ukraine over long period of time. this wasn't some rushed deal in order to spite the russians. it was a long negotiation. russia did not raise objections while its man was in control in

kiev. and i think we've got to be very careful about any suggestion that we would allow russia a veto over the relationships which govern independent countries, who want to negotiate with a bloc like the eu. >> i was just going to add, it also came as well as a surprise to president yanukovych who was, after all, very close to moscow. he didn't expect that degree of resistance, because as you say, he was coming to -- expecting probably to sign the agreement. >> would you want to pose why the russians took this view? >> well, i think the only logic is the russians expected to be able to control the situation by one means or another. when they said perhaps that they were losing the lever of control that they thought they had to

the regime in kiev. they became more concerned about the agreement being signed. but we can only speculate. >> it may also be, of course, that president putin didn't actually think that we were going to get could you address another issue. it needs to be able to have sort of comprehensive response to the sort of tactics we've seen by

russia when it comes to using militia? because it is a gray area. and i'm not sure nato has thought this through. and in answer to that question, also, if you don't mind answering, that they have absolute clarity if similar tactics were used in estonia by the russians, what we've seen in the ukraine, and the estonians stand by that? >> article 5 is very clear. and if an armed attack took place -- >> by the militia. >> well, that isn't what happened in the ukraine. we've seen formed russian unions pouring over the border into ukraine. but article 5 itself is clear. but clearly there is a question, and i think i've already addressed this, and i've certainly explored it with defense committee before, there

is a question about where you draw that line in international law that permits a military response. so we're not just talking about article 5 here. we're talking about a broader question about what kind of attack on a state constitutes armed aggression that entitles the victim to make a military response. and that's a debate which is happening here, it's happening in the united states, it's happening in various areas around the world. and i reject the idea that nato isn't thinking about this. i raised at least the last three nato meetings i've been at, it is increasingly driven by cyber, i have to say, because of the awareness that a major cyber attack can have a very destabilizing effect on a nation, not dissimilar to the effect of, say, a limited air

strike. but as yet, we don't have a clear and internationally accepted answer to the question. i suspect the nations of the world will have to define what constitutes an armed attack that justifies a military response. at some point in the future. >> meeting is adjourned until 5:03. >> we still have a lot of questions to ask. we have 25 minutes left. we actually may have to cut out a chunk. i will have a look at that as we get going. but i thought it would be great for the colleagues to be brief. we move now to libya.

>> it looks as though we have civil war yet again in libya. stores in tripoli are being closed. it's gotten to the point that the libyan parliament is now taking refuge in a greek area. we've also had a call from -- very recently, last month, from the house of representatives for an intervention to protect libya's civilian population from militia. the civilian casualties are going through the roof. do you think libya is at a breaking point? and if so, what would you counsel? >> what was the last part of the question? >> is libya at a breaking point? would you agree? and if so, would the west, washington, london, the house of representatives' request for a further intervention to protect the libyan civilian population? >> i don't think i would use the

term breaking point. but clearly the situation is very difficult on the ground. and if anything, the evidence suggests that the positions between the different groups are becoming more entrenched. i'm going to, if i may, invite simon just to update the committee on a conversation that he's apparently just had with john a powell, the special representative, special envoy, who is just back from libya. that might be helpful. >> jonathan powell, ambassador to libya, visited the country just a very few days ago, really looking to see what the scope was for trying to arrive at some sort of political agreement between the various parties. and of course, i won't for a moment underestimate the difficulty of this. there was some elements which suggested the situation was grave, clearly. there are possibilities there. the fighting is probably not as

bad as it was some while ago. it has died down in most parts of the country, for now. it could resurrect itself. and one of the side effects probably of the fighting has been that there's been more or less a coalescing around libya. and rather than try to negotiate with a whole patchwork of different tribes and groups, there are probably more like two main parties with whom to negotiate. as you say, there is an alternate parliament resurrected in tripoli, on a legitimate basis. so it is clearly a very difficult situation. but there are some prospects by which a political process could be arrived at. >> the eie, do you see dangers

from it? >> i think we're always cautious about interventions of this nature. it seems to have been a limited intervention. but it was clearly in support of one side in the conflict. whereas, our approach is to try to bring the different parties together, and impress upon them the need for an inclusive absolution that would allow the various different factions and tribes in libya to live in -- to co-exist peacefully and to share in what could be quite a significant prosperity. >> those of us who oppose the intervention -- >> can i add.

>> do you think we've made the same mistakes as we did in iraq in 2003, when we failed to plan for what happened after military intervention? >> well, the intervention in libya was made in response to an immediate pending humanitarian disaster. i think the intervention was right. it saved many lives. we were always clear that it was going to be a limited intervention. it was not going to be boots on the ground. and there were no boots on the ground. it was strictly limited in its scope. and we're often urged when we do things to make sure that the objectives are very clearly defined and that there isn't any mission creep. and i think the libya campaign is an example of doing just that. defining the limits of what we were prepared to do. doing it. and completing it.

but, of course, that has meant that the final resolution of the post-gadhafi arrangements on the ground is still a work in progress. it's still a matter of dispute on the ground. >> so you wouldn't argue that we've abandoned them? >> no, we're very much engaged with libya. we're training libyan troops, libyan government troops here in the uk at the moment. we have a prime ministerial special envoy who was just in libya last week seeking to broker some kind of agreement between the principal protagonists -- we absolutely haven't abandoned them. we recognize that libya, and libya's stability is quite important to us. not least in terms of libya's

role in the route for flows of migrants into southern europe, which ultimately will have an impact on us in the uk. >> thank you. >> and now moving to the subject of gaza and israel and palestine. how would you characterize the uk's role in introducing the cease-fire? what steps do we take to facilitate it? >> well, obviously we welcome the cease-fire. it wasn't the first one, of course. we've been actively engaged in urging the parties to these talks to agree to a cease-fire as a necessary first step. certainly not in itself sufficient, but a necessary first step. we haven't been direct participants in the cease-fire negotiations, but we've been

strongly encouraging of the government of egypt in the role that it's taken on. i visited egypt very shortly after i was appointed, and met with the foreign minister, and the president, to urge them to leave no stone unturned in bringing the parties to a cease-fire. and we continue to engage with -- both directly with the parties and indirectly with others who can influence them, and to try to ensure that out of this cease-fire, that has now held for, what -- nearly a week -- over two weeks, we get a substantive and meaningful negotiation, which leads to measurable improvements for

ordinary people trying to carve out their business. so an easing of restrictions on them, a resolution of some of the long outstanding problems around fishing rights, and payment of civil service salaries, and so on. and it will lead to the re-introduction of the palestinian authority into gaza, which we regard as a crucial next step to allowing matters to develop further. >> mike gates? >> as you're very well aware, the policy of the government towards gaza has been very controversial. your former ministerial colleague said it was morally indefensible. and it's been said that the policy of the uk's response that is risked damage to our reputation in the region. what's your response to those comments? >> the deputy prime minister

said we risk damage. he's making a statement of the obvious. of course, whenever we take a position, we risk our reputation in some sense. but we are very clear that the resolution to the problem in gaza has to be through a cease-fire. negotiations around improving the situation in gaza. the reintroduction of the palestinian authority into gaza. and then, a resumption of the broader discussion about the two-state solution as a final resolution for this very long-running conflict. >> you don't, therefore, agree that the government could have said more, or been more outspoken on the issues? >> i'm not sure what you mean by more outspoken on the issues. i mean, we've been very clear

from the outset that israel has a right to defend itself. first of all, israel has a right to exist, which hamas still denies. israel has a right to defend itself. but it has an obligation in so doing to comply with the rules of armed conflict, and the principles around protection of civilians, inflicting the minimum damage possible. >> they've done that. >> well, this is an area, of course, there is a lot of noise about. and there will need to be a proper examination of the conduct of both sides during this period of conflict. the one thing that we do know for certain is that hamas launched rockets out of gaza into israel, aimed at civilian population. that much is clear.

israel is conducting its own internal inquiries, clearly to be credible with the outside world, there will have to be a significant independent element to it. but there will also be international, whether u.n. human rights council, it's established its own inquiry into the events that took place. and we will encourage the parties to engage openly with that quinquiry. and to be sure the inquiry is conducted impartially. >> mr. secretary, i want to preface my question by saying that i have been to sarat, the target of probably the largest number of hamas rocket attacks, and i condemn unreservedly all use of rocket attacks against

israel by hamas, which are clearly indiscriminate. i visited gaza after the 2008 israeli attack on gaza. and there i saw an entire industrialist state flattened. and i saw an entire hospital burnt out with shells. my question to you is, does the british government consider that it is legitimate against a terrorist target to use military force against purely economic and employment targets, and against key social service institutions and buildings like hospitals? >> well, the law of armed conflict is clear, and the laws around humanitarian protection are clear. it would not be a legitimate target, those kind of -- that

kind of infrastructure. unless it was being used for the purposes of military activity. and clearly, one of the accusations that is made is that hamas, during this conflict, deliberately and systematically positioned offensive military equipment in areas of sensitive infrastructure, like hospitals and schools, and in areas of dense population, seeking to use members of the civilian population effectively as human shields. now, that in itself would be illegal activity. these are allegations. there are huge numbers of allegations on both sides. they need to be investigated, and what happened needs to be properly investigated. >> now from buildings to people. does the british government

consider that it is legitimate that if a government like the israeli government believes it has identified a particular hamas terrorist, or perhaps while hamas terrorists, it is then legitimate to destroy use ing air-to-surface missiles, tank shells, artillery shells, entire buildings and neighborhoods, resulting in very substantial civilian deaths of complete innocent men, women and children? and can i just add as a rider to that, speaking as a former security minister, that if the british government had dealt with a terrorist in northern ireland, using military force in the same way as has been used by the israelis, then i'm absolutely confident that the outrage in the house of commons

would have been such that the entire government would have been forced to resign? >> well, i think you're probably aware, sir john, of the rules about proportionality in response. and so, the question that you pose cannot be simply answered, for a military response in pursuit of a military target to be lawful, it has to be proportionate. and it's not possible to make a generic statement about types of attacks, or types of responses without knowing the full circumstances of each individual incident. it isn't possible to make that evaluation. people can speculate, and people have speculated, what is now needed is a proper analysis of each incident that occurred. now, this will not be easy.

but i think it has to happen. there will be mistakes made in the prosecution of any military campaign. there will be incidents that occur which are not justified. and then the question will arise, whether they have occurred by inadvertence, by an error, by failure, or whether they have occurred as a result of deliberate targeting. so there are many questions that will have to be answered, in analyzing exactly what did happen over that period of time. but i don't think it's helpful to speculate, and to seek generic categorizations of types of incidents without knowing the details of the individual incidents in question. >> mark henry? >> well, mr. secretary, i would

certainly agree with you if it was just one or two incidents. but to get the death toll between 2,000 and 3,000, we're not talking about one or two incidents. we're talking about vast numbers of incidents. tv footage of which was seen, health facilities being attacked by tank shells, there's going to be forensic inquiry at some stage in the future that will bring israel to justice, that that is the -- >> if you don't mind me saying so, you have obviously prejudged the case. >> my point is, there are hundreds of cases, many of which were captured on film, many of which were given by eyewitness accounts from u.n. officials, and the government itself said that the death toll in gaza was

unacceptable. after repeated questioning, a death toll of 2,000 to 3,000 compared to 60,000 on the israeli side is by no means a proportionate response to the toll -- >> i'm afraid that's -- >> as seen from the israeli side. >> that's a mistake in understanding, the proportionality test. first of all, let me say that the level of civilian deaths was horrific. i said so on many occasions it's outrageous. and we want to do everything possible to ensure that such a conflict cannot happen again. but the proportionality test does not require us to look at the number of deaths on each side in the conflict. it requires us to look at the response that was delivered to each individual military action. >> i understand that.

i understand that, mr. secretary. but if you look at the outcome as a whole, then statistically, at the very least the fact that so many people died, even if a fraction of those attacks were disproportionate, you know, we wouldn't have the results that we've heard. the point i'm trying to make as well, is that earlier in your responses, the different question, for example, it's easy to say how effective sanctions were in terms of determining the behavior of the russian forces and how they might behave in the future, why hasn't the government talked about eu sanctions and more about the arms sales in the way that we would have expected it? >> because the government doesn't think that in this case sanctions would be appropriate or effective.

and there has been a conflict. there have been significant numbers of deaths. and we deplore the fact that those defendants have occurred. we have been very clear about that throughout. then there are very clear legal constraints on the parties involved in this kind of conflict. and there are accusations on both sides of unlawful conduct. and they need to be investigated. we can't do that here in this committee. we don't have the information. you know, you're taking the gross numbers and you're drawing extrapolation from them. but, of course, many of the rockets that were launched against israel were intercepted by the system that didn't cause casualties. that doesn't mean that they were unlawful. it remained an unlawful act, every one of them. >> i condemn those rockets.

i mean, the actions of hamas. but if it was a boxing match, it would have been stopped after the first round. >> mr. chairman, we and many others would have loved to have others would have loved to have stopped it after the first round, and i can assure members of the committee that we spared no effort in seeking to stop it. >> our colleague made the point. the government would have at least resigned because of action like this. >> with respect sir john was referring to action by the british government. we were not talking about actions by the british government. >> i know i'll just ask one

question, which a number of issues that we can tackle. one is, you're about to respond back to our report, if you could just maybe give us a flavor today of what areas you may disagree with us on. two, do you think a settlement by november with iran on this nuclear program is becoming more or less likely. and just the final item is, there is an announcement that our embassy would reopen in tehran. why is it taking so long? >> okay. on the first question, the committee's report, the government's response to the committee's report will be published on the 12th, which i think is friday. of this week. >> friday of this week? >> yes. >> and in general, we're in broad agreement with the report's findings, not

surprisingly, there are some differences of emphasis on certain points and one area that i could perhaps mention now is the question of trade. with iran. the government's position is that it's important that iran sees agreement on a comprehensive deal as a means to restoring its trade relations. and so we are not encouraging trade with iran. of course within the existing restrictions, it is for individual companies to decide whether they wish to trade with iran. although, it's quite the challenge because of the scale and breadth of the restrictions that are in place. on the question of the nuclear negotiations, these are perhaps a sensitive stage and i don't want to do anything that makes them more difficult. i think both sides understand

the red lines that each other have drawn and i would hope that over the next few weeks, there is going to be a determined effort by both sides to see if more common ground can be found, in particular, during the united nations general assembly in new york, there will be opportunities for various bilateral and multi lateral informal meetings to occur and positions to explored. we are very clear that we want to see a deal done. but we do not want to see a bad deal done. this has to be a deal in order to reassure the world, the international community, that iran is not pursuing a nuclear weapon and that its interest in retaining nuclear enrichment capability is purely directed at a civil nuclear program and

we're some way away from being convinced of that position yet. and finally, on the question of the embassy. it is our intention to reopen the embassy. we have to make sure that inns done in a way that will provide proper protections to their staff, that will allow us to go about their business and perform functions, and there are some technical issues still remaining outstanding to be dealt with with the iranians, they are engaged in those problems with us, we do not expect anything. is it to have a visa service

available in tehran and to be sure we can put in effect an vktivkt i visa service or we risk disappointing people in iran looking forward to the reopening of our embassy, we want to make sure that the two things, the nuclear embassy and the provision of local visa service go properly hand in hand. >> secretary, thank you very much. we'll stick to our side of the bargain. we have not asked you questions on nigeria and iran and drones and the future direction of the front office generally, and we may be write you on this. on behalf of the committee, very much indeed, i -- thank you very much. order.

here are just a few of the comments we have recent lly received from our viers. >> i kmachbted to comment on author jason riley, on his book, he was good to listen to, he backed up all of his conclusions with facts. i so appreciate that. i would like to hear more about how he feels we can change the feeling so that people can lift themselves out of poverty and keep on asending within the system. >> with reference to your changes to your thought at the bottom of the screen a couple of weeks ago, and last thursday night, when they had the

election returns, they had it stretched all the way across the bottom, the results, you could read it. and it's so small on these old tv sets that people have, with a tube that you can't read it even in zoom or anything else format. we appreciate it you stretch it out, different font or something where people can read the thing. >> i would just like to comment and say how much i appreciate cspan's efforts to get important information like the ebola hearings and other important topics out to the public. the news agencies are not doing nearly enough and we really appreciate cspan providing this information, the hearings, the testimony on so many important issues, we just thank you and support you. >> and continue to let us know what you think about the programs you're watching, call us at 202-626-3400.

or comment at comments@c-span.org. like us on facebook, follow us on twitter. >> with congress back in session, here's a message to congress, from one of this year's cspan student competition winners. >> water, it makes up 75% of our bodies. take water away and humanity would perish within a week. water is the most vital substance to a human body, yet it is because of us humans that 50% of all streams, lakes, bays and eschew waries are unsuitable due to pollution. in the u.s., we have taken water for granted. bottles of water, flushing toilets re-enforce many idea. water is un limited resource.

step outside and the diminishing condition tells a different story. it kills marine life, and animals are not the only ones that suffer the negative effects of water pollution. >> in 2014, you must provide federal funding to wastewater treatment agencies across the country. the life blood of our nation is tainted with the negligence of generations, and it must stop here. >> join us wednesday, during washington journal for the theme of the 2015 cspan student cam documentary competition. the head of the veteran's affairs department justifying about some of the problems at the va and the changes he would like to see. that's coming up next on cspan 3. then an oversight hearing on justice department hearing. a look at is -- implementation of the dodd franking law.

south dakota -- bring you a live debate for his open senate seat. democrat rick wieland and independent former senator larry pressler and gordon howie will participate. the republican candidate, governor mike brown has declined the invitation. our live coverage starts at 8:00 p.m. eastern on cspan 2. the head of the veteran's affairs department said that his agency will needs tens of thousands of additional medical staff to fix some of the problems facing the va, secretary robert mcdonald testified in front of the veteran's affairs committee. which is chaired by bernie sanders of vermont.

>> good morning, and welcome to what i believe will be an important and productive hearing. today we will be discussing some of the very serious issues, facing the department of veteran's affairs on the heels of the inspector general's findings, related to long wait times and poor patient care at the phoenix va. the ig's report provides troubling details of the nail your of our nation to provide high quality care to veterans. what happened in phoenix is inexcusable and must never happen again in any va facility. i w i was especially disappointed to learn the extent to which sr. va executives and consider clinical

staff knew about inappropriate scheduling practices in a telling exchange, when asked by a physician in hawaii to share best practices about how the phoenix va have presumably been able to reduce itself patient wait time from 238 days, down to seven days, quite a fete. the chief of primary care e-mailed one of his fellow colleagues in phoenix and stated, quote, wonderful, not sure how to answer this, can i just say smoke and mirrors? end of quote. and of course that's what it was, it was all smoke and mirrors. that individual is no longer with the va. the people who lie, who acted dishonorab dishonorably, who manipulated data in phoenix and elsewhere clearly must be held accountable. the indenment nature of this problem is identified by the igs

report cannot be tolerated. the ig's report detailed numerous cases of poor patient care. in fact several of those cases deserved specialty care. reviews of patient files found problems with con tin knewity of health care, a dedicated psychiatrist or nurse practitioner and limited access to psychotherapy. additionally the ig also discovered the neurology service did not provide timely care. a report regarding the findings will be released in due course. while the results of the ig's report paints a troublesome picture, the ig's -- long waiting lines as news media reports had speculated. i also understand as a result of the attention focused on phoenix, the ig has opened

additional investigations at 93 sites of care, as a result of receiving approximately 445 allegations, regarding manipulated wait times in other va facilities. this committee will continue to monitor the results of these investigations and use this information to inform the committee's oversight efforts in the future. i won't go through all of the data, but the bottom line is the reports worked on by the va, worked on by the ig tells us that tens of thousands of veterans were unable to get the care they needed in a timely manner. and i hope what we will learn today from our new secretary mr. mcdonald, and the ideas of the

inspector general mr. griffith, is in fact how that problem developed, i don't believe that anybody joins the va in order to manipulate data. how does it happen? what were the courses? how do we make sure that this never happens again? what do we do and how quickly do we get rid of dishonorable employees? we gave the new secretary tools, we want to finding out how he's utilizing those tools. maybe most importantly, we want to learn how we go forward into the future to make sure that these problems are never occur again. i noticed in the paper yesterday,a the secretary held a press conference talking about and i want to discuss it with him, his need to aggressively go out and bring no physicians, new nurses, new medical personnel into the va so that we don't have these wait times again. and during this hearing, i look forward also to talking with our new secretary about who's going

to implement the legislation that was recently passed. so there's a lot to go over in this hearing. we thank the secretary for being with us. we thank the inspector general for being with us as well. senator burke. >> good morning, mr. chairman. i would like to welcome secretary mcdonald and acting inspector secretary griffin. today the committee's holding another hearing on the state of health care within va, specifically focusing on the final ig report, as it relates to the -- the release last month as it relates to phoenix. and when i say final, mr. griffith, i realize there are many more yet to come and this will be absolutely crucial to the agency's ability to continue to get a handle on the problems. since our last hearing on the state of va health care, congress has moved forward with

historic legislation that will help improve access to care for veterans across the nation. this legislation is a first step in providing veterans with the ability to choose where they receive care, if va is unable to provide care in a timely manner or if they live outside of 40 miles outside of a va facility. while this is -- there's still much more work to be done. the work of this committee has just begun. as we move forward, it will be crucial for this committee to conduct aggressive oversight to ensure that veterans are able to receive the health care they need, and more importantly, they deserve. the ig report is constructive because it demonstrates critical breakdowns in the system that allowed systemic issues to take root, not only in phoenix, but throughout the entire va system. i would like to highlight two

specific issues that were identified in the final ig report on phoenix. first the ig report describes the care received by 45 veteran who is face either clinically significant delays in care or questionable care from the phoenix facility. additionally the ig reviewed seven suicide that oak kufred between january 2012 and may 2014 and found that nine veterans experienced a delay in care, one veteran experienced a clinically significant delay and five veterans experienced other substandard quality of care. many veterans experienced obstacles while trying to establish needed care after hospitalization or being treated in the emergency room. the lack of follow-up, coordination and quality, and continuity of care, many of these veterans experience is troubling, and quite frankly it's unacceptable. secondly, the most troubling usual described in the report

was va's awareness of the ongoing scheduling challenges that many facilities faced. further more, va had opportunities to address the systemic culture of inappropriate scheduling practices. va did not act to address inappropriate scheduling practices or manipulation of wait time data. this lack of accountability was further ingrained by va's decision to delay -- compliance with va scheduling directives. why would the requirement be waived when va knew that there were questionable scheduling practices occurring within fid kl facilities. it's demonstrated by the roughly 225 allegations at the phoenix health care system and the more than 445 similar allegations at va facilities across the nation, that the ig's received through

numerous sources, employees, veterans and their families. currently the ig is actively investigating 93 sites as the chairman referred to. in the coming weeks, months and years, va will continuing to take swift and firm action to dismantle the corrosive culture that has taken hold within the va and make sure it's not able to resurface. no matter what steps the v takes to challenge the delivery of health care. va will not be able to move forward, if the corrosive culture is not effectively addressed. i have said this before, but i want to reiterate that the culture that has developed at the va and the lack of management and accountability is simply reprehensible. i commend the work that has been

done over the last several months, however there is much more work to be done to repair veterans trust in the system. i look forward to working with you, mr. secretary, as this committee works on implementing and passing legislation that's needed for you to accomplish, what i believe is a very significant reform pathway for veterans and for the va itself. i thank the their. >> thank you, senator kbibird, senator tesla? >> great to have you here, senator mcdonald, as the confirmconfirm ed secretary for the va. thank you for being here, i know the last few weeks have been busy for you, and hopefully productive. thank you for what you've down, what you're going to do, few for the recommendations you're putting forth, i think these are critically important for the va and for us as we look to improve the va. we passed an important bill before we left for the august

recess. that bill was signed by the president. i agree with the ranking member, it's a first step, i hope it's not a first step to private advertise the va, i hope it's a first step to make the va stronger so it can give the services to our veterans that they have earned. with that i look forward to your testimony, look forward for the opportunity to question you on that testimony. >> thank you, mr. chairman, mr. chairman and the ranking member byrd, let me just start out and say thank you for convening what i believe also will be a very important hearing today. i also want to express my appreciation for you to hopefully offer some insight into the issues that we are looking at. mr. secretary, i also welcome you, it's good to have you on board. you've taken over during a very difficult time, but your body of

experience, i think is going to serve our nation well. i do want to say i thank you for your swift action. i hope there's more to come. the inspector general report, we are here to discuss today has confirmed disturbing allegations. about secret wait lists and barriers to health care for our veterans. it's amazing to learn of widespread examples of failures and outright cover ups by va employees. at present, if i have this right, there are 93 other sites where care is provided that are under investigation. that's amazing to me. that's a remarkable number. i am pleased to see that the va agreed with all 24 recommendations that were made by the office of inspector general. my hope is that the va's plans

to address the recommendations are not empty words, that there will be followthrough on what they have agreed to. without the recommended changes, reports of mismanagement, fraud, sub standard care at the va will continue. while tackling the issues identified in the reported, va must also keep in mind other important initiatives. va mucst work quickly to implement the accountability act that was signed into law. the choice card provision is critical to our nation's veterans to allow them the freedom to seek care outside of the va if they choose to and it's needed. other programs that ensure va has the space to provide quality care to our veterans are also critical. programs for construction of state veteran's homes and medical centers just to name a

few. as i mentioned, in this committee, many times, the va construction backlog should be a major concern to all of us. we just simply have to find a solution to replace 1950s era hospitals. we have one in our state, and ensure that these priorities aren't lost in the shuffle. again, i look forward to hearing how the va intends to repair the damage that has been done by this scandal. to regain the trust and confidence, not only of congress. but more importantly, our nation's veterans and their families. mr. chairman, again, i thank you, i yield back. >> thank you very much. senator? >> thank you, mr. chairman, secretary mcdonald and acting inspector general griffith, thank you for being here this morning.

the -- veterans affairs and other systemic problems at the va have severely shaken the trust of veterans, their families and the general public should have in the va health care system. over the last decade, we have sent over 2 million men and women to fight the wars in iraq and afghanistan and some of the problems that we see in the va are due to shortcomings in three major areas as i see it. first, ensuring that veterans are aware of and receive access to va health care and other services that the va provides. second, congress providing sufficient resources effective oversight and ensuring accountability for the va. and third, improving the transition for military service to civilian life. i realize that today, we are focusing once again on the veteran's health care system. to provide effective overeight and account october in may of 24 year, this committee convened

its first hearing in response to the allegations of wait time irregularities in the va and a response to testimony from that hearing and other hearings of this committee. the accountability act of 2014 was passed. and once again i want to commend the chair for his efforts in getting this law enacted. our goal in passing this legislation was to provide va with the tools needed to address the serious problems veterans were facing in accessing care. this law not only granted the va money to build internal capacity in the form of additional hiring, but also provided the va the authority to lean upon the private provider community to ensure timely access to quality care. and assure secretary mcdonald, you will tell us how you are implementing that part of the new law. and during the august recess, i held a field hearing on the state of va health care in hawaii. and during that hearing, i heard from veterans in my state, local va staff and washington based va

staff on what they were doing to improve veteran's experience with the va. the lack of providers was a common refrain throughout my hearing. the va must do more to recruit and retain high quality health care professionals within the skrrva system. we know that the va population is a special population with specific needs. based on the hearings this committee has held this past summer. the inspector general's findings in his final report were not a surprise. we know there are problems relating to patient wait times have been reported on since at least fwooif without action on the part of the va until this year. directors -- to while congress for its part has continued to increase va's budget, clearly

congressional oversight is critical. as is va's efforts to increase accountability within its system. for example the lack of national standardization and procedures and practices will not in itself troubling has led to this decentralized control, leading to a broad avoidance of accountability within the va system. i look forward to working with my colleagues, the inspector general and secretary mcdonald in ensuring that we make the appropriate improvements. thank you. >> senator, thank you very much. >> senator? >> thank you, mr. chairman, and also to the ranking member for holding this hearing today and i want to thank the secretary and also mr. griffin for being here for taking time and updating us. we have met in my office and in this committee and in reno just a few weeks ago, secretary

mcdonald has shown he is contributed to bring -- but the task ahead will be va's most difficult challenge after having failed our veterans and delivering quality health care and timely benefits. the gross mismanagement revealed in phoenix and elsewhere shocked congress and our nation and is a significant crisis to overcome. my hope is that the secretary's goals will not get lost in the bureaucracy and i expect sknlt communication and honesty about what the va needs to re -- just last week, i had the privilege to meet with your veterans in nevada in the past 15 years, it's grown from a small town outside las vegas to a community of 36,000. and in all of the county, there are about 9,000 veterans which is why this community has fought long and hard for a larger va clinic as more veterans flock to

this community. when visiting, i told them about the promise i made to you mr. secretary when we first met, and that was every time i see you, i will always bring up several key issues to nevada inform veterans, of course improving las vegas va hospital and eliminating the disability claims backlog that we have in reno. bob, you deserve credit for quickly approving the clinic as soon as you are confirmed. and i also appreciate director duff and associate director karen for working closely with my office to keep me informed. i'll be looking closely at each of these steps, to determine if there's unnecessary bureaucratic barriers that delay projects like this and will hold the va accountability. i also hope to see improvements in the las vegas va hospital. there's been discussions about how to do this and i would like

to share a few key improvements in what i think needs to be made. american veterans in nevada want to improve transportation of rural veterans to this hospital. right now the dav, disabled veterans have a transportation program, which they are not allowed to take veterans confined to a wheel chair. know stop and think that for a minute. disabled veterans, their transportation program is forbidden to take veterans confined to a wheelchair or ute li lizing an oxygen tanging to the hospital. part of this improvement will be

an enhanced scheduling system the va is currently seeking. every va hospital needs processes and technology that will give directors the investigation they need to determine where resources are missing. and lastly, a point that the secretary has brought up to me and the difference is in regions and management structure, among the three va -- i look forward to working with you to improve the current structure and believe that these organizing these administrations should be a positive step forward to enhancing coordination and improved care to our veterans. and finally, i remain committed to addressing the va disability claims backlog. for years now, nevada ask the worst in the nation with claims being completed in 334 days on average. as co-chair of the va backlog working group, i'll be hosting a round table later today los angeles with senator casey to discuss the needs to overhaul

the processing system. i believe there's no better time to reform the claims process under secretary mcdonald's leadership and the working administration is a strong platform for some of the changes that need to be made. and i look forward to hearing more about the progress and improving care and benefits at the va. and again, thank you mr. secretary and you mr. secretary general for being with us. >> thank you, senator. senator? >> thank you, mr. chairman, thank you for holding this hearing today and to the ranking member as well. thank you to secretary mcdonald. griffin, we're here to listen to you, not so much to talk, but even more important is that we listen to our veterans across the country, who have firsthand experience beyond the inspector general reports, beyond the polling, beyond the hearings that we conduct here. i had a town hall meeting in

newington last night for a couple of hours and welcomed welcome stripe burger, the director of the hartford regional office, as well as the district tofr of the va connected health care system to listen to our veterans, and not just about the delays, shared with the audience, very compellingly, his understanding that mr. veterans with vfw have received outstanding service, but that there is a lack of provitders, nurtss, doctors, staff, that have caused the delays and hindered veterans' access to care. i know that the veteran'sing session to care act to enable va

to hire additional health care providers and clinical staff. but secretary mcdonald, you've identified the practical obstacles to meeting the needs and hiring more doctors and other professionals and that is one of the central challenges of our time. and i hope this committee will play a constructive role in that task and so many others that face you in this very challenging time, as well as rebuilding the facilitiefacilit infrastructure. as if the west haven hospital, where not just renovation, but rebuilding are necessary to replace a 1950s structure that cannot accommodate the most modern technology, equipment that is necessary to care for people in 21st century fashion. i want to say that i hope that we will continue to be of a mind that this health care system is

in crisis. i know that crisis is an overused word in washington where. but it should give us the impetus and sense of urgencya we all feel. as to the need, the immediate need because health care delayed is health care denied. people need it now when they need it. and so mr. secretary, i want to thank you for your determination and the management experience that you'll bring to this task and finally, we all know that we're going to see a surge of veterans coming out of our military, in the next months and years as the army and marine corps downsize, many of them will have the horrific invisible wounds of war that we now have diagnosed as post-traumatic stress or traumatic brain injury. i want to thank the va for its

support in efforts that i and others have made to correct the records of veterans of past wars at times when post-traumatic stress was undiagnosed and untreated and caused many of them, particularly from the vietnam era, to be given less than honorable discharges, those bad paper discharges have been a stigma and a black mark on their records, caused many of them to be homeless and jobless. and i want to thank secretary hagel for now initiating a new era when those records can be corrected. as we sought, this change in policy was the va. and most especially general kin sec i can, who served in that war. and i want to thank all of the dedicated men and women of the

va, for their service in so many ways, most especially in the help that they provided to initiate this change in policy and thank you to secretary hagel for his awareness. and his courage in taking this very, very important step to give honor and respect to veterans who were unfairly treated. when they received less than honorable discharges, when they suffered from post traumatic stress that led to those kinds of discharges. thank you mr. chairman. >> thank you, senator lumen thal. senator moran. >> thank you to you and senator byrd for having this hearing. thank you for your willingness to serve. i hope that you will hit the ground running, and i hope that you utilize your tenure as a secretary to make remarkable improvements, i hope to explore with you during my time of

questioning, a couple of things in particular, with you and the inspector general, i would like to hear about what convinces to employees at the va have been as a result of their misconduct. or those currently on leave on leave with pay or with compensation? sand has anyone been discharged or has there been a plan to discharge anyone as a result of what happened at the department of veteran's affairs. in the broader sense of the legislation that we have passed. my understanding, i think i know this sufficiently well to say this, that many of the authorities that are given to the va.

in particular, i would like to hear how you intend to yult liz arch, and the authorities given to you in the new legislation, not only allow you to extend that program but to expand that program and i would like to asure that you there's no danger of any of those things happening from the va's perspective and to make sure that that program is used while we're in transition to the authorities given to you in the legislation. a couple of examples where this hits home. a gentleman needed a colons of copy, the va, upon our prodding changed their mind and allowed for this service to occur at home. he apparently qualified because of the issue of timeliness, not

because of geography. eat veteran, who has to have cortizone shots, that he has to get from the va, he should qualify in my view for geography. but the va has said no. so how we impment this act in regard to timeliness and -- it's been discouraging to me on one hand and depressing on the other. the discouraging part is if you could react to this quickly and accomplish what has been accomplished in the last month or so, why was it not being done in the first place, if we can come up with ways to solve the problems of how we get veterans in to see a physician and be treated, why was it not occurring all along when you've

been able to accomplish so much in a short amount of time? >> thank you mr. chairman. >> thank you, senator moran. senator begich. >> thank you, mr. chairman, thank you for holding this hearing, secretary mcdonald, thank you very much for our meetings and conversations we have had, provide g being here also. let me just say a couple of things, first, i'm very glad that the piece of legislation passed as it did a month or so ago, but the reality s i guess for senator moran in alaska u we have been doing this, we drag the obama administration along, but they now understand and we have been doing it for three years, we deliver health care from 30 different tribes around the state through our indian health services program which is administered by alaska tribes, delivering health care to veterans native and not native, no matter where they live. it doesn't matter if you're living up in nome, or you're living all the way down the

ket ketchican. it wasn't easy, there was a little bit of back and forth between the va and the health and human services department to get them to understand that this is about delivering care with the same tax dollars, it doesn't matter who is spending it, it was coming from the same kitty that we have to allocate. from my perspective. i'm anxious to see how and what you will do what those recommendations, the reality is, i'm sure mr. secretary, you would prefer not to keep coming to meetings like this and go do the work that needs to be done. i'm glad we're doing oversight, it's important to makes sure that you, the administration, you're now in charge of, the obama administration, all of them are focused on delivers health care at the greatest level possible. i think we have some great examples already that exist as we could utilize as i gave for alaska.

froom in alaska, in anchorage, which is 40% of the state's population, you can go to the va clinic, or you have a choice, you can go to the health service it was clinic or the alaska native hospital. and of those two facilities, those last two i mentioned, if you're on the list, you get in on the same day, as long as it's not major medical. that's an mazing step. we did that before the legislati legislation. i know what i did, i had to hound away on the va, because i remember the first memo i got on it. within six months of coming into office, they said it can't be done, not possible, unrealistic, it's two different agencies. i remember the long laundry list that i got. both from agency and from veteran's organizations. we just pushed the pedal down all the way, because they spelled yes wrong. and the end result is, we're delivering care all the way

across the state of alaska, which is 1/5 the size, mass of this country. so if we can do it there e we can do it anywhere. so in a lot of ways, the piece of legislation we passed only re-emphasizes what can be done and we gave some money. the challenges you're going to have is making sure we have enough professionals. as we know in alaska, the matsu area, still has a problem recruiting primary care doctors, that's going to be a problem, not only in the va system, in the health services and private sector and you name it, it's a problem everywhere. but what did we do there? again, we used our tribal agreement to use south central clinic, to admit almost 500 veterans for care, because we had access and capacity there. so as you look at how to solve this problem and continue to move forward, look at what the assets are that are out there, and i do believe, as provening before this legendation passed,

you have the authority, you have the authority, you have the capacity to push the pedal all the way down. the va, the obama administration, can make these things happen. what we're saying today, we're glad the bill passed. we're glad we have oversight. it takes years to get a primary care doctor into the system. win of the things we want to make sure is with the va, a huge gap, are university is still not certified in cooperation with the va to make sure that our counselors are being used. we need to make sherr that the va makes this happen. they're ready, there's huge gaps in the helgtd care system. i want to make sure you have that on your list. but again, some big challenges

in recruitment. the administration is moving forward, you have a huge task ahead of you. i want to make sure that we're not always going to meetings but we're hearing results and that's what i'm looking for, thank you. >> thank you very much, senator begich. senator boseman. >> thank you, mr. chairman, and thanks to you and ranking member gar for the hearing. i think in the interest of time, i would like to hear the testimony so we will put our statement on the record. >> thank you very much. senator murray? >> thank you mr. chairman for holding this really important hearing and i want to start by thanking the inspector general richard griffin and the department's office of inspector general for all the work that has been done to conduct this review. your investigators and staff have put together an incredibly important report on what happened at phoenix and completing the other investigations, at nearly 100 medical centers is really an enormous task. so i want to thank the oig and

all of our staff for the incredible dedication it's taking and will take to get this done. after a lot of years of making critical contributations to veterans care and benefits, the ig has a reputation of being objective, reliable and thorough in your work. so we all do, thank you. your findings are going to be really vital, as we look forward to this, so i appreciate it. i also appreciate how secretary mr. mcdonald had hit the ground sprinting to get veterans off wait lists and into scare. while the va's latest data continues to show patient accessibility improving across the development, i still am concerned about some of the facilities in my home state of washington. veterans receiving primary care within the puget sound health care system. and at spokane, the new mental health care patients wait over twice as long, 75 days for their

appointments and that has got the to change. so as the va continues to focus on providing vet trangs with timely access to care, it also has to assure that veterans receive the highest quality of care and as the ig report showed, that was all too often not the case in phoenix. they found that the phoenix health care system struggled with many of the basic quality of care issues, things like leaving routine physical examinations a s and evaluation incomplete. or releasing patients before their medications were properly stabilized and failing to provide dedicated mental health care providers to patients. we all expect excellence and if you want to notice, i have said repeatedly as transparency and accountability increase at the va, so are the investigations of

the reports of additional concerns, requiring even more action from the va, this m and this congress. so today mr. chairman, i hope to hear how the va is going to address the 2350i67bdings of the ig. and i want to hear how the va will implement the veteran's access choice and accountability act. yesterday we heard the secretary speak about va recommitting itself to core values. today we need to know how the secretary will turn those commitments into real action and to improve care for our nation's heroes. thank you mr. chairman. >> i think we have heard from all the senators. let me bring mr. griffin and his staff to the table. >> let me welcome richard griffin and his staff. mr. griffin is the acting

inspector general for the ze department of veteran's affairs for today's hearing. normal protocol is for us to have the secretary to go first. i want the secretary to know there is no disrespect in breaking that protocol. but i think it would be more productive to hear what the secretary general has to say. mr. griffin was appointed as deputy inspector general in 2008. he previously served as the va inspector general from 1997 to 2005 so he brings an enormous amount of experience and knowledge to his position. he is accompanied today by dr. john day jr., snimpblt inspector general for health care inspections, ms. linda halladay, for audits and evaluations, ms. maureen reagan, accountant to the inspector general and mr.

larry likenmeyer. mr. griffin, thank you so much for your work and for being with us, the mike is yours. >> mr. chairman and ranking member burr and members of the committee, thank you for the community to discuss the results of the ig's extensive work at the phoenix va health care testimony. our august 26th report expands upon information previously provided in the interim report, and includes information on the reviews by oig clinical staff of patient medical records. the oig examined the medical records and other information for 3409 veteran patients. which included 293 deaths, and identified 28 instances of clinically significant delays this care associated with access or scheduling.

up these 28 cases, 26 were deceased. we found 28 cases of -- that were unrelated to scheduling or access issues. of these 17 patients, sh were deceased. the 45 cases discussed in the report reflect unacceptable and troubling issues in follow-up, coordination, quality or continuity of care. the identity of these 45 veterans has been provided to va, decisions regarding va's potential liability in these matters, i with the department and the judicial system, under the federal tort claims act. informs on the qualifications of the oig physician who is conducted these reviews can be

found in the curriculum vitae submitted to the record with our written system. testimony. we identified several patterns of obstacles to care that resulted in negative imagine on the quality of care provided by phoenix as of april 22, 2014, we identified about 1,400 veterans waiting to receive a scheduled primary care appointment who were appropriately included on the phoenix electronic wait list. however, as our work progressed, we identified over 3,500 additional veterans, many of whom were on what we determined to be unofficial wait lists, waiting to be scheduled for appointme appointments, but not on phoenix's official electronic wait list. yo

your urolog yarks services -- -- the urolgogy service was in turmoil between the 2012 to 2014 time frame. there were a number of urology physician staffing changes, delays in the procurement of von va purchase care and difficulties coordinating urologic care. the va is now working from a list of 246 patients who may be at risk for receiving poor quality urologic care, as a result urology care is under going a review. 20 oversight reports on va patient wait times and access to care. yet vha did not effectively

address it's access to care issues or stop the use of inappropriate scheduling procedures, when skrrksvha conc to our recommendations and -- many medical facility directors did not take the necessary actions to comply with vha program directives and policy changes. in april 2010, in a memorandum to all vision directors, the then deputy undersecretary for health for operations and management called for immediate action to review scheduling practices and eliminate all inappropriate practices. in june, 2010, vha issued a distri directive, reaffirming our patient scheduling proskess and

procedu procedures. in july 2011, an annual certification of wait times was mandated. in january 2012, and may of 2013, the vision 18 director issued reports that found phoenix did not come ply. finally in may of 2013, vha waived the annual requirement for facility directors to certify compliance with the vha scheduling directive. further reducing accountability or wait time data integrity and compliance and appropriate scheduling practices. the iginves investigations at 93 sites of care. investigations continue in coordination with the accident of justice and the federal bureau of investigation. while most are still on going,

these investigations are confirming that wait time manipulations were prevalent throughout vha. this report cannot capture the personal disappointment frustration, and loss of faith individual veterans and their family members had in the health care system that often could not respond to their mental and physical health needs in a timely manner. immediate and substantive changes are immediated. -- needed. the va secretary has acknowledged the department is in the midst of a serious crisis and he has concurred with all 24 recommendations in our report and submited acceptable corrective action plans. mr. chairman, this concludes our statement and we would be pleased to answer questions any

of the members may have. >> mr. griffin, thank you very much. for your testimony and for the work that you and your staff have undertaken over the last many months. by asking you a question that arising because of media reports that troubled me. there has been some suggestion that the ig, the office of inspector general for va is really not independent. i would like to provide you with the opportunity to describe the process that ig utilizes when preparing reports in the draft report review. in other words, you are being heavily influenced by the va, are they editing the reports, are you an independent entity,

finding the truth the best you can. >> thank you for that question. our organization over the last six years, has issued 1,700 reports for purposes of guaranteeing accuracy of our reporting. if the department has information that we missed, in doing our work, they can point out to us that would be factual and convincing, then we may come

to realize well, we got this one part wrong. we do not accept from the department or from anyone else, a dictated response that is based on opinion as opposed to fact. >> let me ask you this. every member of the committee is outraged by what happened in phoenix. outraged in general by unacceptably long wait periods for veterans. >> time and time again being the concerns about the appointment

process, yet nothing seems to happen. in english, describe to us how it happened that we had these long waiting periods that were disguised, that we had some people, not on any waiting list at all. all of this went on and nobody did anything about it. how does this happen? >> that happens when there is a failure of leadership. we are not just talking about phoenix. we have reported this problem for nine years. excellent policy. where in fact publish and is not out. i alluded to some of them. you have to follow through. wait times is not the only issue that we have reported on where vha has promulgated policies to address the recommendations and sent them out and was supposed to be certified they were followed. they weren't.

it is hard to explain the why of that when people do not follow the directive from the headquarters leadership and mislead them about it, there has to be a consequence. >> two brief questions, number one, to what degree. >> i believe there was an awareness in feni, based on some of the e-mail that is we pulled. they are included in our reports.

they were aware it wasn't doable. i am sure you recall from the interim report, someone asked for the report of success that is reported is smoke and mirrors, as is mentioned earlier. i think a big part of the equation for the fix is opposed to what we all know happened, when you look at the veteran has contact at the medical center. or tomorrow, or today versus this veteran can wait 30 days. i think in the private sector you would have somebody with

more clinical background to try to make that evaluation. you know who needs to come in and who doesn't. >> my time is expired. if you don't have the staff. if you can't do t how come that is not transmitted up the channel? >> it should be, i believe in phoenix it was. the outcome is documented in our report. no action was taken to fix it. >> mr. griffin, thanks to you and to your staff for the job that you have performed for the under taking that you are in already in process with. and i prior ig reports, and

fixed the problems, would we be here talking about phoenix or any facility? >> no. >> the problems seem to be rooted in two things. one is the culture. created. i think that culture has been created because there was a lack of accountability, that was evidenced outside of the electronic system, and had they just addressed those, we wouldn't be investigating phoenix to the degree that we are. is that an accurate statement? >> that is accurate. as i mentioned, previously, we couldn't close a recommendation unless we believed that they had taken the appropriate steps to resolve the issue. when you get a copy in 2010, to

knock off the manipulation, and three months later, you get an updated scheduling procedure as a vha directive, at that point, you would believe that people got it. that it would be implemented, and it would be implemented to the letter. based on the warning signs you provided for. >> i think the next panel can probably better explain what rational was. i think there there had been plenty of warning this was going on. i thought the certification was an excellent thing to make people declare yes, i have reviewed it in my facility, yes, our waiting times are according to the policies and procedures of the department.

i know you can't get into specific take-aways, what vulearned about the va, over that period of time. >> referring to the 93 other facilities. we have some initial reporting on those. as of yesterday, given the department 12 individual reports for them to examine and to determine what action would be appropriate in view of the specifics of each of those reports. very much active. i can tell you that at 42 different facilities of the 93,

we found the practice of using the next available date as a desired date. it is something we reported in the final report and interim report. we have 19 facilities, where an apartment was cancel and rescheduled for the same appointment time for the purpose of giving the appearance of shorter waiting time. we have 16 facilities, opposed to be on 13 facilities managers about what was going on in that facility. >> all of the individuals over an initiative over some level of