In 2014, when a Veterans Health Administration doctor in Phoenix revealed that some VHA administrators had falsified data on wait times for patient appointments, congressional Republicans applauded his whistleblowing on behalf of veterans’ health care.
Joined by many Democrats and, later, the bipartisan VA Commission on Care, Republicans said they supported a workplace culture that encourages federal employees to report agency problems, and speak up about misconduct by management.
Now, however, President Trump and his GOP allies are singing a different tune. If their current efforts to muzzle employees who may disagree with VHA policies or practices succeed, both the quality of VHA care and the safety of its patients will suffer. That’s because concerned caregivers will be afraid to criticize deficiencies when they spot them.
As The Washington Examiner reported on February 23, the Trump administration wants to prohibit VA staff members from voicing online criticism even when they’re not at work. The VA’s own Office of General Counsel supported the free speech rights of employees who use social media during their off-duty hours. But in the article, White House spokesman Sean Spicer insisted that all federal employees must toe the administration line.
Pete Hegseth, a Trump supporter and former CEO of Concerned Veterans for America, a conservative nonprofit funded in part by the Koch brothers, was quoted in the article applauding this hardline stance. According to Hegseth, the various expressions of federal employee dissent witnessed since Trump’s inauguration just demonstrate “the depth of the swamp” in Washington, D.C., and “the extent to which the civil service bureaucrats are entrenched in siding with the unions.” Hegseth, like many advocates of VHA privatization, thus used the issue to attack the power of federal employee unions.
Over the past year, GOP members of the House Veterans Affairs Committee have taken direct aim at VHA staff and their unions, most notably the American Federation of Government Employees (AFGE). The Republicans would like to strip AFGE and other union-represented VHA employees of due process protections and make them what’s known as “employees at will.” That means they would be subject to dismissal without just cause, or any opportunity to rebut management allegations against them in any kind of fair hearing.
Republicans on the House Oversight & Government Reform and the House Veterans Affairs Committees favor elimination of paid time off for union representatives who are VA employees but who work full time assisting their VA coworkers in meetings with management about discipline and other job-related problems. The new Congress has also dusted off an obscure legislative tool that could help them cleanse the federal payroll of union troublemakers or, potentially, anyone who disagrees with management or administration policies.
This tool, known as the “Holman rule” for the late 19th-century Indiana congressman after whom it is named, is a budget appropriations device that allows Congress to single out any individual federal employee or program for defunding, even if the overall agency funding remains intact. The rule was created in 1876 and rescinded in 1983. As AFGE President J. David Cox Sr., a former VHA nurse, explained in a statement: “Reviving this rule means lawmakers will be able to vote to cut the pay and jobs of individual workers or groups of workers without getting input from the agencies where these employees work.”
It’s true that VA employees, like all government workers, are still covered by the Federal Whistleblower Protection Act. But in the face of this emerging, multi-pronged attack on federal employee job protections, this cumbersome and bureaucratic law will not be enough to reassure federal workers who want to voice legitimate complaints and objections about ongoing workplace problems. Indeed, this kind of silencing of federal employees will certainly undermine the VHA’s laudable efforts to improve patient safety in hospitals and clinics that now serve some nine million veterans.
Due to safety lapses throughout our larger U.S. system of under-regulated private health care, preventable medical errors are now the third-leading cause of death in the nation. Every year, more than 250,000 patients die, and another 1.5 million are injured. It’s also well documented that lack of union representation contributes to poor health industry working conditions—including understaffing, forced overtime, higher turnover in lower-paid jobs, and—importantly—an absence of whistleblower protections. The bottom line is that with no unions, hospitals are less safe for their patients.
One study found, for example, that when nurses are protected by union contracts, they are much more apt to report hazards to themselves and their patients. In hospitals in California where registered nurses were unionized, the study found, patients had lower mortality from heart attacks than in non-union hospitals. Among the reasons cited was the fact that health-care workers with collective bargaining rights feel freer to speak out to challenge physicians or management. As the authors commented: “The protections offered by unionization may encourage nurses to speak up in ways that improve patient outcomes but might be considered insubordinate and, hence, career-jeopardizing without union protections.”
This clear connection between employee speech and patient safety deserves more attention from veterans’ service organizations and Democrats on Capitol Hill. Veteran advocates must wake up to and spotlight the value of unions, and the due process rights of VHA employees. If Republicans in Washington succeed in muzzling the voices of federal employees and undermining their collective bargaining rights, VHA patients will be the ones who suffer.