ARLINGTON, Va. — Improvements to the veteran’s health care system aren’t always making it from policy writers’ pens to the clinics and hospitals where they’re needed, Defense Secretary Robert Gates said Monday.

“My impression is, it’s still uneven, in terms of implementation at the local level,” Gates told Pentagon reporters after a lunch meeting with Secretary of Veterans Affairs James Peake and other military health care officials.

Gates said the Pentagon and the VA are working to adopt 400 recommendations collected from numerous task forces and study groups that will streamline and simplify the veteran’s health care system.

But “it’s one thing to get the procedures and the policies fixed here in Washington,” Gates said. “It’s another thing to get it implemented right down to the local level, so that the individual soldier, sailor, airman or Marine is seeing the impact of this on the ground.”

Todd Bowers, director of government affairs for Iraq and Afghanistan Veterans of America, a group which champions better health-care coordination between the Pentagon and the VA, agrees with Gates.

“It’s extremely uneven,” Bowers said Monday from IAVA’s New York headquarters.

Bowers said he is in contact with IAVA members across the country in the VA system, and that he is “very excited to hear from our membership that improvements are starting to appear on the local level.”

At the same time, he said, “there is still a tremendous amount of work to be done.”

“We still hear that certain veterans centers have a tremendous amount of staff shortages,” Bowers said, and “there are still pretty hefty waiting times in some veteran’s centers.”

Reducing delays in access to care is a major focus for the VA, Peake said.

“We have worked really hard to get down the waiting list,” he said.

The list “is down to 45,000 people [who must wait for care] for more than 30 days,” Peake said, and “will be down to essentially nothing,” although he did not say when that goal would be achieved.

“I doubt that,” Bowers said.

“A lot of folks are pouring into the system now, and we’re going to continue to see backlogs for quite some time,” he said.

Bowers also challenged Peake’s claim that for VA patients with mental health needs, “you’re going to be seen within 24 hours, and have an evaluation within 14 days, if that is required.”

“I don’t know if he’s using an average, or what,” Bowers said, “but I know plenty of folks who have used the mental health system [recently] and had to wait months to have an evaluation — not less than two weeks.”

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