The CHAIRMAN. You will be here tomorrow, Admiral Boone? Admiral BOONE. We will give a breakdown on that tomorrow. The CHAIRMAN. Mr. McNamara, will you be here? Mr. MCNAMARA. Yes. The CHAIRMAN. At 10 o'clock. It is very important. We will stand adjourned. Mr. BYRNE. May I ask one question, Madam Chairman? Mr. BYRNE. Admiral Boone, you know the hospital situation in Philadelphia. In 1950 there were 775 beds; 163 were taken care of at the naval hospital and 184 at 34th and University Avenue. The new hospital will take care of 488 patients. I understand one ward will take care of 75 beds for TB patients. Admiral BOONE. I think it is 40 for TB. Mr. BYRNE. In the Philadelphia area there are 500,000 veterans,. and these beds are supposed to take care of those people. Ed Linsky sent me a telegram quoting from the report of the Subcommittee on Appropriations as follows: The bill contains $10 million for administration, medical, hospital, and domiciliary services, which is a reduction of $8,960,000 in the budget estimate. The committee has allowed the full amount of the estimate of $5 million for operating expenses in connection with hospitals. In connection with this part of the estimate the committee specifically directs that the Administrator of Veterans' Affairs take such immediate steps as may be essential to furnish adequate hospitalization for needy veterans in the Philadelphia area. As far as the patients in the naval hospital are concerned, what does that mean? Admiral BOONE. We had 400 beds in the naval hospital on a reimbursable basis. The President's budget contained sufficient funds to permit a daily average patient load of 200 through the fiscal year 1953. We started, with the coming in of the new VA hospital, to supply that requirement. We are in the middle of that now. We have run an average of 316, a daily average, up until the last day or two. So we have been over that 200. We had to start the phaseout of beds in the naval hospitals earlier than anticipated. With our budget cut we had to expedite the phaseout. So it is to be effected between April 1 and May 1 rather than June 30. You have to do it on a gradual basis. Mr. BYRNE. That leaves us with 325 beds to take care of 500,000 veterans. In other words, we have been shortchanged in the Philadelphia area. Admiral BOONE. General Gray testified before the Appropriations Subcommittee the other day that he would like to have 250 beds in the Philadelphia Naval Hospital. He could not foresee that the beds we have would meet the Philadelphia area requirements. We have other hospitals at Wilkes-Barre, Wilmington, and so forth, but the veterans of that great area feel they need more than we can provide, and General Gray subscribes to the belief it would be desirable to have 250 beds retained in the Philadelphia Naval Hospital. Mr. BONIN. Admiral Boone, is it not a fact that when the Philadelphia Naval Hospital was built there was a contractual agreement that there would always be a certain number of beds provided for veterans? Admiral BOONE. Yes. I can answer that not from hearsay but from personal acquaintanceship with it. It was in the period during which I was in Washington in an official position that the Director of the Bureau of the Budget finally, after a lot of discussion, agreed to recommending money for the Philadelphia Naval Hospital. Congressman Darrow of Philadelphia was chairman of the Ways and Means Committee. I sat in on these deliberations, and it was understood this hospital would be built for the Navy, but with the stipulation it would be shared by the Navy with veterans. And it has been so, as I understand it, up to the present. In addition, the Navy has operated for veterans a very excellent outpatient clinic. With the elimination of hospital beds or inpatient care, the Navy has informed me they will have to discontinue the operation of the outpatient clinic. The clinic has a relationship to and is predicated on inpatient care. That outpatient care, I might say, has been very reasonable in the way of cost, and we could not duplicate it, I do not believe. Mr. BONIN. Therefore it is a fact that the veterans in that area are being short-changed? Is that not a fact? Mr. BYRNE. Of course it is. Admiral BOONE. I am a Pennsylvanian. I was educated in medicine in Philadelphia. I have a great relationship to it. I have been Inspector General of the Medical Department of the Navy, and over the years I have had acquaintanceship with the situation in the Philadephia area. And I say now I do not believe the beds we have in the VA hospital will meet the requirements of the veterans in the Philadelphia area. Mr. BYRNE. I want to tell you how I and the veterans in the Philadephia area feel about Dr. Diodati. He is wonderful. No matter what hour of day or night a veteran needs him, he is always available. Admiral BOONE. He is an institution within an institution. Mr. BYRNE. That is right. He is a sterling character. Admiral BOONE. If you should lose the supervision of Dr. Diodati, it would be a great loss. Thereupon, at 12: 30 p. m., an adjournment was taken until Thursday, February 19, 1953, at 10 a. m.) MEDICAL AND DENTAL PROGRAMS OF THE VETERANS' ADMINISTRATION THURSDAY, FEBRUARY 19, 1953 HOUSE OF REPRESENTATIVES, Washington, D. C. The committee met, pursuant to call, at 10:30 a. m. in room 356, Old House Office Building, Hon. Edith Nourse Rogers, chairman, presiding. The CHAIRMAN. The committee will come to order. We will proceed with Admiral Boone. STATEMENT OF ADM. JOEL T. BOONE, CHIEF MEDICAL DIRECTOR, DEPARTMENT OF MEDICINE AND SURGERY, VETERANS' ADMINISTRATION Admiral BOONE. Madam Chairman and gentlemen of the committee, if I may have your permission, I would like to first, this morning, try to clarify some points of yesterday and also touch upon some questions which were asked of General Gray and me 2 weeks ago and which were put off for me to answer on this appearance. The CHAIRMAN. I understand you had rather not be interrupted until you have made your statement. Admiral BOONE. Yes; I think it will facilitate things, help the committee and probably save some questions. The CHAIRMAN. All right, you may proceed. Admiral BOONE. First, I would like to, because this is both personal and official, clarify a situation in that someone reporting in the room 2 weeks ago, later quoted in one of the Washington medical papers, that Admiral Boone stated there was "not much difference" between non-service- and service-connected disability. What I said was, according to the record: I wish the critics I am now in the position of seeing the backwash of war. would go through the hospitals with me and see what I see. I do not think there would be so much debate about some of the little things relating to service and nonservice which is certainly contrary to saying "I do not see that there is much difference between service and nonservice." I desire to have that clarified, because I asked to have it corrected and my request was refused by the editor. Another item which I would like to place on the record, if I may, because of questions raised yesterday about the reduction in force, when I was explaining that we complied absolutely with the injunc 147 tions of Congress; that we did not discharge physicians, dentists, nurses, and dietitians, and then I gave the other categories and the numbers that were discharged. I would like to insert into the record the directive from the Administrator of Veterans' Affairs, when, as Mr. McNamara testified yesterday, it was definitely explained by letter, after several letters and conferences between the Administrator, the Director of the Budget, and the President of the United States, that there was no immediate relief for this budget cut, that we should try to live within it, but if we could not, when Congress came back in session, we would have to ask for relief and then by supplemental funds it would be supported. This is [indicating] a TWX sent to the field by the Administrator, advising them how to approach this cut in relation to the reduction in force. In that letter it states that they shall not dismiss, or apply it to, physicians, dentists, nurses, and dietitians. And, I would like to have a followup letter placed in the record from the Administrator which gives in some detail the reduction in force limitations. The procedural steps except for the physicians, dentists, nurses, and dietitians were assigned to the manager for determination of categories of reduction. If I may insert those in the record, I would like that permission. The CHAIRMAN. Without objection it is so ordered. (The documents referred to are as follows:) [Telegram] VETERANS' ADMINISTRATION, September 30, 1952. under pro Your revised full-time equivalent ceiling is established at gram 8400 and — under program 8500 effective October 5, 1952. The program 8400 total covers personnel previously charged to program 8620 as well as a total of full time equivalent covering ceiling previously authorized for special and trainee programs. A detailed breakdown of the limitations for special and trainee programs will be forwarded by separate letter. (1) Managers will be responsible for determining where reductions in personnel will be made and for distributing such reductions so that proper balance is maintained between low and high bracketed employees and will insure that personnel officers are notified not later than Thursday, October 2, 1952, which positions are to be eliminated. Personnel officers will be required to have reductions-in-force notices delivered to affected employees not later than Sunday, October 5, 1952, so that they will have received full 30-day notice on active duty by November 4, close of business. (2) The Commission's retention preference regulations and current VA directives on the conduct of reduction in force will be complied with. In the case of reductions in competitive service positions, the monthly report of critical vacancies will be brought to the attention of the employees concerned. (3) Vocational advisement employees now carried under program 8400 who were formerly charged to program 5000 will not be issued notices of separation pending receipt of specific instructions regarding the vocational-counseling service which will follow. (4) Any physician, dentist, nurse, or dietitian who is made surplus as a result of this action will be reported to the Chief Medical Director not later than Mon day, October 6, 1952, indicating name, grade, specialty, and location preference in order that they may be made offers of transfers to other VA installations. No reduction-in-force notices will be issued to such personnel. (5) Report of reduction in force (RCS 5E-2) where reductions are to be made will be furnished to the Assistant Administrator for Personnel within 5 days following issuance of any reduction-in-force notices. Ceiling authorized herein may be exceeded for the period October 6, 1952, through November 4, 1952, in order to carry out reduction-in-force procedures and to retain physicians, dentists, nurses, and dietitians pending placement. /10/ H. V. STIRLING. VETERANS' ADMINISTRATION, OFFICE OF THE ADMINISTRATOR OF VETERANS' AFFAIRS, To: All hospitals, centers with hospitals, and domiciliaries. DEAR SIR: Reference is made to my teletype dated September 30, 1952, which established your revised full-time equivalent ceiling at under program 8400 and under program 8500. The program 8400 total covers ceiling previously authorized under program 8620, and includes ceiling for special and trainee programs. Subsidiary limitations for special and trainee programs have been established within the overall total, as indicated on the attached breakdown. Any necessary adjustments may be made between subprograms and between full-time and part-time employment, provided the totals for program 8400 and program 8500 are not exceeded. Ceiling previously authorized under program 8200 (research) is continued at the existing level as indicated, and is in addition to the revised ceiling for programs 8400 and 8500 authorized herein. The limitations for special and trainee programs represent the maximum number of positions which may be used for each subprogram. Any increase in the special or trainee limitations must receive prior authorization of the Chief Medical Director. In the event that any of these limitations, other than the Personnel Division limitation, remain unused for the purpose for which allocated and are required elsewhere in the overall program, they will be withdrawn. Where managers determine that the Personnel Division limitation is in excess to actual needs, the excess ceiling may be used in any activity which is not subject to special or trainee-ceiling limitations, as will contribute to the most effective operation of the station as a whole. The vocational counseling service has been added to the special limitations at certain stations. The ceiling authorized for this purpose covers vocational advisement employees previously carried under the regular program 8400 ceiling. Detailed information is being furnished in an all-station letter regarding the transition to be made from the vocational advisory program as it is presently constituted to the vocational counseling service as authorized by change 128 to MEC-4. At stations now having vocational advisement personnel for which no special limitation is authorized for the vocational counseling service, the vocational advisement program may be continued as an interim measure, provided that this can be done within the revised program 8400 ceiling established by my teletype September 30, 1952. Two new training categories have been added, to provide for personnel technician trainees and engineer officer trainees at selected stations. A training program for the vocational counseling service will be established in the near future, and ceiling will be authorized subsequently for this purpose at the stations selected for this training program. This letter will be considered as a reply to any requests for ceiling or inquiries regarding your ceiling to which you have not received a specific reply. Sincerely yours, H. V. STIRLING, Deputy Administrator. |