The United States Government Accountability Office (GAO) has issued Congressional testimony on the performance of the Department of Veterans Affairs (VA) in overseeing health care provided to veterans. GAO found that the VA had fragmented oversight and a fragmented accountability infrastructure that did a poor job in ensuring quality care and patient safety. To read the GAO Congressional testimony on VA oversight of veterans health care, use the first link below. To read GAO highlights of the Congressional testimony on VA oversight of veterans health care, use the second link below.
https://www.gao.gov/assets/gao-22-105474.pdf (GAO Congressional testimony on VA oversight of veterans health care)
https://www.gao.gov/assets/gao-22-105474-highlights.pdf (GAO highlights on VA oversight of veterans health care)