Donovan Slack

USA TODAY

WASHINGTON — The Senate unaminously confirmed Trump nominee David Shulkin to be secretary of Veterans Affairs Monday night.

Shulkin, the lone holdover from the Obama administration among President Trump’s Cabinet picks, has been the VA undersecretary for health since July 2015 and has not drawn the harsh opposition from Democrats that other Trump nominees have faced.

During his confirmation hearing earlier this month, he promised to lead a “major reform and transformation of the VA.” Shulkin said he wants veterans to be able to get care in the private sector when they need it, but he also wants to maintain core VA services.

“There will be far greater accountability, dramatically improved access, responsiveness and expanded care options,” he said. “But the Department of Veterans Affairs will not be privatized under my watch.”

Trump pledged during the campaign that his administration would allow veterans to get VA-paid care in the private sector if they choose.

Read more:

VA nominee David Shulkin vows faster improvement, more choices for veterans

Trump picks David Shulkin for secretary of Veterans Affairs

Candid Veterans Affairs nominee faces big challenges to fix entrenched bureaucracy

Currently, they can only do that if they can’t get a VA appointment within 30 days or live more than 40 miles from a VA facility. Trump’s plan also includes creating a 24-hour hotline for VA complaints, convening a commission to investigate misconduct and swiftly holding employees accountable for wrongdoing.

Shulkin will need help from Congress to get more authority to discipline poor performers at the agency, which has been beset by scandals since 2014, when news broke that schedulers at the Phoenix VA had been keeping secret wait lists, hiding how long veterans had been waiting for appointments and at least 40 veterans died while they waited.

Subsequent investigations found scheduling improprieties at 40 VA medical facilities in 19 states and Puerto Rico and in seven states, supervisors had directed employees to falsify wait times.

In addition to scheduling problems, which the Government Accountability Office found continued after the scandal, the VA has been criticized for keeping health care quality data secret and shuffling managers between jobs and medical centers, even when concerns were raised about the care provided at their previous posts.

When picking Shulkin to take over the VA, Trump said "we're going to straighten out the whole situation for our veterans."

"Our veterans have been treated horribly, they're waiting in line for 15, 16, 17 days, cases where they go in and they have a minor early stage form of cancer, they can't see a doctor. By the time they get to a doctor, they're terminal," he said. "It's not going to happen, it's not going to happen."

Related:

VA bosses in 7 states falsified vets' wait times for care

Exclusive: VA shuffles managers, declares ‘new leadership’

Troubled VA center's director gets new post while under investigation

VA reverses course, releases health care quality data

VA hasn't fixed wait-time problems, GAO finds