I find that it all depends on a lot of things.
It all depends on if they are motivated. I was trying to get help for a problem for years. It ended up getting so bad, it could no longer be ignored. I went in and started saying that they were just sending me home to die which was one of the catch phrases in the news at the time. The Ears perked up, I changed from just a nurse to a full MD, got sent to specialtists and we finally got control of the situation. Unfortunately, some permanent damage was done. Part of the blame goes on me not standing my ground and demanding competent service.
There is also a problem of the lack of a certain specialtist on the staff at a given VA. WE all know that a Virus is easy to take care of and it can be taken care of quickly by medication. They kept treating me for Virus. Come to find out, it was Bacteria which has to be treated much differently. A Virus will go away sooner or later once it runs it's course even if not treated. But Bacteria will not. It has to be treated or it just gets worse. I had bacteria in my lungs. They finally got a Lung Specialitist on staff who know this and treated me. Within just a few days, I began seeing improvement. Let's face it, I was dying and anything that didn't kill me was a huge improvement. It cleared up in about 2 weeks and I could finally breath. Before this was found, they went through the "Put Him on Oxygen" routine which didn't really help. In fact, it actually fed the Bacteria. I shut off the use of Oxygen myself because I felt better without it. Most of my own cures were my own cures. The only thing that wasn't was the one prescription that combated the Bacteria itself. I must have been around something in my lifetime where I was subjected to a bacteria environment and didn't know it and it laid dormant for a very long time. And no, it wasn't contageous unless during kissy face, some sick gal stuck her tongue all the way down my lungs (I think I may get sick on that one).
The other would be funding where they just get backlogged.
I think we all have had similar problems with the VA. But most of it can be taken care of and we are NOT dealing with Quacks like we may run across in some of the Civilian Practices who misdiagnose. Not saying all or even some, and it is an isolated incident.