We’re not sure how many times we’ve seen the phrase “failed VA leadership” in stories and headlines over the years, but we know it has a too-familiar ring.

We’ve listened for years now — decades, really — as Department of Veterans Affairs leaders vowed change and improvement in the health-care services offered to our nation’s veterans. And we’ve even seen the VA make good on those pledges.

But system-wide change hasn’t been forthcoming.

And “failed leadership” is back again in a new report from the VA’s internal watchdog.

It’s another blow to VA Secretary David Shulkin, who was already under fire for abuse of travel funding.

Shulkin spoke with reporters on March 7 about the report, acknowledging that the VA still has “systemic” problems. And once again, the top VA leader is pledging massive change across the organization.

This latest report by the VA’s inspector general appears to have caught Shulkin by surprise with its revelations of “critical deficiencies” at the VA hospital closest to Shulkin’s own office: the Washington D.C. Veterans Affairs Medical Center.

The 144-page report documents supply shortages, “chronic staffing shortages,” “excessive vacancies in leadership positions,” and a “lack of consistently clean storage areas for medical supplies and equipment.” The problems at the medical center, the report says, are “prevalent and deeply intertwined.”

The inspector general also documented “serious, persistent deficiencies” in at least three VA program offices that were directly under Shulkin’s command when he was the VA’s undersecretary of health in 2015 and 2016.

And the report cited other problems across the VA’s national network, including the purchase of at least $92 million in overpriced medical supplies, and the possibility of data breaches as thousands of patient records sat in 1,300 unsecured boxes.

The problems appear to start at the top.

The inspector general’s office reported that it “encountered a culture of complacency among VA and Veterans Health Administration leaders at multiple levels who failed to address previously identified serious issues with a sense of urgency or purpose.” The investigators also found that, “in interviews, leaders frequently abrogated individual responsibility and deflected blame to others.”

The report also found serious problems at VA medical centers in the New England and Arizona regions.

Last week, Shulkin vowed sweeping change, including unannounced audits of the system’s more than 1,700 medical facilities by health experts in the private sector, hiring to fill vacancies at the VA’s hospitals and plans to streamline the bureaucracy and improve communications.

The White House restated its support for Shulkin, saying he’s done a “great job” of bringing change to the VA. “We’re proud of the work that we’ve done and we’re going to continue to do everything we can to help veterans in this country,” spokeswoman Sarah Huckabee Sanders said.

Sorry, but we’ve heard that song too many times before, from a long string of VA leaders. Some significant parts of the VA are still broken.

So what needs to happen? First, it’s really time to determine if the government’s second-largest department is capable of carrying out its mission. Is the VA simply too big to succeed? Is this a healthcare bureaucracy that will inevitably collapse under its own weight and is impossible to effectively manage?

We know that veterans groups and Shulkin himself have a fierce belief that the government must provide proper health care for the nation’s veterans, and that the job can’t be parceled out to health professionals in the private and nonprofit sectors. Yet, does a veteran’s heart disease or cancer need a substantially different medical treatment than the same illness in a person who hasn’t served?

Conditions like traumatic brain injury, loss of limbs and other battlefield injuries often do need specialized treatment and the VA should maintain top-notch clinics to provide that care.

But we have to wonder, as we see failure after failure in the VA system to provide routine medical care, if the system will ever be capable of serving all the healthcare needs of every American veteran.

— This editorial was excerpted from the Fayetteville (N.C.) Observer.