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Hawaii veterans complained to U.S. Sen. Mazie Hirono on Tuesday about the reams of bureaucracy that often prevent them from getting timely access to health care and other services.

Among their concerns were the long waits to be seen by Veterans Affairs doctors, troubles traveling from the neighbor islands and an overall sense that their needs are being ignored by those whose job it is to serve them.

“The core issue may be one of attitude,” said Victor Craft, a Vietnam War veteran from Oahu. “The veteran is not a piece of paper to be shuffled through a never-ending corridor of administration. They are people.”

Hirono held a field hearing of the U.S. Senate Committee on Veterans’ Affairs in Honolulu to address the concerns of Hawaii residents who served in the armed forces.

Attendees included Craft and several other veterans, including Hawaii Army National Guard Capt. Elisa Smithers, who said she was a combat veteran who has struggled with alcoholism, nightmares and violent outbursts ever since serving tours of duty in Iraq and Kuwait.

VA officials and others involved in providing medical services to the military also testified during the hearing to explain what they’re doing to help ease the burden on veterans, particularly those living in Hawaii.

In June, the VA released an internal audit showing average wait times for incoming patients. Hawaii’s VA system was the worst in the nation, with an average wait time of 145 days.

“It is clear that no veteran should have to wait for benefits they’ve earned for serving their country.” — James Tuchschmidt, a top VA official in Honolulu for a Senate field hearing

The latest data from the VA shows that figure has dropped to just over 56 days, which is still not good. Only six of the other 140 other VA facilities in the report have longer average wait times for new patients.

These long lags are part of an ongoing scandal involving the VA, which includes allegations that officials in Phoenix attempted to cover up how many people had died on a hospital waiting list.

“It is clear that no veteran should have to wait for benefits they’ve earned for serving their country,” said James Tuchschmidt, the VA’s acting principal deputy under secretary for health. “No apology can express the regret for what happened.”

This isn’t the first time Tuchschmidt has issued a public apology on behalf of the VA. In July, he told the House Veterans’ Affairs Committee that that some VA employees were retaliated against after complaining about wait times and other issues.

Tuchschmidt explained that the VA was working to improve conditions for patients throughout its system, and has been seeing declining wait times.

He said that will be made easier by a recent bill signed into law by President Barack Obama, which allows the VA to spend $16.3 billion on hiring doctors and implementing other measures to deal with the overload.

About $16 million of those funds will go toward a planned clinic on Oahu’s leeward side that, once completed, will double the clinical capacity for veterans on the island.

Still, there are many complaints from Hawaii’s veterans about the geographic challenges of living in an island state.

“The veteran is not a piece of paper to be shuffled through a never-ending corridor of administration. They are people.” — Victor Craft, Vietnam War veteran

Not only is it difficult for neighbor island veterans to make Oahu-based appointments, but they also struggle to get reimbursed for those trips.

Wayne Pfeffer, the head of the state’s VA system, testified about the many improvements he’s seen in the system over the last several months.

He pointed to declining wait times and said that the combination of hiring more doctors and expanding clinical space will go a long way in cutting down on future delays.

Pfeffer wants to recruit more local doctors. Part of that will include working closely with the University of Hawaii medical school and taking advantage of federal tuition reimbursement programs to boost recruiting.

“Streamlining the hiring is going to be very beneficial,” Pfeffer said. “We’re trying to really build a network so we can sustain the current and future growth.”

To improve communications with veterans, he said he has established a committee of neighbor island representatives who will provide him with an on-the-ground assessment every month.

Hirono stressed during the hearing that dialogue needs to improve between veterans and VA officials.

She noted this on several occasions while highlighting the many complaints she’s heard over the past several months, even before scandal erupted in Phoenix.

“There is a need for much more robust effort at communicating with our veterans,” Hirono said. “This is not news to you all that the veterans are very frustrated that their needs are not being heard.”

The senator has been one of the more outspoken members of Hawaii’s delegation when it comes to veterans issues.

She called for an investigation into the Hawaii VA system shortly after learning that the state’s veterans were subjected to the longest wait times in the country.

Hirono didn’t spend a lot of time grilling VA officials during Tuesday’s hearing, but instead wanted to focus on what it was they were doing to improve the situation.

She also wanted Tuchschmidt and the other Washington, D.C.-based officials to understand the “unique circumstances” Hawaii veterans face.

“There always needs to be more done, but it’s a matter of what are we going to address.” — U.S. Sen. Mazie Hirono

But most importantly, she said the hearing was a way to continue to hold the VA accountable and to make sure that problems are being addressed at the local and national levels.

“There always needs to be more done, but it’s a matter of what are we going to address,” Hirono said. “I think the communication piece is important, and so Mr. Pfeffer has to continue to have a commitment to listening to the veterans.”

U.S. Rep. Tulsi Gabbard, a vocal advocate on veterans issues, was noticeably absent from Tuesday’s hearing.

The congresswoman was scheduled to attend the event, and even had a name plate set for her at the head table alongside Hirono.

What made her absence all the more surprising was her outspoken desire for Pfeffer to be fired. She has called him dishonest and unqualified.

State Rep. Mark Takai, who recently won the Democratic bid for Hawaii’s 1st Congressional District, was the only other local politician to testify during the hearing.

Takai is a veteran and a lieutenant colonel in the Hawaii Army National Guard.