Secretary of Veterans Affairs Jim Nicholson yesterday said there has been a "spectacular turnaround" in the last 10 years in the perception and quality of care at VA hospitals.

"The medical care is currently in an extraordinarily good state," Nicholson said, despite a $1 billion shortfall this fiscal year that had veterans groups calling for long-term funding solutions.

Lawmakers and the Bush administration took steps in late June to cover the budget shortfall. Nicholson, meeting with The Advertiser's editorial board, yesterday said he expects the VA will need $1.5 billion to $2 billion over what the president has requested for fiscal 2006.

"And I think Congress will be very supportive of that," he said.

Nicholson said the VA budget for fiscal 2006, which starts Oct. 1, will be about $72 billion — bigger than the budgets of 24 states.

The VA secretary, in office for 6 1/2 months, spoke to some of the 15,000 American Legion national convention attendees in Honolulu this week.

The Disabled American Veterans organization found in a survey that members who use the VA medical system gave high marks for the care they received, but timely access remained a problem.

Survey respondents reported they waited almost 38 days for VA outpatient primary care appointments, with one in five reporting waiting times of more than 60 days.

The VA's goal for waiting times is 30 days or less for medical appointments across all categories, the organization said.

The VA, with 157 major medical centers, has 7.5 million veterans enrolled for medical care, and 3.5 million enrolled for disabilities.

There is no VA medical center in Hawai'i, but there is a "sharing arrangement" with Tripler Army Medical Center, Nicholson said.

The VA priority now is taking care of service members returning from combat theaters, he said.

That will include more than 2,200 Hawai'i National Guard soldiers and reservists now in Iraq.

Nicholson said the system is not being overloaded by the unprecedented use of citizen soldiers in combat.

"Some of our hospitals have increased loads, and are working harder than they have in a long time, and that's one of the reasons we needed more money," he said, " ... but we're in good shape."

Reach William Cole at wcole@honoluluadvertiser.com.