WASHINGTON (AP) — In a scathing appraisal, a review ordered by President Barack Obama of the troubled Veterans Affairs health care system concludes that medical care for veterans is beset by “significant and chronic system failures,” substantially verifying problems raised by whistleblowers and internal and congressional investigators.

A summary of the review by deputy White House chief of staff Rob Nabors says the Veterans Health Administration must be restructured and that a “corrosive culture” has hurt morale and affected the timeliness of health care. The review also found that a 14-day standard for scheduling veterans’ medical appointments is unrealistic and that some employees manipulated the wait times so they would appear to be shorter.