For Trump’s VA secretary, confirmation was easy. Now comes the hard part. | McClatchy Washington Bureau

The Senate on Monday unanimously confirmed David Shulkin to be secretary of Veterans Affairs, with Democrats and Republicans alike praising the 57-year-old physician as the right person to reform the beleaguered agency.

"Although progress has been made in recent years there are still changes at the VA we need to address," Sen Dick Durbin, D-Ill., said in a speech on the Senate floor ahead of the vote. “I believe he’s the right person to head the VA today.”

Shulkin is the first non-veteran to head the agency. He is also the only person in President Donald Trump’s cabinet to have served in former President Barack Obama’s administration, having previously worked as the agency’s undersecretary for health. He took over the job in 2015, a year after a scandal about long wait times at veterans’ hospitals and efforts to cover them up shook the agency.

Now he will have to deliver on the president’s campaign promise to overhaul the agency and make quick moves to fix long-standing problems in its sprawling bureaucracy.

[READ MORE: One of Trump’s first moves is already hurting a loyal group of supporters: Veterans]

In his announcement in January, Trump said he was confident in Shulkin’s ability “to lead the turnaround our Department of Veterans Affairs needs.”

During his confirmation hearing, Shulkin pledged to advance reform efforts, but was careful to point out that he wouldn’t go to the extreme of privatizing the VA’s services, which had been floated during Trump’s campaign and transition.

"There should be no doubt that if confirmed as secretary, I will seek major reform and a transformation of VA. But (the VA) will not be privatized under my watch,” he said. During his campaign, Trump said that he would allow veterans to get healthcare paid by the VA in the private sector.

[READ MORE: Here are 4 government programs Trump’s team wants to privatize]

Shulkin’s confirmation was supported by all major veterans groups despite his not having served in the U.S. military.

"His selection is unprecedented. Our membership overwhelmingly supported the selection of a veteran for this critical leadership position," Iraq and Afghanistan Veterans of America CEO Paul Rieckhoff said in a statement when his selection was announced, but also commended his experience.

Even groups that harshly criticized the previous administration’s efforts to reform the agency supported Shulkin’s nomination, despite his previous work in Obama’s VA.

“Shulkin is right in line with what the president has been saying, and he has made it clear he supports more accountability and expanded healthcare options,” said Dan Caldwell, legislative director of Concerned Veterans for America, in an interview with McClatchy.

The small, conservative organization backed by billionaires Charles and David Koch, who have long supported privatizing veterans’ healthcare, advised Trump’s transition team on veterans issues. Trump reportedly met with Pete Hegseth, who served as the group’s CEO until January this year, about the top VA job.

Shulkin won’t continue in the direction his former boss, outgoing VA secretary Robert McDonald, was taking the agency, Caldwell said.

“We have felt in conversations with Shulkin in the past that he’s been more open to the kind of reforms we support,” he said, mentioning expanded options for healthcare, more private-public partnerships, and increasing the firing authority of the VA secretary.

“You can’t objectively look at the data and think that the VA under McDonald improved,” he said. “And part of it was that he was constantly complaining about his inability to fire people, but didn’t support bills to solve the problem.”

In his previous position in the VA, Shulkin oversaw 1,700 healthcare sites that served more than 8 million veterans every year.

Trump frequently spoke about the VA being a “disaster” in his campaign stump speech, and made veteran supporters a key focus of his rallies by bringing them out to speak . He skipped the final primary debate before the Iowa caucus to hold a fundraiser for veterans issues, after complaining that Fox anchor Megyn Kelly had treated him badly at a previous debate. Veterans groups denounced the event, saying that Trump was using them as “political props.”

Trump’s plan to “Make the VA Great Again,” as described on his campaign website, proposed modernizing the VA, expanding investment in technology, embedding clinics in rural areas and firing incompetent executives.

Trump said his proposed changes would cost less than the current system because he would eliminate inefficiencies. His plan did not include details about how much it would cost or how he would pay for the changes.