posts are vacant, and might attract more individuals to serve, particularly when a vacancy occurs in the latter stages of an administration.

Nothing in this recommendation is meant to suggest that the President or secretary would not have the authority to remove individuals for cause, at any stage in their tenure. A potential problem with this approach, in a new administration, could be that the incumbent would be seen as an “outsider” in an almost wholly new department team and not integrate well with the new staff. Of course conflicts among staff members can occur regardless of whether they are holdovers or brand new, and such impediments to teamwork are a not uncommon management problem.

Related Recommendations

  1. The secretary should work with the President and Congress to establish a selection process for the department’s senior-level officials that protects the scientific and administrative integrity of major departmental units, promotes progress toward departmental goals, and is based primarily on the candidates’ qualifications and experience. Congress again is strongly urged to consider longer terms for some of these officials—especially the directors of NIH and CDC, and the commissioner of FDA—which would provide critical continuity in the nation’s public health and scientific endeavors.

  2. The President should make timely appointments and Congress should expedite the confirmation process for key HHS officials, including the secretary, deputy secretary, surgeon general, and the heads of FDA and NIH. Secretarial appointments, such as the director of CDC, also should be expedited.

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