V.A. Medical System Staggers as Chaos Engulfs Its Leadership

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Christopher Vojta, a health care executive with degrees from both the business and medical schools at the University of Pennsylvania, was helping run the department’s 1,200 hospitals and clinics until he quit abruptly last week.

Dr. Amy Fahrenkopf, a health care executive educated at Yale and Harvard, who had joined the department to streamline its $14 billion private sector Choice program, quit Monday.

Louis Celli, the national director of veterans affairs and rehabilitation for the American Legion, one of the largest and oldest congressionally chartered veterans organizations, said it was clear from his contacts within the department that there was a “corrosive culture building.”

“You have the majority of the 360,000 employees who go to work every day and perform the jobs they were hired to do,” he said. “What we are hearing, by and large, from the rank-and-file employees is that this is the worst it has ever been.”

The department planned to announce a major reorganization of its health care system administration this week, designed to avoid failures in care that have incited repeated scandals in the hospital system. It did not happen.

Department officials said nothing has been delayed, and the reorganization plan is being reviewed.

This week the left-leaning veterans group VoteVets sued the Trump administration, saying the appointment of Mr. Wilkie as acting secretary violated federal law, and that the sidelined deputy secretary should have automatically been given the acting position. If successful, the lawsuit could nullify all decisions the current acting secretary makes.

And relations between the White House and veterans policymakers on Capitol Hill — particularly the leaders of the Senate Veterans’ Affairs Committee — have reached a low. Mr. Trump continues to savage Senator Jon Tester of Montana, the committee’s top Democrat, for his role in gathering and publicizing the allegations against Dr. Jackson. Privately, administration officials have also gone after the committee’s Republican chairman, Senator Johnny Isakson of Georgia, for supporting Mr. Tester.

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