Thousands of healthcare workers have left the Department of Veterans Affairs (VA) since the start of Donald Trump’s second term, raising concerns over patient safety and the future of the nation’s largest integrated healthcare system. Internal records reveal a steady decline in “mission-critical” staff, including doctors, nurses and mental health professionals, despite official assurances that patient care would remain unaffected.
The departures come as the VA faces increased demand, driven by a surge of nearly 500,000 new patients eligible for treatment under 2022 legislation expanding care for toxic exposure. Critics warn that staffing shortages are straining resources to breaking point, with reports of unsafe conditions in some facilities. The agency has rejected claims of systemic risk, attributing recruitment difficulties to long-standing national shortages in the healthcare sector.
Sharp Decline in Mission-Critical Personnel
Agency workforce dashboards, reviewed by The Guardian, show the VA has suffered a net loss this fiscal year of around 2,000 registered nurses, 1,300 medical assistants, 1,100 nursing assistants and licensed practical nurses, 800 doctors, 500 social workers and 150 psychologists. These figures represent a monthly fall in staff numbers since Trump returned to office. The reduction forms part of a broader plan to cut 30,000 positions through attrition, a hiring freeze and deferred resignations.
VA Secretary Doug Collins has stated the cuts are aimed at reducing bureaucracy, insisting that quality of care will improve despite fewer personnel. Yet union representatives and veterans argue the opposite. Manuel Santamaria, a disabled army veteran, described the reductions as “a betrayal”, warning they remove accountability for those who served.
Conditions on the ground appear strained. Patricia Fieldings, a registered nurse in Augusta, Georgia, reported repeated “assignment despite objection” notices, describing situations where untrained staff were reassigned to specialist units, jeopardising patient safety. According to a 2023 inspector general report, 86% of VA medical centres were already experiencing severe doctor shortages before these losses.
Rising Pressures and Privatization Fears
The staffing decline coincides with policy moves many see as steps toward privatising veterans’ healthcare. The 2026 budget proposal allocates $11 billion more for private care vouchers, funded by cuts to the public system. The Access Act, currently advancing in Congress, would make it easier for veterans to seek taxpayer-funded private treatment.
The VA has dismissed fears of privatisation as politically motivated, noting it has opened 13 new clinics since January. However, a blue-ribbon commission and studies by the Congressional Budget Office and Rand Corporation have found that veterans generally receive better, more cost-effective care in the public system. Private providers, they concluded, often lack the expertise and coordination needed for complex military-related conditions.
Meanwhile, reports from facilities in New York, Georgia and Nevada detail overworked staff, broken equipment and extended wait times. Union leaders allege the agency is retaliating against whistleblowers by terminating collective bargaining agreements, limiting oversight of working conditions. The VA maintains that these changes will allow staff to “spend more time with Veterans” and adapt services more flexibly to patient needs.
