Trump fires Veteran affair's secretary David Shulkin in favour of his personal physician

He is replacing Mr Shulkin with Rear Admiral Ronny Jackson

Mr Shulkin, at left, sitting next to the president during a cabinet meeting (Getty)

President Donald Trump has ousted another high ranking member of his administration, Secretary of the Department of Veterans Affairs David Shulkin, in the latest in a series of high profile departures as the White House shakes up its operations.

The decision, announced by Mr Trump in a tweet, after weeks of speculation over what would happen to Mr Shulkin, and whether his job was safe.

Mr Trump said that he was nominating Navy Rear Admiral Ronny Jackson to replace his outgoing secretary, while praising Mr Shulkin's service in Washington.

"I am thankful for Dr David Shulkin's service to our country and to our great VETERANS!" Mr Trump tweeted.

Robert Wilkie, an undersecretary at the Pentagon, will fill in for Mr Shulkin until the Senate can approve Mr Jackson's nomination.

Mr Shulkin's departure follows after months in which he has been locked in a power struggle with some senior White House staff members, who have wanted him to be removed from his post. His leaving suggests that they were eventually able to convince Mr Trump that the Veterans Affairs secretary — who was an appointee of President Barack Obama — needed to go.

The outgoing secretary had pledged during his tenure that the VA would not be privatised while he was in charge, and had promised expanded opportunities for veterans to get care in the private sector. Political appointees in the White House who wanted him to be given the boot have pushed for a more comprehensive overhaul of the system to go further and provide even more access to VA-funded are in private sector health networks.

Mr Shulkin's departure marks a U-turn for the secretary, who Mr Trump was praising as recently as a few weeks ago for doing a "great" and "incredible" job at the helm of the VA.

But Mr Shulkin turned that tide of compliments around by publicly warring with an VA inspector general's report that found he and his staff had committed ethics violations while planning and then during a trip to Europe last year.

He first disputed the findings that he had improperly accepted tickets to Wimbledon, and for his wife's airfare during the 10-day trip. He proceeded from there to refuse to accept the report's findings that his chief of staff had misled ethics officials to get his wife's airfare cleared.

While Mr Shulkin later apologised and expressed regret for those actions —and repaid the airfare — his behaviour left a bad taste in the mouths of members of Congress, veterans groups, and other stakeholders in the department's healthy operation who might have spoken in his defence, and many of those groups stayed silent as he publicly disputed the report. That period of silence reportedly left the senior White House political appointees with a window to push for his ouster.

They then reportedly pressed heavily for his removal, leading the White House to unilaterally remove Mr Shulkin's chief of staff from his position, and instal former Trump transition member Peter O'Rourke in his. During that time, White House Press Secretary Sarah Huckabee Sanders repeatedly said that Mr Trump supported the work of his VA secretary, but that his work was "under review".

Mr Shulkin joins a long list of top officials who have now left the Trump administration, including the recent departures of former Secretary of State Rex Tillerson, former national security adviser HR McMaster, and White House adviser Gary Cohn, all of whom left the administration this month.

He will be replaced by Rear Admiral Ronny Jackson, who has served as the White House physician for the past three administrations, including former President George W Bush, and Mr Obama.