WASHINGTON — Federal union officials accused the Veterans Affairs Department of undermining its own health care system by not filling thousands of open department health positions while they push new rules covering more medical appointments at private-sector hospitals.

But VA officials dismissed the criticism as unfounded, since the department completed more appointments than ever before last fiscal year and has kept staff vacancy rates below comparable industry standards.

At issue are nearly 49,000 empty posts within VA, just under 12 percent of the 420,000-plus jobs there. Department officials said that vacancy rate is normal for the sprawling bureaucracy, noting that they had a net increase of more than 3,000 employees last quarter.

The current number of vacancies is greater than the approximately 35,000 positions that were open 18 months ago, when critics and lawmakers first accused department leaders of not doing enough to keep the agency fully staffed. It’s also above the 45,000 unfilled slots reported last September.

Union officials call the new figure “unconscionable” and part of a concerted effort by President Donald Trump’s administration to drain resources from the VA.

“The administration is setting us up to fail so they can dismantle veterans’ preferred health care provider,” said Alma Lee, National Veterans Affairs council president for the American Federation of Government Employees.

AFGE leaders have fought with VA officials for years over efforts to expand outside health care options for veterans. President Donald Trump has said that doing so gives veterans more varied and convenient choices, while the union has labeled it an effort to privatize core VA responsibilities.

The department vacancies have played a significant role in that fight, because union leaders say hiring more health professionals would reduce wait times and appointment backlogs throughout the system.

VA officials say they have worked to do that, but nationwide shortages in a host of medical professional specialties limit the effectiveness of that approach. They also argue that using existing private-sector infrastructure to help give veterans more options works in conjunction with the hiring push.

Of the vacancies, almost 43,000 are in the Veterans Health Administration (11 percent of the total workforce). In the past, department officials have said many of those open jobs are part of the normal hiring process for any large organization and that comparable health care companies have vacancy rates of 20 percent or more.

VA spokesman Curt Cashour noted that the department hired an additional 1,045 mental health professionals in the last year. He also said the department’s total number of full-time positions has grown steadily in recent years.

“VA has more employees than ever before, its budget is bigger than ever before and the department is completing more internal medical appointments than ever before,” he said. “Privatization is a myth that has been thoroughly debunked.”

Democrats in Congress have promised to force the hiring issue in coming months, as VA officials put into place new outside care rules authorized under the Mission Act, signed into law last summer.

Cashour noted that new employee recruitment is expected to grow during that period, as department officials increase hiring efforts in keeping with the Mission Act standards.

Department officials have also said that the eased rules for outside care appointments will not increase the total number of veterans health care appointments in the private sector. In 2018, 34 percent of all VA appointments were outside the federal system, down from 36 percent in 2017.