By Ian Dunt
The UK's largest public service union has started legal action against the health secretary in a bid to derail plans to reform the NHS.
Unison is challenging Andrew Lansley's white paper proposals, which it brands "the most fundamental changes to the way the NHS operates since it was created".
The union claims that the day after the white paper was published, NHS chief executive Sir David Nicholson wrote to all NHS chief executives instructing them to start implementing the proposals "immediately".
Unison then says it wrote to Sir David telling him the order was illegal, because it failed to properly consult the public, as required under the NHS partnership agreement, the NHS Constitution and section 242 of the NHS Act.
The union said Sir David replied that he would write again to NHS chief executives saying implementation should wait until a consultation was concluded, but that it would be restricted to how, not if, the changes should be applied.
The letter provoked a furious response from Karen Jennings, Unison head of health.
"The NHS Constitution enshrines the principle that the public, staff and unions have an absolute right to be consulted," she wrote.
"And that means not only on how the proposals are to be implemented, but also whether they should go ahead in the first place.
"The Department for Health's refusal to recognise this clear and important legal duty leaves us no option but to issue legal proceedings as a matter of urgency."
A spokesperson from the DoH told politics.co.uk: "The Department's position is that its decisions on consultation are lawful and it will be defending the claim by Unison."
DoH officials are standing by the level fo scrutiny and consultation the reforms will recieve.
"The government has already launched public consultations, on specific elements of the white paper, and further documents will be published this year," a spokesperson said.
"Many reforms are also subject to parliamentary approval as part of the health bill."
The legal challenge is a sign of increasingly tense relations between the government and the trade union movement, which is gearing up for a 'day of action' to coincide with the autumn spending review.
A report in the Independent this morning suggested behind-the-scenes efforts were taking place for a meeting between David Cameron and union leaders, so both sides could attempt to enter into a dialogue.
But most analysts are expecting an autumn of discontent, as unions galvanise support to fight the spending cuts programme.