By Ian Dunt
The government's controversial plans for the NHS are facing a legal challenge from Unison, the UK's largest public services union.
The union said NHS chief executive, Sir David Nicholson, is pressing ahead with plans that have neither parliamentary approval nor legal backing.
Sir David is accused of pre-empting the result of the consultation into the plans by writing to strategic health authorities, primary care trusts (PCTs) and other providers with a series of "actions that we need to start now".
"The government's white paper will change forever the NHS as we know it. These sweeping changes were not part of any party manifesto and it is outrageous that these changes are being brought in without consulting the public, patients, staff and unions," said Karen Jennings, Unison head of health.
"The NHS constitution enshrined in law the right to consultation and yet, in writing to NHS managers, Sir David is working on the premise that the consultation is only about the best way to achieve pre-determined outcomes - this makes it nothing more than a paper exercise and a sham.
"We have asked for a response within seven days and if we are not happy with the reply we are reserving the right to issue urgent Judicial Review proceedings."
Health secretary Andrew Lansley announced the NHS reform plans before the end of the parliamentary term.
Opponents say they amount to an attempt to privatise key sections of the NHS, although the government strenuously denies this.
Yesterday a government attempt to secure private sector investment in the management of 50,000 temporary NHS staff was branded another example of privatisation by the back door.