Legal action has been initiated by Unison against the Secretary of State for Health challenging his refusal to consult the public on proposals in his White Paper, Equity and Excellence: Liberating the NHS.

The proposals could bring the biggest changes to the operation of the National Health Service since its birth under Atlee’s Labour government.

The day after the White Paper was published, NHS Chief Executive Sir David Nicholson wrote to all NHS chief executives instructing them to begin the proposals “immediately”. The trade union wrote to Nicholson claiming this instruction was unlawful.

Nicholson said he would write again to NHS chief executives reminding them they should not implement the White Paper proposals until the consultation period had ended.

The union argued no steps should be taken to implement the changes in any way, until the public have had the opportunity to consider and comment on them.

But he said the consultation was limited to how the proposal should be implemented not on whether the proposal should be implemented – i.e. the public’s view on the White Paper proposals themselves was not being requested and would not be considered.

Unison’s head of health, Karen Jennings, said: “I find it incredible that the NHS Chief Executive would say he believes there is no legal duty on the Secretary of State to consult on the merits of the proposals in the White Paper.

“The White Paper contains sweeping changes to the NHS and how it should be run. The NHS Constitution enshrines the principle that the public, staff and unions have an absolute right to be consulted. 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. ”