Health service union Unison is planning to seek a judicial review over the government’s plans for a massive reorganisation of the NHS.

The union claims the government is acting unlawfully by giving primary care trusts and others advice on how they should start to implement the recent NHS white paper without consultation or Parliamentary support.

The white paper – ‘Equity and Excellence: Liberating the NHS’ – includes plans to scrap strategic health authorities and PCTs and to hand 80% of the health service budget to GP commissioning consortia.

In a letter, NHS chief executive David Nicholson told NHS organisations that he expected the paper to lead to a large decrease in managerial jobs. He also set out plans for how the NHS should prepare for the changes.

However, Unison claims the letter pre-empted the result of the government’s consultation on the white paper and subsequent Parliamentary process.

The union has written to the government stating that it believes it is unlawful for a series of changes to be made to the NHS without giving the public, patients and interested parties “a proper opportunity to have their say about the proposals.”

Karen Jennings, Unison’s head of health, said the government’s white paper would change forever the NHS.

She added: “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 the unions.”

Jennings said the right to consultation was enshrined in the NHS Constitution. She added: “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.”

Unison said it had asked for a response to its letter within seven days and if it was not happy with the reply it would reserve the right to issue urgent judicial review proceedings.

A Department of Health spokesperson said the NHS chief executive was not encouraging NHS trusts to act before consultation.

He added: “NHS Chief Executive, Sir David Nicholson, has written to encourage the NHS to begin locally led consultations and take first steps on the implementation of the White Paper, without pre-empting the wider consultation.

"Many reforms are also subject to Parliamentary approval as part of the Health Bill.”