A senior health professional faces disciplinary action after signing a letter to The Independent opposing the NHS reforms and provoking accusations yesterday that ministers are presiding over a "top-down bullying policy" designed to silence critics.
The medical professional, who has not been named, has been summoned to a meeting with the chief executive of his trust to explain himself, MPs were told yesterday.
The Independent can also disclose that the Liberal Democrats are confident of winning further concessions within days to provisions in the troubled Health and Social Care Bill to increase competition.
Evidence of heavy-handed tactics by NHS managers over criticism of the reform emerged after 23 clinicians sent a letter to this newspaper warning that the shake-up will "cause more harm than good". One signatory has received a letter from the director of an NHS trust which reads: "It is inappropriate for individuals to raise personal concerns about the government reforms.
"You are therefore required to attend a meeting with the chief executive for the actions you have recently taken."
Raising the "sinister" case in the Commons, Andy Burnham, the shadow Health Secretary, said: "It is, it would seem, your new top-down bullying policy and it is happening right across the NHS. The truth about your mismanagement of the NHS is coming out – staff bullied into silence and professionals frozen out."
Health Secretary Andrew Lansley replied that he did not know about the letter and accused Mr Burnham of resorting to abuse.
Last night, Mr Burnham said: "I fear this sort of behaviour could take place more widely. I have been told anecdotally that there is a lot of this going on."
David Cameron yesterday insisted Mr Lansley "understands the health service better than almost anyone else in Parliament" and had his full support. He said he was confident the Government could win the arguments over the reform and show that it would improve standards of patient care.
But new Coalition strains emerged as senior Liberal Democrat sources predicted that the Prime Minister would authorise new concessions to the Bill in the Lords next week. The party is pressing for it to enshrine more explicitly that competition should be based on quality rather than price. One source said: "It is the section on competition that is causing the real problems and I believe there will be further movement on that."
The party insists it made significant gains last year when Mr Cameron ordered a "pause" to the Bill, but believes sections are "up in the air" again.
The crunch is likely to come next Wednesday when the Lords debates the section concerning competition and Monitor, which will regulate the new-look NHS. Most of the Bill should have cleared the Lords by 9 March, when the Liberal Democrat spring forum begins in Gateshead.
Nick Clegg, the party leader, hopes that enough of the outstanding questions will have been settled by then to avert protests from activists about the Bill.
Last night Mr Clegg said the Bill had been changed "very considerably" since last year's pause, adding: "I am a Liberal Democrat and I care passionately about the NHS. "If I felt that this legislation would lead to the privatisation of the NHS, as the critics claim, if I felt this legislation would lead to the ruin of the NHS, of course we would drop it."