Britain's largest union warned today that hospital wards could close and operations be cancelled if a northern NHS trust goes ahead with plans to sack 5,400 staff and re-employ them on worse terms and conditions.
North Tees and Hartlepool NHS Foundation Trust is threatening to sack its staff in a dispute over sick pay. They have been told they will be dismissed on March 31 next year unless they sign new contracts.
Unite has written to 40 local GPs warning them of the consequences if the sackings go ahead.
The letter from Unite and other health unions calls for the sacking threat - made in a formal legal document - to be withdrawn. They are advising their members not to sign new contracts.
The trust covers 365,000 people living in East Durham, Hartlepool, Stockton on Tees and part of Sedgefield.
Unite's head of health Rachael Maskell said the last thing the union wanted was disruption that could adversely affect patient care and said the Department of Health itself had branded the trust's action as "high risk."
Unite and other health unions have called for urgent talks over the dispute which would see the trust tearing up the national provisions for sick pay.
In the letter to the GPs signed by joint unions, Ms Maskell said: "With 5,452 members of staff being threatened with redundancy on 31 March 2013, there is a very high risk that staff will not engage with detrimental terms and conditions, and simply not be employed on 1 April 2013. If that were to happen to a significant extent, the trust would not be able to function.
"The NHS workforce will always put patient safety first, and we will be happy to work with you to ensure that patients do not suffer any detriment as a result of the trust's decision."