An NHS chief executive who was fired and ‘gagged’ by his former Trust has spoken out about failings in the NHS which he believes is putting patients at risk.

In an interview for BBC Radio 4’s Today programme, Gary Walker, former chief executive of United Lincolnshire Hospitals Trust, explained his reasons for signing the agreement, saying he had no choice but to sign an agreement linked to a confidentiality clause in April 2011.

He said: “I was in danger of losing my house - I have children to support. And one thing you must remember that if you’re attacking the very top of the NHS the sanctions are pretty dramatic. So I spent 20 years in the health service and I'm blacklisted from it. I can't work in the health service again.”

This comes a week after the Francis report into the higher-than-expected deaths at Staffordshire hospital between 2005 and 2008 blamed NHS managers and the regulator for doing enough to protect patient safety.

Walker raised the issue of problems with A&E waiting times, but said these were largely ignored. “It’s a simple decision: you have emergency care or you have care that could wait. It’s not nice to wait but it could wait and therefore we chose as a board - it was not just me - that we should take priority - that emergency care should take priority.”

Walker says demand for emergency hospital beds in 2008 and 2009 became so acute that he felt he had no other choice than to abandon the 18-week government target for non-emergency cases.

He also warned senior civil servants that he was confronted with the same choices that resulted in the Mid Staffordshire NHS Foundation Trust scandal. He blamed a “culture of fear” at the highest levels in the health service for attempts to silence critics.

His former hospital is now one of 14 hospitals in England that are now being investigated for high deaths rates by the NHS’s medical director Sir Bruce Keogh.

In early 2010, Walker was sacked as chief executive of the United Lincolnshire Hospitals Trust on grounds of ‘gross professional misconduct’ for allegedly swearing in a meeting.

He and former trust board members claim the real reason lay in his refusal to hit Whitehall targets for non-emergency patients.

A spokesman for the SHA told the BBC it “totally refuted” Mr Walker’s allegations, describing them as “unfounded”. The spokesman said the SHA had always acted “appropriately and properly” in the “interest of patients”.