Health Secretary Jeremy Hunt has written to all English NHS trusts to urge them not to use gagging clauses to stop staff raising concerns over care.
He says a culture of openness is vital if the NHS is to avoid mistakes seen at Stafford Hospital, where abuse and neglect led to hundreds of deaths.
It comes after Gary Walker, a former NHS boss in Lincolnshire, broke such an order by talking to the BBC.
Mr Walker said he had been gagged from raising fears over patient safety.
The former chief executive of United Lincolnshire Hospitals Trust (ULHT) said he had no choice but to sign an agreement linked to a confidentiality clause in April 2011.
He was sacked in 2010 for gross professional misconduct for allegedly swearing in a meeting.
Mr Walker said he was gagged by the NHS from speaking out about his dismissal and his concerns over the quality of care at the trust.
After breaking the order, lawyers for the trust then warned him he would have to repay £500,000.
Test caseThe health secretary said on Friday he did not want to make a judgement about Mr Walker's claims but there were "a lot of very serious allegations that we need to get to the bottom of".
He said this could become a test case for other "gagged" NHS employees, but said he did not know how many of these orders were in place.
Mr Hunt said the trust should have been concentrating on the concerns raised, rather than instructing their lawyers .
ULHT has said the allegations that they had tried to stifle debate about patient safety issues were "incorrect".
Employment solicitor Andrew Tobey told BBC Radio 4's Today programme it was "emotive" to use the term gagging order, adding that agreements which included mutual confidentiality obligations were not always "the blunt instrument they are made out to be".
"It is perfectly possible to refine these clauses to still allow the ex-employee to talk to regulatory bodies about patient safety," he said.
Mr Tobey added such contracts could benefit the NHS and the taxpaying public because "the aim of of these agreements does stop ongoing litigation" following the dismissal of an employee, and "allows both sides to move forward" without costly court battles.
ULHT is one of 14 trusts in England currently being investigated for high death rates, in the wake of the Stafford hospital scandal, where hundreds are believed to have died after receiving poor care.
It was revealed on Friday that police and prosecutors are now studying a damning report into failures at Stafford to see whether any criminal charges should be brought against staff.
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