UNPRECENDENTED strike action by nurses is looking increasingly likely after talks broke down yesterday between the Department of Health and trade unions.
In a statement, the department said it is "deeply disappointed" and described planned NHS walkouts as "damaging".
Permanent Secretary Richard Pengelly, who is the most senior decision maker in the north's health service in the absence of a minister, cited "budgetary constraints" for the reduced pay offer which was made earlier this week - and equated to £51 million of this year's budget.
Negotiations between union chiefs and department civil servants aimed at averting industrial collapsed yesterday afternoon.
The Royal College of Nursing (RCN) last night branded the department's pay deal as "another insult to nursing and a blow to patient care".
Unison, which represents the majority of healthcare workers, is to begin 'work to rule' action this Monday, with its general secretary Patricia McKeown last night defending the decision, saying: "We already have an unsafe system. We want to make it safe."
RCN chief Pat Cullen said that at a time of 3,000 nursing vacancies in the north, her members were "extremely angry" that the pay gap between them and their NHS counterparts will widen further.
And she warned the department's pay deal has "affirmed the decision" of nurses to take industrial and strike action in coming weeks, the first in the trade union's 103-year-old history.
"We are aghast that the department still does not appear to take seriously the issues facing nursing staff in Northern Ireland and, in comparison to figures presented to the trade unions earlier this year, there appears to be even less in the budget now," Ms Cullen said.
"The department has indicated to the trade unions that it cannot address the issues until a minister is back in place...We simply cannot wait any longer to start to resolve this crisis and our members will not accept anything less than parity with colleagues in the rest of the UK."
Mr Pengelly insisted they had "worked hard" with trade unions to make progress in what he said were "very difficult circumstances".
He added that he had asked them to defer industrial action due to winter pressures.
Earlier this week three health trusts were forced to cancel some planned operations due to lack of specialist theatre nurses.
Mr Pengelly said: "While I would have preferred to be in a position to make a higher pay offer, this is the best we can afford given the budgetary constraints and limited authority in the absence of a minister."
The pay offer represents a 2.1 per cent increase to the pay bill for Agenda for Change - which is the framework covering most of the north's health and social care workforce.
More than £100 million of the health budget would be required to bring the north's NHS workers into line with their English counterparts.
In a joint statement released by the HSC Trade Unions NI, they attributed the collapse of the pay negotiations to "nothing new" being offered by the department chiefs and employers.