Giving Northern Ireland health service staff the same pay deal as workers in England could only be funded by making service cuts on an unprecedented scale, a senior civil servant has warned.
The Department of Health’s permanent secretary said it is impossible to give pay rises under the current budget.
Peter May said he is aware of the “potential impact this could have on staff and on industrial relations”.
England staff are to get a 5% pay rise plus a one-off sum of at least £1,655.
That has been accepted by a majority of unions representing NHS England staff, although nurses and junior doctors are still engaged in industrial action.
Mr May made the comments in a letter to Stormont’s parties as part of a consultation exercise on the health budget.
He said the health service is currently facing unfunded spending pressures of £472m of which £375m relates to a pay claim matching NHS England.
He said: “Funding this pay offer under the current budget settlement would require large scale cuts on an unprecedented scale, with severe and lasting implications for health and social care services.
“Given the legislative basis supported by guidance from the secretary of state, I have concluded that taking such a decision would be out with my authority as permanent secretary.”
He added that like other departments “we are in an impossible position of being asked to fulfil conflicting responsibilities”.
“This involves trying to balance our responsibilities to live within the budget we have been given, act in the public interest and safeguard services.”
Mr May also laid out more details on cuts.
Almost £35m is to be cut from a programme aimed at reducing the huge backlog in Northern Ireland’s waiting lists.
More than £61m will still be spent on this scheme and the intention is to ‘backload’ the cut, meaning funding will continue at last year’s level initially.
Mr May added: “In the event of additional funding for health being made available later in this financial year, a minister may have the option of increasing waiting list initiative investment.”
Unite the Union said the statement was “unnecessarily provocative to health and social care workers” ahead of Thursday’s meeting between trade unions and the Northern Ireland Secretary Chris Heaton-Harris.
Kevin McAdam, from the union, said the comments had “ramped up tensions within the workforce”.
“Our members have resisted further strike action in order to allow space for talks but this statement leaves us with no other option but to prepare for further action,” he added.
Ciara Gallagher, chair of the British Dental Association’s Northern Ireland dental practice committee, said “cuts have consequences and these will be irreversible”.