Stormont's embattled Executive has been pushed to the brink after Health Minister Edwin Poots threatened to bust his departmental budget by tens of millions of pounds.
In response Sinn Fein immediately demanded that either Mr Poots or his DUP boss Peter Robinson should decide if the health chief is up to the job.
Mr Poots' unprecedented move was seen an attempt to increase pressure on Sinn Fein's refusal to implement welfare reforms which have resulted in multi-million pound penalties imposed on the Executive by the UK Treasury.
But it was also being viewed as a clear signal of a potential DUP exit strategy from the Executive. Mr Robinson has already warned the welfare stalemate could bring about the demise of the present administration.
If the Health Minister keeps to his promise of ignoring spending limits on his department then it could spark a crisis at Stormont. If spending targets are exceeded then civil servants may be forced to take control of budgets and this could lead to the collapse of the power-sharing executive.
Rival unionist parties warned the DUP against playing politics with health spending and welfare reform.
The growing sense of instability around the Executive has intensified since the DUP revealed Sinn Fein had forced it to exempt education from further cuts along with health.
Mr Poots' position was backed by his party colleague, Social Development Minister Nelson McCausland, who also warned the £29m he has to save so far will mean job losses, cuts in Housing Executive grants and maintainance and a possible rents rise.
Health was awarded an extra £20m in the delayed June monitoring round, but Mr Poots had bid for an extra £160m and initial proposals from Mr Hamilton had been to give him £40m.
Mr Poots said yesterday his "bottom line" was £60m but the Executive had already agreed "in principle" to further cuts totalling £87m to offset the reductions in the annual lump sum provided by the Treasury.
Mr Poots warned the Executive, which has not met for several weeks, " I cannot deliver £140m of savings", and told BBC's Nolan show: "The consequence is they find someone else to do it, or they do it themselves, or they find the money."
The health chief made clear he would not implement cuts he believes will compromise patient safety and added: "The consequence of that is, we will break the budget by tens of millions of pounds unless more money is allocated to health."
He later added: "We have already suffered a massive real reduction in health spending as a result of Conservative/Lib Dem cuts; now most of the cuts are as a result of Sinn Fein's unwillingness to deal with the welfare reform issue. It makes me angry that these further cuts have been imposed unnecessarily on health."
But Sinn Fein's Mickey Brady, a member of Stormont's health committee, said the health service was too important to be "held hostage to internal unionist bickering".
"Mr Poots suggested maybe he is not the man for the health job, if this is so, then he and his party leader should immediately consider his future."
He added: "The current crisis has nothing at all to do with the issue of welfare cuts which we successfully resisted during the monitoring round. The health budget was protected and an additional £20m was allocated to health."
Ulster Unionist health spokesperson Jo-Anne Dobson said Mr Poots should have acted on the developing crisis within the health service three years ago.
Recalling the DUP had pilloried her colleague Michael McGimpsey when he ran Health, she sugggested "games of political brinkmanship" are being played between Mr Poots and Mr Robinson and called for a special meeting of the Executive.
TUV leader Jim Allister argued that dysfunctionalism within the Executive had spread to the DUP. "Collective responsibility doesn't now even operate at party level, never mind cabinet level," he said.
The DUP's Peter Weir, however, claimed all party members were focused on the impact of the cuts – made necessary by the failure to implement welfare reform.