A pay rise of up to 29% for hundreds of thousands of NHS staff will not be implemented in Northern Ireland, a medical union has warned.
The Royal College of Midwives (RCM) here has said it is the latest devastating blow for hard-pressed workers who continue to prop up the ailing health service here.
The situation has arisen due to the failure of our political parties to come to an agreement and return to work at Stormont, meaning a 1% pay rise cap remains in place indefinitely.
Breedagh Hughes, RCM (NI) director, said she understands health officials are poised to announce an increase in midwifery training places in a bid to address a shortage.
However, she said she was concerned the growing disparity in pay between midwives here and the rest of the UK will result in members of the profession leaving to work elsewhere.
"We are critically short of midwives in Northern Ireland," she said.
"Midwives are working additional hours to keep the service running safely and we even have midwives who are retired coming back to work shifts just to keep the service going.
"That's why it is good news that there is to be an increase in the number of training places.
"However, there is no light at the end of the tunnel when it comes to pay, unfortunately."
Ms Hughes said a three-year pay deal that is close to being agreed for workers in England cannot currently be offered to NHS employees here.
More than one million health service employees in England are set to vote for a pay deal that will see staff receive a hike of at least 6.5%, rising to 29% for the lowest paid staff.
A ballot is to be run by the 14 trade unions who negotiated the deal, and the vast majority are advising their members to accept the Government's offer.
"This pay deal has been done in England where the 1% pay cap has been lifted," said Ms Hughes.
"England is due to get this fairly substantial boost, similar plans are under way in Scotland and Wales generally does what England does.
"However, because there is no Finance or Health Minister in place in Northern Ireland, there is no one to decide how budgets should be divided up and no one to negotiate on pay deals.
"There are no ministers in place to make any decisions.
"Workers in Northern Ireland are already paid less than in the other three nations.
"So, while we are getting more training places, if midwives see their counterparts in Scotland are getting £3,000 or £4,000 more for doing the same job, what is the incentive for qualified midwives and nurses to remain?"
Ms Hughes said the RCM had discussed the matter with the most senior civil servant in the health service.
However, permanent secretary for the Department of Health Richard Pengelly has said he is bound by the 1% pay rise cap imposed by former ministers.
MS Hughes added: "It is going to be extremely difficult for our members to accept they are doing the same job, working under the same pressures, with not enough staff, and they are going to be paid considerably less than elsewhere in the UK."
The Department of Health said: "Any consideration of pay issues for 2018/19 and beyond will need to be taken in the context of public sector pay policy for Northern Ireland, which is a matter for the Department of Finance."
The Department of Finance said: "Public sector pay is a devolved matter that is determined locally and pay policy has yet to be set for 18/19. When this is in place, it is for departments to bring forward pay proposals for approval."
In January the Belfast Telegraph reported that the number of nurses and midwives leaving the profession here has risen by 50% in four years. Just under 600 nurses and midwives left the register in 2013/14. This rose to 928 in 2016/17, while a further 506 left the register in the first two quarters of 2017/18.