The Northern Ireland Executive is now seven months into the financial year without a budget. One of the remarkable things about this situation is the relatively muted practical impacts.

Public sector managers have adapted to emergency budget procedures; the money still flows, services are delivered, wages are paid.

But this week real consequences began to emerge as hospital doctors ran out of patience and announced two strikes next month The lack of a Stormont budget means the doctors cannot be given the 3.5% pay uplift which was recommended by an independent body and accepted by the health minister.

Elsewhere in the UK doctors have had that extra 3.5% in their pay packets since April.

"I don't know long you'd like us to wait?" said Clodagh Corrigan from the doctors' union, the British Medical Association (BMA).

The BMA met the health minister two weeks ago, and Corrigan said they were told that there will be no pay rise before Christmas "if at all".

In response resident doctors will hold a 24-hour walk out on Friday 20 November while consultants and specialists will operate a much-reduced service on the following Monday. A nurses strike may not be far behind. Royal College of Nursing (RCN) has opened a ballot for industrial action for the same reasons as the doctors.

"It is despicable that, year after year, nursing staff in Northern Ireland are forced to fight for a pay award that colleagues elsewhere in the UK receive as a matter of course," said Professor Rita Devlin, executive director of the RCN in Northern Ireland.

"Would governments in England, Scotland or Wales allow their health service staff to go indefinitely without a pay award?

The answer is no. "So why is Northern Ireland expected to accept this?" Health Minister Robbie Butler has attempted to strike a conciliatory note while acknowledging there will be no movement without a budget deal.

"I remain committed to implementing this year's pay award but unfortunately, I am currently unable to do so in the absence of a sufficient budget being agreed for my department," he said.

There is no budget because of a consensus among the executive parties that the operation of the UK's devolution funding formula now leaves them so short that they cannot produce a workable financial plan.

The UK government has conceded that more funding is necessary and has offered an additional £1.5bn over the next three years with a first tranche of £525m to be paid this year. The Stormont parties say this is nowhere near enough. On Tuesday, Finance Minister John O'Dowd laid out his position in the assembly.

"Pressures across departments in the current financial year are around £1.6bn. The offer that is currently on the table is around £525m.

"Public sector pay alone is £500m or thereabouts, and any settlement or agreement has to include money for pay uplifts for teachers, nurses and other public-sector workers." Secretary of State Sir Chris Bryant has reacted with exasperation.

"You cannot keep overspending willy-nilly and not expect consequences from that. It's just irresponsible," he told the BBC.

ld a virtual meeting with Stormont ministers on Friday. There was no sign of agreement. More discussions will be held next week.

Bryant has suggested the absolute deadline for reaching a deal is January because at that point the money available to spend under the emergency arrangements will run out. A deal will need to be reached much sooner than that if strikes are to be avoided.

Ann Watt, the director of Pivotal think tank said this is a "very difficult situation" with "no easy solution here at all".

"The executive is clear that the thing they want to do most is make those public sector pay awards," she told the BBC's Sunday Politics programme "I think it's very difficult to see how that circle is going to be squared in the short time available if the pressures are three times the amount of funding available." Watt said that while a deal might be made with the UK government, "the scope to do anything this year is extremely limited given the stage we're at".

She added the public sector in Northern Ireland is "much, much bigger than elsewhere in the UK" and that the funding received from Westminster has to be used on a "much bigger number of people" compared to England.