Stormont plans to overhaul Northern Ireland's struggling health service have been "thrown into disarray" by the DUP pulling the First Minister out of the Executive.
Health experts warned efforts to tackle waiting lists and staff shortages are in jeopardy as Paul Givan's resignation means the Executive cannot approve a three-year budget.
A 10% funding boost for the health service was among the key priorities in Stormont's draft budget in a bid to rebuild the care system in the wake of the Covid-19 pandemic.
The impact on health is among the key consequences of the Executive being unable to meet in the absence of a first and deputy first minister.
Concerns have also been raised over issues including fears that next month's long-delayed official apology for survivors of institutional child abuse cannot go ahead.
The Royal College of Nursing's Northern Ireland director Rita Devlin said nurses would be "appalled" at the DUP move as the health and social care system was "already beyond the point of collapse".
She said: "There is an urgent need, for example, to promote the recruitment and retention of nursing staff, to develop safe staffing legislation, and to rebuild health and social care services, amongst many other priorities.
"We also need the three-year budget for 2022-25 to be approved in order to provide the basis for these priorities to be delivered.
“RCN members will feel shocked at this decision and what it will mean for the people of Northern Ireland.”
Dr Tom Black, chair of the British Medical Association's Northern Ireland council, said the health service was at a "critical stage" emerging from the pandemic.
He said: "We are waiting for the urgent care review, the elective care review and a road-map for rolling out multi-disciplinary teams across Northern Ireland.
"We also have a shortage of doctors here, and we were hoping to see funding for an increase in training numbers. All of these need the security of three year funding; it is central to us being able to rebuild our health service."
He added: "Our waiting lists are shocking and people here are waiting unacceptably long times for appointments and treatment. The last thing we need is another political crisis, more disruption and uncertainty.
"Doctors, and all healthcare staff, have worked tirelessly over the last two years and this is another blow to their morale."
Last night, the Health Minister said he was “deeply concerned about the consequences of today’s decision”.
Robin Swann added: “I will remain in post, but the task of rebuilding our health service has been made all the more difficult. A three-year budget was crucial for fixing our waiting lists and funding our mental health and cancer strategies.
“I have sought urgent legal clarification regarding the decisions on Covid restrictions I had really hoped could have been made by the Executive next week. My priority is and will remain supporting our health and social care system, but patients and staff deserve better than this.
“My intention has been to see a significant removal of Covid restrictions, replaced by guidance, at the earliest opportunity. I believe that time is very close. I will have more to say on this in the coming days, guided by legal advice and the latest public health assessments.”
Ulster Unionist health spokesperson Alan Chambers, whose party colleague Robin Swann is Health Minister, warned of the impact on plans to transform and rebuild services.
The MLA said: "The minister has long been clear that a multi-year budget was essential to deliver the improvements needed to tackle waiting times, as well as funding his new landmark cancer and mental health strategies.
"It now looks like our health and social care system has been robbed of the opportunity of an agreed budget.
"Given that a three-year budget will now not be put in place, the current focus on rebuilding and reform, along with staff recruitment and retention will be thrown into disarray."
Sinn Féin leader Mary Lou McDonald also warned of the implications for Stormont's budget as a result of the First Minister's resignation.
She said: "It is disgraceful that the budget now won't be passed and that investment in services such as cancer care and mental health are now in jeopardy."
Alliance leader and Justice Minister Naomi Long told the BBC's Evening Extra programme that no agreed budget would have "major implications".
She said: "It is significant. In order to be able to tackle the challenges in terms of our health service, in terms of recovery from Covid, in terms of delivering public services, we need to have certainty of the budgets, not just for next year but for the next three years.
"It creates uncertainty for third-sector organisations and charities for example who are on contracts with government departments, who will then not have certainty of their funding on the way ahead."
Mr Givan quit as First Minister as part of the DUP's protest against Brexit's Northern Ireland Protocol.
In a speech after Mr Givan resigned, DUP leader Sir Jeffrey Donaldson argued the Irish Sea trading arrangements had "jeopardised our medicine supply in the middle of a health pandemic".
He stressed his party's support for investing and reforming the health service.
The Lagan Valley MP said: "We want to invest more in our health service, coupled with much needed reform, so that we can properly tackle our hospital waiting lists."
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