Senior doctors in England will be consulted on taking industrial action if the government’s 1% pay rise offer is not improved.
The British Medical Association says it will ask members about action if there is not a figure nearer 4%.
The proposed 1% was widely condemned by health workers in England.
The Royal College of Nursing has already said it will consider balloting over industrial action and has called for a 12.5% pay rise this year.
Pay review bodies covering most NHS workers have made recommendations which have not yet been published.
In England, ministers must decide whether in the light of those reports they will increase their proposed 1% offer.
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Industrial action by consultants would involve stopping paid and unpaid overtime, which would affect patient clinics and attempts by hospitals to reduce waiting lists, the BMA says.
It argues that senior doctors are exhausted and feel undervalued because of previous below inflation pay rises.
If industrial action is taken it would be the first by consultants since the 1970s apart from a day of action over pensions in 2012.
What’s the significance?
Consultants, at the top end on NHS salary scales because of their years of medical experience and leadership, have not been minded to get involved in public pay disputes till now.
The possible overtime bans could slow down attempts to reduce hospital waiting lists.
This could be seen as sabre rattling and a bid to sway ministers ahead of their wage announcement.
But it is indicative of the likely level of anger across the NHS workforce if the government response to the pay review bodies’ recommendations is not far off the original 1% proposal.