The Northern Ireland Executive is now seven months into the financial year without a budget, which would be a fun fact for a pub quiz if it weren't for the bit where hospital doctors have now run out of patience and announced two strikes next month.

For months, the remarkable thing was how muted the practical impacts seemed. Public sector managers adapted to emergency budget procedures; money kept flowing, services were delivered, wages were paid. Impressive, in the way that a car sputtering along on fumes is impressive.

But this week the fumes ran out. The lack of a Stormont budget means doctors cannot be given the 3.5% pay uplift 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. In Northern Ireland, they have had patience, which does not pay the bills.

"I don't know how long you'd like us to wait?" said Clodagh Corrigan of the British Medical Association (BMA). The BMA met the health minister two weeks ago and, according to Corrigan, was told there will be no pay rise before Christmas "if at all". In response, resident doctors will hold a 24-hour walkout on Friday 20 November, while consultants and specialists will operate a much-reduced service the following Monday.

The Royal College of Nursing (RCN) has opened a ballot for industrial action for the same reasons. "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?" A question to which no one has yet offered a satisfying answer, possibly because there isn't one.

Health Minister Robbie Butler attempted 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. Translation: committed, yes; able, no; budget, please.

There is no budget because the executive parties agree that the UK's devolution funding formula leaves them so short they cannot produce a workable financial plan. The UK government has conceded more funding is necessary and offered an additional £1.5bn over the next three years, with a first tranche of £525m this year. The Stormont parties say this is nowhere near enough.

On Tuesday, Finance Minister John O'Dowd laid out the arithmetic 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." So: £1.6bn needed, £525m offered. Math remains undefeated.

Secretary of State Sir Chris Bryant reacted with exasperation. "You cannot keep overspending willy-nilly and not expect consequences from that. It's just irresponsible," he told the BBC. He held a virtual meeting with Stormont ministers on Friday. There was no sign of agreement, because of course there wasn't.

Bryant has suggested the absolute deadline for a deal is January, when the money available under emergency arrangements runs out. A deal will need to be reached much sooner than that if strikes are to be avoided. In other words: the clock is ticking, the doctors are walking, and everyone is very committed to things they cannot currently do.