Britain's National Health Service is balanced on the edge of a major crisis as the government and health workers are preparing to carry their confrontation over pay into its 18th week.
Unresolved, the crisis threatens not only a partial collapse of the health system nationwide, but could also prove a major blow to Prime Minister Margaret Thatcher's so far successful policy of limiting pay increases to British workers.
Mrs. Thatcher in the past has notched up an impressive series of victories over trade unions seeking to break through her government's 6 percent pay guideline. Notably, coal miners and railway workers have let the ''Iron Lady'' have her way over pay. But the health workers are proving much more resistant.
Last week members of the Royal College of Nursing, who are pledged under their rules not to strike, voted two to one against acceptance of a specially devised 7.5 percent pay hike offer. Stepping up the pressure on Mrs. Thatcher and her Social Services Secretary Norman Fowler, the Trades Union Congress (TUC) prepared to call for a nationwide one-day strike on Sept. 22 to back the health workers' case.
Such a strike, if held, threatens to violate the Thatcher government's controversial legislation aimed at restraining trade union activity. It may also heighten public pressure on the prime minister, who is aware that the health workers are generally low paid and command much community respect.
Industrial action by health workers has brought hospitals in some parts of England to a near halt as only emergency services operate and supplies of food and other essentials are held up by picketers.
Intensification of the struggle could lead to collapse of services in some places. Government ministers have made it clear that the Army will be brought in to keep services operating if a full-scale shutdown is ordered by health service workers.
Mrs. Thatcher, no novice in facing strikers in close confrontation, has ordered Secretary Fowler to hold firm in his refusal to budge on the current pay offer to health workers. Labour opposition spokesmen have urged the prime minister to sack Fowler as a way of breaking the deadlock and arranging a return to pay negotiation.
Two key issues for the government are at the center of the dispute. An improved pay offer to workers in the national health service, Mrs. Thatcher says , would be a sign of government weakness and encourage other groups of workers to challenge official guidelines.
At the same time the threatened TUC-sponsored nationwide strike is a challenge to conservative government trade union laws, which aim to curb industrial action by one or more unions in support of another.
The Royal College of Nursing's decisive vote against the revised pay offer put forward by Fowler has been interpreted as a setback for the government. Fowler hoped to split the nurses from other health workers being offered less than a 7.5 percent increase.
The nurses, however, decided that they could not accept the offer, arguing that the proposed pay rates would be too low to maintain a(decent living standard. Some nurses noted that Britain's police have been given pay increases of around 10 percent - above the official limit.
One result of the confrontation that worries hospital administrators is the tendency of nurses to leave the profession in apparently increasing numbers, looking for higher-paid jobs.
Some administrators are saying it is unfortunate the government has allowed itself to be seen to be defending its pay policy against workers whom many members of the public deeply respect.
But the fact remains that the battle lines have been drawn sharply, and neither side can retreat without appearing to concede defeat.
The TUC meanwhile appears to be happy to have the health service crisis as the focal point of its planned one-day strike. TUC leaders bitterly resent the government's trade union code and by organizing sympathy strikes on behalf of the health workers hope they can rally public support against the new laws.