HEALTH workers stepped up their campaign against public sector pay cuts this morning by refusing to answer phones.
Dublin and the north-east region were the first places to be hit, with nurses and other hospital staff ignoring phone calls from the public.
The action is set to continue all week but will rotate between HSE divisions.
The escalation comes just days after union chiefs warned that an all-out strike could be on the cards as soon as next month.
Thousands of lower-paid civil service workers have also now signalled that they would support a more visible form of protest.
General secretary of the Civil Public and Services Union (CPSU) Blair Horan described the fact that 83pc of their 13,000 members voted in favour of further action as "decisive".
Today's action hit health service in Louth, Meath, Cavan and Monaghan as well as all services north of the Liffey.
Staff were advised not to answer phones between 9am and 1pm, although calls to the emergency departments were being dealt with.
However, calls dealing with other services such as coronary care and maternity units were only being monitored on an hourly basis to establish which required urgent attention.
Health workers in the west are due to take a similar approach tomorrow, before the campaign moves to the HSE's southern division on Thursday and the Dublin/mid-Leinster region on Friday.
Unions had given the HSE advanced notice of which areas will be hit each day, however they may not offer the same 'goodwill gesture' in the coming weeks.
Yesterday the unions also indicated that they will be asking their members not to take on any work associated with vacant posts.
The Government moratorium on recruitment means that many jobs have been left unfilled for months, with remaining staff expected to pick up the slack.
Members of IMPACT working in other sections of the public service are also continuing with their campaign against the €1bn cuts.
Workers employed in areas such as education, local authorities and social welfare offices have selected a number of tasks which they will not complete.
These include a refusal to handle parliamentary questions and Freedom of Information requests, while some staff are refusing to work outside normal hours.
Members have also decided not to co-operate with work experience or FAS graduate programmes.
IMPACT has already proposed a series of rolling work stoppages and the backing of a similar tactic by the CPSU makes it much more likely to happen.
"CPSU members have voted decisively for escalating the current dispute over the pay cuts," said Mr Horan.
"Members were shocked and dismayed that the Government would cut their low pay rates by 5-6pc while restoring pay level of senior managers on €150,000."