In an unprecedented outburst of militancy, hospital chaplains have overwhelmingly rejected a pay offer accepted by 200,000 other NHS workers.
The nation's ministers of health voted by five to one to demand more than the 3.25 per cent deal proposed by management, and some have even said they would contemplate industrial action.
It is believed to be one of the few occasions that priests have held a ballot on their pay.
The Rev Graham Theobald, a senior activist in the ecclesiastical section of the Manufacturing Science Finance (MSF) union, said that many of his colleagues in acute hospitals were on call for 120 hours a week and the new offer would give them a starting salary of only £15,287 a year.
Mr Theobald said that priests were inevitably forced to take a drop in salary when they joined the service and that hospitals were finding it increasingly difficult to attract recruits.
"The maximum you can earn is £22,000 a year at the moment plus a housing allowance of £3,000. But that allowance has been static for some time and in London £3,000 is a joke," he said.
He said that industrial action would be "a massive step" for the 300 clerics involved and individuals would have to make their own minds up about it, but it might be considered.
Mr Theobald said that in voting against the offer - part of a three-year deal - the ministers were showing solidarity with the other 200,000 NHS employees who were not covered by pay-review bodies.
MSF said that pay levels for those not covered by the system had fallen behind doctors' and nurses' by as much as 30 per cent in five years.
"With this historic vote to reject the three-year pay deal, hospital chaplains are telling the Government to recognise the vital role they play in delivering spiritual healing to patients, their families and NHS staff," Mr Theobald said.
"Hospital chaplains are health professionals and as such should be properly rewarded for their professionalism in handling many physical and emotional problems."
Officials at MSF pointed out that priests could earn thousands more in prisons and the Armed Services, and, if they had opted for secular jobs, tens of thousands more.
Mr Theobald argued that NHS chaplains even fared badly compared with Church of England vicars who received free accommodation and were considered to be self-employed and therefore paid less tax. New entrants to the health service were invariably qualified to degree level and required to have three years' experience.
Alastair Henderson of the NHS Confederation, which represents hospital management, said the chaplains performed an extremely valuable service, but the overwhelming majority of the health service workforce had accepted the deal. He said there would be an opportunity to evaluate their jobs as part of a proposed new pay system.
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