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Anaesthetists at Counties Manukau hospitals have threatened industrial action in protest at critical staffing shortages.
The health board is short of about 20 fulltime-equivalent anaesthetists.
About 45 fulltime-equivalent anaesthetists are based at Middlemore Hospital and the Manukau SuperClinic.
Ideally, the Counties Manukau District Health Board should have about 65.
The staff shortages meant the anaesthetists are spending more time doing clinical work and neglecting their non-clinical duties, which include research, training, quality improvement and auditing.
Anaesthetists have threatened that, if the situation continues, they will begin a "work to rule" regime to ensure non-clinical duties are accommodated.
Such a regime would see anaesthetists rostered on entire shifts dedicated to non-clinical work.
Chief medical officer Don Mackie told the Herald yesterday that the work-to-rule threat had not yet manifested into action.
He said the health board would meet in the next few days to discuss the shortages. They had not impacted on clinical services.
Intense population growth had contributed to a sharp increase in workload for Counties Manukau anaesthetists over the past two to three years, Dr Mackie said.
But until now the anaesthetists' "can-do attitude" had kept the extent of the shortages hidden.
Recent work at finding out exactly how many anaesthetists the board needed had exposed the extent of the shortages - a gap "that perhaps we weren't aware of", Dr Mackie said.
This year an internal review had unearthed a range of potential problems associated with the shortage which could have impacted on Middlemore's ability to remain an Australian and New Zealand College of Anaesthetists-accredited provider of training.
The problems revolved around the supervision of trainee anaesthetists, but rosters were altered immediately to fix them, Dr Mackie said.
Alongside population growth, difficulties in recruiting anaesthetists was a contributing factor to the shortfall.
That meant filling 20 positions in a year - if that was the verdict following this week's meeting - would be "a major challenge".
But Dr Mackie noted that a handful of new anaesthetists were close to being appointed at Counties Manukau.
