KEY POINTS:
Public hospital patients booked for health care can expect to start receiving deferral notices late next week, as a looming national strike by junior doctors forces officials into contingency planning.
The 2500-member Resident Doctors' Association formally told district health boards yesterday that house officers and registrars would strike for 48 hours from 7am on April 22. But more strikes are possible.
"There might be more," said association general secretary Deborah Powell. "If we don't get it sorted out, strikes are likely to continue."
Patients are expected to be told, probably starting next Tuesday, of the deferral of their elective surgery or outpatient appointments, as public hospitals wind back to providing just emergency care.
The timing of the first strike in the week before the long weekend starting with Anzac Day will compound the disruption if another strike is scheduled for the following week.
It will be the second national strike by junior doctors within two years. The last was a five-day strike in June 2006. It was hugely disruptive.
This strike will be a complete withdrawal of labour, although the union says it will comply, as required by industrial law, with hospitals' contingency plans that are likely to ask some unionists to help out to preserve a patient's life or avoid permanent disability.
"This is about retaining junior doctors in permanent DHB employment," Dr Powell said. "They are leaving for Australia and to locum back to DHBs or private accident and medical centres."
The aim was to narrow the gap with locum and Australian pay rates.
The number of house officers - junior doctors in their first postgraduate years - was in a crisis, with a net loss of 217 in the first three months of this year, she said. At some provincial health boards, such as Southland and Whanganui, half or more of house officers were locums.
She said boards nationally would spend a significant amount of their junior doctor base salary budget on locums, money that would be better spent on a good pay rise to encourage permanent staff to stay.
But three rises of 10 per cent would be just a start. The rates would still be below those in Australia, "let alone the New Zealand locum rates".
Health Minister David Cunliffe's spokeswoman said he had no comment. Mr Cunliffe intervened in the senior doctors' pay dispute, which is now subject to a proposed settlement and ratification ballot.
But Dr Powell said the minister had written to her union a month ago to say that he would not intervene in its dispute.
DHB spokesman David Meates accused the union of "holding a loaded gun to the heads of patients".
The strike would force hospitals to cut back services to make sure they could provide urgent and emergency cover. However, he warned that the doctors' demands could not be met.
"DHBs are prepared to meet and talk at any time, however, the reality is that we'll never get a deal with this group while they're claiming 40 percent."
WHAT'S AT STAKE
* Junior doctors have sought three pay rises each of 10 per cent in a three-year deal.
* The district health boards have offered two of 4 per cent each in a two-year deal.
* The boards say that other conditions sought by the union lift the cost of its claims to an increase of 40 per cent over three years.
