KEY POINTS:
Junior doctors, who walked off the job for 48 hours today, have increased their pressure on district health boards by announcing that they will strike again.
The Resident Doctors' Association's general secretary Deborah Powell said the union would issue fresh strike notices in response to the refusal of DHBs to increase their salary offer despite the crisis in New Zealand's medical workforce.
But the health boards said the suggestion of further strike action "beggars belief" and the union should be looking forward, not backwards.
Dr Powell did not state the date of the next strike or strikes.
"Feedback from our members is that we desperately need to resolve this issue," she said.
"If we wait any longer then patients will not be negatively affected only during days of strike action, but on a daily ongoing basis."
She said the crisis was so bad that junior-doctor vacancies in some regional hospitals could lead to their being closed for short periods.
Some 2100 junior doctors are striking until 7am on Thursday, seeking three pay rises of 10 per cent and other improvements for a three-year deal.
The health boards have offered two rises of 4 per cent over two years.
The Government estimates that more than 8000 people have had elective surgery or an outpatient appointment postponed because of the strike.
It maintains New Zealand is not in a medical workforce crisis.
But the union said many junior doctors were leaving permanent health board employment to go to Australia, where they could earn much more than in New Zealand, or to go into locum work at New Zealand hospitals, increasing their hourly rate three-fold.
The loss of junior doctors from permanent health board employment would lead in future years to a reduced number of New Zealand-trained surgeons and specialist physicians, it said.
DHBs spokesman David Meates said: "This union should be more concerned about finding a way to solve the dispute rather than trying to prolong it."
"We have offered a way forward to look at how we can address underlying workforce problems; this group is looking backwards.
"We've suggested ... to talk about a new direction and ways to invest more in our junior doctors; their response is to go on strike and now threaten even more action.
"We've increased the number of doctors by 300 over the last five years and their earnings have gone up by 28 per cent since 2001. That hasn't worked, yet the union's recipe is more of the same."
Mr Meates said DHBs had achieved forward-thinking agreements with other unions, but not the junior doctors' union.
"Junior doctors need to ask themselves if their approach is in keeping with the modern, team-based approach to medicine that their colleagues have embraced."
Some hospitals report their emergency departments have been quiet today.
One senior doctor, who asked not to be named, said a week of surgery had been cancelled for the two day strike that began today. He said this was necessary so patients could be cared for by the skeleton staff after their operation.
"We have to can a week of work," the doctor said.
He said support amongst senior doctors for their junior colleagues was split.
The doctor said the cost of the strike ran into the tens of millions and was disruptive.
