KEY POINTS:
Elective surgery has virtually halted, thousands of outpatient visits have been deferred and non-emergency patients have been asked to avoid emergency departments as hospitals brace for the crippling junior doctors' strike starting tomorrow.
More than 2000 house surgeons and registrars will strike for 48 hours from 7am tomorrow - the second strike by the Resident Doctors Association in two years - unless there is a break today in its impasse with district health boards.
Senior doctors will help to do the strikers' work, for which they will be paid $300 to $500 an hour on top of their normal pay. Some say they will donate part of the extra pay to charity.
The strike starts tomorrow but many hospitals have been virtually emptied of non-acute cases since late last week and will remain so until next Monday. Because Friday is a holiday (Anzac Day), only a limited amount of elective surgery will be done on Thursday after the strike ends.
Reflecting a national message, Auckland's three district health boards have placed advertisements in major news media stating that they will be "offering very limited services, including emergency services" during the strike. The advertisement says: "Non-urgent surgery, outpatient and mental health clinics may be affected and services may be postponed."
Non-urgent patients who go to hospital emergency departments would be asked to go to their general practitioner or an accident and medical centre, the health boards said.
But their hospitals and community maternity units would continue to accept women in labour.
The Counties Manukau board's chief operating officer, Ron Dunham, said yesterday that the aim during the strike was to keep Middlemore Hospital's occupancy level - which was ideally 85-90 per cent normally - below 80 per cent.
Major elective surgery was normally done early in the week so patients could be discharged before the next weekend, to "keep your reserves for acutes over the weekend".
If any elective surgery was scheduled for today, it would be only straightforward day-surgery, and more of this could be done on Thursday after the strike.
But the health board would not start building back up to its usual workload until next Monday.
Mr Dunham said that at Counties Manukau DHB, the strike's impact on outpatient visits would not be so severe but if specialists were needed for acutely unwell or injured patients, that could change.
David Meates, spokesman for health boards chief executives, said the DHBs had offered to meet the junior doctors' union again, but the union had refused to meet unless the DHBs increased their offer.
The boards would not do this because it would lift the pay increase to junior doctors out of line with settlements with other health workers.
WHERE TO GO
* Hospitals are appealing for the public to "keep emergency departments for emergencies only".
* For non-urgent sickness or injuries, see a GP or phone Healthline on 0800 611-116.
* An estimated 8000 patients who were scheduled for elective surgery or an outpatient visit have had their bookings postponed.
THE DISPUTE
* The junior doctors' union had wanted three pay rises of 10 per cent over three years and other changes, a pay claim that district health boards said would increase their costs by 40 per cent.
* The union reduced its claim to one it said was similar to the DHBs' offer to senior doctors. DHBs said the reduced claim would still increase their costs by 30 per cent over three years.
* DHBs have offered junior doctors two rises of 4 per cent for a two-year deal.
