Resident doctors will issue notice of a second strike, after a new offer from district health boards failed to end their dispute.

Members of the Resident Doctors Association will walk off the job for 48 hours, starting at 7am on Wednesday November 23, the union's national secretary, Deborah Powell, said tonight.

She will send the legally required 14-days' notice to district health boards tomorrow.

Her announcement came after the DHBs said their "world-leading offer" was rejected by the union in mediation today.

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Powell said the offer was not as good as stated by the DHBs.

The new strike by resident medical officers (RMOs) follows one of 48 hours by the union that began on October 18. That walkout led to thousands of patients' non-urgent operations or clinic appointments being postponed by the DHBs.

The dispute was at first over the union's demands for safer working hours and its assertion that long hours were putting patients and doctors at risk. But after the DHBs agreed to safer rosters although without paying for the resulting days off, the row took on a pay element too.

The DHBs today gave details of their latest offer, including:
• A 5 per cent pay rise over three years, and
• A payment of $200 when working a weekend shift.

DHBs' present "investment in RMOs" is $500 million a year. The offer would have lifted that by $88.4 million over the term of the proposed agreement.

"Today's offer gives the union what they have been publicly asking for: a contractual guarantee that no RMO would work more than four nights or 10 days in a row," said the DHBs' spokeswoman, Julie Patterson, the chief executive of the Whanganui DHB.

"The offer would see all the rosters, unacceptable to the union, fixed."

The 20 DHBs expected their offer to settle the dispute because it addressed all the health and safety issues the union had raised and offered the $200 payment.

"The RDA seems to be all over the place," Patterson said.

DHBs were very disappointed by new strike, which would cause further disruption to patients.

"I would have thought that taxpayers would be pretty horrified that services are again facing postponement and deferrals on the basis of the union expecting their members to be paid for their days off."

Powell said the 5 per cent pay-rise offer was no better than what other health workers were receiving except that it was over a longer term.

She calculated that even with the $200 weekend payment, members would on average be $5000 to $7000 worse off a year because the roster changes would put them into a lower salary band.

The DHBs have previously said the union expected doctors to be paid for days off resulting from the roster changes.

The union said: "The DHBs have proposed a system that would see thousands of dollars being deducted from each RMO's salary, far out of proportion to the number or value of rostered days off they may get under safer hours rostering."

Powell added that the DHBs had not contractually committed to the safer hours.

"There is no guarantee of recovery days after nights; they have referred to a guideline, which is not committing to them contractually."

She said the public was showing strong support for safer working hours. "They don't want a doctor that's tired."