Rotorua Hospital has postponed more than 50 procedures and several outpatient clinics as it moves to cater for "essential emergency services" during a two-day doctors' strike.

From 7am tomorrow , only urgent cases will be treated at the emergency department at Rotorua Hospital while the strike is under way.

Essential emergency care such as acute surgery, emergency department treatment, intensive care and maternity care will continue to operate but 52 elective procedures and an unknown number of clinic appointments have been postponed.

It is not clear how many of the 75 junior doctors employed at Rotorua Hospital will strike after the union and health boards failed to reach agreement over working hours.

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The union says the current rostering system - where resident doctors work rosters including seven nights in a row and 12 days in a row - is unsafe for patients and for doctors.

However, district health boards said they were disappointed their latest offer was rejected and it would have led to doctors having some of the best working hours in the world.

Lakes District Health Board communications officer Sue Wilkie said Rotorua Hospital was pleased with how its contingency planning had gone, but would probably have liked to reduce the number of inpatients further ahead of the strike.

She said this afternoon the occupancy rate was 79 per cent, although more patients were likely to be discharged later today.

Miss Wilkie said all elective procedures scheduled for the two days of the strike had been rescheduled - generally within the next month.

She said many outpatient clinics needed to be rescheduled or reduced including surgical, orthopaedic, ear nose and throat, medical, gynaecology and specialist antenatal.

"A number of the 75 junior doctors currently employed by Lakes DHB have indicated they are not intending to strike, but we can not be certain of the number until the strike is under way."

She said the hospital was confident with the plans in place.

"A good number of the 90 or so senior doctors across the two hospitals [Rotorua and Taupo] will be providing services to those most in need across the 48 hours of the strike. Some junior doctors who will not be taking industrial action will also be working."

She said some nurses who normally worked in training and professional development had been seconded to help during the strike.

Lakes District Health Board union delegate Dr Tom Reynolds said doctors were reluctant to take strike action but believed it had to be done.

"We were really hopeful we would be able to avoid it."

Dr Reynolds said he wasn't sure how many junior doctors would be striking, as some who had recently arrived from the UK were not taking part.

"Everyone has a sense of resignation . . . a frustration . . . but under that there is some optimism this is one of the few ways we have to see change."

Up until today he said there was still the hope the strike might not go ahead.

While junior doctors would spend the time recovering, he said they also planned to do some non-hospital based volunteer work.

Dr Reynolds said most patients and other staff he had spoken to had been supportive of the action.

He said junior doctors were increasingly being asked what day they were on by patients, who were becoming more aware of the hours they worked.

He said some doctors were being asked by patients whether they had been home or if they had slept.

"It is certainly a bit more noted."

Dr Reynolds said he wasn't aware of any flack junior doctors had been given by colleagues over the action.

"As with any group there are a range of opinions. If perhaps ideologically they don't agree they have kept it to themselves."

Dr Reynolds said he was confident planning in place by the health board was robust and would ensure the safety of patients during the strike.

"We have a really good group of senior doctors. I think most [of the impact] will largely be around the flow. Everyone will still be able to get urgent care."

He said the strike wasn't just about the doctors' own safety, but making changes for future doctors and making sure patients were safe.

The last time Lakes DHB was affected by strike action by junior doctors was in 2008.

ADVICE TO PATIENTS:

- People unsure whether their appointments or procedures are affected can call 0800 223 647.

- Pregnant women whose specialist antenatal appointment has been changed should contact their lead maternity career immediately if they have concerns. If they can't contact them they should ring the hospital and ask to speak to the birthing unit.

- People should make sure they are up to date with prescriptions and other requirements and make the GP or Lakes Prime Care their first port of call.