Junior doctors employed by district health boards have announced they will strike for a second two-day period this month.
The industrial action is set to disrupt treatment for non-urgent patients, with scores of specialist appointments and elective surgeries now being rescheduled.
The NZ Resident Doctors' Association (NZRA) has this afternoon released plans to strike between January 29 and 30.
It comes a day after the group confirmed that a 48-hour period strike would take place next week starting at 7am on Tuesday until 7am on Thursday; after mediation with DHBs failed to come up with anything they agreed on.
The association claims DHBs are pursuing claw backs in terms and provisions of the Multi-Employer Collective Agreement.
NZRA said the DHB team's claw backs would remove the protection of the union and expose vulnerable junior doctors to disruptive and dangerous work conditions.
The association's senior advocate, David Munro, said: "The [residential medical officers] are more determined than ever not to accept claw backs to their terms and conditions.
"This vote for a second strike testifies to their resolve. The RMOs are clearly not going to be backing down.''
NZRA said the DHB team's position meant junior doctors could be moved to any hospital in the country as district health boards see fit and required to work more than 16 hours in a row without guarantee of rest or safety.
Vice president Dr Kathryn Foster said it had been a long process, bargaining with the DHBs since February last year.
Foster said they did not expect the conditions eventually presented to them - which sought general changes to the way they worked and changes they felt would be disruptive and potentially detrimental to many RMO doctors.
"We entered into that process to try and re-negotiate with the DHBs to get something that would be acceptable to our members, with improvements to the conditions.
"But unfortunately, all we've been offered is claw backs in terms of our terms and conditions of employment - which has been a real shame, actually.''
However, the DHB group said they "strongly dispute'' claims made by the union about bargaining discussions related to the collective agreement for junior doctors.
DHB spokesman Dr Peter Bramley said it was untrue for the union to say they wanted to move junior doctors around the country at will.
"Rosters across multiple hospitals in non-urban areas and any combined duty and on-call period of more than 16 consecutive hours currently requires the approval of the RDA.''
He said DHBs would prefer affected employees make decisions about rosters locally, rather than the union.
"DHBs are committed to being good employers supporting safe care and safe working conditions,'' he said.
HOW WILL HOSPITALS FARE?
Hospitals and medical clinics - and patients, as a result - will be affected some way or another because of the strikes.
Contingency plans will be put in place to help keep things running smoothly.
However, hospitals are urging people to keep the emergency department free for genuine emergencies and to seek treatment from a GP or an accidental and medical clinic if injuries or illnesses are less serious.
The Auckland DHB will continue to provide emergency and life-preserving services on the planned strike days, a spokeswoman said.
"This includes all acute services and those services defined as life-preserving (eg: cancer treatments). Our message to the public is if you need our care, we are here.''
Non-urgent and non-acute services, however, are being rescheduled. Those patients due for an appointment or surgery and who have not been contacted are being told to attend their appointments as scheduled.
Waitematā DHB director of hospital services Cath Cronin reassured patients that they would be providing safe and high-quality care to both inpatients and emergency patients over these strike periods.
"The number of staff participating in the strike is yet to be confirmed, but our planning covers all scenarios,'' she said.
"Some patient procedures and appointments may need to be rescheduled. If patients have not heard from us, they should present to have their procedure or attend their appointment.''
Further south, the Counties Manukau DHB says a large number of its health services were unaffected.
Health chief medical officer Dr Gloria Johnson said the strikes inevitably meant that some non-urgent patient appointments and elective surgery may need to be rescheduled and would be contacting those people affected.
"We apologise to our community who have been impacted by this industrial action. It is an unfortunate and unavoidable consequence of the strike action undertaken by those of our staff who are members of the NZ Resident Doctors Association.''