The Ministry of Health is refusing to say if it will penalise district health boards for missing elective surgery targets because of the doctors' strike.

The 73-hour strike by the Resident Doctors' Association at 18 DHBs began yesterday and ends on Friday at 8am.

Only one of the 20 DHBs met the Government's elective surgery treatment target in November, the latest data published by the ministry, and nine failed by a significant margin. The target is that patients accepted for treatment receive it within four months.

Missing the target for four months in a row puts a DHB at risk of having some of its elective services funding withheld by the ministry.

Northland District Health Board chief medical officer Dr Mike Roberts. Photo / Supplied
Northland District Health Board chief medical officer Dr Mike Roberts. Photo / Supplied

Northland DHB's chief medical officer, Dr Mike Roberts, has said it is challenging to meet the target in December and January and it is almost inevitable Northland will miss it following the strike. This would put $1.5 million of funding in jeopardy for each month of missing the target after the ministry decided to act.

Hospitals have postponed an estimated 6000 cases of elective surgery and outpatient appointments so staff, especially senior doctors and non-striking resident doctors, can focus on emergency and acute care.

Roberts said the ministry position at first was that there would be no leniency over the impact of the strike on electives.

"They have now said that they are waiting to have a conversation with chief executives ... this week and may change their stance."

The ministry's acting director of service commissioning, Keriana Brooking, told the Herald today, "The ministry understands that there is some lost capacity, and that DHBs are collating information on the impact of strike activity, including postponement of elective activity, as part of their contingency planning.

"The ministry will review its position as this information becomes available."

Roberts also said there was concern that DHBs would not receive any extra state funding to cover the likely increased costs from agreeing to the Resident Doctors' Association's demands and that having to absorb the costs would erode the level of care for patients.

Brooking wouldn't comment on this, saying the costs of any settlement with the association was a matter for DHB chief executives.

Meanwhile, the DHBs' national co-ordinator for contingency planning, Anne Aitcheson, said hospitals had been running smoothly during the strike and had not needed to call on the life-preserving-services agreements with the association for members to come back to work.

"The rosters have held up great. Some of our bigger hospitals are still quite busy."

Middlemore's occupancy was up today, having got down to 92 per cent yesterday, and Waitemata DHB had reported 94 per cent today.

"A number of the regional hospitals are down to 80 per cent which in terms of the plan is where we want them to be," Aitcheson said.

The clinical head of Middlemore's emergency department, Dr Vanessa Thornton, said: "Over the last 24 hours, Middlemore Hospital was at 96 per cent occupancy, with 301 people through our emergency department.

"We continue to have a steady mix of medical and surgical cases consistent with a normal busy day at Middlemore Hospital. Cover continues to be provided by senior doctors, non-striking junior doctors and senior nurses.

"We are here for those who need us. However, during the strike if people are unwell and it is not urgent or severe then we encourage people to please contact their GP in the first instance."