A new survey reveals a significant shortfall of senior doctors at Wellington's Capital and Coast District Health Board (CCDHB), the senior doctors' union warns.
Clinical leaders surveyed at the DHB said there was a shortage of 46 full-time clinicians, while only 13 full-time vacancies were being advertised.
The union said 17 out of 24 clinical heads of department responded to the survey, which was carried out between June last year and January this year. They pointed out there were not enough doctors to cover clinical service needs.
"It's become the norm that we have entrenched shortages in our public health system, and it's become the norm that specialists are overworked," Association of Salaried Medical Specialists executive director Ian Powell said.
"One of the results of that is that we actually have a 50 percent burnout rate of specialists in our public hospitals, which is an appalling situation."
The study followed similar surveys at the Hawke's Bay and Palmerston North MidCentral DHBs.
"This is not simply a Capital and Coast issue," Mr Powell said.
"What is clearly emerging is that this is a national phenomena, and it's a deplorable one, and it's an indictment of the leadership of our health system that we have got to this state."
Mr Powell said clinical leaders pointed to rapidly increasing acute workloads, with one referring to the latest assessment of their workload, called job-sizing, as a "sham".
He said doctors suffered stress and burnout as a result.
"Our estimate is that since 2010, in relative terms, $1.5 billion at least has been sucked out of the district health boards from government. Now, it is in a sense the specialists [who] are paying for this financial retrenchment with their health."
DHB actively recruiting 'in New Zealand and overseas'
Capital and Coast DHB wouldn't be interviewed, and could not say whether it was short of 33 specialists.
In a statement, chief medical officer John Tait said its standard practice was to fill all clinical vacancies.
"We actively recruit in New Zealand and overseas, however - like other DHBs - we are seeing a shortage in the number of senior doctors who are available to take on these roles. Where we have difficulty filling vacancies, we use locums to fill the roles in the short term."
Over the past 12 years, the number of senior doctors that had been working across the DHB had increased to match demand for services, Dr Tait added. He said CCDHB currently had 408 senior doctors - approximately double the number it had in 2005.
Meanwhile, senior doctors are getting a pay rise after more than a year of negotiations with all 20 DHBs. Under their new collective agreement, which runs to March 2020, senior medical and dental officers will receive a 6 percent rise over almost four years. They get nothing in the first year, until July this year, and 2 percent a year after that.
Two new steps are also added to the top of the pay scale, lifting their base salary from $227,500 to $240,000 in 2019.
Mr Powell said doctors did not get everything they wanted, but it was good to have a deal. "It's a good settlement, it's not a great settlement. It falls short in some critical expectations but nevertheless we hope it will go some way to at least retaining more of the specialists that we currently employ."
DHBs welcomed the prospect of a significant period of industrial stability.