Senior doctors have voted to strike for 24 hours next month – set to be their most significant strike yet, in a nationwide move.

Members of the Association of Salaried Medical Specialists (ASMS) – the senior doctors’ and dentists union – employed by Te Whatu Ora have gone on strike twice in two weeks, each for two hours.

On Friday, members voted “overwhelmingly” in favour of two additional strikes in October: a 12-hour strike on October 2​, and a 24-hour strike on October 24​.

Te Whatu Ora (Health New Zealand) says the 12-hour strike will disrupt planned care for 500​ patients – 200​ who had already been waiting “a long time”.

The 24-hour strike would have a “much greater impact”, with up to 1700​ patients’ care deferred, 350​ of whom have been waiting “for quite some time”.

ASMS executive director Sarah Dalton​ on Friday afternoon said “it’s time for Te Whatu Ora to walk its talk about valuing senior doctors and dentists”.

It was not a decision taken lightly, Dalton said.

“However, they see services unable to operate as they should every day – now they are standing up to keep doctors in our struggling hospitals.”

Doctors want quality time with patients and whānau, not more overtime, she said.

At present, doctors were experiencing high levels of burnout, overwork and moral injury, trying to cover “massive” workforce gaps.

“Te Whatu Ora’s refusal to provide an inflation adjusted salary is rewarding specialists going the extra mile with a pay cut,” Dalton said.

She said there are “many issues” confronting the health system, but salary is “one problem Te Whatu Ora could solve today if they chose”.

Urgent care would still be provided during the strikes, Dalton said.

ASMS and Te Whatu Ora (Health New Zealand) are set to go back into mediation on September 19, ahead of a further potential four-hour strike signalled for September 21.

This week, striking doctors described to Stuff the “real life and death consequences” that understaffing, “decrepit infrastructure” and chronic delays can have on people.

“It hurts us when our patients can’t get an MRI for 12 months, or when patients spend 24 hours in the emergency department waiting for a hospital bed to become available on a medical ward,” emergency medicine specialist Dr Gary Payinda earlier said.

“People suffer, some die. We are witnesses to that harm.”

Te Whatu Ora said it was “extremely disappointed” ASMS had indicated further strike action without letting members know the details of the current pay offer.

Chief executive Margie Apa​ said it is “very concerned about the impact on patients from any ongoing industrial action, particularly those who may have been waiting for surgeries or appointments for some time”.

To date, 500​ people have had their care disrupted by the strikes, she said.

“That’s a real shame and will no doubt cause frustration and anxiety for those affected and their whānau.”

Apa said health officials will endeavour to rebook affected patients as soon as possible, but some may have to wait several weeks or months as schedules are “so heavily booked”.

“Our goal to have no one waiting longer than 12 months for surgery by the end of December, except for orthopaedic, may be difficult to achieve now.”

Apa said Te Whatu Ora urged the union to present the latest offer made at bargaining to our senior doctors and dentists, so they can judge for themselves.

This included salary increases over the next year of 7%​ and 12.9%​, amounting to between $15,000​ and $26,000​, she said.

“We have looked at every possibility to further improve the value of the offer, but to do this would involve finding it from elsewhere, and we would need to do that work – something that is very difficult.”

In the meantime, contingency planning continues for the already-scheduled four-hour strike next Thursday.

Patients were urged to attend their appointment or surgery unless told otherwise.