The health agency says it has put a fair deal on the table, but the executive director of the Association of Salaried Medical Specialists, Sarah Dalton, told Morning Report the increase on offer of $15,000 - $26,000 failed to keep up with inflation.

"Our members are really fed up and a number of them are angry at the inability to get their employer to give them an inflation adjustment."

Dalton says there was also a degree of what she termed "jiggery-pokery" in the figures offered in the latest mediation round.

"Te Whatu Ora have included regular salary-step increments that members would get irrespective of whether we're bargaining or not into those numbers, so we would say they have inflated those numbers beyond what's actually on the table."

But Andrew Slater, chief people officer at Te Whatu Ora, told Morning Report the current offer was the best the agency could provide given the competing demands it was facing.

"We think that there's a fair offer on the table, we re-shaped the offer last week, we added about an additional 16 million [dollars] to the deal and we really were hoping that the union would take that out to its members and test it," he says.

"The offer that's on the table is the best offer that we can provide."

Te Whatu Ora had inherited pay issues from 20 district health boards that had been competing with each other for doctors, he says, and the agency had made "a number of funding reprioritisations" in order to put the deal that was on the table together.

But Dalton says Te Whatu Ora had not provided the union with any compelling or detailed reasons why it was unable to meet its demands.

"I guess that's one of our frustrations - not only, they will not meet our offer, but when Andrew and his colleagues talk about that their offer is fair and that they can't offer more because of other priorities, they've either been unwilling or unable to explain to us what they mean by fair, and what those other priorities are," she says.

"They haven't been able to give us any kind of a meaningful response, so all we can do is go back to our members and say 'they haven't offered what we've asked for, and they haven't given us a compelling or a detailed reason why'."

New Zealand's health system was short at least 1700 doctors, Dalton says, and some of the things the union had asked to be considered during the most recent negotiations - such as a 'public only' allowance for people who chose to work only in the public system, and rural and regional allowances "to encourage redistribution of our workforce to places who really need more doctors" - had not been addressed.

New Zealand also relied "very heavily" on overseas-trained doctors and dentists, so was competing for staff in an international market, she says.

"We have nearly 50 percent of our senior medical and dental workforce trained overseas, and now, as we try to recruit, people simply aren't applying for jobs."

She says she would not apologise for the salaries doctors and dentists already earned as they had trained in their fields for many years and their earnings had been hit by inflation in the same way as other professions.

"If your health employer is saying, 'we can't afford to pay doctors enough to maintain the value of their current earnings' I would really love to know what is a higher priority than keeping those doctors here in New Zealand working."

Slater says it was "regrettable" that negotiations between the two parties had been unable to avert tomorrow's planned strike action.

About 250 planned care procedures would be impacted, he says, but Te Whatu Ora had contingencies in place for such eventualities and emergency departments would be open.

Slater says surgery patients with appointments scheduled for tomorrow should turn up for those appointments unless they had heard from Te Whatu Ora.

"We would've either contacted you or we will be contacting you in the coming hours."

Negotiations between Te Whatu Ora and the union would resume on Wednesday, Slater says.

- RNZ.