Funding woes have left Hawke's Bay DHB struggling with a lack of senior doctors, according to their union.
Data supplied by the Association of Salaried Medical Specialists shows Hawke's Bay has a 20 percent shortfall in the number of senior doctors it needs.
"Too much work is being carried on two few shoulders," says executive director Ian Powell.
"Senior doctors… make decisions that determine whether people's lives are improved or not, cured or not, saved or not, whether patients are harmed or not. With a 20 percent shortage of them, that's a very, very difficult and stressful situation."
Not only is there a shortage, Dr Powell says the DHB isn't even trying to fill most of the vacant roles due to a lack of funding.
"Compared with 2010, district health boards today are getting $1 billion less," he says.
In the meantime, senior doctors employed by DHBs are having to carry the load when others are sick or need to take leave.
"In about 54 percent of the situations there's not adequate internal cover," says Dr Powell.
"When it's for longer-term leave, 64 percent of heads of departments believe there's inadequate access to locums, temporary appointments made from outside the DHBs to cover them."
Surveys are planned at other DHBs around the country.
"We don't necessarily think it's unique to Hawke's Bay."