The pay gap between public hospital staff and their chief executives has been described as 'grotesque' by the senior doctor's union.
The head of the Association of Salaried Medical Specialists said figures from the State Services Commission published late last year showed rising inequity between workers and their bosses
Ian Powell was scathing of some district health boards' decisions to give their chief executives pay rises while their hospital staff struggled to get by.
"The average salary band increase across all DHB chief executives was 3.5 percent - significantly more than the 0.5 percent average pay rise recorded for people working in public health in the year to June 2015.
Mr Powell said a recent State Services Commission report on remuneration movements for chief executives in the public sector showed that a number of district health board bosses had received large salary increases in 2014/15.
"Auckland DHB's chief executive gained about 12 percent, according to the SSC, although the DHB itself claims this does not take into account issues to do with the timing of 'at risk' payments.
"The two other big winners were the chief executives at Waikato and Northland DHBs, who are reported to have gained about 11% and 10% respectively."
Mr Powell said while there were chief executives who worked very hard, the inconsistency and unfairness in pay stood out.
He said the boards had a very poor understanding of labour markets and how they reviewed their performances.
"It's essentially achieving lines on paper, achieving a perception of financial goals, cost-cutting, which inevitably comes at the expense of reducing the quality and range of services being provided."
The industrial advisor for the Nurses Organisation agreed.
Lesley Harry said nurses' pay did not reflect their increasing responsibilities and workload.
"When the pay increases are in the realms of 23 percent more which was the case for some DHBs that really is disproportionate.
The disparities caused low morale, said Ms Harry.
The Ministry of Health declined to be interviewed, but in a written statement, the Lead Employment Relations Chair and Chair of the Bay of Plenty DHB, Sally Web, refuted concerns that salaries between ceos and staff were out of kilter.
'We believe the statement does not correctly represent the positions of all staff across the health sector. Salary negations in the sector are across a number of different unions and national Multi Employer Collective Agreement and cover many different issues ranging from percentage increases to change in salary steps. All this needs to be considered when looking at the total increases.'
Ms Webb said a chief executive's salary was set by individual District Health Boards boards in liaison with the State Services Commission.
There are 20 DHBs in New Zealand.
Ms Webb said 'any comment regarding chief executive salaries would need to be sources from the individual Board Chairperson'.