Health sector unions say a move by some senior managers to forego a pay rise is symbolic only, and should not be extended to others in the sector.
Director-General of Health Stephen McKernan and members of the Health Ministry executive leadership team will refuse pay rises this year, saying the move is in recognition of restraint needed during the recession.
Mr McKernan described it as a small but important signal during difficult economic times.
"There's very much a clear need for restraint both in the ministry and I think even in the broader health sector," he said.
Senior managers at Hutt Valley District Health Board have followed suit and a spokesperson for the chairpersons of all district health boards says others are considering their positions.
The union representing senior doctors, the Association of Salaried Medical Specialists, said these are symbolic gestures and deepening doctor shortages will not be resolved by reducing terms and conditions.
The Public Service Association said workers who did not get a pay increase when funding was more available still need one.
The union's national secretary, Richard Wagstaff, said clerical and administrative staff working for South Island boards receive lower pay than those doing the same jobs in other parts of the country, and there is no excuse not to fix such problems.