Health staff owed billions of dollars for botched Holidays Act calculations feel they are being "doubly punished", as Health New Zealand makes savage budget cuts to pay for them.
Te Whatu Ora's latest quarterly report, released on Thursday, shows the cost of Holidays Act breaches and untaken long service leave has now hit $3.6 billion - up from $3.2b in December.
What it owes - and the cost of fixing the problem - rose another $170 million in the quarter to the end of June, as the total (unaudited) deficit for the year neared $1b ($934m).
Nurses Organisation chief executive Paul Goulter said much of the so-called "unbudgeted" staffing costs blamed for Te Whatu Ora's worsening financial outlook should not have been a surprise to health officials - or the government.
"This is a self-inflicted wound by Cabinet," he said.
"As far as we can tell, it is due to the failure of Cabinet to approve the full pay equity payout - and that left Te Whatu Ora carrying a large chunk of it on its balance sheet - round about half a billion dollars."
The holiday pay "fiasco" had been dragging on for years, Goulter said.
In August he wrote to Health NZ chief executive Margie Apa on behalf of his members to protest repeated delays in making agreed payments - and the agency's recent decision to "pause" the approval of consultants to fix payroll systems.
"Quite frankly, what our members are saying 'We still haven't even got it - so why is this being brought into account when we haven't got the money?'.
"And they're increasingly angry about Te Whatu Ora's inability to pay what's owed."
The multiple payroll systems still used by the former district health boards were "incapable of doing the job", Goulter said.
"But the point is, this has been around for many years. These workers are still largely waiting for their money.
"And now they're being doubly punished for it because they're being told there's this massive deficit and they're going to have to make cutbacks."