Health workers heading interstate for better pay is one reason a NSW union is threatening "escalating industrial action" from next week.
Health Services Union delegates on Tuesday voted to recommend members take action unless the NSW government changed its offer of a four per cent wage rise by Friday.
The union wants a six per cent rise excluding super or a flat rise of $3500 that would most benefit those on lower pay.
A final decision will be made by tens of thousands of members in local branches at hospitals, ambulance stations and aged care facilities.
Wages had hit rock bottom in NSW and contributed to the 12,000 vacancies in the state health system, the union said.
Workers had been fleeing to Queensland, ACT and Victoria because the pay is significantly better and housing is cheaper.
"We are prepared to negotiate but the government needs to put an offer on the table for our members to consider," union secretary Gerard Hayes said.
Industrial action could take many forms including linen delivery bans, finance processing bans, stop-work orders and strikes.
It's the latest move in the union's fierce pay dispute with the new Labor administration.
Treasurer Daniel Mookhey was heckled and asked pointed questions about his own pay packet during an address to the union's annual conference on Monday.
The government's four per cent offer applies to all public sector workers and is on top of a mandated 0.5 per cent increase in super contributions.
If accepted, it will be backdated to July 1.
Health Minister Ryan Park is confident talks with unions will keep progressing but won't yet entertain an increase to the highest wage offer in the past decade.
"Discussions will take place with unions and with their representatives around what that might look like within a particular workforce," he said on Tuesday.
"But the treasurer has been very clear about that (offer) so we don't see that changing any time soon."
The health system had plans in place should union members take industrial action next week, he said.
If accepted, the government's wage offer would boost base pay by an extra $2204 a year for a hospital security guard, $2970 for a third-year registered nurse or a first-year paramedic and $9670 for senior specialist doctors.
NSW Health workers who salary-sacrifice will also see a bit more pay through the winding down of a tax measure that only affects those staff.
It comes after annual inflation to May reached 5.6 per cent, mainly driven by housing, food and household goods and services.
