A Northland GP is urging the district health board to be honest about institutional racism in its health services and stamp it out.
Kyle Eggleton, who works for Māori health provider Ki A Ora Ngātiwai, said systemic bias was a factor in disastrous Māori health statistics.
Dr Eggleton said he audited himself for bias when he worked in general practice and thought he'd be squeaky clean.
But he found he was much less likely to prescribe cholesterol-lowering drugs to Māori patients than to Pākehā.
"I came to the conclusion that I was making assumptions about people. So I would think 'well you're less likely to take your medications because you're Māori' - and that was a false thought.
"We have to challenge our own thinking in order to change our behaviours."
The same sort of false thinking lurked in the DHB systems, he said.
Māori health providers didn't get to design the programmes the DHB believed would help their people, the contracts imposed on them were often short-term and overly monitored compared with Pākehā providers and the nurses working for them were paid only 75 percent of what they would earn at the DHB itself.
Dr Eggleton said these the results were continuing high rates of third-world diseases like rheumatic fever and early death for Māori.
Northland DHB said it was well aware of the dangers of institutional racism and it had been working hard to eliminate it.
DHB chairperson Sally McCauley said the board had made great strides, including most recently, pulling together the region's two primary health organisations, Manaia and Te Tai Tokerau, to focus on addressing these issues.
"I'm actually quite surprised- because Northland DHB focuses heavily on our Māori, our Māori who we love and want to ensure that their health is as good as anybody's, and we provide the very, very best service for them, and access to services."
The DHB's general manager for Māori health, Harold Wereta, said the Māori health team had worked diligently to eliminate racial bias, starting with a compulsory programme for all staff on engaging with Māori. Staff had also had training in the Treaty relationship.
"We've had a very good response from clinicians, nurses, as well as staff and allied health and the administration side of the organisation."
Mr Wereta said some of the worst Māori health outcomes were showing signs of improving, but the problem of lower-paid nurses in Māori organisations was one the board needed to tackle.
He said maybe it was time Northland DHB went public about racial bias in health services because that would reflect the māhī it was already doing to stamp it out.