Nick Saville-Wood's favourite sentence in te reo Māori is "kei te pehea koe?".
The phrase, which means "how are you?", is perhaps fitting for the Lakes District Health Board chief executive, who has been taking one-on-one te reo Māori lessons roughly twice weekly for a year.
Saville-Wood said learning te reo is part of what he and many other leaders in the health sector are doing to try to address inequities in Māori health.
He said the district health board is trying to encourage staff's familiarisation with te reo as well, with polytech level courses in Māori language.
"Although about 38 per cent of [Lakes District Health Board's] population's Māori, about 50 per cent of our patients that come through [Rotorua] Hospital are Māori, which is an indictment in its own right, but be that as it may, with our socio-economic deprivation levels in this town, that's to be expected.
"The ability to be able to greet and welcome people in te reo I think has a huge ability to make people feel comfortable in our environment, which is a scary environment in the first place."
He said one of the biggest challenges in the health system was equity.
"Our statistics definitely indicate – across the country - that there is an equity issue for services for Māori and services for Pākehā. That being this DHB's biggest priority, it is vitally important that we get, in partnership with iwi … a good idea of what we can do that will change that paradigm."
He said he saw te reo as an indelible part of that.
"It's our journey from moving from a providing a Pākeha worldview on things to a te ao Māori worldview.
"We have to do that with the direction and participation of Māori. Te reo happens in that particular arena.
"If you don't have an interest in te reo that can be an impediment."
The cost for each session Saville-Wood takes is $125, which in the last financial year came to $6850. As part of the chief executive's professional development, this was based on "evaluation of priority and ongoing need", according to a Lakes District Health Board spokeswoman.
"As such, there is no specific budget."
Staff te reo classes were run through Te Whare Wānanga o Awanuiarangi at no expense to the health board, as they were covered as a Tertiary Education Commission initiative which had been trialled since 2019.
The health board's latest Te Kaoreore Dashboard – which measures Māori health outcomes – showed Māori were more likely to present at the emergency department, more likely to have small babies and Māori babies were less likely to be immunised by the time they were eight months old. Māori were also less likely to attend outpatient clinics, both under and over the age of 15 years.
Massey University Māori health expert Professor Chris Cunningham said one major issue for Māori health was what he called "cultural dissonance" where Māori tended to feel out of place in a Western medical environment.
He said cultural dissonance could lead to anxiety and discomfort in the health setting as well as miscommunication.
Cunningham said health leaders learning te reo Māori was a step toward bridging that gap.
"It's got to be a good thing."
However, it didn't have a large impact alone and needed to come alongside a wider change to address inequities.
He believed the health system struggled to understand the "mechanism" by which inequities occurred – that is, the root cause of it.
"Then we are forced to have a conversation about racism and people get uncomfortable and shift in their seats. But it's one of the main explanations for it."
Cunningham believed the planned Māori Health Authority "might be the sea change we need" but he was keen to see what happened on "day two" of the organisation and how it would make the impactful changes needed to address Māori health inequity.