The Associate Minister of Health Peeni Henare says the tide has turned in the relationship between Taranaki District Health Board and Māori health providers, but changes need to become permanent.
A month ago, Māori health leaders told a visiting Henare they were frustrated dealing with the DHB.
They have since voiced concerns around resourcing Māori Covid vaccination efforts, and with poor communication and collaboration from the DHB, resulting in low jab rates especially for younger Māori.
Henare said he was upfront with the DHB and they have responded.
"I do think that the tide has turned here. What I witnessed today is very different to what I witnessed a few weeks ago when I was here."
Vaccination rates in Taranaki have now reached 68 per cent of eligible Māori for first doses, and 46 per cent for both doses.
That's 16 per cent and 20 per cent behind the overall eligible population, but is also about 15 per cent better than Māori rates three weeks ago.
Henare said the change needed to continue and be locked in for good.
"I was quite clear today to all players… that my expectation is that this doesn't just change for the vaccine, it changes for everything."
Henare said child immunisation and health checks have fallen away due to the focus on Covid.
He said Māori health providers need to be involved in DHB decision-making from the start.
"Māori health providers prove themselves time and time again and they should be given that chance… They have to be there from the start and not as an afterthought."
The chief executive of Taranaki DHB, Rosemary Clements, said she would not concede that there had been failings in Covid vaccine rollout for Māori.
"What happened was there was an emergency situation – which is what this is – going on, and that everybody was charged with working together."
"And I think that when doing that in a fairly anxious state, let's face it, then I think that there's room for miscommunication and misunderstandings."
Clements said the DHB had made changes.
"Far more of an open-door policy: we're certainly talking."
She said she now met weekly with the region's iwi chairs and leaders of the Māori health providers, and a healthy relationship had developed.
"I meet once a week with the [iwi] leaders… and then our teams are meeting three times a week [with Māori health providers] to assess where they're vaccinating, where they need to go next and I think it's going really well."
Clements said mobile clinics and vaccination camper vans, walk-in vaccinations rather than appointments, and incentives such as ice cream vans and a bacon buttie breakfast were attracting more to vaccinate.
In South Taranaki, Te Pāti Māori co-leader and Ngāti Ruanui leader Debbie Ngarewa-Packer said any improvement has come from Māori efforts.
"The reality is it's improving because we're overreaching in our relationship management. We've literally allocated people around us to be wholly focused on being the interpreter and the engager with TDHB."
Ngarewa-Packer said the problem was a fixed management mindset that refused to accept it was wrong.
"So we have a huge culture issue. If Rosemary can't accept that there were failings can she at least accept that we were right? The only thing that's changed is we have stood up."
"What I have seen, all good intentions aside, is that this is a DHB that is not fit for purpose for some of its community."
"I'm on the ground so it's different, I'm talking from what I've seen. TDHB is still the same TDHB, the difference is they now have Government ministers looking at them."
In North Taranaki the chief executive of health provider Tui Ora, Hayden Wano, was more optimistic.
"I would say there's a strong focus and good motivation, and the level of communication is the best I've seen in terms of the number of people involved in these conversations."
Wano said there was now much better collaboration across the region, including the DHB as a critical part of the sector.
He said when things don't work there's a network of people able to create a breakthrough.
"There's a sense of urgency and sense of a common purpose and that's backed up by our willingness to work together."
"There's collaborations happening at lots of levels and I think that we're starting to see the signs of that. I mean a month ago we had 49 per cent of first shots for Māori and now that's increased to 68 per cent within a month, so we're starting to see the effects of our collaborative approach."
Like the minister, Wano also wants to see the lessons of the vaccine rollout continue.
"The silver lining on this, although we've got a challenge in front of us, is that we can build some of these things, the way we're operating now, into the future."