The provider of health services to Maori on the West Coast of the South Island has been told to sort out its problems, or risk losing its health board contract.
West Coast District Health Board pays Rata Te Awhina Trust $500,000 a year to deliver health care to Maori from Karamea to Haast.
The board has given the trust six months to improve its service which it says is failing to meet the needs of some West Coast Maori.
A new trust board led by local mana whenua was elected nearly a year ago to oversee the changes.
It has employed a manager to make changes and to give advice on where improvements can be made.
The board's deputy chair, Francois Tumahai, says the main reason some Maori are missing out is the large area the health care provider has to cover - the equivalent of Auckland to Wellington - and the costs and time associated with the travel.
Mr Tumahai, who is also chair of Ngati Waewae, says given the level of DHB funding, the existing staffing arrangement is unsustainable.
He says redundancies and changes to job descriptions are possible but assures Maori their local health services won't suffer.
The trust employs about 30 people. It also receives Government funding to provide welfare, education and justice services for local Maori.