The embattled Rata Te Awhina Trust is bringing in more leaders with greater experience to sort out its problems.
Seven jobs will go and five will be created in a restructuring of the trust, which provides Maori health services on the South Island's West Coast.
The trust is contracted by the West Coast District Health Board and several government ministries to deliver health and social welfare services.
But the authorities have been worried for some time that the services being provided are inadequate and some Maori are missing out.
The trust has said the cost and time associated with travel over the large area it covers - the equivalent of Auckland to Wellington - has been blowing its budget.
The president, three managers and three administrators have been made redundant
They've all been guaranteed interviews should they apply for the five new roles of general manager, administrator, and three team leaders spread across the West Coast. Until now, all staff have been based in Hokitika.
Some administration of the trust will also be outsourced to reduce its costs, but it has allowed for a higher salary bill to attract more experienced staff.
The trust says the changes may take some months to implement, because historically it has been difficult to recruit health professionals to the West Coast.
It says it will now begin stage two of the restructuring, involving reviewing the contracts and how they're delivered. It says this won't result in more job losses.
