The Waitangi Tribunal says it is taking far too long to calculate how much compensation Māori health services should get to make up for years of underfunding.
In a report, released today, it said any further delay risked compounding the prejudices Māori have already suffered in the primary health system.
The tribunal also called on the government to ensure the newly-appointed Māori Health Authority is given enough money and power to uphold tino rangatiratanga.
The recommendations are the outcome of the tribunal's Health Services and Outcomes Inquiry, Wai 2575, which started in 2016 and has heard from more than 200 submitters.
It has already found the Crown had breached Te Tiriti o Waitangi by failing to actively address Māori health inequities, and had failed to uphold its obligations in the primary health sector.
In assessing the progress made since, the tribunal called the Māori Health Authority a significant and positive development.
But it had a warning.
"The well-worn adage that 'the devil is in the details' is relevant here; the quality of the authority's governance and where it's ultimate accountability will lie are crucial details that go to the heart of the stage one claims.
"The Māori Health Authority's mandate appears clear. What remains uncertain is the ability of Māori to exercise that mandate effectively and in accordance with tino rangatiratanga."
The report warned that if the Crown supports the establishment of the authority, but fails to fully uphold and empower tino rangatiratanga, then it will be acting inconsistently with its treaty obligations.
The tribunal also highlighted the poor progress in working out how much Māori health providers have previously been underfunded by, and what compensation should be.
A methodology was meant to have been agreed between claimants and the Crown to quantify the extent of underfunding of Māori primary health services since 2000.
An independent report commissioned by claimants, as a start point, showed there had been significantly underfunding since 2000 - and it had cost the country billions of dollars.
But the tribunal has expressed disappointment that little progress has been made since.
"After more than two years, we are disappointed that this is largely due to the Crown not engaging with the claimants on this issue," it said.
"The longer this crucial work is delayed, the more the prejudice Māori have already suffered as a result of ongoing health inequities is exacerbated."