When te Tiriti o Waitangi is upheld there should be no racism against Māori and in particular institutional racism should disappear, meaning there should be no health disparities and the aspiration of health equity could be achieved. At a moment when the Waitangi Tribunal is investigating health-related breaches of te Tiriti o Waitangi, we argue that institutional racism, a key determinant of health inequalities, has become normalised within the health sector. Anti-racism literature recommends planned, systems-based approaches to eradicate the problem. Historically the Crown response can be characterised by denial and inaction. The Crown has the power and resources to take action through mechanisms such as they are currently applying to child poverty and gender pay inequity. We need our new government to uphold our Tiriti responsibilities and require a plan to end racism in the New Zealand health system.