Abstract
"He aroha whakatō, he aroha puta mai" – if kindness is sown, then kindness you shall receive. Kindness in healthcare is often treated as an individual quality. Less attention has been paid to the organisational and relational conditions that sustain kindness in the daily reality of healthcare work. This study explores those conditions in a specific and instructive context: a large kaupapa Māori primary care organisation in Rotorua, Aotearoa New Zealand. Working in partnership with Korowai Aroha Health Centre, we conducted a co-designed modified expert panel with fifteen staff members representing clinical, administrative, community and leadership roles. The activity was informed by participatory action research principles and structured within a socio-ecological framework to explore the conditions for kindness at individual, team and organisational levels. Participants described kindness in relational terms, as something built through many small daily choices and interactions rather than through isolated acts. Kaupapa Māori values, including manaakitanga, whanaungatanga and the protection of mana, were consistently reflected in participant accounts, not as abstract principles but as practical descriptions of how people worked together each day. Conditions identified across all three levels included self-reflection and reciprocity, seeing colleagues and patients as whānau, open and honest communication and protected time for connection. At the organisational level, participants identified the role of governance, business models, cultural investment and resourcing in either enabling or undermining these relational practices. Sufficient funding, careful hiring and workload design were not peripheral but understood as central to whether kindness could be sustained at all. While grounded in one specific kaupapa Māori context, this study offers something not yet present in the kindness literature: an account of how Indigenous values and organisational infrastructure interact to shape the conditions for kind practice—and what that means for how kindness in healthcare is understood and supported more broadly.