The delivery of health services, including speech-language therapy (SLT), is influenced by the culture of the healthcare discipline and the unique cultural, social and political history of the country. Among the multitude of terms referring to cultural competence and related concepts, it is timely for the SLT profession in Aotearoa (New Zealand) to determine a unified and strategic approach to cross-cultural service delivery. This article examines foundational issues to consider before establishing that approach. The Aotearoa context is strongly influenced by colonization, te Tiriti o Waitangi (the Treaty of Waitangi), immigration and questions of biculturalism and multiculturalism. Within this, issues arise because the Aotearoa SLT workforce is not representative of the population it serves. Because of te Tiriti, it is necessary to begin by addressing issues facing Māori, the indigenous peoples of Aotearoa. These include health inequities, racism, color-blindness and white privilege. The Hauora Māori (Mā...