It is a truism that the approach to and the organization of the delivery of public goods and services cannot remain immutable over time, impervious to the changes in the economic, social and political contexts within which it occurs. Continuing changes in the economic, social and political environment require that the approaches to the management, organization and financing of the delivery system should also change if it is to remain cost-effective, quality-responsive, beneficiary-friendly and efficient. Otherwise, it is more than likely that the system would be irrelevant to the actual requirements of the community, at cross purposes with the realities of the policy and increasingly a captive of the more affluent sections of the community. This study has opted to take a long-term holistic view of the likely future demands on the system and of the structures, organization and processes that are necessary to meet demands. In adopting this approach, the study questions the structures, organizations and processes thathave evolved over time, and recommends the institution of radically new ones, rather than tinkering with what exists. The study attempts to deal with the issues related to the organization, management and financing of the delivery of health care by the public sector. The study also discusses the emerging reality within which the public sector healthcare delivery system operates and is likely to operate in the medium term. The study provides an overview of the existing public health care delivery system and also discusses the issues thatarise therefrom.