Providing public, non-profit, and private sector services as cost-effectively as possible is a complex task and change is frequently found to be difficult. Nevertheless, progress is essential. Often times, the ultimate interests of the service user – the patient in the case of health care services, for example – can be overlooked in the drive to make component parts of the system, without keeping in mind the holistic nature of the individual’s needs. Focusing on the systemic behavior of the organization can lead to breakthroughs in service provision. Leadership of a high order is required to manage the interest groups involved.