This article focuses the necessity of a change in health services, overcoming the factors that are the cause of low performance. Special treatment is accorded to the management as a fundamental factor to reach the organizational objectives, through planning, coordination, direction and control. The management of health services requires knowledge and skill in the technical, administrative and psychosocial dimension. The manager must mobilize and engage his personnel in organization and production of health services. The idea of health team is reexamined, re-thinking the role of each professional. The logic of the public organizations where the interest of burocracy prevails over clientele interests is discussed. The manager as a decision-making person needs, to perform his functions, information, autonomy and references. In this sense it shows the importance of the health model and the question of decentralization.