This paper discusses the major problems of planning and implementation that confront the development of comprehensive health services in India. The problems are categorised into four major groups, viz., those pertaining to decentralisation and integration largely dependent upon higher echelons of the organisation, including political; those relating to managerial processes, and those pertaining to the recipients of services and the interphase between the community and the health services organisations. The same are discussed in the national perspective, without specific reference to any particular state. A number of issues are raised to stimulate thinking and discussion.