This paper notes that the debate raging between private sector and public sector delivery service systems ignores the fact that governance issues are central to efficient and equitable access to water. This paper starts by assessing the Millennium Development Goals and access to water and sanitation, stating that the official statistics are often misleading, underestimating the true scale of the problem of access to water and sanitation. Sections II and III cover the reasons why a debate between public and private delivery systems can be unhelpful for equitable delivery, particularly for the urban poor. Section IV discusses the difference between the business-as-usual bureaucratic approach to governance and the more effective transparent, inclusive and integrated approach that creates opportunities for all members of civil society to take part, not just the affluent or political elite. The fifth section looks at ways of improving the mechanisms for inclusivity, and Sections VI and VII examine two potential threats to this, namely the General Agreement on Trade in Services, and corruption. The paper draws the conclusion that the concerns surrounding governance for private sector participation in water services are similar to those for public sector management of water services, and that effective governance is equally necessary for both approaches.