The subject of this paper is long range planning or policy development for healthcare in the Netherlands. Especially the co-ordinating function of planning will be discussed. In healthcare different actors or stakeholders are involved. Each of these actors may have their own interests, expectations, goals, and knowledge. The main goal of this paper is to discuss the alleged centralisation versus decentralisation dichotomy in healthcare strategic decision making and planning. The development of facilities for radiotherapy is used as an exemplary case for this explorative research. The radiotherapy case illustrates that a more centralised, comprehensive, and systemic way of planning and strategic decision making might be necessary to take into account and balance the different developments, which are relevant for this specific problem field, at the macro level. This kind of strategic process involves inputs from medical specialists and other experts with various disciplinary backgrounds. All relevant knowledge regarding facts and trends on demographic, social, epidemiological, technological, and therapeutic factors, and also those concerning the basic disciplines (such as biology) should be collected and analysed to obtain the insights needed. This expertise can not be found on a local or even regional level. It requires initiatives from co-ordinating boards like the Health Council, but also professional bodies play an important role, next to initiatives from influential and respected individuals.