A ten year review of developments in the organisation and management of allied health services in Australian acute care public hospitals reveals a steady transformation away from a medically managed universal model towards more complex and contested models of governance. This article revisits early observations about the reorganisation of allied health services and presents more recent research findings to guide managerial decision-making about restructuring the diverse disciplines that constitute allied health. A new organisational model “integrated decentralisation” is presented as an approach to managing allied health services which accommodates multiple stakeholder demands in the context of New Public Management (NPM) related reforms. The focus on the institutional level is complemented by examining developments in the profile and activity of allied health at the regional, state and national levels to present a more comprehensive picture of change over the decade of the 1990s.