This article is based on a consultancy report dealing with environmental health that was undertaken for the West Coast District Municipality in 2004. It has two main objectives. Firstly, it is an examination of the most costeffective and efficient options for the delivery of this service. There was a dispute between the West Coast District Municipality and some local municipalities in its jurisdiction about which level of local government should provide the service and the consulting team was brought in to consider various options in this regard. Secondly, this article attempts to locate the environmental health function between district and local municipalities within the academic discourse on political decentralisation. It argues that the decentralisation literature does not deal adequately with situations where there are two-tiers of local government sharing powers and functions. This has contributed to a vague and conflicting set