Field investigation of 27 medium to small water systems in Ontario Province has revealed a pattern of deviations in operations that is similar to those reported in the United States over the past 25 years. In this recent Ontario survey of water utilities, the key findings were: (1) a need for full cost pricing of public water supply to consumers; (2) better understanding of water treatment train performance; and (3) a need for management driven accountability to search beyond regulatory minimum requirements for safe water quality. Much of the deteriorating state of operations was a reflection of limited financial base to support an effective management programme. In the survey, small utilities were found to suffer the most from below cost operations which forced the application of a patchwork approach to water treatment and system repairs. Furthermore, small system water plant operators had rare opportunities to take part in workshops on technical issues. These utilities need to partner with the public on water supply issues for financial support to cover daily operations, infrastructure decay and emergency repairs. Ignoring system problems or applying patchwork remedies will eventually lead to unsafe water quality if the current state of affairs is not recognized as a dangerous public health risk.