The amalgamated hromadas shall arrange delivery of municipal services on their territory using their powers and financial capacities based on the opportunities provided by the decentralisation reform and government support for the sectorial reforms. This includes provision of healthcare services.

The rather difficult situation happened with the Bibrka City Hospital. The outdated equipment and abandoned premises have become the reason that many hromada residents receive specialised medical services in the city of Lviv.

Having thoroughly studied all the problems associated with the medical institution, at the second session in February 2019, the newly established Bibrska urban AH decided to create a communal non-profit enterprise "Primary Healthcare Centre". With the support of the Lviv LGDC, which explained the need to provide only primary healthcare at the level of AH, the hromada leadership took a clear position regarding the obtaining of primary healthcare.

As a result of the events, the hromada took over the authority to manage the primary link in medicine. The newly created communal non-profit enterprise hired exclusively those staff being able to build an effective network of medical services. At the last session of the Bibrska urban AH, the sum of 1.5 million was allocated from the hromada budget to repair the premises and to buy the necessary equipment for the family medicine clinic. During this time, the network of rural health posts was analysed, the optimisation plan was developed, and the agreement with the National Health Service was made.

Oleksandr Horyn, Chief Medical Officer of the communal non-profit enterprise "Primary Healthcare Centre" at the Bibrka City Council, says that the clear position of the hromada when setting up an enterprise makes it possible to take effective decisions. "We have already partially optimised the network of rural health posts, as some of them are generally unnecessary, while others, on the contrary, need to be preserved due to the popularity of services, and they need to be invested in. Because of proper start-up opportunities, we will gradually complete the whole network", said Oleksandr Horyn.

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