Purpose: The purpose of this research is to investigate the effects that privatisation of primary level in 2005 had on the healthcare system and its stakeholders in Macedonia. Context: The transition of the country from command to market economy has also imposed reforms in the healthcare sector, bringing the concession model as an outcome of the intended improvement of the efficiency of service delivery on primary level. And while the primary healthcare has been reformed with success in regard to some financial indicators, undertaking it as isolated segment, has imposed other challenges to its structural and functional existence within the healthcare system. Methods: Through desktop research and questionnaire survey, this research is looking into the effects of the transformation of primary healthcare on the functionality of the delivery of health services, especially focusing on the links between the primary on one side and the preventive and secondary levels on the other. Findings: The initial findings show that the links between the primary healthcare and the preventive and secondary levels of care have been disrupted, and that the regulatory and policy mechanisms are yet to be established in order to regain the continuum of care for the patients. Conclusion/Discussion: Primary care together with the preventive services provides the essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community at a cost that the community and the country can afford. Due to its crucial role as main pillar of an effective healthcare system, the primary care should be placed at the focus of every healthcare reform, especially in the developing countries and the transition economies alike, towards providing sustainable healthcare systems that can provide patient-centred care for all. [ABSTRACT FROM AUTHOR]