The majority of health and medical services fall under the responsibility of county councils, whose representatives are elected by the residents every four years. County councils are obliged to provide health and medical services of good quality as well as to promote good health in the population. Primary care is delivered through 1 100 (public or private) primary care units in the country. In most of the counties, it is possible to bypass primary care and access specialist services directly (there is no gate-keeping).