Transformation and development of organisational matters, characteristic for the 18th and 19th centuries, included the issue of public health care. The development of economy, social and medical sciences changed the understanding of joint responsibility of the state for public health. The Teresian-Josephine reforms in Austria, concerning public issues, including the sanitary-epidemiological matters, were enforced in the areas of Polish annexed territory in 1772 and 1795. The normative regulations for Galicia and Lodomeria from 1773, 1861, 1891 established the responsibilities and rights for medical practice, activities of sanitary institutions and general medical care for the society. Austrian sanitary legislation created central institutions and self-governed local structures, responsible for public health. Introduction of modern local administration had a deciding effect on the development of self-governed institutions in closed and open health care system. Apart from sanitary national administration, public health care matters were governed by local-governed authorities of the insurance sector and private subjects. This advanced decentralisation and handing of health care matters to local self-governments shaped the new system of public health care.