I'm a public health doctor and am increasingly worried by the fragmentation and additional layers of bureaucracy that the Bill will introduce.

At the moment, for better or worse, the responsibility for the health of every individual lies with the Chief Executive and Board of each Primary Care Trust. Whether it's a problem with your GP, local hospital or public health, it is the PCT's responsibility to sort it out.

Under the new system, if you have a problem with your local hospital, you will need to take it up with the Clinical Commissioning Group which commissions their services. If it's a problem with your GP, you will need to take it up with the National Commissioning Board who will be responsible for commissioning GPs. If it is a public health issue, you will need to take it up with the local authority.

The Health and Wellbeing Boards who are supposed to hold this all together in the new system have no real power as they do not hold the commissioning budgets and in any case will not have the degree of operational oversight needed to ensure a safe system

Competing interests: I work as a public health doctor in the NHS