Sir – We should all be worried by the profound concerns of the majority of the health and social care professions about the consequences of this Bill even after numerous amendments, delays and backtrackings, should it ever reach the statute book.

Nobody in Government was mandated to pursue a top-down reorganisation of the NHS; indeed Mr Cameron categorically stated there would be no more top-down revisions and yet this Government has launched into this massive, destructive and costly atomisation of a precious (albeit imperfect) organisation.

It is fundamental to the principles of the NHS that the Government is responsible for a service to every citizen of this realm, free at the point of use. The passing years have seen this principle eroded by ad hoc charges and now, of course, by Scotland and Wales adopting their own control. But Westminster retains responsibility for the NHS in England. It is shocking to see the weakening and probable destruction of the Secretary of State’s ‘duty to provide a comprehensive health service’. The Bill is with the Lords now and will be returned to the Commons shortly. It is essential that this duty is unequivocally restored but, despite Government claims, amendments tabled so far have not secured it.

There are clearly other detailed points of concern but this appears to be the over-riding point to secure. Then the Secretary of State will be compelled to clarify the other anomalies and contradictions. I urge readers to press the point on their MPs and lobby the House of Lords to insist on the red lines set down in Professor Allyson Pollock and colleagues’ critiques.

(More information can be found on www.healthprofessionals4NHS.co.uk, www.keepournhspublic.com and www.allysonpollock.co.uk.) E.M. Birchall, Enstone