Bristol has high cancer mortality rate and too few MMR jabs
High cancer mortality rates and a low number of MMR vaccinations have been identified as the health challenges facing Bristol.
The issues were identified as primary care trusts prepare to hand over their role to clinical commissioning groups.
Dr Janet Maxwell, the city's director of public health, said the new groups were up to tackling those issues.
But former director Gabriel Scally said he feared they would "fall between the cracks" in the changeover.
The changes to the NHS are part of the biggest reorganisation since its creation.
'Legacy of smoking'
Dr Maxwell, joint director of public health for Bristol City Council and NHS Bristol, said: "We know we have major problems with cancer in the city and we've known that for some time.
"We have to use the possibilities of the new system, new arrangements, to help tackle that even better than we have before.
"We know the major preventable cause of cancer is smoking and Bristol does have this legacy of generations of people smoking because of the tobacco industry in the city.
"We still see that legacy now in some [deprived] areas of the city where 40-50% of people are still smoking on a regular basis.
"What we're ensuring is that we take services [such as stop smoking clinics] to where people are."
She said: "Any period of change is going to be difficult with people changing jobs. We are very mindful of making sure we get through that transition into the new organisation without services suffering."
Dr Scally, former public health director of the South West Strategic Health Authority, resigned last year over the changes.
'Shift some money'
"A decision has been made to split off important public health services like screening, like immunisations, and have them dealt with by clinical commissioning groups and by NHS commissioning boards," Dr Scally said.
"I think the whole thing is a potential recipe for disaster with this fragmentation of responsibilities in the system.
"I think we are going to have to be careful and very vigilant that some of these key issues like screening for cancer, like immunisation, don't fall between the cracks."
He said prevention programmes were not the only ones needed to tackle cancer.
"It's also early detection... being able to get into the healthcare system, get the investigations they need and get the treatment quickly.
"If the new system can do anything, perhaps it can shift some money towards the public health system [from big hospitals]."