In Norway, primary health care is characterised by decentralisation of both care of patients and general public health services to municipal level. In all but the larger municipalities, both these services are carried out by the same primary health care doctors. In order to strengthen the quality of the doctor-patient relationship, and the associated responsibility, four municipalities are testing out a system where all inhabitants are placed on a specific doctor's list. Since the design of the test primarily emphasises the doctor-patient relationship, many community health doctors and planners are concerned about how this will affect local public health tasks. The authors discuss the experiences from these four municipalities as regards the impact on public health tasks and suggest new ways of organising public health at municipal level based on the doctors' overall responsibility for their listed patients.