Sir,- I would like to comment further on the points raised by your correspondent C. Daniels, (British Dental Journal 2003; 194: 466) regarding the annual retention fee for specialist lists. As he correctly points out, specialist lists are of value to the profession as a whole.

He also highlights the fact that some of the individuals on the specialist lists were accepted under grandparenting clauses, rather than by virtue of them having undergone formal training. Antony Townsend, responding on behalf of the GDC, attempted to justify the higher specialist fees with reference to the transition and set-up costs, particularly the conduct of appeals. It is reasonable to assume that the vast majority of appeals would have related to practitioners who, to quote your previous correspondent, 'would not be recognised as specialists in any other country'.

There will, of course, be differing opinions as to whether this was appropriate, and I do not wish to enter into that particular debate. Nevertheless, the GDC were effectively inviting practitioners who were generalists, and who would not automatically have qualified for specialist status, to be considered for inclusion on the lists; this only lends further weight to the argument that the set-up costs should have been borne by the profession as a whole.

Mr Townsend goes on to suggest that, now the transition period is nearing completion, a lower fee may be paid in the future. Again, one might argue why the transition costs for these arrangements, which will presumably now be in operation for many years, should be incurred just by one generation of specialists. With regard to his further point, about there being only two fee-paying specialties, I understand this is simply due to legislation not permitting fees to be levied on specialties which are at present only recognised within the UK.

One presumes that the non-fee paying specialties currently enjoy all the advantages (if indeed there are any) of those who do pay. Would it be too much to hope that, when legislation finally allows the GDC to levy a fee on all specialties, initial fee levels for those that are currently 'free of charge' will also reflect their notional contribution to the transitional costs, and thus allow the others to be recompensed?

It is noteworthy that the General Medical Council does not feel it necessary to charge additional fees, despite having a vastly increased number of specialties, with all the complexity that that entails. It is not the actual amount of money at stake which is my main concern, but rather the principle. The GDC appears to have adopted a policy that they think they can get away with, rather than one which is equitable. I remain unconvinced by Mr Townsend's arguments, and I suspect that a lot of my orthodontic specialist colleagues will feel the same way.