Sir, some years ago (1990/92) when dentistry was in crisis the BDJ published a letter from me under the headline No alternative. The letter was copied, dissected and discussed by many of the dental papers at the time. The situation has not changed and the sentiments expressed then are still valid. There is one change however in that I am now retired from general dental practice. I made the changes that my bank manager urged and enjoyed a hard working but moderately rewarding final decade in dentistry. The previous 27 years, utterly committed to the NHS GDS, had become increasingly dire.

The GDP of today owes nothing to the NHS. The GDS owes today's GDP for the infrastructure that s/he has provided, also for the employment of staff and the business risks taken. The GDP of today needs to be at least as 'businesslike' as the NHS authorities. Indeed the NHS expects him to be so and loads him with debts and responsibilities. Placing the NHS logo on a document does not sanctify it.

GDPs can expect a real reward for their efforts, not a formulaic obfuscation that hides the truth. The nGDS Draft Contract is built upon the 'discredited' formulae of the past and is therefore of little use to GDP or their patients. The treadmill has not been removed, just disguised. If implemented nGDS will define what dentistry is for a generation to come and thereby dumb down British dentistry and move it even further from First World norms.

I urge GDPs to grasp the nettle and take their own, their families' futures and their patients' welfare into their own hands. Difficult decisions will need to be taken whether 'to stay' or 'not to stay'. Whether they wish to run a charity or a business must be decided. Change is in the hands of every practitioner, not just in the un-negotiated edicts of DoH.