Sir, I am writing to add my voice to the concern, which is emanating from the profession, about the new NHS dental contract.

In particular, I think that the means by which money is distributed in the new contract is much too rigid. Money now flows to the practices from the PCT, rather than via the patient as in the old model. This is an obvious and perhaps intended consequence of the new arrangements. The power to 'spend' money has been taken from dentists and given to the state. Yes devolved locally, a local command economy, but ultimately controlled by the treasury.

In our area the downside of this model has come quickly. Our primary care trust has now 'spent' its dental budget for the year. As the great majority of practices joined PDS, the budgetary problem has been caused by a combination of perhaps over generous PDS contracts to retain existing NHS practitioners and a fall in patient charges, which has had to be underwritten by the PCT. Extra NHS provision has been provided with recruitment of foreign dentists and this is welcome.

There is no money for growth in our area. If a practitioner wants to increase their NHS commitment it will not be possible during 2006/7. If a Vocational Dental Practitioner wishes to stay in the area after VT will they get a contract?

I think that the contract is also bad for patients. The money has ceased to flow to practices with the patient. There is no incentive to take on new patients with a fixed contract value, and certainly no incentive to embark on, for example, a molar endodontic treatment, when there are an equal number of units of dental activity available for an extraction. How will a patient with high treatment needs, in an exempt category, but without a dentist be able to get treatment other than emergency care?

I listened with interest to a recent Radio 4 programme discussing the successes and failures of this government. The point was made that good governance had followed wide consultation and lengthy reflection prior to policy launch. When policy was put forward without this proper period of reflection and consultation, and what I would describe as the 'back of a fag packet' mode of administration occurred, poor policy ensued.

I am afraid that the new contract, and especially the late entry of UDAs, shows all the hallmarks of policy written on the back of a fag packet.