Sir, the legislative jigsaw relating to the new NHS contract has fallen into place over a period of time but one piece – the National Health Service (Performers List) Amendment Regulations 2005 which went on the statute books on 13 December 2005 escaped most people's attention.

Whilst the main Performers List regulations encompassing medical performance came out in April 2004, the dental implications of the amended legislation are extremely significant:

  1. a

    Undergraduates from UK dental schools will have to undertake vocational training (VT) to obtain a place on a Performers List. They will have to take any VT job going no matter what the location as they no longer have the opportunity to become an assistant for six months before finding a VT place that suits them.

  2. b

    Undergraduates who take house officer posts will also have to do Vocational Training or demonstrate the equivalent to a year in general practice after their house jobs to be allowed onto a Primary Care Trust's Performers List.

  3. c

    Non-EEA (European Economic Area) nationals will have to do vocational training or demonstrate the equivalence of VT, the process of which will now be a function delegated to PCTs and Deaneries since the Dental Vocational Training Authority (DVTA) has been abolished. This means that dentists from countries such as South Africa, Australia and New Zealand who traditionally took up assistant posts and worked on the practice owners' contract numbers will not now be able to do so very easily.

  4. d

    Those dentists who have been enticed by the Department of Health to acquire the IQE will not now be able to practise on the NHS without a further year of vocational training or its equivalent unless they were assistants working in the NHS prior to 31 March.

  5. e

    In complete contrast anyone who was an assistant on 31 March 2006 automatically goes onto the Performers List even if they have been in the country for a short while or have no training or experience comparable to vocational training. This potentially presents a real risk to PCTs who may find themselves performance managing dentists who lack the relevant experience or skills necessary to work in the NHS in the UK.

  6. f

    Anybody graduating from EEA countries can join a Performers List subject to the usual conditions but will not have had to do vocational training or demonstrate equivalence.

All these have huge implications for the movement and employment of dentists and far reaching consequences for manpower predictions. Add to this the increasing number of part time associates whose contracts are not being renewed by practice owners whose NHS contract value and UDA allocations are limited, and you have a serious problem in the making. Unemployment in dentistry has arrived.