We are a two dentist practice who were in PDS for 20 months before 1 April 2006. PDS was working well and we were very happy and surprised that a change to our way of working was beneficial to our quality of working life and our patients.

For existing PDS practices the work reflected in the test period has not been translated to the nPDS UDA target. This is because of increases by PCTs to UDA totals to try and protect themselves against a patient revenue shortfall, for which they will be responsible under the new contract.

Approximate calculations of surgery time for treating NHS patients (taking into account time for CPD, Clinical Governance, Good Practice Scheme, practice meetings, holidays etc) give us each a target of 6.2 UDAs per hour. The acting Chief Dental Officer has suggested that a reasonable rate of work is 3 UDAs per hour.

While it is relatively easy to work at a rate of 6 UDAs per hour, eg two fillings, one filling and three check-ups, it is not easy to be rewarded with 6 UDAs per hour as they are of course only measured on completed treatments. We may have to forget about time for prevention due to pressures of UDAs.

The Government spin to take dentists off the treadmill by only measuring courses of treatment sounds good, but targets are of course dependent on the length of a course of treatment. These vary tremendously — I have a patient to be seen today who requires at least 10 teeth filling, a thorough scaling, and an extraction — not good value for 3 UDAs if you have to provide the treatment.

The CDO would probably argue that the patient whom you see, who requires one filling that can be done at the recall appointment, will generate 3 UDAs in about 15 minutes. This is fair comment, but how do we know that the swings will equate to the roundabouts in this untested UDA system? I don't think that they will, especially in an unfluoridated area of high dental disease. Is it a fair form of remuneration? Again, I think not.

The effect that this will have is an incentive to actively treat whether necessary or not, no incentive to produce quality work and certainly not to welcome new patients or lapsed attendees, who may well require much more work in return for the UDAs that they produce.

While the political spin 'opens up dental surgeries as NHS access centres' by finishing with patient registrations, we all know that this will not increase new patient access as practices are already working to capacity.

There are further problems when an associate or partner leaves. These changes are not taken into consideration by the new contract. The vacancy created has a financial and UDA value. This may exceed the capabilities of the new dentist, or indeed may be insufficient.

Incidentally, my patient requiring all the work has failed his half hour appointment. I can't charge him for this, or claim any UDAs, making his treatment even more costly for me.

Is it me, or is someone trying to destroy NHS dentistry once and for all?