Sir, having now read and tried to come to grips with the new GDC guidance, the profession needs to come off the fence and say that it fails to protect patients; it shows a deep mistrust of the profession, and it is essentially unworkable and intrinsically dishonest.

Where the guidance says that registrants must not accept payment that might affect or appear to affect their judgement, that describes the UDA system and probably most of the variations on it, or those so far proposed.

When I rang the GDC just before the introduction of the 2006 contract to say it was unethical I was told that this was a political question not an ethical one.

We are told to note all the discussions on treatment when we recommend a crown. I could write an essay to describe the process each time (and each time it would be subtly different).

Even though a doctor or a care worker can be trusted to do a domiciliary visit on their own dentists no longer can be. All this does is give a field day to the lawyers who can always claim that we must be at fault because we failed to fulfil these well-meaning but ridiculous standards.

1. Sawbridgeworth