Sir, I am Cardiff graduate (1999) practising in Australia since 2003 and, as with the authors of Consent - a new era begins,1 I am also a dento-legal adviser for Dental Protection, but based in its Brisbane office. The opinion piece explored the recent Montgomery case and its possible impact on the approach to consent in the UK which has strong echoes of, and an almost identical description of a 'material risk', as the watershed Australian case of Rogers v Whitaker (RvW) roughly 25 years ago. As I also maintain clinical practice I have made the same 'journey' that UK colleagues may well be embarking upon in understanding and applying the 'particular patient' test.

In the immediate period following RvW there was concern in Australia that the pendulum had swung too far in terms of the level of expected understanding of each patient's needs, fears, hopes, concerns and expectations – even when meeting and treating patients for the first time. Predictably enough the judgement was seized upon by claimant law firms and allegations regarding a failure to warn quickly became a regular feature of medical/dental negligence claims, although in the years that followed, several important legal cases have qualified and softened the apparently open-ended expectations.

In Australia the regulatory guidance regarding consent was changed fundamentally by RvW but in contrast the GDC's guidance in the UK was in place long before Montgomery and in a sense the law has caught up with the profession. Many contemporary clinicians are already adopting a more patient-centred approach to consent in response to our consumerist culture and perhaps reflective of the current generation of practitioners for whom 'doctor knows best' was never the norm.

It is virtually impossible to extrapolate from the Australian experience to the UK as the medicolegal landscapes starkly contrast. Significant tort law reform took place in Australia in the wake of the paralysing medical indemnity crisis in the early 2000s which dramatically reduced medical (and dental) litigation in Australia almost overnight resulting in the current relatively benign litigation environment. In contrast, at almost exactly the same moment in time, the UK was moving in the opposite direction and the Woolf reforms were transforming the UK into a global hotspot for clinical negligence litigation, led by the 'no win – no fee' law firms.

The Montgomery ruling is best viewed as an opportunity, not a threat. Clinicians who try to engage and actively involve their patients in decisions have little to fear from Montgomery and will be largely unaffected. However, it may well be different for those clinicians who maintain a paternalistic approach, as we saw in Australia. If material risks are discussed, and (importantly) this fact is adequately recorded in the clinical notes, Montgomery need not open the floodgates for claims based wholly on a failure to warn of material risks, however excited the claimant law firms might become initially.