I sometimes wonder why it now seems acceptable for pedestrians and cyclists to ignore the rules of the road at traffic lights while motorists cannot do the same. In London especially pedestrians have always had complete disregard for 'cross now' signs and often risk all in an attempt to cross the road against the lights, but in the last ten years this disregard for the Highway Code has extended to cyclists. They will often 'jump' a red light if it appears safe to do so and have no concern over travelling up a one-way street the wrong way.

This pattern of behaviour raises some interesting questions. When did it start exactly? Why does no-one seem to mind? Who will be next – motorbikes and scooters? How long before cars decide that if it looks clear at a red light then it is all right to cross the road against it? How will the police decide who to prosecute?

There are similar examples in many other walks of life where current rules and regulations are ignored - up to a point. On the road the point at the moment seems to stop with some cyclists, as if by popular unwritten assent. What about the ethics of a dental practice though? Where are we prepared to ignore the current practice of ethics when it comes to the treatment of patients? More importantly, what are we going to ignore in the future? Perhaps of more relevance in the current environment of patient focus, what are we going to reconsider and re-enforce?

Before I move on I would like to clarify the example I have chosen - the ethical aspects of patient care. Section 2.4 of Maintaining Standards, the manual of guidance for dentists in the UK produced by the General Dental Council (GDC), states quite clearly that 'a dentist must act to protect patients when there is a reason to believe that they are threatened by a colleague's conduct, performance or health.' The statement makes it quite clear that this must take precedence over personal or professional loyalties. Yet how often do we know of a dentist who is acting unprofessionally (often unknowingly) and we do nothing about it other than discuss it among ourselves? It is often the subject of conversation during dinner at BDA Section meetings or coffee breaks during a postgraduate event. I know of several practitioners who seem to really struggle to understand and accept the fact that some form of performance review of an associate is not only good sense but also important for the protection of the patients of the practice.

It appears that while most dentists are happy to accept responsibility for the ethical treatment of their own patients they have more difficulty in accepting responsibility for the ethical treatment of the public at large. This lack of 'professional responsibility' (using the word 'professional' in its original meaning) must be condemned by any profession if it wishes to retain its perceived freedom in today's world. After all, as a caring profession we have a duty and a responsibility to ensure that all members of our profession behave in a manner that puts patient care first, and that includes the patients of other dentists as well as our own.

We can see the importance of all of this when we reflect on clinical governance. I am often asked by dentists in general practice why clinical governance is yet another piece of beauracracy that is being imposed on dentists in the NHS. The answer is clear. Clinical governance involves good management at the point of delivery of patient care, and it would not need to be imposed unless our own self-governance was lacking in certain areas that are important to patients.

For some the old-fashioned view that the profession should put itself first still over-rides the protection of patients, despite the clear guidance from the GDC that this is not so.

For some the old-fashioned view that the profession should put itself first (in other words not identify a colleague's behaviour because it would bring the profession into disrepute) still over-rides the protection of patients, despite the clear guidance from the GDC that this is not so. Like the cyclists ignoring the Highway Code these dentists ignore the GDC. And often the rest of the profession acts like we all do when we see a cyclist jump a red light - we ignore it.

We do so at our peril.