Just over half way through my Presidential year is a good time to reflect on where I and the BDA have been and where we are going. I have had a tremendous opportunity to meet and talk to a very wide range of our members in all areas of practice; to hear their concerns about the future and relay their worries back to those at Wimpole Street who are working so hard on their behalf. We knew that 2003 was going to be difficult and no crystal ball is required to predict that the next 12 months are going to be even more so.

Over the next few weeks we expect to get more specific information about the changes to the way NHS primary dental care is managed in England. The imminent issuing of draft proposals by the English health department - at long last - is the result of considerable pressure from the BDA. The BDA will undertake a consultation of members affected by these changes once the draft proposals are published. I would urge those involved to take part in this process so we can send out a powerful and representative message on behalf of the profession. It is important to be clear that this is not about negotiating the new arrangements. The reforms are already enshrined in the new legislation. This is about making our views known and strengthening our ability to influence and to promote your interests with authority and solid evidence.

As I write this, the changes only affect England though the Health and Social Care Act also covers Wales. We will have to wait to see how and when the National Assembly for Wales responds to the legislation. Meanwhile in Scotland we see another highly significant process get underway with the launch of the Scottish Executive's own consultation exercise on modernising dental services.

One thing I have learned this year is that we have some first-class dedicated staff looking after your interests. They sometimes have taken the flak from some of our members frustrated by the perceived dilatory release of information from the Department and that is grossly unfair. Nevertheless, they will continue to extract information from the government, spread the knowledge and intelligence we glean.

I was very pleased to see another important and related initiative emerge from the BDA recently. The 'choices' programme encourages general dental practitioners to review the balance of their practice and the potential of developing private work. There is a twin track approach within the Association to get the best deal for the profession within the NHS and also to provide support and advice for colleagues who wish to increase their private practice. This was plain to see in the BDA's robust and vigorous handling of the Office of Fair Trading's investigation into private dentistry.

The effectiveness of our response to the OFT investigation was based on the quality and depth of evidence submitted by the BDA. This year's work on water fluoridation also illustrates brilliantly how getting the tactics right pays off. As someone who has to spend a lot of time dealing with the 'antis', I know how difficult this task was, but through a skilfully orchestrated campaign involving partnership work, we ensured a change in legislation that opens the door to water fluoridation in areas in England and Wales where communities want it. The real clout of the campaign came from the involvement of the membership; specifically from your commitment and willingness to take the time to write to your local MP.

We are all very proud of our profession and together, the Association and its members, can achieve great things for it and our patients.

Serving as President has given me some insight into what dentists are thinking in general practice, in community and hospital settings, in universities and the armed forces. As I look to the year ahead, a further prediction I can make with confidence is that the BDA's commitment to its members will continue with even greater energy and dedication; from your elected officers, the staff in all four national headquarters and our colleagues at branch and section level. We are all very proud of our profession and together, the Association and its members, can achieve great things for it and our patients.

In closing I wish you and the members of our sister associations in the profession the very best wishes for 2004 and hope that dentistry in Britain is now moving forward to new standards of excellence.