Sir, The comments in the letter from J Hardie (BDJ 2004, 196: 187) may be true of his experience of capitation plans in North America, however the position in the UK is rather different.

Denplan Ltd, a provider of such plans in this country, has always held that the fees should be set by the dentist and not by a third party. This avoids the potential for a third party to erode fees over time or to indulge in 'cost-containment' to the disadvantage of both dentist and patient.

Additionally, by encouraging the dentist to carry out an initial assessment, patients can be allocated to one of five 'bands' according to the risk factors they present.

This minimises the risks Dr Hardie describes, where a 'catch-all' fee level is applied to all patients. Whilst dental insurance plans are indeed a solution for some patients, the advantages of capitation are that neither the patient nor the dentist has the added paperwork and delays associated with individual claims, and that for both there is predictability of cost or income.

At this time, many dentists will want to consider the benefits of having alternative sources of funding for their practices, something which the BDA has indeed supported with its current 'Choices' Seminars.