The following letter is part of a group in response to an Opinion article 'Cause for concern: BDA v GDC' published in the BDJ on 25 May 2018 (https://www.nature.com/articles/sj.bdj.2018.358).

Sir, I write having read the interesting and thought-provoking opinion piece of our retiring colleague R. A. Baker.1 It is always interesting to see what conclusions are made from an outside perspective rather than from being involved and having perhaps more detailed information. When he said 'treating colleagues with so little respect' I needed to re-read to check to whom he was referring, and was surprised that he referred to those at the BDA.

He refers to those at the CQC [Care Quality Commission] and GDC [General Dental Council] doing a 'thankless job' and hopes the regulators would be 'understanding and forgiving'. Whilst the CQC has changed dramatically with a change of leadership and a much better relationship with the profession, with the GDC to date, there has been no change of leadership.

He states that the BDA has had little impact in changing GDC policy, but I dispute that. Via a judicial review where the GDC was shown to have acted illegally, and by pressure on politicians, the Chair and Chief Executive of the GDC were summoned to a Health Select Committee in March 2015 to respond to the criticism laid. By the autumn, the Chief Executive had left.

He quotes a mantra to never litigate, I am afraid if I had taken his advice, from 2006 I would have a contract that allowed NHS England (previously the PCT) to terminate my contract for no reason and cause. Sometimes when things are so wrong and dialogue has reached an impasse, it is only the power of the law that rectifies the injustice. Being 'unfailingly polite' is never the same as being willing to listen.

He states we should 'accept regulation willingly'. The profession accepts regulation, but is a desire for a fair regulator an unreasonable ask? Should we willingly accept an unfair one? Ignorance I am afraid is never 'bliss' in the long term.

He states he was 'forced to go private' in the 1990s and that the regulator should not deal with 'the pricing vagaries of the NHS'. Many of our colleagues have not been able to follow his path but instead are working in a system that was castigated by the Health Select Committee a decade ago, and it is my assertion that the GDC should have been concerned with a contract not fit for purpose.

Indeed his many proposals for better practice have been incredibly difficult for practitioners seeing a 20-30% drop in income since austerity and yet still managing to provide excellent care for patients. I agree with him that 'we cannot hope for speed and thorough examination of a case at low cost. These are mutually incompatible', but it is the very system many colleagues find themselves in.

It is fanciful to suggest the raising of the ARF 'as necessary to ensure justice' is compatible in any form, as costs do not equal justice. Only a fair and proportionate regulator does that. Even the GDC accepts the placement of an advert for the Dental Complaints Service was a mistake. Sadly, Dr Baker thinks otherwise.

I hope I have been kinder than Dr Baker's consultant who he quoted and would like to wish him an enjoyable retirement in Portugal.