Nick Daley, a practising dentist for 25 years, is carrying on a family tradition at Daleys Dental Practice in Liverpool – his grandfather, father and uncle have been cleaning, filling and capping teeth since 1921.

He has two practices – one private and one NHS – seeing 8,000 to 10,000 patients a year.

But since 2006 his NHS practice has come under threat from the dental contract, and he has paid back thousands after refusing to compromise standards.

“It would be easy to play the system,” he said yesterday, “but if you’re honestly trying to provide the right treatments for people rather than treat them as a means to meeting a target, then it’s easy to miss a figure that is set at the beginning of the year.”

In the first year under the new contract, Dr Daley paid back £75,000 to his local primary care trust and is facing a repayment bill of £51,000 for 2007-08. “When you are trying to run a business employing 25 people, £125,000 is a lot of money to suddenly find out of next year’s budget,” he said. “Then you have to do the same amount of work for less money. It has had a catastrophic effect.”

Dr Daley, 50, does most of his work in his NHS practice. He agreed that the system of units of dental activity (UDAs) pushed practitioners to “drill and fill”.

“UDAs prevent me from doing the dentistry I was trained to do, which is to look after patients properly, not just a quick fix.

“I don’t push people to have private treatments because many can’t afford it – 95 per cent of the dentists I know support the health service but say that the contract demoralises them. There are lots of young dentists but they don’t have the right experience or incentives under this new system.

“We are not offering the comprehensive level of care that we were doing in the past and in that sense it’s a step back.”

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