FROM April 2, a high proportion of dental patients in the Malvern area will be deprived of NHS cover.

A proportion of our contributions to the cost of the NHS entitle us to reasonably affordable dental treatment but now there will be a massive increase in our costs, typically by about 300 per cent.

A little notice in my dentist's waiting room had made me aware of the fact that there was a dispute between the dentists and the authorities over the terms of a new contract.

Ignorant of the cost of 'going private', I imagined that since I presently pay 80 per cent of the cost of treatment under the NHS, I would have to pay the remaining 20 per cent.

However, a quick look at the NHS Statement of Dental Remuneration made clear what I should have realised all along, namely that the NHS charges represent only a part of total dentists' remuneration.

This is based on a fixed annual salary of between £30,000 and £50,000. I presume also (the 120-page NHS document is very daunting) that the NHS pays the dentists' support staff and possibly other expenses as well.

When my dentist goes private, all of these items have to be paid for directly by his patients - hence the massive rise.

Most of this rise will be the result of effectively returning my NHS entitlement to the Chancellor.

The PCT spokesman (Malvern Gazette, February 17) responds by suggesting we transfer our business to new dentists, more or less instantly summoned to the area - from wherever they can be attracted. But for most, this is neither possible or desirable.

Our relationship with our dentist is a delicate one. My trust in my dentist is absolute but it is something which has been built up over more than ten years.

I cannot throw that away, risking the possibility that a change will set me back to the beginning with a new practitioner. Nor do I want to repay the excellent care that my dentist has taken of me by abandoning him.

Who is to blame for this fiasco? First, it is outrageous that a matter of such importance appears to have been settled without the patients being brought in to the debate.

From what I learn of the new arrangements, I am not at all surprised that the dentists find them unacceptable. I find it amazing that the dentists' negotiators didn't bring things into the open - they would have had no difficulty in getting public support.

Certainly the Department of Health should be ashamed of the fact that their actions have led to the betrayal of the general public's interest.

The changes should be suspended until there has been a full public debate with the opportunity for an input from the patients.

JOHN KIRTON, Fruitlands, Malvern Wells.