A Birmingham orthodontist yesterday won an important High Court victory over his NHS dental services contract as a judge described rules and regulations dentists have to negotiate as "rubbish".
Lawyers for Dr Eddie Crouch argued that South Birmingham Primary Care Trust (PCT) had breached NHS regulations by suggesting it could terminate the contract "at any time and without cause".
The PCT denied that it had acted unlawfully, but Mr Justice Collins indicated the orthodontist had won when he told Dr Crouch's legal team after a day-long hearing: "I am with you on the termination point."
The judge is expected to give a formal judgment in favour of the 47-year-old today, or tomorrow.
Dr Crouch, who runs a practice in Acocks Green, Birmingham, said after the judge gave his indication: "For every single dentist in the country, his words are a great reassurance."
During the hearing, the judge was scathing about NHS regulations for dentists.
He said: "It is like going through a marsh, trying to leap from tussock to tussock. I do pity those poor dentists who have to struggle with this kind of rubbish".
The judge, sitting at London's High Court, still has to make up his mind on whether Dr Crouch has won a second, wider-ranging legal challenge. It concerns the question whether the PCT unlawfully failed to consult the public adequately in order to assess local orthodontic needs before introducing the new personal dental services agreements (PDSAs) in April 2006 to improve the service.
Nicholas Stewart QC, appearing for Dr Crouch, argued that the trust had not complied with its duty under section 11 of the 2001 Health and Social Care Act.
And he told the Mr Justice Collins: "The assessment is just not good enough."
The PCT strongly denied the allegations. Dr Crouch believes that a win on this second challenge could have massive implications for NHS dentistry provision throughout England and Wales, with each having to go back "and effectively check they had commissioned enough dentistry in their area".
Outside the courtroom he said that dentists round the country had no choice but to sign the new agreements.
He said: "The voice of the patient has been completely ignored. There was an ultimatum. We were told that either we signed up or we were out of the NHS. A gun was held to our heads."
He said that, instead of improving services, the agreements had limited services and caused a rise in waiting lists - especially hitting socially deprived areas, like the one in which he practised, where people could not afford to go private for orthodontic services.
He said: "What they have done is to cash limit services."
Dr Crouch qualified in 1984 and provides braces and orthodontic care for children. He said: "Since the introduction of the contract I have gone from no waiting list to having 700 people on the list.
"As a result of inadequate funding I was unable to treat anyone new in the first year of the contract. No new patients could be taken off the waiting list. This year I was able to take about 60 people off my list and into treatment."