Bonfire of the verities

The emphasis on ensuring improved governance within the UK dental care system continues to rely on the identification of poorly performing individuals. Such an approach, while addressing certain political expediencies, fails to take into account both the wider system issues and the extensive literature on how to influence performance in a positive way. If sustainable improvements in the qualities of care are to occur, an acknowledgement of the system's shortcomings by the main parties must be made and where individual performance has fallen below that regarded as acceptable, the contribution of the delivery system in general needs to be noted. In addition, changes to the clinical negligence arrangements away from an adversarial approach to one that uses an open non-punitive process is necessary. As in health, the environment that individuals find themselves in is a major determinant of good outcomes.