I have a Dreamcast motherboard which sometimes displays video and sometimes doesn't. The problem is present with composite and RGB SCART, because of this I am thinking composite/sync issue as it works fine with my VGA cable (which uses separate H and V sync). Audio is present at all times. I thought it might be an issue with the DAC chip so I swapped this for another but it gave no change. When the video is displayed it works perfectly and I can play a game with no problems.
I swapped over the GD-ROM unit from another console and it is working now. I put the original unit into the console that I took the GD-ROM unit from and that is also working. I connected everything together correctly with the original configuration, took it apart again to test the board etc. so I don't think it was an issue of them being incorrectly connected. It seems like they just didn't get along somehow.