Marianne Rigge (Consuming passions, 9 December) refers to a feature in Good Housekeeping which, in talking about surgeons success rates, states: Ideally you need to know how many similar operations a year your surgeon performs and his complication rate.

Obviously you may feel uncomfortable asking him This use of the generic he (to mean he or she) is not HSJs practice - to its great credit. It is, however, surprisingly common elsewhere, not least in the NHS.

The usual defence (particularly among older managers and clinicians who have received a traditional education) is that it is grammatically correct.

Quite true. But substantial research evidence shows that, in reality, adults - of both sexes - and children all picture only men when he is used in this way. (In fact, he was never used naturally to mean everybody, but was declared generic by an act of Parliament in the 18th century. ) But does it matter anyway? Many would say not, dismissing the whole issue as trivial, and as a hobbyhorse of those obsessed with political correctness when the NHS has so many more important issues to attend to.

The real answer, however, is yes, it does matter - not least, to organisational effectiveness.

Language and social change are inextricably linked.

So, if we want NHS leadership to benefit from female strengths ( Maiden over?, news focus, page 12, 28 October), we must choose our words rather more carefully .

There are several easy ways round using the generic he. While he or she, can be an inelegant solution, rephrasing the sentence or making it plural (using they) is usually a practical alternative.

Sarah Carr Warrington