Your news story 'Agencies cash in on working time limit' (page 2, 22 October) misleads by using the wrong terminology. The split is not between full-time and part-time workers but between workers who are NHS employees and those who are agency employees.

Your editorial comment in the same issue seems to suggest that, morally, agencies should carry the costs of the European working time directive. Why? Agencies are not charities and necessary costs of sending staff on temporary assignments have to be met by the client.

I hope the directive will not be used to portray agency and hospital staff as 'them' and 'us' and agencies as 'baddies'. Trusts, the government and even HSJ should recognise their value. Agencies and their staff are not jumping on bandwagons.

I have worked for a medical secretarial agency for four years. The people who run such agencies are ex-NHS employees, as are the people who work for them whose personal circumstances dictate that they do agency work. For secretarial and clerical workers, commitment to the health service usually makes them work at lower rates than in the commercial sector.

Hospitals use agency secretarial and clerical staff partly because of a recruitment problem. This is partly due to poor pay, but also the lack of college courses to train medical secretaries.

This is being addressed by my agency, which has initiated and is running a medical secretarial course with a local college.

Agency staff are also needed for holiday and sick leave. Some hospitals run secretarial 'banks' for this purpose, but this has never worked well. Hospitals seem not to have much enthusiasm for the idea.

Perhaps in some cases using an agency is cheaper. I have had contracts with trusts which have decided it is more economical to pay me through my agency than to employ me directly. Agency work enables me to fit around short-term and part-time contracts as a researcher and clinical audit worker.

Half of my working time is spent with an NHS employer and half working in the NHS but through the agency. My NHS employer cannot afford to pay me for more hours than I do now. I feel sometimes the NHS gains more than me (or the agency) from my flexibility.

The agency assignment I have just finished was to cover for a vacancy still open after a year. I have not taken leave for a year myself because the shortage of medical secretaries meant the agency usually had no one to cover for me. I am also due for my first pay rise in four years because trusts are not willing to pay any more for agency staff than they absolutely have to. Your comment about trusts have little negotiating strength surprises me.

Something is needed to force action in response to these problems and perhaps the working time directive is it.

Liz Symonds