I read with interest Jane Dudman's article ('Up and running', e-novation, 11 October).

I am pleased that Dr Richard Harries is not intending to make medical secretaries redundant, and would wholeheartedly agree with him that there is a national shortage of this rare breed.

However, I would be interested to know the cost of implementing voicerecognition systems, which have reportedly had numerous setbacks in hospitals.

It would seem that most voice-recognition systems on the market fail to 'recognise' the many voices they need to 'understand' if they are to process clinical correspondence on behalf of the medical secretary.

Systems would also require the dictation to be clear, thorough and grammatically correct to enable the accurate processing of correspondence.

Once this process is corrected and completed the physical process of forwarding the correspondence to the intended recipient and dealing with enclosures, arrangements for tests, and so on, would still need an assistant in the office to complete the tasks.

The duties and responsibilities of a medical secretary are - as we know - changing, and it would seem that, rather than typist, the job title of medical personal assistant would be more appropriate.

Part of the problem with recruitment and retention is the lack of recognition of the role of the medical secretary, a failure which is often reflected in pay scales.

Voice recognition will, I am sure, be of value to the medical team in the future, but only if the administrative support is of a calibre to be able to process and administer it appropriately and effectively.

Valerie Williams Career and salary adviser British Society of Medical Secretaries