Published: 02/06/2005, Volume II5, No. 5958 Page 18 19

Jane Keep, senior fellow, Birmingham University health services management centre; independent practitioner in organisational development and change

With regard to concerns over workforce capacity (Barometer, page 24, 19 May) the NHS needs to truly embrace the whole of its workforce - including volunteers, carers and patients. As health analyst David Sobell and others have pointed out, self care accounts for 80 per cent of care provided.

Human resources teams need to start to look at how to embrace the hidden as well as the explicit 'workforce' capacity to tackle these concerns. 'Staff' are finite.

On another point, when new health secretary Patricia Hewitt was on stage at the HR in the NHS conference, one of the things that struck me, regardless of politics or policy, was the 'femaleness' of her presence. The NHS has achieved a huge amount recently, but it still feels very male. Maybe Ms Hewitt's appointment is a chance to bring the NHS back into balance with the injection of some more female energy.