Steve Ainsworth's article on job titles (Yorkshire terrier, 8 April) seems to be based on an assumption that senior NHS managers have for years been on some sort of power trip, succumbing to craving more and more impressive- sounding titles which would 'truly reflect and encapsulate their worth and importance'.

While this may be true for a very small proportion of the profession (just as it would for any other group), I feel sure that it is not for the vast majority of senior managers, who I believe are perfectly happy - and proud - to be 'humble public servants'.

Language change is natural; just as change affects human life in general, it also affects the way we communicate.

It follows that language would only stand still if society stood still. Since the NHS changes particularly rapidly, it is inevitable that the language we use to refer to its constituent parts and to the people who manage it will do the same.

Despite the pressures of today's NHS, would we really want to be stuck in a time-warp, suspended in some year before 1974? I think not.

Sarah Carr

Warrington