I refer to your news story, 'Hospital trusts warn of chaos as medical secretaries threaten strike' (page 7, 22 March), and as chair of the British Society of Medical Secretaries regret that this essential group of workers is having to resort to such action.

When will their low rate of pay and poor working conditions be investigated?

Medical secretaries play a crucial role in the delivery of health services, and it is only when they threaten such severe action as striking that they are listened to and eventually some kind of bargaining takes place.

As their professional body, this society has been campaigning for years with trusts and managers to look at their medical secretarial structures.

We have produced a salary and career document with a suggested structure and salary scale which reflect the many variables found within this group.

We feel that our document is very fair and constructive. A number of trusts have already acted on the information contained in this document, have used it to their local advantage and have been grateful to the society for helping them try to solve this problem.

Another concern is that there is no recognition that medical secretaries require specialised training. There is a huge problem across the UK with the recruitment and retention of medical secretaries.

This, in the main, is due to the lack of recognition of the skills required, low pay scales and lack of further training. It is high time that medical secretaries were able to use their expertise within a career structure and that trusts stopped looking at medical secretaries as mere typists.

Trusts should not be content to employ 'anyone who can use a keyboard' just to fill the vacancies. This is a key role and there is a high riskmanagement factor here.

This society has developed some excellent successful training packages. In the areas where trusts are taking advantage of these, and when aligned with our recommended salary structure, they have found that they can recruit and retain medical secretaries more easily.

Like the medical laboratory scientific officers, medical secretaries are a forgotten section of key workers and it is time that the government and Unison began to look at this group of workers crucial to the delivery of healthcare, and concentrate less on the groups with the high media profiles.

Ann Rhodes Chair British Society of Medical Secretaries Rochdale