Jan Hesketh's pertinent article ('Easy come, easy go', 15 November, pages 24-27) on the boom in agency use in the NHS comes close to identifying the root of the problem; it will be a brave manager who tackles it.

Search around the average trust - can you find a surgical ward without 28 medical, gynaecology or ear, nose and throat outliers?

Can you find a cardiology ward actually full of cardiology patients? An orthopaedic ward that doesn't have 15 elderly people who are there because there are no elderly care bed?

The NHS is taking nurses for a ride. No other healthcare group is affected by latter-day bed and financial management in the way nurses are. Would you ask a consultant to suddenly switch specialties? Do occupational therapists find themselves having to provide physiotherapy? Do radiographers give anaesthetics? Of course not. So why nurses?

Remember the good old days when a nurse could say, 'I work in ENT', or 'I specialise in endocrinology'? Well, bring them back. You might then get the nurses back.

Cheryl Blaber Bristol