There is an important additional issue arising from the likely job losses resulting from the current round of mergers (news and 'Bitter pill', news focus, 21 January). It seems most will be among community or mental health trusts. Are we consequently going to see a disproportionate number of redundancies among female chief executives and senior managers?

The NHS is not so well provided with women in senior managerial positions that it can sustain the loss of many female chief executives. Unison is concerned that the gender profile among senior managers in the NHS is going to become worse than it already is after these mergers.

The NHS needs more, not fewer, women in senior positions. Let's also hope the service is not discarding skills and expertise it can ill afford to lose.

While recognising that we are talking about different positions, it will be interesting to see whether the appointment of primary care group chief executives does anything to redress the gender balance among senior staff. Unison will be closely watching the process.

Alastair Henderson

National officer

Unison senior managers sector

London WC1