I HAVE felt for some time that the NHS hierarchy has been doing their best to "bury" medical secretaries in a deep hole, and the current Agenda for Change is the manhole cover with which they will suffocate us once and for all.

So before voting in the local elections in May, it is in our interest to read all the literature and discuss the implications fully.

After a two-year fight for re-grading, at the expense of proficiency allowances -- qualifications brought into the NHS at our expense -- we are once again being trodden underfoot.

To add insult to injury, aspects of our jobs which we have been undertaking for many years are being creamed-off by individuals, creating for themselves fancy job titles -- and even fancier salaries.

What do we do exactly? The public may well ask. Even our managers, who pick our brains and steal our ideas for improvement, are surprised by the multiplicity of our workload. There are no boundaries to the job of a medical secretary, and certainly no job description which fully covers the requirements of the post. We have as much, if not more, daily patient contact than any other hospital sector and we are the only members of a specialised team, apart from the consultant, who does not move on after three, six or 12 months.

We are undervalued, but still passionate to execute a first-rate job!

MEDICAL SECRETARY,

Pennine Acute

Hospitals NHS Trust.