It appears from your News Focus on 'integrated health care' (page 16, 4 June) that this term is being advanced to cover a concoction of orthodox and complementary medicine.

It seems extraordinary that no less a luminary than Iain Chalmers should present himself as a catalyst for such a shotgun affair. His mentor, Archie Cochrane, must be turning in his grave, having pleaded more than 25 years ago that all forms of treatment provided by the NHS should be proved effective, and not based on opinion.

And Iain Chalmers is not alone. August bodies such as the British Medical Association are evidently quite receptive to such partnerships, and the opprobrium of 'association with unqualified persons' has long gone. It now seems to be a way to gain brownie points and even some royal blandishments.

Resistance to this rising tide of complementary medicine makes one unpopular, and the King Canute response has become familiar: 'Huge public demand and they pay the taxes... Most orthodox treatment is unproven anyway... Nobody can prove it doesn't work... Saves money on expensive drugs...'

These half truths are sufficient to seduce the flexible-minded. There are many vested interests, and those already providing treatment of doubtful value probably welcome the company. Undoubtedly, the NHS continues to be riddled with 'therapies' founded on claims that are untested or untestable.

Hardest to accept are the intellectual gymnastics performed by those who pay lip-service to evidence-based effectiveness, yet also embrace complementary medicine. Ian Carruthers, chief executive of Dorset health authority, regrets that 'less than 400,000' of the budget he holds is being spent in this way. He also wishes that more complementary medicine should be made available by the NHS. The true hallmarks of NHS treatment - waiting lists and arguments about rationing - must therefore be just around the corner. One can only assume that Dorset has no waiting list for truly effective treatment, such as joint replacement, for which 400,000 would be very welcome.

Surely new NHS services should be provided only when those advocating them produce convincing evidence of their benefits - preferably beyond the placebo effects, and in referenced journals.

I hope this is the kind of issue the National Institute for Clinical Excellence will address.

Archie Cochrane RIP. You did your best, and it certainly isn't your fault.

David Crosby

Hon consultant surgeon and chair

Cardiff Community Healthcare trust