Marianne Rigge's 'consuming passion' of support for the commissioning of counselling services by PCGs is puzzling ('Consuming passions', pages 16-17, 5 August). She acknowledges that sound evidential support for its effectiveness in the wide variety of conditions where it is used is lacking. One might have expected that institutions such as the College of Health would help provide it. It is surely insufficient justification to quote a PCG chair who observes 'that many things GPs do aren't evidence-based'. This may be so, but there is no reason to increase the number. Whenever possible it should be reduced, especially when it is claimed there are insufficient resources to provide services of undisputed effectiveness, for which many suffering potential recipients are required to wait for long periods of time.

I feel sure that Ms Rigge would not be passionate in supporting a surgical technique or new drug that had not been thoroughly scrutinised in regard to its value, and who could disagree?

This is not meant to discredit the efficacy of counselling but simply to require it to withstand the same close examination that one should expect of any therapy provided at public expense with the NHS.

D L Crosby

Hon consultant surgeon

Late chair

Cardiff Community Healthcare trust