This paper takes as its starting point Paley’s critique that the term ‘spirituality’ in health care is artificial, unnecessary and obscurantist; and his conclusion that healthcare providers should abandon it to focus their resources on exclusively materialist ways of addressing the same issues. Accepting the force of Paley’s critique and his conclusions, the author nevertheless argues that reductionist and ‘spiritual’ approaches to patient care are not mutually exclusive. They can be brought into a fruitful relationship through the use of resources that Paley himself commends. This means that his arguments can be understood to strengthen rather than weaken the case for a parallel chaplaincy provision; and help to define the role and purpose of chaplaincy in an avowedly secular organization.