In the last few days two lords with fingerprints on health policy reform - one a new minister and one a former one - both criticised the NHS's attitude to innovation.

In the last few days two lords with fingerprints on health policy reform - one a new minister and one a former one - both criticised the NHS's attitude to innovation.

Lord Hunt told a conference that primary care trust managers were 'too conservative' about commissioning services using new technology, focusing on short-term costs (news, page 6). They apparently lack the necessary 'passion' and 'understanding' to create a genuine research culture.

Meanwhile Lord Warner, who stepped down from the Department of Health at the end of last year, has blamed staff reluctance to change practice and support the national IT programme for the service's failure to show increases in productivity.

Both lords have been a-leaping to the conclusion that it is the fault of NHS staff that the government has apparently too little to show for record investment. The reality is that many teams in many trusts have been making improvements in the way they work - the Dr Foster data discussed above shows significant falls in overall mortality rates, for instance. But the continuing obstacles of weak incentives for clinicians and lack of agreement over what measures constitute success mean it remains difficult to prove that at a national level.

Lord Hunt won a reputation as a friend of NHS managers; they will hope he now helps them overcome these obstacles on the route to sustainable innovation.