On 4 February 2009, the Royal College of Physicians of London (RCP) published a report entitled Innovating for Health: Patients, Physicians, the Pharmaceutical Industry and the NHS.1 The report is the outcome of deliberations by a working party convened by the college in September 2007, chaired by Richard Horton (editor of the Lancet), and it comprises 70 pages and 42 recommendations. Despite its heritage the work is flawed, thereby diminishing the validity of the recommendations and the obligation to take them seriously.

The ideal working party has clear and understandable terms of reference; has a membership selected to tackle the problems at hand; concentrates primarily on resolving questions posed by its terms; produces a report that sets out the problems in such a way that each recommendation follows logically from the text; and finally, offers recommendations that are realistic and correctly targeted. In this instance, these ideals are often unmet.

Let us start with the terms of reference. …